Category Archive: Physician Articles

  1. Help, My BMI Says I’m Overweight!

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    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.

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

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    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.

  3. The Battle of the Brands in the Medication Aisle

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    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)

  4. Importance of exercise in young adults and teens

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    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.

  5. The #1 Secret to Aging Well

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    Dietitian and Diabetes Educator Tiffany Rios, RD, CDE, of Shore Physicians Group, wants you in on a secret: maintaining your muscle mass is one of the most important factors for healthy aging.

    “It’s projected we lose about 3-8% of muscle per decade after the age of 30, and this rate of decline is even higher after age 60,” Rios said. “But there are things you can do to minimize the effects of age-related muscle loss, also known as sarcopenia.”

    Sarcopenia puts you at greater risk for serious health issues, including falls, fractures and debilitating injuries. According to the CDC, one in five falls in older people causes broken bones or head injuries. When these injuries occur in older age, they can make it hard for a person to get around or even live alone. Often, these injuries can lead to hospitalization and many other serious complications – even death.

    “Exercise training and proper nutrition can dramatically improve muscle mass and strength. I recommend an exercise-training schedule that incorporates both resistance and aerobic exercise at least three days a week. Sustaining an exercise program and muscle mass can also help to ward off insulin resistance which is common as we age,” Rios said.

    Rios also stresses that in addition to exercise, diet plays a critical role in maintaining muscle mass.

    “Sustaining muscle mass requires sufficient amounts of quality protein. The Standard American Diet is often filled with processed foods low in fiber and protein, making it hard to meet your protein needs. Roughly 1g of protein per kilogram is needed to maintain and build muscle. For example, a 140 pound woman/2.2= 64g of protein. Excellent protein sources include eggs, pasture-raised chicken, wild-caught fish, grass fed beef, lentils, and organic Greek yogurt and cheese.”

    Hormones also can impact your muscle mass. Testosterone, in particular, helps us build muscle, but a person’s testosterone level will also fall naturally with age – by 1 to 2 percent per year after age 30. To sustain testosterone levels, make sure you’re doing strength-bearing exercise and incorporate foods rich in Zinc, such as legumes, nuts and seeds, oysters, fatty fish like salmon or mackerel, ginger and pomegranate. These are all healthy options for boosting testosterone production.

    Rios says the most important takeaway is that you should keep exercising throughout your life. It is the most important thing you can do to live a longer, healthier and happier life. She reiterates the importance of nutrition as well. “Reduce processed foods and increase foods that include protein, zinc and nutrients that support healthy hormones.”

    Source: Pubmed:

  6. Your ‘Achilles Heel’: More than a Metaphor

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    Have you ever wondered why the tendon connecting the calf to the heel bone is called the Achilles tendon? In Greek mythology, Achilles was a hero and a warrior who fought in the Trojan War. As a baby, his mother held him by his heel and dipped him into the river Styx, and everywhere the water touched became invulnerable to harm. However, the water did not touch the area on his heel where she held him, and many years later, the Trojan Prince Paris shot a poison arrow into his heel, killing him. That’s why today the term “Achilles heel” is often a metaphor for vulnerability.

    Your Achilles tendon can also be vulnerable to injury, but it’s not often a common concern for most people. Shore Physicians Group Orthopedic Surgeon in Somers Point, New Jersey, Dr. Dante Marconi, said the Achilles tendon is a very important structure. “It allows you to plantar flex, or move the foot in a downward motion away from the body. That movement is important for many actions, most importantly, everyday walking,” said Dr. Marconi. “While athletes are at an increased risk of an Achilles tendon tear, a rupture can also happen from trips, falls, and other injuries.”

    Symptoms of Achilles Weakness

    According to Dr. Marconi, as we age, the Achilles undergoes degenerative changes. “Tight calves and the overall lack of mobility of the ankle can increase the risk of injury,” said Dr. Marconi.

    For some, an Achilles tendon tear will happen with the classic “pop” that feels like a shade just rolled up the back of the leg, signaling a rupture. Dr. Marconi explained that there may be early signs a tear could happen, such as tenderness or pain in the area around the Achilles, but a rupture or tear can also occur without warning.

    “The rupture happens when there is excessive force in the area of the Achilles tendon. Forced dorsiflexion (upward motion) or plantar flexion (downward motion) of the ankle can lead to an Achilles injury.”

    Achilles Treatment Options

    An Achilles injury can stop even the strongest in their tracks. But does that mean surgery is the only option to repair a damaged Achilles?

    Dr. Marconi says patients do have options, but it depends on whether the injury is a full or partial Achilles tear.

    “Initially, we would treat partial tears non-operatively,” said Dr. Marconi. “If symptoms do not improve over time, surgery could be warranted. Also, we can treat a full-thickness tear non-operatively if it is treated immediately after the injury and without significant retraction of the tendon edges.”

    He explained, “Many factors determine if a patient is a candidate for surgery. After an acute injury, their ages and activity levels are a big factor. The amount of retraction of the tendon is also a consideration. High-level athletes who are trying to return to elite levels of sport typically benefit more from surgical intervention. Patients trying to return to moderate exercise who need a functional ankle with minimal pain could be a candidate for non-operative management. Delay in treatment usually leads to poor outcomes with non-operative management, so patients should be seen immediately by an orthopedic surgeon.”

    Achilles Tear Recovery

    Dr. Marconi explained there are two ways to surgically repair an Achilles tear. One way is with open surgery, a traditional surgical method where the surgeon uses a scalpel to open the tissue and repairs both tendon ends with sutures. The second way is with minimally invasive surgery, which involves a small incision and a precise device that allows the surgeon to place the sutures in the appropriate position to allow the tendon edges to heal. Patients are non-weight bearing for three weeks, progressing to full weight bearing by six weeks. Patients can wear a sneaker after eight to 10 weeks in a post-operative boot. Normally, the patient can return to jogging in about five months and return to their athletic activity in six to nine months.

    Non-operative treatment rehabilitation is similar to the operative protocol, according to Dr. Marconi, however, the first two weeks require immobilization in plantar flexion to help begin the healing process.

    Dr. Marconi said, “Whether we use a surgical or a non-operative option, patients should expect to have excellent mobility. In terms of overall strength, the goal is to obtain 90% of their pre-injury strength.”

    Is a Repeat Rupture Likely?

    The fear of another Achilles rupture is legitimate, but Dr. Marconi explained, “In the past, non-operative treatment has been known to have an increased risk of re-rupture in the same leg. However, with modern, accelerated rehabilitation protocols, this increased risk of rupture is close to the re-rupture rate after a surgical tendon repair. There is always a risk of re-rupture after surgical treatment due to the prior injury and development of scar tissue. There is also a risk the contralateral, or opposite side, could rupture if the same condition occurs that injured the prior tendon.”

    Other Contributing Factors to Achilles Injuries

    Aside from activity-related factors in an Achilles rupture, Dr. Marconi indicated steroid injections to the area can increase the risk of a rupture. Likewise, he said, certain antibiotics have been known to increase the risk of an Achilles rupture.

    How to Avoid Achilles Injuries

    Maintaining an adequate range of motion of the ankle as well as muscle strength can help decrease the risk of an Achilles tendon rupture. Stretching is also key. Dr. Marconi said, “The more stretch the muscle and tendon have, the further distance tolerated before the time of rupture.”

    Dr. Marconi is a proponent of education as well. “Seeing an orthopedic surgeon, sports medicine physician, or physical therapist can help a patient become educated on proper technique and appropriate exercises to help decrease their risk of a rupture. Otherwise, frequent stretching and exercise can help decrease the risk of a tear. Patients who increase their activity level can suddenly be at risk for rupture; therefore, patients should gradually increase the intensity of their workouts if they are starting something new or have taken a significant amount of time off.”

    Dr. Dante Marconi treats patients ages 10 and up at Shore Physicians Group’s Orthopaedic Division located at 710 Centre Street in Somers Point, New Jersey. For more information or to make an appointment with Dr. Dante Marconi, click here or call 609-365-6280.

  7. Women at 50: Eight Things Your Doctor Wants you to Know

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    Featuring Alex Buford, DO and Cindy Nunan, DNP, FNP-BC
    Shore Physicians Group – Mays Landing Primary Care

    As women approach 50, it’s more important than ever to visit your doctor regularly and be open with them about health and wellness changes you may be experiencing. When you have an open and honest relationship with your doctor, they can better help you live a healthier and happier life as you age.

    Alex Buford, Doctor of Osteopathic Medicine, (DO), and Cindy Nunan, Doctor of Nursing Practice (DNP), FNP-BC are primary care providers at Shore Physicians Group’s Mays Landing office. They are both passionate about helping their patients – especially women – live their best lives. In this article, they share eight things they want women 50 and above to know:

    1. You don’t have to put up with menopause symptoms. “If you’re experiencing frustrating menopause symptoms, especially hot flashes and sleep disruptions, we can help you,” said Dr. Buford. While it is different for each patient, Cindy Nunan, DNP and Dr. Buford offer an array of menopause support options. “We may suggest hormone therapy or diet changes, such as avoiding certain spices or getting enough nutrients. Hormone creams can also sometimes be helpful, and even certain antidepressants,” said Dr. Buford.
    2. It’s time to get serious about cancer screenings. Colonoscopies, mammograms and pap smears are the three cancer screenings women should have already had by age 50, but if you are behind on them, just see your doctor and get back on track now. Dr. Buford also looks for symptoms that could be signs of cancer. “If you’re experiencing sudden and unintentional weight loss, getting full fast, skin changes in the breast, or even night sweats, it’s important to tell us,” said Dr. Buford. She added, “After 50, pap smears continue to be important if you still have your cervix. If you no longer have it, you may still need certain screenings depending on why your cervix was removed.”
    3. Your happiness matters. Mental health issues can sometimes fly under the radar, so it’s important to bring up any possible mood changes with your doctor. “Tell me if you’re not as happy as you used to be. Are you no longer enjoying your favorite hobbies, retreating from family and friends, have significant sleep issues, or even overeating? These could all be a sign of mental health issues, which we can help with,” said Dr. Buford. “If it gets too complicated, we can refer you to a specialist.”
    4. Get ahead of heart disease and diabetes. Dr. Buford and Cindy Nunan, DNP agree that being active is the key to preventing heart disease and diabetes. “You just have to keep moving,” says Cindy Nunan, DNP. “I tell people 30 minutes every other day, five times a week. But, doing something is better than nothing.” Dr. Buford adds, “If you’re watching TV, stand up and move around for a few minutes. March in place, arm circles – start small to slowly build healthy habits.” Dr. Buford said she uses a risk screening tool to determine how frequently each patient needs a basic metabolic blood panel. She adds, “Keeping your blood pressure under control is also huge. If you snore or have sleep apnea, that needs to be addressed as well because it can increase your risk for developing serious chronic conditions.”
    5. Maintain a healthy immune system. Illnesses like flu, Covid, and pneumonia can be more serious in certain older patients because our immune systems can weaken as we age. Cindy Nunan, DNP looks at each patient’s medical history to determine which vaccines and supplements are appropriate for them. However, her biggest tips for a healthy immune system are to wash your hands, get plenty of rest, and exercise regularly.
    6. Resistance training can help slow bone loss. Cindy Nunan, DNP and Dr. Buford use a fracture risk screener to determine which patients are at risk of developing early osteoporosis or osteopenia (bone loss). Based on those results, they may recommend a DEXA scan earlier, but typically they’re not needed until age 65. They both stress the importance of resistance training to slow bone loss. “Ideally, you would have started resistance training in your late 20s/early 30s, but it’s never too late,” Cindy Nunan, DNP says. Dr. Buford adds, “You can use resistance bands, your own body weight, even cans of food. Gardening, pulling weeds – that counts too.” Cindy Nunan, DNP said smoking also contributes to bone loss by reducing blood supply to the bones and preventing calcium absorption, so now is a great time to quit.
    7. Don’t neglect your eyes. Cindy Nunan, DNP says, “Any changes in someone’s vision requires a visit with an eye doctor. They have the tools to see inside your eye and look for glaucoma, cataracts, etc.” People with certain chronic illnesses such as diabetes need to be screened annually. If you’re already seeing an optometrist for glasses or contacts, be sure you’re going regularly so they can catch any underlying vision issues.
    8. Your dietary needs change. Metabolism slows as you age, so it’s important to be more conscious of maintaining a well-balanced diet, and reducing your fat and salt intake. But it can be harder when you have more free time to socialize. Dr. Buford says, “Your kids may be more independent now, so you may be going out to eat with friends or getting takeout more frequently, which can really increase your calorie intake. Portion control is a big one. Yes, you can have a cupcake or a cookie (unless you have certain dietary restrictions) but it can’t be every day. Eating late at night can also lead to weight gain.” Cindy Nunan, DNP says if her patients have gained more than a few pounds, she wants to find out why. “That weight gain can go back to depression or anxiety, perhaps. It’s a touchy subject for a lot of people, so establishing a relationship with my patients is important. I want them to feel comfortable talking to me.”

    If you are looking for a primary care provider you can trust, consider making an appointment with Alex Buford, DO or Cindy Nunan, DNP, FNP-BC at their Mays Landing office by calling (609) 365-6217. The Mays Landing office is located in the Festival at Hamilton Shopping Plaza (next to HomeGoods) at 4450 East Black Horse Pike, Mays Landing.

  8. Tips You “Knee-d” to Know to Help Ease Joint Pain

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    As we hit the milestone of 50, it’s only natural that our bodies will start feeling new aches and pains. While there is no fountain of youth, there may be measures we can take to mitigate some of the issues we face as our bodies evolve.

    One of the most common culprits of discomfort is knee pain.

    “Every time you walk, there are up to 7 pounds of force on the knee for every 1 pound of body weight you carry,” explains Dante Marconi, MD, Orthopaedic Surgeon and Sports Medicine Specialist with Shore Physicians Group. “So, after 50 years of stressing the knee cartilage with weight bearing, walking, running, and repetitive cyclic movements, there is a high possibility that people will experience some degree of pain in their knee.”

    So, how physiologically does this happen? Let’s start with a broad view explanation of how the knee works. The knee joins the thigh to the shin and is made up of the femur (thigh bone), tibia (shin bone), fibula (small bone that runs alongside the tibia), and the patella (kneecap).

    The knee joint has four major ligaments that connect the bones together to keep the knee stable.

    • The anterior cruciate ligament (ACL) prevents the tibia from sliding forward onto the femur;
    • The posterior cruciate ligament (PCL) prevents the tibia from sliding backward onto the femur;
    • The lateral collateral ligament (LCL) stabilizes the knee on the outside of the joint; and
    • The medial collateral ligament (MCL) stabilizes the knee on the inside of the joint

    All of the joint surfaces are covered with strong joint cartilage which provides a well-lubricated surface for low-friction movement between the bones. This cartilage contains a natural lubricant called the synovial fluid, commonly known as joint fluid. The menisci (shock absorbers), also help lessen the total load seen by the bone and joint cartilage.

    Over time, this joint cartilage can wear down, which increases the friction and results in pain. And, because there is limited blood flow in the knee joint, healing is poor compared to other areas of the body.

    So, what can you do to prevent knee pain, especially after you hit 50? Dr. Marconi offers these tips:

    • Strengthen the muscles in the front and the back of the leg. This will keep everything balanced and stabilize the knee. Maintaining a strong core (abdominals, low back, glutes, and hip abductors) also contributes to maintaining healthy knees.
    • Maintain full range of motion by stretching before and after exercising.
    • Always use proper form during exercise and activity.
    • Use footwear with proper support, as there is a kinetic chain from the foot to the hip. Moderate use of:
      • high heels (which can strain the calf muscle, tighten the Achilles tendon, and lead to ankle sprains)
      • flip flops (lack of ankle support and changes how your foot accommodates to the ground)
      • sliders (lack of support and can increase the risk of ankle sprains and falls)

    “Proper exercise protects our joints and is very important for overall joint health. I encourage exercise at any age, and it is certainly never too late to start,” said Dr. Marconi. “I advise for everyone to know their limitations, especially if they are trying something new, and I highly stress to use good mechanics and keep good form.”

    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.

  9. Wound Care Patient has a New Outlook on Caring for Himself and Others, Thanks to Shore

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    Thirty-seven-year-old Kevin Jordan used to be a construction foreman with the mindset most young people have—that he was invincible. Kevin has type 2 diabetes, but he never gave much thought to his condition or his overall health.

    But in 2021, reality struck. Kevin stepped on a nail at work and didn’t think anything of it at the time. However, in September 2021, Kevin discovered he had osteomyelitis from his injury, which is an infection in the bone.

    After speaking to a doctor, Kevin was told he would need to have his entire leg below the knee amputated. Kevin came to Shore for a second opinion, and to his delight, Dr. Matthew Lawrence, a vascular surgeon at Shore Physicians Group, informed him that he would not need to lose half his leg.

    “Dr. Lawrence is top-notch,” said Kevin. “He saved my shin and foot.”

    Dr. Lawrence performed surgery on Kevin, including a skin graft, and amputated only two toes and part of his right foot.

    Dedicated to his job in construction, Kevin recovered and returned to work for eight months before developing an ulcer. Due to his neuropathy, Kevin did not feel pain, but he knew something was wrong. He decided to push through and keep working through the summer, but unfortunately, he developed a blister as well, which ruptured, causing him to lose his pinky toe.

    After his positive experience with Dr. Lawrence, Kevin chose to return to Shore. Dr. Christopher Lucasti, Infectious Disease Specialist and Epidemiologist, referred Kevin to Wound Care at Shore.

    In September, Kevin began treatment in Shore’s hyperbaric chamber to help the wound heal, and he just recently finished his treatment.

    “I would never go to another hospital; the care at Shore is above and beyond,” said Kevin. “I have developed a lot of personal relationships with the doctors and nurses at Shore. I feel like I’m part of something special here. The people here aren’t looking for money or fame; they truly want to help other people.”

    Kevin came to Shore 4-5 days a week for two hours to receive his treatment and worked with hyperbaric tech Jessica Lynch.

    “Jessica is amazing,” Kevin shares. “We grew up in the same area. She took care of my grandfather and knows my whole family. We’ve developed a true friendship, much deeper than a typical patient-caregiver relationship. If I need to talk, she’s here to support me and answer any questions.”

    Although Kevin’s injury was an unfortunate circumstance, he focuses on the silver lining.

    “I’m in a much better place now,” Kevin said. “I’m taking care of my type 2 diabetes now with help from Dr. Vijay Balakrishnan from Shore Physicians Group and the dietary team at the hospital. I have a better mindset now, thanks to the compassion Shore’s providers have shown me. When this is all done, I would love to be able to work at Shore. I would really enjoy being able to talk with patients and help them through their tough times the same way the people I met at Shore helped me.”

  10. Men: Don’t Ignore Your Prostate

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    If urologist Dr. Michael Schutz, who treats patients at Shore Physicians Group, could send one message to every male, it’s this: “Don’t put off getting screened for prostate cancer.” Prostate cancer can be serious, but when caught early, it has a 99% 5-year survival rate according to the American Cancer Society. Regular screenings for prostate cancer are the best way to detect prostate cancer early and save lives.

    Aside from non-melanoma skin cancer, prostate cancer is the most common cancer in men in the U.S. Out of every 100 American men, about 13 will get prostate cancer during their lifetime, and about 2 to 3 men will die from it. In fact, prostate cancer is one of the leading causes of cancer death among men of all races and Hispanic origin populations.

    There are three factors that can increase your risk for prostate cancer:

    1. Age: Prostate cancer is more common in men 50 and older, and most commonly diagnosed in men aged 65 to 69.
    2. Family history: Having a father or brother with prostate cancer more than doubles your risk of developing it.
    3. Race: African American men are 1.7 times more likely than European American men to develop prostate cancer, and 2.3 times more likely to die from it. (American Cancer Society)

    Who Should Get Screened, and When?

    “Unfortunately, there is not much we can do to prevent getting prostate cancer, so it is incredibly important that men are screened and keep up with their screenings,” said Dr. Schutz. “Men in these high risk categories should be screened yearly from age 40 through 75. Others should be screened once a year from ages 50-75, and those with a PSA less than one can be screened every other year.” Prostate cancer screenings involve a simple prostate-specific antigen blood test (PSA) that can detect abnormal levels of PSA. Then, the doctor may order imaging such as an ultrasound, MRI or biopsy.

    Prostate Cancer Treatment

    When prostate cancer is confirmed, a patient will be presented with treatment options, including radiation therapy and surgery. Each treatment plan is unique and based on the patient’s age, stage and aggressiveness of the cancer, and other health concerns.

    Advancements in radiation therapy such as those Shore Cancer Center has recently introduced can reduce toxicity of treatment and improve effectiveness. These advancements include the TrueBeam Linear Accelerator which provides faster and more accurate, targeted treatment. Patients undergoing radiation therapy generally do not experience pain. Those who undergo surgery can typically resume usual activities within a week or two following surgery.

    With both radiation therapy and surgery, every effort is made to save nerves and prevent nerve damage. There is no treatment without side effects, including bladder incontinence and erectile difficulty.

    “There are medications and procedures available to help patients overcome or adapt to the side effects,” added Dr. Schutz. “Again, I cannot stress enough the importance of screenings and that early detection can save lives.”

    Free Screenings for the Uninsured or Underinsured

    If you are unable to get important cancer screenings such as prostate cancer screenings because you are uninsured, have high insurance deductibles, or out-of-pocket expenses, you may be eligible for a screening at no cost to you at Shore Medical Center. Shore has been the lead agency for the NJ Cancer Education and Early Detection (CEED)* program in Atlantic County since 1997. Through this program, Shore is able to provide FREE cancer screenings to people who live in Atlantic County and are uninsured or underinsured with a limited income. The cancers included in this program are prostate, breast, cervical, and colorectal. This includes cancer screenings such as mammograms, annual examines, pap tests, colonoscopies, PSA tests and more.

    To find out if you are eligible, please call 609-653-3484 or click here and complete the online form and someone from the NJ CEED program at Shore will contact you.

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