Category Archive: Uncategorized

  1. Help for Varicose Veins

    Comments Off on Help for Varicose Veins

    If you have varicose veins, you may feel a little uncomfortable about showing off your legs. You may also feel pain, discomfort and swelling along with tired and achy legs. It is a myth that varicose veins are a problem only women will have; men can suffer from varicose veins as well, according to Dr. Leonard Galler MD, Board Certified General Surgeon with Shore Physicians Group and Chairman of the Dept. of Surgery at Shore Medical Center.

    How veins work

    The body has what amounts to a system of conduits or tubes that allow for oxygen-rich blood to flow from the heart throughout the body. The blood flows from the heart via arteries and the oxygen depleted blood is carried back to the heart to be reoxygenated through veins. The veins work efficiently by utilizing a series of valves that keep the blood moving. According to Dr. Galler, when those valves do not perform the job they were designed for, blood may leak back. This can weaken the vein walls, cause veins to bulge and may result in swelling or even blood pooling in the lower extremities, according to Dr. Galler. He advised that anti-inflammatory drugs along with other medications may be given to the patient to help reduce the swelling, inflammation and pain.

    How varicose veins normally develop

    Dr. Galler explained that in the legs soft vessels with minimal muscle can collapse over time. “The veins can get dilated,” said Dr. Galler. “There can be a number of other reasons for the veins to dysfunction and lead to the development of varicose veins. There could be a genetic predisposition to varicose vein development. Galler indicated that if parents have varicose veins, their offspring is likely to manifest varicose veins in their lifetimes. There could be damage to the deep system of veins from trauma or surgery that can lead to vein dysfunction. Often after a blood clot, deep vein thrombosis (DVT), varicose veins can develop because of physiological changes.

    Contributing factors for some patients can be obesity, pregnancy, chronic straining and constipation.

    Cosmetics and Symptomatic

    “Most patients do not like how varicose veins look and seek solutions for cosmetic reasons. Many patients have symptomatic varicose veins. They complain of aching legs that are often accompanied by swelling, burning and itching symptoms which can be severe enough to seek help. There are also patients who have developed severe swelling and edema with ulcers who need surgical care. These patients are at risk for infections and significant morbidity. Dr. Galler added that there are multiple recommendations that can be offered from a vascular surgeon to help all these patients regain quality of life.

    Important first steps

    Dr. Galler explained the importance of finding the causes of the varicose veins by ultrasound studies to determine vein anatomy and functionality. The ultrasound will determine blood clots and reflux from the values which will guide treatment.

    Compression stockings are the first line of treatment and often advised by surgeons. Dr. Galler said the compression stockings will help with the swelling by compressing the dilated veins, removing the pressure gradient and reducing weeping of fluid from the veins. Using the stockings along with medication to help with the swelling is beneficial to many patients.

    Treating Symptoms of Varicose Veins and Spider Veins

    Dr. Galler explained that there are several procedures that he performs frequently and that have proven to be very beneficial to his patients. These range from sclerotherapy of veins and spiders veins, laser ablation of veins and sealing of incompetent superficial veins with radiofrequency energy, and surgical removal of veins with minimal invasive techniques. Each of the procedures have their roles with benefits.

    Help Yourself

    There are a number of things someone suffering with varicose veins can do to gain relief of symptoms and help with cosmesis. If simple maneuvers such as exercise, weight reduction and support hose is not effective, it is then best to discuss options with a vascular surgeon such as Dr. Galler who would perform a full evaluation and direct a treatment plan.
    To learn more about what might be the best course of action to help with varicose veins, spider veins, and more or to make an appointment with Dr. Leonard Galler call 609-927-8550.

  2. What is Brain Freeze & Why Do We Get It?

    Comments Off on What is Brain Freeze & Why Do We Get It?

    Few things taste better on a hot, steamy summer day than an ice cold frozen treat like tall, sweet water ice or a great big ice cream cone. But in the excitement of that delicious treat-in-hand, too much of a good thing too fast can cause sphenopalatine ganglioneuralgia, better known as a “brain freeze.” It is a short-term headache typically linked to the rapid consumption of ice cream, water ice, ice pops, or very cold drinks.

    Brain Freeze Causes
    What happens when we experience that brief, yet quite uncomfortable brain freeze is the quick cooling of capillaries in the sinus and oropharyngeal area resulting in vasoconstriction or narrowing of the blood vessels. The rapid changes near the sensitive nerves in the palate create that sensation of a brain freeze.

    According to research done at Harvard Medical School led by Dr. Jorge Serrado there are several possible reasons for the sudden onset of pain. One theory is that it’s a relationship with the trigeminal nerve, which runs through the upper palate of the mouth. When something cold hits it, it may directly increase blood flow to the brain. Another theory is that a huge gulp of an ice-cold drink cools the blood; body’s quick attempt to warm up again is what causes the pain.

    Dr. Serrado said it is hard to study headaches in a laboratory because it is difficult to recreate what triggered the headache but it is pretty straightforward to recreate what leads to a brain freeze. The researcher said he hopes to take some of the lessons learned from inducing a brain freeze to do further study on headaches in the lab. This explains at times, rare headache disorders, according to Neurologist Dr. Joshua Daniel of Shore Physicians Group.

    The Brain Freeze Cure
    It may hurt, but that pain is brief. Take it slow: These annoying aches happen when there is a rush of cold hitting the palate or roof of mouth at one time, so the key is to pump the brakes and take it easy when licking a frozen treat. This will allow the body to acclimate to the sudden cold temperature as well as let it warm up just a bit.

    Pass on the straw. Sipping from a straw sends the chill straight to the roof of the mouth, just where it needs to go to set off that brain freeze. Press your tongue to the roof of your mouth, it may shorten the duration of the brain freeze by warming the area. There is some research that suggests caffeine prior to indulging in something cold may cut the risk of having a brain freeze due to the slight reduction in blood flow associated with the caffeine.

    To learn more about managing headaches or to make an appointment with Dr. Daniel call 609-365-6206.

  3. Migraine Treatments Show Promising Results

    Comments Off on Migraine Treatments Show Promising Results

    A pounding head and blinding headache, loss of production at work, and family time lost are very real for people who battle migraines. The pain is severe and may last from three hours to three days and can be debilitating. But migraine patients of Neurologist, Dr. Joshua Daniel of Shore Physicians Group are having very promising results from new treatments available.

    Dr. Daniel is utilizing a number of treatment options for patients suffering from migraines with very successful outcomes such as Emgality, a calcitonin gene-related peptide targeted therapy along with several others in that class. Dr. Daniel said the therapy is working great for his patients and added that he uses it as a preventative medication, It is also sometimes used as an abortive treatment, adding that it can shorten the duration as well as the severity of the headache.

    What Is a Migraine?

    A migraine is a headache with throbbing pain that is often severe enough to hamper daily activities and may last from four hours to three days if untreated. Migraine is one of the most prevalent diseases in the world, affecting more than 30 million American adults, according to Dr. Eric Pearlman, Senior Medical Director of Lilly Pharmaceuticals. It is three times more common in women than men. Foods, stress, and hormones can be migraine triggers, according to the American Migraine Foundation. Some patients seek the help of a neurologist for their migraines as well as cluster headaches, a less common and different kind of migraine.

    Migraines vs Cluster Headaches

    Migraines and cluster headaches, although both debilitating, feel and act differently, according to Dr. Daniel. While they are both headaches, migraines and cluster headaches have a different mechanism and pathology. People with migraines may experience nausea, sensitivity to light, and vomiting, whereas those with a cluster headache, which is generally felt on one side of the head, experience watery eyes and a runny nose. Some people who experience migraines can predict the onset because it’s preceded by an “aura,” or visual disturbances — flashing lights, zigzag lines, or a temporary loss of vision, for instance. By contrast, cluster headaches come on suddenly, are almost always one-sided and can be confused with sinus headaches. The pain is distinct and can feel like a hot poker in the patient’s eye, according to the American Migraine Foundation. While a classic migraine can be lengthy in duration, a cluster headache can arrive and depart swiftly over a period of time.

    Managing Migraines

    One very effective weapon in the war against migraine is calcitonin gene-related peptide targeted therapy. As explained by Dr. Pearlman, when a person is experiencing a migraine, the levels of CGRP increases and results in a cascade of pain and unpleasant symptoms.

    Dr. Pearlman explained that as a CGRP inhibitor, Emgality binds to CGRP and interferes with its activity, therefore getting rid of or lessening the effects of the migraine. Even more positive news for migraine sufferers is that there is not just one treatment, rather there are other options as well. When asked if there is a lot of encouraging news for people suffering from migraines and other debilitating headaches, Dr. Daniel said, “Absolutely, we have so many treatments now available. I started Shore Medical Center’s migraine infusion center and do probably the most Botox treatments for migraines in the area and now can offer all of these new migraine medications. We are finding success with not only meds but we utilize devices for migraines as well.”

    Migraines are individualized and vary patient to patient there is no one-size-fits-all treatment plan. Dr. Daniel treats strokes, headaches, seizures, neuropathy and other neurological conditions. He is also fluent in Urdu and Punjabi.

  4. Sixty Percent of People with Thyroid Disease Don’t Know They Have it: Are You One of Them?

    Comments Off on Sixty Percent of People with Thyroid Disease Don’t Know They Have it: Are You One of Them?

    The thyroid is a small but mighty hormone-producing gland in your neck that influences the activity of cells and tissue throughout the body, regulating metabolism and energy. Endocrinologist Dr. Vijay Balakrishnan of Shore Physicians Group says normal functioning of the thyroid is vital to metabolism. It plays a major role in the growth and development of the human body and helps to regulate many body functions by constantly releasing amounts of thyroid hormones into the blood stream. When your regulator is out of kilter, understanding the symptoms and getting the right treatment is key to getting the body’s system back on track and helping you feel your best.

    Thyroid statistics

    When things in your body are off and you can’t explain why, thyroid problems could be the culprit. The number of people whose thyroid has gone awry are rather staggering. According to the American Thyroid Association, more than 12 percent of the U.S. population will develop a thyroid condition at some point in their life. Although no one is immune to thyroid problems, including men and children, the vast majority of those with thyroid issues are women who run a risk five to eight times greater than men of experiencing thyroid problems in their lifetime. Sixty percent of the people with thyroid disease or its symptoms are not aware of it.

    Common symptoms

    Are you dragging and fatigued after a good night’s sleep or feel like your brain is in a fog? Maybe you gained weight but have not changed your diet, you have the chills, your heart is racing or there is more hair stuck in the hairbrush than normal. These are signs that something is off and it could be that your thyroid is misfiring.

    Other symptoms that there may be thyroid-related problems include: dry skin, brittle nails, numbness or tingling of the hands, constipation, muscle weakness or trembling hands, abnormal or irregular menstrual periods, diarrhea or vision problems.

    Hypothyroidism and Hyperthyroidism

    An unexplained change in weight is one of the most common signs of a thyroid disorder. Underactive thyroid, called hypothyroidism commonly presents symptoms like fatigue, weight gain and constipation. On the flip side, an overactive thyroid, which is called hyperthyroidism is associated with weight loss, palpitations, tremors and anxiety.

    According to Dr. Balakrishnan, the most common cause for hypothyroidism is an autoimmune disorder or after thyroid surgery. The physician said the most common cause of hyperthyroidism is Graves’ disease and viral thyroiditis.

    Thyroid Nodules

    Thyroid disorders also include thyroid nodules and goiter, which means the enlargement of the thyroid gland. According to Dr. Balakrishnan, “the majority of times thyroid function is normal with a thyroid nodule and the need to evaluate is essentially to rule out cancer.” A patient may need a biopsy of the thyroid nodule which will depend on multiple factors like the size of the nodule, the imaging characteristics on thyroid ultrasound and associated pressure symptoms.

    To learn more or to make an appointment with Endocrinologist Dr. Vijay Balakrishnan of Shore Physicians Group located at 18 West New York Ave in Somers Point call 609-365-5300.

  5. Tick Tock- June is Prime Tick Season

    Comments Off on Tick Tock- June is Prime Tick Season

    Frank Sinatra meant it lovingly when he sang “I’ve Got You under My Skin” in 1946 but when summer breaks out, there can be something a lot less desirable getting under your skin, like a tick. Spring and summer are prime tick season and Dr. Gregory Carson, Medical Director for Shore Urgent Care in Northfield said they are currently treating patients for tick bites. He added that more rural areas such as in Ocean County are seeing more tick related patients.

    According to the Center for Disease Control says ticks do not hibernate but are normally dormant in the winter months. Extended below freezing temperatures will kill off some but not all species of ticks. Information from the CDC indicates that many varieties of ticks will take shelter during the winter months in leaf debris and become quite active in the spring. They warn that while it is simple enough to come in contact with ticks while hiking or camping, many people will get bitten by a tick in their own back yard.

    Dr. Carson said visits to urgent care for possible tick bites more often than not will be from the patient’s property. “Tall grass is really where the ticks like to be and they can easily attach to clothing or get on pets, people just need to be aware and to be vigilant about checking themselves and their children and pets for ticks when they come in the house,” said Dr. Carson.

    Standard treatment for tick bites
    When a patient comes to urgent care with the tick still on the skin it will be removed and standard procedure will put the patient on a regiment of antibiotics. Dr. Carson said often patients will come into the Shore Urgent Care Center and do not realize they have been bitten by a tick but are experiencing the symptoms of a tick related illness. Patients may be fatigued, suffering with flu-like symptoms and if they have been in an area where ticks are likely they may be tested for Lyme disease. The physician added that a blood test taken too soon after the possible tick bite can give a false negative reading so they normally wait several days before drawing a blood for Lyme disease. “Though we may wait to draw blood for Lyme disease, we do not wait to see if the traditional bull’s eye rash appears,” said Dr. Carson. “That could put them several days to several weeks behind in recovering from the bite if we waited. Our normal standard of care is that we will normally prescribe doxycycline or amoxicillin and then instruct the patient to follow up with their primary care physician.” Dr. Carson said it may take 3 to 30 days for a rash to appear.

    Proper tick removal
    Dr. Carson said it is very important to get the tick out from the skin. “I tell patients to use tweezers and to go as close to the edge of the skin as possible. The motion should be straight up; do not twist or jerk or it will break off, possibly leaving the head under the skin,” said Dr. Carson. “Clean the area with rubbing alcohol and never try to crush the tick.” According to Dr. Carson, if the patient wishes to have the tick evaluated for disease, they may do so by taking the tick to the County Health Department for evaluation, but he added that the tick must still be alive for the health department to test.

    Brown Recluse Spiders
    Ticks are not the only thing around to bug you this time of year, Dr. Carson said patients have come into Urgent Care with suspicion of being bit by a brown recluse spider. “A bite from the brown recluse spider can be pretty nasty and the patient can develop a cellulitis in the surrounding tissue. We normally will prescribe a topical cream for the affected area.” The brown recluse spider is normally found around wood piles and its bite can make a person quite sick.

    CDC recommendations
    The CDC suggests caution when returning to the home from a possible tick infested area, First-check clothing for ticks. Ticks may be carried into the house on clothing. Any ticks that are found should be removed. Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing. If clothes need laundering, hot water is recommended. Cold and medium temperature water will not kill ticks.

    Next examine any gear and pets. Ticks can catch a ride into the house on anything but especially on pets so carefully examine pets, coats, and back packs. Shower soon after being outdoors. Showering within two hours of coming indoors has been shown to reduce your risk of getting Lyme disease, according to the CDC and may be effective in reducing the risk of other tick-borne diseases.

    Check your body for ticks after being outdoors. Conduct a full body check upon return from potentially tick-infested areas, including your own backyard. Use a hand-held or full-length mirror to view all parts of your body. Check these parts of your body and your child’s body for ticks:

    • Under the arms
    • In and around the ears
    • Inside belly button
    • Back of the knees
    • In and around the hair
    • Between the legs
    • Around the waist

    For more information on the Shore Urgent Care Center located at 2605 Shore Road in Northfield click here.

  6. Shore Physicians Group Welcomes Certified Diabetes Educator and Dietitian Tiffany Rios to its Endocrinology Practice

    Comments Off on Shore Physicians Group Welcomes Certified Diabetes Educator and Dietitian Tiffany Rios to its Endocrinology Practice

    With the right lifestyle changes, people with prediabetes and diabetes can prevent or manage the disease and vastly improve their quality of life and longevity – but making those changes without support can be difficult. That’s why Shore Physicians Group (SPG) is proud to welcome Certified Diabetes Educator and Registered Dietitian Tiffany Rios, RD, CDE, who was recently hired to help patients with diabetes or at risk of developing it to make those necessary lifestyle changes. Rios is seeing patients at SPG’s Endocrinology office located at 2605 Shore Road in Northfield.

    Rios, who is bilingual, comes to Shore Physicians Group with more than 12 years of experience as a dietitian, health coach and diabetes educator for various healthcare organizations, including Sharp Healthcare in San Diego and most recently with Virtua Healthcare, where she served a multicultural community in Camden providing screenings, assessments and education for diabetes self-management.

    In her role with Shore Physicians Group, Rios will provide an array of community nutrition education services including diabetes education for individuals and groups; ongoing weight management programs, lectures, and screening programs; coordination of nutrition-based community projects; and assistance in the delivery of additional community health programs.

    Mark Stephens, Chief Administrative Officer of Shore Physicians Group, says Rios complements the SPG Endocrinology team, which consists of Dr. Matthew Corcoran and Dr. Vijay Balakrishnan, and diabetes educator and advanced nurse practitioner Denyse Gallagher.

    “Atlantic County has one of the highest rates of diabetes in the state, with a higher prevalence especially among the Hispanic and African American communities. Tiffany has a proven track record of helping people with diabetes make lifelong behavior changes, especially those populations who are at greatest risk. We’re fortunate to have her on board serving not only SPG’s patients, but anyone in need of her care. We look forward to the difference she will make in helping people with prediabetes and diabetes conquer their disease and lead healthier lives,” Stephens said.

    Rios received her undergraduate degree in Nutritional Science – Dietetics from Rutgers University and her registered dietitian certification from South Jersey Healthcare System (now Inspira). She has won several awards for excellence, and has a record of success partnering with other community health organizations to reach those in need.

    “From the moment I met the SPG endocrinology team I knew they were passionate, caring, and aligned with my mission to help patients thrive. My goal is to provide patients with compassionate service, as well as the Nutrition education and tools needed to enhance their health and wellness.”

    To learn more, contact the Endocrinology office at 609-365-5300.

  7. Oh, My Aching Joints

    Comments Off on Oh, My Aching Joints

    If your morning starts out with joint stiffness, do you just chalk it up to your age or blame the gardening you did over the weekend? Or, is it possible that what is causing the discomfort is some form of arthritis? According to Rheumatologist Dr. Manpreet Tiwana of Shore Physicians Group, it is important to understand what is causing that discomfort because some forms of arthritis, if left untreated, may result in irreversible damage.

    “Any form of arthritis can be life changing, as it impacts quality of life, but with so many advancements and treatment options, better outcomes can be achieved. Early diagnosis and control of arthritis along with being compliant with treatment is very important for overall good joint health,” said Dr. Tiwana.

    Types of arthritis

    There are more than 100 types of arthritis according to the Arthritis Foundation, but the three most common types of arthritis are osteoarthritis, rheumatoid arthritis and psoriatic arthritis. All three varieties of the disease will cause joint stiffness and pain and will often be accompanied by swelling, but what they can do to the joints and how they are treated are different.

    Osteoarthritis

    Dr. Tiwana said osteoarthritis is the result of the regular wear and tear on our joints from injuries and aging. It is a degenerative condition, which means it gets worse over time as the smooth cartilage that cushions the joint breaks down. Bone spurs at the side of the joints can form and the bone underneath the cartilage hardens. These changes cause pain, swelling and problems moving the joint.

    There is no cure for osteoarthritis, and Dr. Tiwana said treatment of the disease is more about treating the symptoms -trying to reduce discomfort with various medications or joint injections with the goal of improving the patient’s range of motion. In some cases surgical intervention is a consideration.

    Rheumatoid Arthritis

    Rheumatoid arthritis is an inflammatory arthritis that is associated with the autoimmune process. That means that the body’s immune system begins to start fighting its own joints. If left untreated, rheumatoid arthritis can cause permanent deformities in the joints.

    Once a diagnosis of rheumatoid arthritis is confirmed, Dr. Tiwana said she works quickly to control the inflammation in the effort to avoid permanent joint damage. She added that every patient is unique and will need a plan that includes immunosuppressive medications to block the mechanism leading to swelling and joint damage tailored specifically to them that works in conjunction with any other medical conditions they may have.

    Psoriatic arthritis

    Like rheumatoid arthritis, psoriatic arthritis is an autoimmune disorder. The swelling and joint pain is also often accompanied by a rash. Nearly 30 percent of people who have psoriasis, a skin condition that causes red, scaly, thick patches on the skin that often form over joints, are likely to develop psoriatic arthritis according to the Arthritis Foundation. It can affect any joint in the body. Dr. Tiwana said that medication for this autoimmune disorder is tailor made for each patient utilizing a variety of medications. Various treatment options can lead to remission of the condition but medications will most need to be taken most likely lifelong. Professional golfer Phil Mickelson has psoriatic arthritis and attributes his physician, the use of nonsteroidal anti-inflammatory drugs (NSAIDS) and other antirheumatic drugs for getting him back on the golf course, according to Golf Magazine.

    See your Rheumatologist

    There have been tremendous advancements in the treatment of arthritis. Dr. Tiwana said it is important for people who are waking up in the morning with stiffness to determine how long it is affecting them. If the joint pain is associated with visible swelling in joints or persisting for more than six weeks with morning stiffness lasting longer than one hour, it is advisable for that person to consider seeing a physician for evaluation, said Dr. Tiwana.

    The physician added, if left untreated, rheumatoid arthritis and psoriatic arthritis patients may develop permanent damage to joints and they can lose complete joint function and risk losing the capacity to walk..

    Diet and Exercise

    Dr. Tiwana said diet and exercise are vital to good arthritis control. “There is a component of inflammation in all variations of arthritis, whether it is osteo, rheumatoid or psoriatic. Foods which have anti-inflammatory properties like fish or fish oil and turmeric have all been found to be beneficial. Foods which are fried, processed and have processed sugars are found to increase inflammation. Exercise is vital for any type of arthritis as it maintains good muscle tone and health that promotes good joint function,” according to Dr. Tiwana.

    To discuss symptoms or to set up at appointment with Dr. Tiwana, who is certified in both internal medicine and rheumatology, or a member of the Shore Physicians Group Rheumatology team located at 700 Shore Road in Somers Point, call 609-365-6212.

  8. Know Your Numbers: Getting Technical about Diabetes

    Comments Off on Know Your Numbers: Getting Technical about Diabetes

    Diabetes is a disease that occurs when the body’s blood glucose level, also called blood sugar level, is too high. Blood glucose is our body’s main source of energy, which comes from the food we eat. Our pancreas produces a hormone called insulin, which takes the glucose that comes from food and helps get it into our cells, where it is used for energy. Sometimes the body does not make enough insulin or it does not use the insulin well and the glucose stays in the blood and does not reach the cells. Over time, too much glucose in the blood can cause a wide range of health problems.

    Know your numbers
    Shore Physicians Group diabetes educator Denyse Gallagher, APN, has been helping patients and the community-at-large understand and manage their diabetes for the past decade. Patients diagnosed with Type 1 or Type 2 diabetes have to monitor the sugar level in their blood. “Diabetes patients really need to know their numbers,” explained Gallagher. “Not just what their blood sugar level is right now, but they need to know their A1C levels as well so they can keep their goals in focus.”

    Gallagher explained that a person’s A1C number is the measure of a person’s blood sugar level over a three-month period. People with Type 1 and Type 2 diabetes need to check their blood glucose levels daily (for some it is multiple times a day) to make sure they are keeping it within a manageable range. Keeping track of their A1C number allows them to see the trends in how their body is responding to certain foods. It allows them to set goals and make changes so they can get to and stay within safe levels. She cautioned that even for patients who are normally able to remain within safe A1C numbers, managing diabetes means being vigilant about the number because life happens and something like excess stress or even an infection unrelated to the diabetes may cause the A1C numbers to fluctuate.

    Thanks to new technology, it has become easier for patients to manage their disease. The old method meant a finger prick to get a drop of blood each time to measure their glucose level and insulin injections. Now, glucose monitors like Free Style CGM Libre continuously track glucose levels giving the patient the information they need to make management quicker and easier without the need for the finger sticks. The information may be downloaded as well. Insulin pumps can deliver the proper amount of insulin through a pump without the need for an injection.

    “The continuous monitoring is a two-fold benefit to the patient because it will show a trend. For example, if the number is 110, the patient will also know whether it is going up or down and how quickly is it going down. The patient is able to use those numbers as a predictive tool,” said Gallagher. “Every time you have a number, you have an opportunity to make a choice.”

    Types of Diabetes
    The most common types of diabetes are Type 1, Type 2 and gestational diabetes . For those with Type 1 diabetes, their body does not make insulin and their immune system attacks and destroys the cells in the pancreas that make the insulin. Type 1 diabetics must take insulin every day.

    Patients with Type 2 diabetes, the most common type of diabetes, do not make or use insulin well. People can develop Type 2 diabetes at any age, even during childhood. However, this type of diabetes occurs most often in middle-aged and older people. Gestational diabetes develops in some women when they are pregnant. Most of the time, this type of diabetes goes away after the baby is born. However, those who have had gestational diabetes have a greater chance of developing Type 2 diabetes later in life.

    According to the National Institute of Health, diabetes affects 1 in 4 people over the age of 65 and as of 2015, 30.3 million people have been diagnosed with diabetes. Gallagher estimated that on top of those 30 million who have been diagnosed, one in three people are walking around with diabetes or may be pre-diabetic but do not know it.

    Who is more likely to develop type 2 diabetes?
    You are more likely to develop Type 2 diabetes if you are age 45 or older, have a family history of diabetes, or are overweight. Physical inactivity, race, and certain health problems such as high blood pressure also affect your chance of developing Type 2 diabetes. You are also more likely to develop Type 2 diabetes if you have prediabetes or had gestational diabetes when you were pregnant.

    What health problems can people with diabetes develop?
    If you ignore the symptoms of diabetes, Denyse Gallagher said you are flirting with disaster. These symptoms include frequent urination, feeling very thirsty, feeling very hungry even though you are eating, extreme fatigue, blurry vision, cuts and bruises that are slow to heal, weight loss even while eating more, and tingling, pain or numbness in the hands or feet

    “The sooner someone sees their healthcare professional, understands what is going on with their symptoms, and gets it under control, the better. Left unchecked, the symptoms of diabetes can lead to significant health problems,” said Denyse Gallagher.

    Diabetics are at risk of heart disease, stroke, kidney disease, eye problems, dental disease, nerve damage and foot problems that can lead to amputation. While there is no cure for diabetes, it is a disease that can be managed through medication and lifestyle. Understanding their disease, knowing their numbers and keeping their goals in focus can make living with diabetes manageable.

    Denyse Gallagher, APN, treats patients at Shore Physicians Group’s office located at 2605 Shore Road in Northfield. For questions about diabetes or to make an appointment with Gallagher or another member of the Shore Physicians Group endocrinology team, call 609-365-5300.

  9. Does Gum Disease Increase the Likelihood of Alzheimer’s Disease?

    Comments Off on Does Gum Disease Increase the Likelihood of Alzheimer’s Disease?

    A diagnosis of dementia or Alzheimer’s disease is enough to scare anyone. With more than 5.5 million Americans over the age of 65 currently diagnosed with Alzheimer’s disease, and that number is expected to double by the year 2050 according to the Alzheimer’s Association. Understandably, people are desperate to find causes, treatments and cures which despite ongoing research remain elusive.

    When studies seem to yield any solid data, the media is quick to splash headlines that grab the attention of families hopeful for better understanding of who at risk of getting the disease or if there is a way to treat or minimize the effects of Alzheimer’s. A May 2018 study published online in the Journal of Alzheimer’s Disease linked periodontal disease and an increased likelihood that gum disease may play a role in predicting Alzheimer’s disease.

    Size of the Study Does Matter

    Neurologist Dr. Joshua Daniel of Shore Physicians Group, said unfortunately the sample study was too small to establish a definite link between periodontal health and the likelihood that people with gum disease are at a greater risk to develop Alzheimer’s disease.

    Researchers in England, Drs. John Crean and Sim K. Singhro, examined brain tissue samples donated by 10 patients without dementia and 10 patients with dementia. They found gum disease bacteria, lipopolysaccharides, in the sample from four of the people with dementia and none of the people who did not have dementia. Bacteria can enter the bloodstream through everyday activities such as eating, chewing and brushing teeth and once in the bloodstream, the bacteria can be carried to other parts of the body. The researchers hypothesized that when the bacteria reaches the brain, it may trigger an immune system response (like it does in the mouth), killing brain cells. This immune response could be one mechanism that leads to changes in the brain, which is typical in Alzheimer’s disease. It could play a role in causing symptoms such as confusion and deteriorating memory.

    Study Linking Biomarker to Alzheimer’s Disease

    One recent study Dr. Daniel thought may show promise looks for a protein in the blood, a neurofilament light, which could be a biomarker for Alzheimer’s disease. A paper published in March 2018 supports the idea that dying neurons release a slew of proteins into the brain and traces of those neurofilament proteins make their way into the blood.

    In the largest study to date on neurofilament light proteins in people with dementia, Swedish scientists at the University of Gothenburg reported high levels of this protein in the blood of people with Alzheimer’s disease and mild cognitive impairment. Neurofilament light was also associated with worsening cognitive scores over time and with brain atrophy. While it is not sensitive or specific enough to stand alone as a diagnostic marker, the protein distinguishes Alzheimer’s disease and mild cognitive impairment from healthy control patients who do not have a diagnosis of Alzheimer’ about as well as the presence of tau in cerebrospinal fluid from a spinal tap. Tau is a normal protein in the brain that changes and may damage brain cell structures in patients with Alzheimer’s disease, and is identified through a spinal tap. Blood neurofilament light would be a more easily accessible biomarker for prognosis and progression. Washington University researcher Anne Fagan reported in Alzforum, a news website and information resource for Alzheimer’s disease and related disorders research, that the work with the neurofilament light plasma marker needs to be replicated, but if the blood testing performs as well as the cerebral spinal fluid then it could have a huge impact.

    Dr. Daniel said that while the studies are encouraging and may help with early diagnosis they still need more data and more information. Having a path to cover the expense of the testing could be difficult, adding that getting the insurance companies to cover it will be the biggest challenge.

    Neurofilament light research is not limited to Alzheimer’s disease and mild cognitive impairment. It is also suggested as a marker for neurodegeneration in everything from amyotrophic lateral sclerosis (ALS) to traumatic brain injury and atypical Parkinson’s disease. Research is ongoing.

    To make an appointment with Dr. Joshua Daniel at Shore Physicians Group, located at 649 Shore Road, Suite O in Somers Point, call 609-365-6202.

© 2024 Shore Physicians Group. All rights reserved. Website by Masterpiece Advertising