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Breast cancer is now the most common cancer in the world. In fact, 12% of all new cancer cases in 2021 will be breast cancer. As a result, chances are you know someone who has faced this terrible disease. And it is likely you have wondered about breast cancer screening.
Currently, there are several recommendations about breast cancer screening. There are benefits to screening and early detection, but there are also potential problems. Your doctor should help you decide which tests you need based on your history and risk. For high-risk men and women with a family history of cancer, BRCA genetic testing is invaluable.
Breast cancer screening is a great way to take charge of your health. Here's what you need to know about breast cancer screening.
According to the National Cancer Institute, screening means looking for the disease before there are any signs. Hence, the best time to get checked is before you have symptoms.
Screening is looking for abnormalities. It may find cancer at an early stage. Because of advanced detection, doctors can more easily treat the disease. Patients also have better odds at survival. Each type of cancer has unique guidelines for screening.
Overall, current guidelines and recommendations say that most women should have a mammogram to detect tissue changes beginning at age 40.
Men are also affected by breast cancer. However, most guidelines do not include them in the recommendations. A doctor can give male patients personalized guidelines for screening.
Here are the most current routine recommendations for women starting at age 40.
| Organization | Women Age 40-49 | Women Age 50-74 |
| US Preventive Services Task Force (USPSTF) | Individualized to the patient | Digital mammogram every 2 years |
| American College of Obstetricians and Gynecologists (ACOG) | Offer annual mammogram | Mammogram every 1-2 years until age 55, then every 2 years |
| National Cancer Institute (NCI) | Mammogram every 1-2 years | Mammogram every 1-2 years |
| American Cancer Society | Offer annual mammogram until age 45, then mammogram every year | Mammogram every year age 50-55, then every two years after age 55 |
| American College of Radiology (ACR) | Annual | Annual |
Some men and women worry about breast cancer because they have a family history of cancer.
Women with a personal or family history of some cancers could have changes in their genes. These mutations are known as BReast CAncer gene 1 (BRCA1) or BReast CAncer gene 2 (BRCA2) changes. They may mean a higher cancer risk.
High-risk patients should see a doctor or specialist. They will need a risk assessment, genetic counseling, and in some cases, lab testing. Mutations in the BRCA1/2 genes may lead to:
Genetic testing for BRCA1/2 requires a special blood test that your doctor can order. The doctor can explain the details. They can also answer questions you might have.
According to the National Cancer Institute, many women with ovarian and breast cancers are not receiving these genetic tests, even though they have become inexpensive and easily accessible.
Now with telemedicine, it is easier than ever to get this valuable testing done. An online provider such as a virtual gynecologist or virtual physician can tell you if you need it and when or how to get it.
My Virtual Physician offers consultations about this important BRCA gene testing. For little or no out-of-pocket cost, they can arrange for you to have your blood drawn. They make it easy. They work with many local LabCorp or Quest outpatient testing centers who can provide this service for you.
Like much in healthcare, tests may not be “one risk fits all.” That is why you should talk to your doctor about what is best for you. He or she will consider factors such as lifestyle, family history, and other health concerns. Then they can help you decide what to do.
Your doctor can recommend one of these methods below. If you do not have a doctor, a virtual doctor online can be a great place to start.
The most common test for breast cancer is called mammography. It is ordered by a doctor. Mammograms look for early changes in the tissue that could be dangerous.
A mammogram is a special type of X-ray that shows the breast tissue. Sometimes, doctors can see lumps on the images that they cannot feel.
Women who have a high risk of cancer or have dense breast tissue may require magnetic resonance imaging.
The MRI test is more sensitive and can detect finer irregularities. MRI images also give a clearer picture of the breast tissue. Unfortunately, this screening method is much more expensive and therefore is not used for routine exams.
Breast cancer testing is an active area in clinical research. Other methods include:
Physicians can explain the options to patients. And they can help them make informed choices about each type of screening.
Doctors can help guide a patient to the best choice. Physicians also tell their patients about risks that they need to consider.
Your doctor should tell you when to get screened for breast cancer. Talking to a board-certified physician about the right time for you to have a cancer screening may prevent problems.
Specialists caution patients that there are risks involved with all medical tests, including cancer screening. Some of them include:
This is why you should talk to your doctor when you are thinking about breast cancer screening.
My Virtual Physician offers a full line of virtual physician services. To talk with one of our board-certified physicians, click to book now. Our caring experts can talk with you about a screening plan that is best for you.
If you have suggestions for other topics you want to read about, let us know! Don’t forget to follow us on social media.
Sources:
Breast Cancer Overtakes Lung As Most Common Cancer - WHO. Reuters. Feb 2, 2021. https://www.reuters.com/article/health-cancer-int/breast-cancer-overtakes-lung-as-most-common-cancer-who-idUSKBN2A219B
Cancer Screening Overview (PDQ®)–Patient Version. National Institute of Health. National Cancer Institute. Aug 19, 2020. https://www.cancer.gov/about-cancer/screening/patient-screening-overview-pdq
Breast Cancer Screening. U.S. Preventative Task Force. Jan 11, 2016.https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening
Breast Cancer Risk Assessment and Screening in Average-Risk Women. American College of Obstetricians and Gynecologists. Practice Bulletin. Number 179. July 2017. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/07/breast-cancer-risk-assessment-and-screening-in-average-risk-women
American Cancer Society Guidelines for the Early Detection of Cancer: Breast Cancer. American Cancer Society. Jul 30, 2020. https://www.cancer.org/healthy/find-cancer-early/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html
New ACR and SBI Breast Cancer Screening Guidelines. American College of Radiology. Apr 4, 2018. https://www.acr.org/Media-Center/ACR-News-Releases/2018/New-ACR-and-SBI-Breast-Cancer-Screening-Guidelines-Call-for-Significant-Changes-to-Screening-Process
BRCA Overview. Basser Center for BRCA, Penn Medicine. Accessed Jul 24, 2021. https://www.basser.org/brca
Chen, S., Parmigiani, G. (2007). Meta-Analysis of BRCA1 and BRCA2 Penetrance. Journal of Clinical Oncology, 25(11), 1329-1333. https://doi.org/10.1200/JCO.2006.09.1066
Fewer Women with Ovarian, Breast Cancer Undergo Genetic Testing than Expected. National Cancer Institute. Apr 9, 2019. https://www.cancer.gov/news-events/cancer-currents-blog/2019/ovarian-breast-cancer-testing-inherited-genetic-mutations
BRCA1 and BRCA2 Testing. BreastCancer.org. Sep 21, 2020.https://www.breastcancer.org/symptoms/diagnosis/brca
Pediconi, F., & Galati, F. (2020). Breast cancer screening programs: does one risk fit all?. Quantitative imaging in medicine and surgery, 10(4), 886–890. https://doi.org/10.21037/qims.2020.03.14
You know the stuffy feeling when sinus pressure in your face is so intense that you can’t think straight. It could be a sinus infection. But what if you're unable to feel anything? Can sinusitis cause facial numbness?
Sinusitis is associated with signs and symptoms, including a runny nose, facial pain or pressure, and a change in the sense of taste or smell. Facial numbness is another less common symptom. However, facial numbness could be a sign of other more serious conditions. So it is best to discuss facial numbness with a doctor.
How do you know what is causing facial numbness? And when should you schedule an online doctor appointment? Here is what you need to know when it comes to talking to a doctor about sinusitis.
Sinusitis is one of the most common health complaints leading to doctor visits. Sinusitis is an irritation or infection in the sinuses. Sinuses are hollow passageways behind the cheekbones and around the eyes. Healthy sinuses are filled with air. They produce mucus to keep nasal passages moist.
Sometimes sinus passageways become blocked. Bacteria, viruses, and allergic responses cause swelling or inflammation in the passages. These are frequent causes of sinusitis.
Individuals with sinusitis may have different symptoms. Sinus problems can be chronic, meaning they last over a longer time, or acute, meaning sudden onset with short duration.
Some commonly reported signs of acute sinusitis lasting less than four weeks are:
Signs that are frequently seen with chronic sinusitis that last 12 weeks or more include:
Sinusitis, whether recently starting or bothering you for a while, can be diagnosed by a history and examination with a doctor.
You should never ignore facial numbness. It is important to report new or worsening feelings of tingling or no sensation at all to your doctor for evaluation.
Altered sensation in the face could be complications such as:
A doctor can evaluate possible reasons for the symptoms and help develop a plan for diagnosis and treatment.
Yes! An online doctor consultation may be a great option. Feelings of facial tingling or numbness can be urgent. But sometimes it is difficult or costly to see a doctor right away. Booking a virtual physician appointment is a way to get fast and convenient care.
A recent article published by the Open Forum Infectious Diseases found virtual care for sinusitis was associated with better diagnosis and treatment than in-person primary care visits.
Virtual physicians may be able to diagnose and treat this condition without making a trip. Sinusitis symptoms can make driving difficult. An online doctor appointment can feel like a house call. You get personalized care in the privacy of your home without the inconvenience of traffic, waiting rooms, and commute time.
Signs and symptoms can be bothersome. Yet, left untreated, it can progress into worse problems. Book an appointment with a virtual physician online today.
My Virtual Physician offers board-certified physicians who are now accepting new patients in many states. Click "BOOK APPOINTMENT NOW" to book an appointment with convenient evening and weekend hours. Or let us know if you have questions about your symptoms. We are standing by to help.
References
Johnson, K., Dumkow, L., Burns, K., Yee, M., & Egwuatu, N. Comparison of Diagnosis and Prescribing Practices Between Virtual Visits and Office Visits for Adults Diagnosed With Sinusitis Within a Primary Care Network, Open Forum Infectious Diseases, 6 (9), 2019. https://doi.org/10.1093/ofid/ofz393
Wyler, B., Mallon, W. Sinusitis Update. Emergency Medicine Clinics of North America, 37, (1), 2019. https://doi.org/10.1016/j.emc.2018.09.007
Ziegler, A., Patadia, M. & Stankiewicz, J. Neurological Complications of Acute and Chronic Sinusitis. Curr Neurol Neurosci Rep 18, (5), 2018. https://doi.org/10.1007/s11910-018-0816-8
Telemedicine surged this past year. Analysts say virtual healthcare will top 1 billion visits this year. But is it right for everyone? Parents may wonder if an online pediatrician is a good choice.
Telemedicine (TM) is a great resource for most people, even parents. Online doctors treat many pediatric health concerns through video visits. Yet, some cases require an in-person physical exam. When in doubt, the doctor, or their team, can help parents decide what is best for each situation.
Those who are curious about online pediatrician appointments should read on. Here we share why you should book an online pediatrician visit.
Online pediatrician visits can be a good choice. For instance, a recent pediatric study found that TM lowers lowers healthcare costs raising patient satisfaction. Easy access to doctors from the safety and comfort of home is invaluable. TM is an innovative solution to one of parenting's great challenges: a sick child.
Before booking an online pediatrician appointment, follow these steps.
Ask your doctor if TM is a good idea when you have a problem. In some cases, a doctor may want to see your child in person. In-office exams allow doctors to use instruments. Some tests cannot be conducted through a video screen.
Your doctor may also have a list online showing which concerns they can treat through online appointments.
To book an online pediatrician visit, you must have the equipment and connection to meet with the doctor. In other words, if you are booking a visit with a tablet or cellphone, make sure you have a strong signal and full bars. At home, log in to WiFi to get the best video quality.
Also, check with your doctor to find out what platform they use. Some have a mobile app. Others may want you to download the software before the visit.
It is good to arrive for your TM visit 10-15 minutes early. Log in ahead of time, so you don't feel rushed and can figure it out. You'll also have time to troubleshoot technical issues before the doctor arrives.
When deciding if you should book an online appointment, the last thing to think about is which provider to use. Each office has cost, appointment times, and patient reviews that vary.
A recent article by CNBC warned that TM is in high demand. Some will have longer wait times. Check your doctor's availability ahead of time. A little online research can go a long way to helping parents find the right online doctor.
Pediatricians can treat many common problems with a video consultation. Some concerns that are easily evaluated in a virtual visit are:
If you are unsure, check with your doctor. They can let you know the best choice for you.
In some cases doctors may need more tests. When a pediatrician needs more tools to treat a sick child, they may refer parents to an in-person visit or urgent care.
Some doctors' offices, like My Virtual Physician, work with local partners. They can arrange lab tests by sending an order to a laboratory. Later, they can review the results with the patient over video.
Telemedicine providers can arrange X-rays or other diagnostic tests this way too.
In some cases, online doctors prescribe medication. Online pediatricians can fax refills to local pharmacies. During the TM visit, online pediatricians will explain the treatment plan and any instructions to parents, just like in-person appointments.
Not all problems are best solved by an online appointment. Here are a few reasons to check with your doctor before booking an online pediatric appointment.
When a child needs in-person medical attention, but you can't book an appointment with a pediatrician, an urgent care center or emergency room may be the best option.
Dr. Ayyagari is a board-certified pediatrician of 20 years. She is licensed in Pennsylvania, Virginia, Texas, and Florida and is accepting new patients. Click "BOOK APPOINTMENT NOW" to book an appointment. Or let us know if you have questions about your child. We are standing by to help.
This past year tested many young businesses. Telemedicine is not new. But the My Virtual Physician (MVP) business model is. The virtual doctor practice offers the best in online doctor services as a direct-to-consumer multi-specialty provider licensed in multiple states. Regardless of 2020's challenges, the MVP virtual doctor team didn't slow down. They focused on their path to becoming the #1 online doctor and forged ahead.
Over the last 12 months, MVP worked hard to bring high-quality medical care into homes in 15 states. They now offer online pediatric, gynecologic, and primary healthcare services for patients of all ages. Plus, they provide same-day scheduling for online physician appointments, some in-network insurance benefits, and five-star customer service.
As the #1 online healthcare provider, MVP doctors get to know their patients. Quality care is emphasized, and they aim to provide the best patient satisfaction in telemedicine. Here’s what patients are saying about MVP's online doctors:
“I would give My Virtual Physician more stars if I could”
“Dr. Howard has the best personality and is very friendly.”
“The future of medical visits; what better way to social distance.”
“A+ would recommend to everyone.”
Since their launch, MVP has opened new offices and added service lines such as nutrition and diabetic care. The practice has partnered with more online doctors and added office staff. Just this Spring, MVP enhanced their patient portal for self-scheduling, and integrated a program to trend patient reviews.
This one year anniversary milestone is cause for celebration. It is exciting, and this is only the beginning. Despite any challenges that lie ahead for this medical practice, their progress shows that the future is very bright for My Virtual Physician.
Congratulations to Dr. Howard, Dr. Masghati, Dr. Ayyagari, and all of the My Virtual Physician Staff.
Meet Dr. Aravinda Ayyagari! We are ecstatic she has joined our My Virtual Physician practice.
She is a board-certified pediatrician with almost 20 years of experience. She serves on several hospital committees and enjoys volunteering her time in different settings ranging from the local school to the board of Easter Seals, and even traveling to El Paso, TX as a volunteer physician at a migrant center. She also serves as the state of Delaware CATCH grant coordinator to increase children’s access to healthcare services.
In her free time, she enjoys traveling, cooking, exercising, and spending time with friends. She loves hiking with her husband and two children in various destinations both domestically and internationally - covering Asia to South America. As a family, they have been amazed at how people are much more alike than different. They are looking forward to their next adventure!
Dr. Ayyagari speaks Spanish and some Telugu. She enjoys caring for patients of different cultural backgrounds.
Most recently, she started Bridge Care Pediatrics, a direct primary care which provides all pediatric and newborn housecalls. www.bridgecarepeds.com
January is a month when some choose to make new year resolutions. It is a time to reflect on the past 12 months. And look where you want the next 365 days to take you. Time reported that 50% of Americans resolve to exercise more. But is exercise safe for everyone?
Exercise is safe for most people. But, some adults should check with a doctor before starting an exercise program. Those with health problems must talk with their doctor to lower their risk of injury or other harm.
In this post, you will learn about safe exercise and how to reduce your risk of injury.
Research shows that regular physical activity is vital for health. Exercise also plays an important role in disease prevention. New studies show that physical activity boosts mood and makes the immune system strong. Some say, exercise is the best medicine.
The U.S. Department of Health and Human Services recently updated the Physical Activity Guidelines for Americans. The guidelines provide science-based recommendations to help people improve their health through exercise. Information presents the types and amounts of activity that provide the best benefits.
To determine if exercise is safe, children and young adults need a yearly physical. Check-ups help identify health problems that interfere with exercise or that increase the risk of injury. Through preventative care, doctors can identify breathing problems like asthma or heart conditions.
Also, adults should check with their doctor about exercise if they have:
These conditions can affect the way the body produces and uses energy.
Some movements are more comfortable to perform, and some are more gentle on the joints. Here are a few of the safest exercises to try this year.
Walking is the safest exercise because it is simple. This activity requires no training; you have already been practicing for years! It is safe, you don’t need any equipment, and you can walk almost anywhere. You can walk alone or make it a group activity. Walking only 30 minutes daily increases cardiovascular fitness, bone density, and weight management.
The next exercise, swimming, tops the list of safe exercises because it is “low-impact” on the joints. Swimming gets your heart rate up, builds muscle, and increases endurance. Water activities are great options to get in shape with low risk of injury.
Strength training eliminates contact injuries associated with other sports. The exercises are safe and effective for increasing your heart rate and muscle mass. Push-ups and sit-ups are examples of simple strength training exercises you can try. Use a spotter when lifting heavy weights or attempting new exercises for safety. Spotters also help you get the most out of your workout.
Here are some more tips for preventing an exercise-related injury:
For most people, exercise is safe. And it provides many health benefits. But physical activity can cause injury. If you are wondering what I’m talking about, here are some examples.
Traumatic injury is one type of exercise-related injury to avoid. Trauma is when there is physical injury to the body. A traumatic injury can affect joints, bones, or muscles.
To prevent this injury, ease into physical activity. Do not rush into an exercise without warming up, or work too hard. Doing this increases the likelihood of injuries like strains and sprains increases.
Overuse injury is a second type of exercise-related injury. Exercise stresses the body. When joints or muscle groups work too hard there is an increased risk of overuse injury.
This type of injury can also occur when your body does not have enough rest between activities. For this reason, it is important to get “rest days” in your exercise routine.
If you experience a trauma such as a fall, muscle strain, or contact injury during exercise, consider these interventions.
For strains and sprains, doctors recommend R-I-C-E, which stands for Rest, Ice, Compression, and Elevation. You should:
For discomfort, adults can take over-the-counter medications like acetaminophen, ibuprofen, or naproxen. Look for medications labeled “non-steroidal anti-inflammatory” because these reduce swelling pain.
Braces, splints, and slings support injuries and gives relief while also promoting healing.
To talk about starting an exercise program, or what activities might be right for you, talk with one of our board-certified physicians. You can click below to book an appointment. My Virtual Physician’s caring experts offer services to address your healthcare needs. If you have suggestions for other topics you want to read about, let us know! Don’t forget to follow us on social media!
Menopause is manageable. If you or someone you know is going through this stage of life, you may be wondering how to manage menopause.
Menopause is a natural process that many people associate with uncomfortable symptoms. Many women report mood swings, hot flashes, night sweats, and weight gain. Despite the unpredictability, menopause is manageable. With a basic understanding and simple lifestyle choices, women can thrive during this time.
How do you manage some of the common complaints? Well, it helps to start with a grasp on what causes this change.
Menopause is a time in a woman’s life when the menstrual cycle stops. During this period, the ovaries produce less of a hormone called estrogen. Changing hormonal levels affect many body processes.
Three phases make up the process of menopause:
Premenopause (“pre” means "before"): years before periods stop, estrogen levels decrease and periods may become irregular
Perimenopause (“peri” means "around"): the ovaries lower estrogen production, and periods stop; when a woman has not bled in 12 months, she has reached menopause
Postmenopause (“post” means "after"): after menopause, symptoms become milder and less frequent
Menopause generally affects women in their 40’s or 50’s. Studies show that the onset age of menopause is affected by many factors, including genetics (age the mother began menopause), the number of pregnancies a woman has had, body mass index (BMI), physical activity, and other factors. The average age for menopause in the United States is 52.
Symptoms may last during the postmenopausal time for up to four or five years, but they will become lighter.
Menopause varies among women. Yet, many report some common symptoms.
Empowering women with understanding about the natural process, and recommending lifestyle changes known to improve signs and symptoms, helps patients and their doctors manage menopause.
So, below you will find details about what causes these common complaints, and ways to manage them.
Mood swings happen with menopause because of changing hormone levels. Estrogen decreases during menopause. This important hormone relates to production and regulation of other key hormones such as serotonin, dopamine, and norepinephrine.
Serotonin is a mood-stabilizing hormone. Thus, fluctuating estrogen levels can lead to a disruption in serotonin production.
In other words, women in perimenopause may notice that they feel more emotional, sensitive, anxious, or worried.
To reduce or prevent mood swings, women should practice healthy habits, including:
Doctors believe that night sweats and hot flashes occur during menopause because of hormones. Estrogen and progesterone hormones help to regulate body temperature. During the natural process of menopause, when hormone levels change, many women find that they experience periods of feeling very hot to the point of sweating, even though their environment has not changed. Night sweats are episodes that occur while sleeping.
Hot flashes vary from seconds to minutes. They may happen once a day or 20 times in a day. Some women never experience them at all.
To deal with hot flashes, women could:
Weight gain is another common complaint of menopause. And it happens because, you guessed it, hormone changes. Estrogen plays an essential role in regulating fat storage. As estrogen levels go down during menopause, there are changes in the way the body stores fat. Also, for many women in their 40’s and 50’s, activity levels decrease, and metabolism slows. This triple whammy makes weight gain probable.
To prevent menopausal weight gain, women might consider:
Menopause symptoms generally become less intense and less frequent as time goes on. Some women may experience few or none at all. Yet, if you feel like your symptoms are severe or disrupt your life, you should talk to your doctor. There are other medical treatments, such as medications or hormone replacement therapies, available.
To talk with one of our board-certified physicians, click below to schedule an appointment. My Virtual Physician offers comprehensive OB/GYN services to address women’s healthcare needs. Our caring experts can treat menopausal signs and symptoms. If you have suggestions for other topics you want to read about, let us know! Don’t forget to follow us on social media.
If you have ever wondered if your blood pressure is normal, you are not alone. We know that maintaining readings in a healthy range can help prevent serious life-threatening conditions. So, is there a magic number for blood pressure?
There is no “magic number” for blood pressure, because readings are affected by many factors and can vary throughout the day. Rather, there are clinically defined ranges that doctors consider normal, elevated, or pathologic. A reading is considered "normal" when it is less than 120/80 mmHg.
Hypertension is a medical condition in which blood pressure is too high. The World Health Organization (WHO) says that over a billion people have hypertension, but fewer than one in five have the problem under control. So when does high blood pressure become hypertension, and how do we manage it? Read on to find out.
Blood pressure is determined by the force of the blood that is pumped from the heart into the body’s largest vessels, called arteries.
Readings are written as two numbers. The first or top number, called the systolic reading, should be less than 120. Systolic pressure measures the force inside the arteries when the heart contracts and pushes blood from the heart. The second or bottom number, called the diastolic reading, should be less than 80. Diastolic pressure measures the force inside the arteries when the heart is relaxed or resting, in between beats.
Both readings are measured in millimeters of mercury, written as “mmHg.” Depending on where, when, and how it is checked, you may get slightly different readings. Your numbers change throughout the day. This means that blood pressure readings must be evaluated over time.
According to the American Heart Association, a "good" reading is less than 120/80 mmHg. High blood pressure, or hypertension stage I, starts at 130/80 mmHg. At this stage, your doctor will probably recommend steps to try to lower your pressure. Interestingly, some doctors debate about these numbers, and at what point a patient should be treated.
What is undisputed, however, is that the risk of heart disease and stroke is doubled for each increase of 20 mmHg systolic and 10 mmHg diastolic. Keeping your number under 120/80 decreases the likelihood of health dangers including death.
Many factors affect your readings, including:
Regardless of what causes your high blood pressure, we know that over time it causes serious complications. Hypertension changes the walls of blood vessels. Damaged arteries and vessels stiffen and reduce blood flow. In other words, This process harms vital organs.
Many factors affect what your blood pressure reading is. Similarly, several things can lower your numbers.
The National Institute on Health (NIH) recommends the DASH diet. This eating plan, named the Dietary Approach to Stop Hypertension, gives guidelines for a balanced, heart-healthy diet. You can read more about the DASH eating plan here.
Cardiovascular activity strengthens the heart and can actually lower your systolic and diastolic pressures. The American College of Sports Medicine (ACSM) recommends exercise for prevention and treatment of hypertension. Find the guidelines here. The ACSM asserts that regular exercise can result in reduction of 5-7 mmHg which means a 20-30% risk reduction.
If you are overweight, losing weight will decrease your number. According to Cardiologist Dr. Matthew Alexander, even a 5-10 pound weight loss could lower your blood pressure by 5-20 mmHg.
Stress, anger, and fear-based emotions affect the cardiovascular system. Over time, chronic stress can lead to hypertension.
Practices such as biofeedback, mindfulness, and meditation counteract these feelings. Studies have shown the power of the mind to improve body function. For instance, recent research concluded that stress management therapies can decrease systolic pressure 6-10 mmHg.
If you have high blood pressure, or if you’ve already tried these suggestions to lower your numbers without success, it may be time to talk to your doctor. That is to say, doctors can prescribe a personalized treatment plan to get your readings into a safe range. In some cases, that plan includes medications. For example, there are many drug therapies available today, including diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), calcium-channel blockers, and more. A doctor can recommend the best treatment for you.
In summary, there really isn’t a “magic number” for everyone because many factors affect the reading. If you worry that yours is too high, be proactive in making lifestyle choices that are known to help lower blood pressure to a safe range.
To talk with one of our board-certified physicians, click below to schedule an appointment. My Virtual Physician offers healthcare services to address all of your healthcare needs. Our caring experts treat high blood pressure and can help with your medication questions. If you have suggestions for other topics you want to read about, let us know! Don’t forget to follow us on social media.
Vaginitis is an uncomfortable topic, in more ways than one. This common problem sends millions of women to their gynecologists each year. This means that it's likely that you or someone you care about will be affected. So what are the common causes and treatments of vaginitis?
Vaginitis is a condition in which the vaginal wall becomes inflamed. Women with vaginitis often report itching, burning, or a vaginal discharge. Common causes include changes in the normal pH balance of the vagina and infections. Vaginitis is curable, and treatment targets the source of the irritation.
Below you will find answers to the common questions about vaginitis. To learn about the common causes and treatments, read on.
Vaginitis is a term that means inflammation of the vagina. This irritation causes bothersome symptoms such as:
Vaginitis is a treatable condition that may last only a few days, or up to several weeks. It usually affects women during their reproductive years.
Vaginitis can be acute or chronic. Chronic vaginitis is rare, but can be caused by conditions such as postmenopausal atrophy or allergic dermatitis. About 85% of cases are related to one of the three major causes: bacterial vaginosis, Candida (yeast) infection, or Trichomoniasis infection.
Bacterial vaginosis (BV) occurs when there is an overgrowth of certain bacteria in the vagina. The body normally contains various microbes growing in a delicate balance. When the normal flora of the vagina are disrupted, some grow out of control and can change the pH balance.
Antibiotics, some body care products such as scented soaps and perfumes, and even sexual intercourse can cause BV because they can affect the body’s normal balance. Women with BV may show no symptoms at all, or they may have signs and symptoms of vaginitis.
In some cases, BV causes a green or yellow-ish discharge or fishy odor.
Yeast infections are an overgrowth of a fungus called Candida. Few of these yeast producing organisms are normally found in the vagina. However, when too many grow and disturb the natural balance, the vagina wall becomes irritated or inflamed. This can also create a thick, white vaginal discharge and itching.
Trichomoniasis is the most prevalent curable sexually transmitted infection (STI) in the world. It is caused by a microscopic parasite called Trichomonas vaginalis that affects women more often than men. Notably, only about 30% of infected individuals may not know they have it because they do not have any symptoms.
While symptoms may be uncomfortable, vaginitis does not usually cause long-term effects. The condition can, however, increase a woman’s risk for STIs, affect pregnancy, or contribute to negative post-surgical outcomes. For these reasons, it can be a serious condition and individuals who suspect they have vaginitis should see their doctor.
Care for patients with vaginitis begins with the patient’s history and examination. Then diagnostic testing may help determine the best course of treatment.
Wet mount microscopy is commonly used for diagnosis of vaginitis. In this test, a doctor may add a drop of saline to a sample of vaginal fluid and then look at it under a microscope. Clue cells, yeast, or trichomonads on the slide can lead to a diagnosis. In some cases, doctors may culture the sample to see what microbes are growing.
A gynecologist may test the vaginal pH using pH paper or test strip. PH levels vary slightly depending on age, but between 3.8 and 4.2 is considered normal. Some stores and websites sell pH test kits for at-home testing. If your pH level is abnormal and you have symptoms, talk to your doctor.
Medications can treat certain infections that do not go away on their own or those that keep coming back, called recurring infections. Metronidazole, tinidazole, or clindamycin are some of the common prescriptions.
Now that you know what vaginitis is, you are likely wondering how to prevent it. Here are some steps you can take to prevent infection, maintain pH balance, and reduce the risk of vaginitis.
Practice good hygiene. Wash daily with water and a gentle soap such as Aveeno fragrance free, Dial basics, or Dove sensitive skin bath bar. Keep skin clean and dry, especially after the gym. Dry your vagina with tissue after urinating.
Choose cotton undergarments. Cotton wicks away moisture and promotes air flow better than other fibers. This means it doesn’t trap heat.
Avoid douches, perfumes, and strong soaps in the vagina. These can alter the pH and irritate the vagina.
To talk with one of our board-certified physicians, click below to schedule an appointment. My Virtual Physician offers comprehensive OB/GYN services to address women’s healthcare needs. Our caring experts treat vaginitis, yeast infections, sexually transmitted infections, and more. If you have suggestions for other topics you want to read about, let us know! Don’t forget to follow us on social media.
Answer: Sort of. Acid reflux is the same as gastroesophageal reflux which just means that the contents of the stomach are backing up into the esophagus &/or mouth. Occasional reflux is completely normal and can happen to anyone, though usually it is following a meal and there are no real long-term consequences or bothersome symptoms and the episodes of reflux are short-lived. GERD on the other hand is Gastroesophageal Reflux Disease…so that means someone that suffers from GERD has bothersome reflux symptoms that can result in damage to the esophagus and their symptoms are typically a daily or somewhat routine occurrence. These symptoms include things like heartburn, regurgitation of food, and sometimes there is difficulty swallowing. Some people may have a persistent cough and nothing else.
Answer: It is actually a little complicated, but when you eat…food starts in your mouth where you chew it up and then when you swallow it goes into this long muscular tube which is your esophagus and that tube propels the food from your mouth to your stomach. At the end of the esophagus where it meets the stomach it has what we call the lower esophageal sphincter. It is essentially an area on the esophagus that compresses together and keeps stomach contents from coming back up into the esophagus and it has to relax and open up to let food into the stomach. This sphincter can weaken or not have as tight of a seal as normal and when that happens it does a really bad job at keeping things in the stomach…especially is you lay down right after you eat.
Answer: There are some foods that will trigger reflux symptoms in certain people and the more and more that happens the reflux will then progress to GERD. Some things related to increasing your risk of GERD include alcohol, smoking, caffeine, chocolate, certain medications, and so on. Being overweight is also a risk factor for the development of GERD. Studies have shown that losing weight improves reflux symptoms and frequency and can be a reason to undergo weight loss surgery if you are obese. Pregnancy increases your risk, but that usually resolves after delivery. And you can have something called a hiatal hernia which essentially means you have part of your stomach with or without the lower esophageal sphincter pushed up into your chest through your diaphragm which loosens sphincter tone.
Answer: Usually this can be diagnosed on history and symptoms alone if you have the usual symptoms of heartburn and regurgitation and that can usually be treated with a trial of PPIs or proton pump inhibitors which block the acid production in the stomach and see if that gives you relief of your symptoms. If you don’t have the usual symptoms or there is an indication that something more concerning may be occurring you will need some tests. These tests include an EGD (more on that next week…but it is a test where a doctor puts a camera on a long tube or scope into your mouth and looks at your esophagus and stomach), a 24 hours pH monitoring study where a little probe is placed in your esophagus so it can record how many times a day and at what time the pH in your esophagus changes due to the acid and what that number changes to, and also a manometry study which really just checks the pressure of your esophagus…like the whole thing…that helps make sure there is no problem with the way the esophagus moves food and it is in fact the lower sphincter pressure causing the problem.
Answer: It can be bad. Most people don’t have serious complications as long as they are treated. There are some serious complications that can happen if you have severe GERD and do not treat it. You can get a stricture in your esophagus which is scar tissue causing a narrowing or blockage. This can result in difficulty swallowing or food getting stuck in your esophagus. The process of ulcerations that heal over and over again causes this scar tissue and narrowing. You can have erosive esophagitis. This is when the acid causes ulceration in the esophagus and those ulcers can sometimes bleed. You may not vomit blood or see bleeding per se, but blood can be detected in your stool. You can also get Barrett’s esophagus which is where the cells in the lining of the esophagus change to a completely different type of cell from all the damage. The change in these cells can actually change further and develop into cancer. The acid can actually get into your lungs and cause asthma type symptoms or permanent lung damage and it can damage your teeth. Like I said, most people don’t have serious complications, but these complications are why it is so important to see your doctor and discuss your particular case with them and get treatment as soon as possible.
Answer: First and foremost…talk to your doctor. Everyone is different and should be treated as such. Common things work and should be done, but talk to your doctor to make sure you are treating the correct problem before you start trying to self medicate. There are some lifestyle things that can help like avoiding foods that you notice trigger your reflux, don’t eat close to bedtime, and try not to lay down after eating…try to eat several hours before you plan to lay down. You can lift the head of your bed up, but it involves more than just piling up pillows behind you, so really just try to avoid eating before bed. If you are overweight, try to lose weight. Not only for your overall health but like I said earlier, a lot of people have relief from their symptoms after they lose weight. Surgery is an option, but treatment with medication is always tried first because it is the least invasive option. Surgery does not come without its own complications. Talk to your doctor about taking a histamine blocker or PPI for any symptom relief before trying it on your own. Antacids like tums can help treat the minor symptoms, but if you find you’re using those a lot it’s time to see a doctor. If you feel like the reflux is getting worse or you start losing weight and you aren’t trying, or you feel like you’re choking you should also get to your doctor as soon as possible. If you’ve been treated and are still having symptoms then talk to your doctor about changing medication or what surgical options are available to you if you want to explore that option.
Advanced practice nurses work alongside physicians in many settings. As more facilities employ nurse practitioners to work with their doctors, you may wonder: is care improved by a collaborative approach?
The truth is that care is better when physicians and advanced practice registered nurses (APRNs) or nurse practitioners work together in a collaborative care model. When these professionals come together to treat the patient, the result is a synergistic effect that improves care outcomes and increases satisfaction.
To find out how, read on.
A care approach by a doctor and APRN team improves:
A recent article on collaborative care between physicians and nurses found that outcomes improves in many areas. To sum up, the results were better compliance, lower symptom severity, and fewer hospitalizations.
There are many reasons for these findings. Firstly, when doctors and nurses work together on a treatment plan, they complement each other. Each brings a different set of skills, knowledge, and background. Putting these two views together gives a better picture of the patient and how to treat them.
Physician and APRN teams provide a more comprehensive treatment plan that addresses more factors affecting health and illness than each one could alone.
Certainly, a team approach improves satisfaction in many ways. Patients, family members or caregivers, and the healthcare providers themselves report more contentment from this care model.
One reason for increased satisfaction is the focus on health promotion. Nurse practitioners provide education. They can counsel patients and families, and they even perform care coordination. Patients and families get great benefits from this added care management. It makes them feel they are getting better care.
Secondly, when APRNs work with physicians in outpatient settings, they help to increase efficiency and optimize patient care. For example, clinics or offices that use nurse practitioners are able to give patients more appointments. These care teams can make same-day visits, walk-ins, and extended hours possible. APRNs can provide routine health care services, while letting physicians to treat the more complex cases.
Healthcare continues to change. Read more about in our article here. More doctors and patients are focusing on preventative care, health, and wellness.
Meanwhile, factors such as a growing, aging population and increased access to care under the Affordable Care Act have helped create a greater demand for physicians. The workforce is not able to meet the need. Moreover, the physician shortage is expected to continue. Nurse practitioners are one of the answers to this crisis.
Working with doctors, nurse practitioners can diagnose and treat patients in many settings from hospitals to specialty clinics.
Nurses provide health promotion and education. Consequently, APRNs complement the care that physicians provide. They are an integral part of the healthcare team. The results of this doctor-nurse collaborative care model include improved health outcomes and increased satisfaction.
To talk with one of our board-certified physicians, click below to schedule an appointment. My Virtual Physician treats health conditions, provides routine screening, counseling, and more. If you have any suggestions for additional topics you want to read about, let us know! Don’t forget to follow us on social media.
Author: Jane Kaufman
Swag Bagz Inc is a New York City 501(c)3 nonprofit that gifts bags of self-care items to women in need.
Swag Bagz volunteers fill reusable fabric tote bags with items such as scented soaps and sanitizers, hand lotions, lip balms, essential oil roll-ons and decorative pouches filled with menstrual supplies.
Bags are distributed to women, predominantly low-income and women of color, at stressful and challenging or celebratory times in their lives. Swag Bagz Inc gives bags to women at domestic violence and homeless shelters, women visiting abortion clinics, and women graduating from career training and substance abuse programs, among others. They include transgendered women, LGBTQ individuals, and gender-nonconforming recipients as well.
This generous organization partners with other non-profit groups to reach these women.
The aim of Swag Bagz is to care for recipients by helping them care for themselves, and see themselves as worth caring for. For a woman in need, having a few attractive, scented items just for herself can bring joy. Also, they help her feel seen, acknowledged, and deserving.
Certain scents, such as lavender, have been shown to affect mood, cognition, and socialization in positive ways. We all like “free stuff.” Why should Hollywood celebrities be the only ones to get swag bags?
To donate or learn more about this organization, visit https://swagbagzinc.org/
Stefanie:
Welcome, everyone! Thank you for joining us today.
My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states.
Welcome to Talk Tuesday. We are continuing our weekly educational series, talking with our expert physicians, exploring some common healthcare concerns, and hopefully answering some questions you may have.
Today our physician expert is Dr. Salome Masghati, a practicing gynecologist and minimally invasive surgeon who is one of our telemedicine providers. We are talking about a complaint our doctors commonly see or treat, and that is URINARY TRACT INFECTIONS or UTIs.
Dr. Masghati, thank you for joining us today.
Stefanie:
So let’s cut to the chase Dr. Masghati, can cranberries cure a UTI?
Dr. Salome Masghati:
Many people believe that cranberries or cranberry juice can treat a UTI, and the answer is it's complicated.
There have been many studies on cranberries as a UTI treatment, and research has shown that an active ingredient in cranberries called “proanthocyanidins,” or PCAs for short, is effective in preventing E. Coli bacteria, the most common cause of UTI infections, from attaching to the bladder wall lining and colonizing or creating an infection.
So PCAs or cranberries may help prevent a urinary tract infection but once there is already an infection, that treatment may not be effective.
A cup of cranberry juice may only contain a small amount of this active ingredient with a lot of sugar! Cranberry tablets or pills may be another option for prevention.
Stefanie:
So if someone wants to try cranberry juice for prevention of a UTI, how much should you drink?
Dr. Masghati:
A recent article in Pharmacy Today recommends at least 36 mg of PAC daily.
For the prevention of UTIs, 300–500 mL of cranberry juice cocktail (26% cranberry juice) daily and 400–800 mg cranberry extract twice daily.
Or 36–72 mg of cranberry PAC equivalents per day, found in about 360–720 mg of cranberry extract, has been shown to be effective.2
The research shows some evidence that cranberry products may reduce the incidence of UTIs but the most effective amount and concentration of PACs that must be consumed and how long they should be taken are unknown.
Stefanie:
So cranberry juice and cranberry extract tablets together may help prevent infections but what about someone who already has a UTI?
Dr. Masghati:
Truly if someone has an infection, either their body will be able to fight off the infection, or they may need an antibiotic medication to kill the bacteria that is causing the infection.
Stefanie:
That’s interesting, so you say in some cases a UTI can go away on its own because the body is able to fight off the infection?
Dr. Masghati:
Yes, in some cases. Approximately 25-42% of the time these uncomplicated UTIs may resolve without any medical treatment.
Stefanie:
Ok, so when would it be time for someone to see a doctor about their UTI?
Dr. Masghati:
Untreated infections can spread and become serious. You should talk to your doctor as soon as you suspect a UTI.
Also for signs such as fever, chills, flank pain, or abdominal pain with nausea or vomiting. These can be signs of a serious infection.
Stefanie:
For someone who is going to make an appointment but has not yet, is there anything that they can do to manage the UTI?
Dr. Masghati:
There are some things you can do for relief, or even after you have seen your doctor while you are waiting for an antibiotic to work.
It is important to stay hydrated, drinking plenty of water flushes out the bladder.
When going to the bathroom it is important to try to empty the bladder completely. Some adults with UTI have a frequent urge to urinate or sensation of pressure in the low abdomen which can make it feel as though you need to urinate. Going to the bathroom frequently to empty the bladder can help.
If there is pain in the low abdomen a heating pad may provide some relief.
Over the counter pain relievers such as Motrin or Tylenol can also be taken to help with discomfort.
Stefanie:
Dr. Masghati you have shared some great information today. I appreciate you joining us for Talk Tuesday and helping us understand more about UTIs and cranberry juice. For everyone else joining us as well, this has been Talk Tuesday with MyVirtualPhysician. If you would like to connect with one of our board certified OB/GYNs, or for more information you can check out our website at www.myvirtualphysician.com. We look forward to seeing you again and we hope you have a great week.
A urinary tract infection can be painful and bothersome. Perhaps you’ve heard that drinking cranberry juice is a simple effective cure to treat the infection without the hassle of seeing a doctor. Is this the case?
Many people believe that cranberries, or cranberry juice, can cure a urinary tract infection (UTI). However, the truth is that while cranberries may help prevent recurrent infections, they are not an effective cure for a bladder infection.
If you’re wondering why this is so, and what you can do if you do have an infection, read on.
There have been many studies on the effects of cranberries in urinary tract infections. Research has shown that an active ingredient in cranberries called “proanthocyanidins,” or PCAs for short, can affect bacterial growth.
The most common bacterial cause of urinary tract infections is an organism called Escherichia Coli or E. Coli. This bacteria usually lives in the intestines of healthy humans and animals and most are not harmful, however some strains can cause infection.
PCAs found in cranberries can prevent E. Coli from attaching to the bladder wall lining. In other words, they can help prevent infection.
While PCAs found in cranberries can help prevent infection, it is important to note that a cup of cranberry juice may only contain a small amount of this active ingredient. Moreover, cranberry juice cocktail drinks are loaded with sugar. Cranberry tablets or pills may be a healthier option for prevention.
For UTI prevention, a recent article in Pharmacy Today recommended two options:
The research shows some evidence that cranberry products may reduce the incidence of UTIs but the most effective amount and concentration of PACs that must be consumed and how long they should be taken are unknown.
Urinary tract infections are common, affecting approximately 50% of adult women during their lifetime.
In some cases, simple urinary tract infections go away on their own. One study found that approximately 25-42% of uncomplicated UTIs resolve without any medical treatment. However, in other cases, the body’s immune system is not able to kill and eliminate harmful bacteria on its own. Doctors may prescribe antibiotics for infections that require treatment.
There are some things you can do for relief, or even after you have seen your doctor while you are waiting for an antibiotic to work.
It is important to stay hydrated, drinking plenty of water flushes out the bladder. When going to the bathroom it is important to try to empty the bladder completely. UTIs can cause frequent urges to urinate or pressure in the low abdomen. Going to the bathroom frequently to empty the bladder can help.
Heating pads may provide some relief of low abdomen discomfort. And over-the-counter pain relievers such as Motrin or Tylenol can also be taken to help with discomfort.
Untreated infections could spread and become serious. Talk to your doctor as soon as you suspect a UTI. These can be signs of a serious infection:
If you need treatment for a UTI or want to talk about your symptoms with one of our board-certified physicians, click below to schedule an appointment. My Virtual Physician treats conditions including urinary tract infections, other urinary problems, sexually transmitted infections, and more. If you have any suggestions for additional topics you want to read about, let us know! Don’t forget to follow us on social media.
Stefanie:
Welcome, everyone! Thank you for joining us today.
My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states.
It is Talk Tuesday and we are back with our weekly educational series, talking with our experts, exploring some common healthcare concerns that we see, and hopefully answering some questions you may have.
Today our physician expert is Dr. Daniel Kessler and one of our telemedicine providers. We are talking about coping with anxiety during the holidays.
Stefanie:
Well the holiday season is upon us and I know that this year has been challenging for many, so some people are already stressed or anxious and not looking forward to the holidays. Is it normal to have anxiety during this time?
Dr. Daniel Kessler:
It can be common to have feelings of anxiety during this time.
The Oxford dictionary defines anxiety as feelings of worry, nervousness, or unease, typically about an event or something with an uncertain outcome that may be coming. These can be normal and natural. Many people have these feelings from time to time. During the holidays, Americans may feel financial strain as it can be a season of shopping and gift-giving. They may have to come together with family members that they don’t often see or grieve separation from loved ones and relationships can be challenging or cause anxiety and worry. Many adults have unrealistic expectations for the holiday and that can create anxiety. And already busy schedules can feel the burden of holiday events and activities that can make you even more busy, anxious, or restless.
Stefanie:
That makes sense, the holidays can definitely cause anxiety, the worry, nervousness, or unease. So when is anxiety abnormal, or when is it a problem?
Dr. Kessler:
In some cases, those thoughts or feelings become intense and excessive, or individuals may become focused on common everyday events or situations that generally should not produce those feelings or at one time did not make the person feel that way. This type of anxiety usually causes physical symptoms such as sweating, racing heartbeat, or even weakness and feeling tired all the time.
This second more extreme sense of anxiety may be out of the norm, and may require evaluation by a healthcare professional.
Stefanie:
Are there other symptoms, other than the intense feelings you mentioned, that someone could look for or identify as signs that they should get help, or someone they know or care about should see a physician?
Dr. Kessler:
Symptoms of an anxiety disorder can vary from person to person so if someone is concerned they should talk to their doctor.
But some other signs or symptoms could include:
Stefanie:
So Dr. Kessler, these may be reasons to talk to your doctor about your anxiety. But for our listeners who may experience some mild feelings of stress or worry around the holidays, and maybe they are reluctant to talk to anyone about them yet, can you tell us about coping with anxiety, and specifically for coping with anxiety during the holidays?
Dr. Kessler:
Sure, There are definitely some steps you can take to manage mild anxiety.
Probably the most important thing is self care and self awareness. Many people overlook taking care of themselves during this season, which is often about giving to others. But you have to be aware of how you’re feeling, and take care of your mental and physical health during this time.
So here are 6 things that we can all do, to try to stay healthy and happy this holiday and keep anxiety at bay.
Number 1 - Adequate hydration
Don’t forget to drink 8-10 glasses of water each day. When you are dehydrated, you won’t feel your best. Also keep in mind drinks like coffee and alcohol may contribute to anxiety so it can be helpful to limit or cut out caffeine and alcohol for a time.
Number 2 - Good nutrition
Stress can cause changes in your metabolism, or how you burn energy. Skipping meals leads to spikes and drops in blood sugar that can wreak havoc on your system. It is important to eat regularly and maximize your nutrient intake with healthy foods. Taking a multivitamin won’t hurt either.
Number 3 - Get enough sleep
National Sleep Foundation guidelines say that the average adult needs seven to nine hours of sleep. Staying up late at holiday parties and getting up early to wrap presents can be detrimental to your health. Practice good sleep hygiene by setting a bedtime and sticking to it when you can.
Number 4 - Exercise
Studies show that physical activity is excellent for mental health. If you find yourself anxious or worried take a walk or a jog, practice yoga, whatever physical activity that you find enjoyable.
Number 5 - Stay connected to others
Social isolation can be a symptom of anxiety and may also trigger it. During the holiday season, make it a point to stay connected to family and friends. Communicate by phone or in person when possible. When separated from loved ones, look for settings where you can volunteer. Many charities offer opportunities to serve. Being with others can suppress feelings of anxiety or depression. It is helpful to share feelings with others and reach out when you can.
Number 6 - Be intentional with your schedule
Set boundaries with your time, and don’t feel about declining invitations if they cause stress, anxiety, or depression. Limit events that cause excessive worry. You want to be connected, but you also want to be selective in some way, and make the best of your holiday season. It can also be helpful to stick to your normal routine. Change can cause stress so just be aware of that.
Stefanie:
Thank you Dr. Kessler, you have given us some great tips for coping with anxiety during the holidays.
I appreciate you joining us for Talk Tuesday and telling us what we need to know about anxiety. For everyone else joining us as well, this has been Talk Tuesday with MyVirtualPhysician. If you would like to talk with one of our board-certified physicians about your health concerns, you can check out our website at www.myvirtualphysician.com. We look forward to talking with you again, and we hope you have a great week.
Much mistle-toeing and hearts will be glowing. It’s the most wonderful time of the year, right? For some, the holiday season brings to mind financial strain, complicated relationships, stressful schedules. The hustle and bustle of the holiday season cause worry for many. Coping with anxiety during the holidays can be a challenge.
Coping with anxiety during the holidays is essential to your mental and physical health. It is necessary to know how to cope with anxiety and depression and recognize when support or help may be needed to manage.
Here’s what you need to know.
The holiday season is upon us. It can be common and normal to have feelings of anxiety during this time. Financial pressures, excessive commitments, and unrealistic expectations can trigger stress, anxiety, or depression.
For some, the holidays are a time of memories, some good or some unpleasant. For those separated from loved ones, it can be a time of sadness or grieving. Many experience feelings of isolation and loneliness.
Furthermore, during the winter months, the days are shorter and less sunlight can cause seasonal mood changes.
Anxiety is defined as feeling worried or nervous that something terrible is going to happen. Many people have these feelings from time to time.
During the holidays, Americans may feel the financial strain as it can be a season of shopping and gift-giving. They may have to come together with family members who they don’t often see or grieve separation from loved ones, and relationships can be challenging or cause anxiety and worry.
Furthermore, many adults have unrealistic expectations for the holidays, and that can create anxiety. And already busy schedules can feel the burden of holiday events and activities that can make you even more busy, anxious, or restless.
In some cases, anxious thoughts or feelings can become intense and excessive.
Individuals may become overly focused on common everyday events or situations that should not produce fear or worry, or at one time did not make the person feel that way. This type of anxiety usually causes physical symptoms such as sweating, racing heartbeat, or even weakness and feeling tired all the time.
Signs and symptoms of an anxiety disorder could include:
This second more extreme anxiety may be out of the norm, and may require a healthcare professional evaluation.
Many people overlook self-awareness and self-care during this season that is often about giving to others. But don’t forget, it’s hard to pour from an empty cup. You must take care of your mental and physical health to give others your time, effort, and resources.
When unpleasant feelings of worry or restlessness seem magnified or more frequent, here are some things you should be doing to make sure you can effectively cope with anxiety during the holidays:
If you have tried these tips above and don’t feel any relief, or if you battle with intense anxiety that interferes with your daily life, it may be time to ask for help.
A primary care physician can talk to you about your anxiety or may recommend further treatment.
SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental or substance use disorders.
If you would like more information on anxiety or want to talk about your symptoms with one of our board-certified physicians, click to schedule an appointment. If you have any suggestions for additional topics you want to read about, let us know! Don’t forget to check out our weekly education series Talk Tuesday on our podcast page, and follow us on social media.
My Virtual Physician now offers virtual doctor visits in Las Vegas. Their telemedicine visits offer comprehensive services in the following areas:
In the middle of a pandemic, along with a cold and flu season, many residents fear going out in public. Due to high patient volume, Las Vegas physician offices are busy. In some cases, patients can't get an appointment with their physician when they need it... until now. Las Vegas residents can now conveniently access a virtual doctor with My Virtual Physician.
Patients emphasize the convenience of having an online doctor visit where they receive the personalize care they need, all from the comfort, privacy, and safety of their homes. Patients can skip the waiting rooms and old magazines and enjoy waiting for their appointment in their own home. When it comes time to talking with the provider, their doctor is ready to connect and focus with them one on one. My Virtual Physician can effectively treat the following gynecology conditions during an online visit:
Our patients rave about our primary care services. The virtual doctors at My Virtual Physician understand getting to know their patients, their medical histories, and the factors impacting health and wellness. With top-notch and on-demand Las Vegas primary care telemedicine services, My Virtual Physician can effectively treat patient health concerns involving:
Residents in Las Vegas, Nevada can schedule a virtual doctor appointment or choose a provider through a secure and fast online booking system. Our Las Vegas OBGYN accepts Medicaid. Contact us to learn more about our services!
Stefanie:
Welcome, everyone! Thank you for joining us today.
My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states.
It is Talk Tuesday and we are back with our weekly educational series, talking with our experts, exploring some common healthcare concerns that we see, and hopefully answering some questions you may have.
Today our physician expert is Dr. Daniel Kessler, Primary Care Physician, and one of our telemedicine providers. We are talking about a topic affecting one in ten Americans, Diabetes.
Dr. Kessler, thank you for joining us today.
Stefanie:
Let’s start by talking about Diabetes statistics. According to the American Diabetes Association, in 2018, 10.5% of Americans were estimated to have diabetes and about one-fifth of those were undiagnosed. Those are pretty significant numbers. Should people be concerned about diabetes?
Dr. Daniel Kessler:
Well that depends. We know about risk factors that can increase the likelihood of getting Type II diabetes. The CDC says you’re at risk for developing type 2 diabetes if you:
If you have non-alcoholic fatty liver disease you may also be at risk for type 2 diabetes.
So for individuals with risk factors, there should be some concern or at least awareness.
Stefanie:
So let’s talk about early detection. Why is it important? Why is early detection key in diabetes?
Dr. Kessler:
Early detection is key in diabetes because early treatment can prevent or at least slow serious complications. When a problem with blood sugar is found, doctors and patients can take effective steps to prevent irreparable damage to the heart, kidneys, eyes, nerves, blood vessels, and other organs.
An article in the Current Opinion in Endocrinology, Diabetes and Obesity journal recognized that there are many reasons why earlier detection of diabetes could be of benefit to the individual and the healthcare system, because it creates the opportunity to treat the high blood sugar.
Furthermore, undiagnosed diabetes is often associated with potentially-preventable, costly complications. ER visits and hospital stays can be expensive!
The base estimated cost of living with diabetes is around $9,600 per year. This includes prescription medications, diabetic testing supplies, doctors appointments, and routine care. This cost will be higher for uncontrolled or unmanaged diabetics who more care, more medications, more doctors appointments. Early detection can save thousands of dollars.
Stefanie:
So Dr. Kessler, for our listeners who may not be familiar with diabetes, can you tell us what a diagnosis of diabetes means? What is diabetes?
Dr. Kessler:
Sure, Diabetes is a metabolic disorder in which your body is not able to efficiently turn the food you eat into energy, leaving sugar to build up in the bloodstream. This creates two problems: the cells are not getting the sugar energy they need, and the sugar is accumulating in the blood. High blood sugar, known as hyperglycemia, causes damage to many tissues and organs of the body. This is why diabetes is a serious condition that can be dangerous.
Normally when you eat, your body breaks food down into glucose. As your blood glucose level rises, the pancreas releases insulin. Insulin is a hormone that tells body cells to let the glucose inside.
In diabetes, either your pancreas does not make insulin correctly, or your body cells do not react to the insulin the way they should. This means that the glucose stays in the blood, which is why diabetics experience high blood sugar, also known as hyperglycemia. Over time, hyperglycemia can damage nerves and blood vessels.
Stefanie:
I understand. And how do doctors know that the pancreas is not making insulin right or the body cells not reacting to the insulin?
Dr. Kessler:
Well, a blood test can determine if a person has diabetes. There are two tests commonly used.
A glycated hemoglobin test, known as a hemoglobin A1c (HbA1c) test, measures the glycated form of hemoglobin to determine the three month average of blood sugar. This blood test takes about a minute to perform, and results are generally available in two to three days. A normal HbA1c is below 5.7%. Prediabetes is 5.7 to 6.4%. A result of 6.5% or more is classified as diabetic. Another test doctors use to detect diabetes is a fasting blood glucose, or fasting blood sugar (FBS), test. This blood test measures the basal (base) sugar levels of the blood. Testing is usually performed in the morning after the patient has had nothing to eat or drink for eight hours or more. This test may take around ten minutes and results can be immediately available. A normal FBS is 70-100 mg/dl (3.9 - 5.6 mmol/L). An abnormal fasting blood sugar test may be repeated by the doctor or additional tests may be performed for confirmation of the abnormal blood sugar reading.
Stefanie:
And what these tests find, high blood sugar, can it go away? Can diabetes go away, or can early diabetes be cured?
Dr. Kessler:
Diabetes is a chronic condition which means it may not go away. It is possible, however, to reverse some of the effects of diabetes, and to even go into a remission state for those with Type II Diabetes. Remission in diabetes means that your blood sugar levels are within the normal range and you have not required medication to manage your blood sugar for six months or more.
Lifestyle changes like a healthy diet, daily exercise, and weight management can improve the way your body uses insulin, and can improve the prognosis for someone diagnosed with diabetes.
Stefanie:
Thank you Dr. Kessler, you have definitely helped me to understand diabetes better and how important it is for individuals to know their risk and talk to their physician to prevent problems and even get diagnosed and treated early!I appreciate you joining us for Talk Tuesday and telling us what we need to know about early detection in diabetes. For everyone else joining us as well, this has been Talk Tuesday with MyVirtualPhysician. If you would like to talk with one of our board-certified physicians about diabetic screening or your risk, you can check out our website at www.myvirtualphysician.com. We look forward to talking with you again, and we hope you have a great week.
In 2018, about 10.5% of Americans were estimated to have diabetes. Furthermore, about one-fifth of those cases were undiagnosed. It is important that individuals know their risk, and talk to their doctor about screening when it comes to diabetes. So, why is early detection key in diabetes?
Early detection is key in diabetes because early treatment can prevent serious complications. When a problem with blood sugar is found, doctors and patients can take steps to prevent permanent damage to the heart, kidneys, eyes, nerves, blood vessels, and other vital organs.
With simple tests for early detection, patients can make changes to reverse diabetes and even go into remission. Read on to learn more.
Diabetic care often focuses on treatment of the condition. While treatment is important, early detection increases the potential for effective changes early in the disease process.
An article in the Current Opinion in Endocrinology, Diabetes and Obesity journal recognizes that there are many reasons why earlier detection of diabetes could be of benefit to the individual and the health system, because it creates the opportunity to treat the high blood sugar and the risk factors for heart disease that often show up with diabetes. Individuals who don't know that anything is wrong may suffer long-term effects such as cardiovascular disease and stroke.
Furthermore, undiagnosed diabetes often results in potentially preventable, costly complications. Hospital stays could be avoided if patients are aware of their illness and work to manage it.
Diabetes can be expensive. The estimated cost of living with diabetes is around $9,600 per year. This covers prescription medications, diabetic testing supplies, doctors appointments, and hospital care. Medical expenses rise drastically when emergency room visits are needed for unmanaged diabetic complications.
Diabetes is a disease in which your body is not able to efficiently turn the food you eat into energy. Sugar then builds up in the bloodstream. Therefore, two problems arise: the cells are not getting the energy they need, and sugar is accumulating in the blood. High blood sugar, known as hyperglycemia, causes damage to tissues and organs of the body. That is to say, this is why diabetes is a serious condition that can be dangerous.
Normally when you eat, your body breaks food down into sugar molecules, called glucose. After that, the particles get into the bloodstream and your blood glucose level rises, signaling the pancreas to release insulin. Insulin is a hormone that tells body cells to let the glucose inside.
In diabetes, either your pancreas does not make insulin correctly, or your body cells do not react to the insulin the way they should. As a result, glucose stays in the blood, which is why diabetics experience high blood sugar, also known as hyperglycemia. Over time, hyperglycemia can damage nerves and blood vessels.
A blood test can determine if a person has diabetes. Doctors commonly use two tests to check for diabetes.
A glycated hemoglobin test, known as a hemoglobin A1c (HbA1c) test, measures the glycated form of hemoglobin to determine the three month average of blood sugar. This blood test takes about a minute to perform, and results are generally available in two to three days. A normal HbA1c is below 5.7%. Prediabetes is 5.7 to 6.4%. A result of 6.5% or more is classified as diabetic.
Another way a provider can use a blood test to see if you have diabetes is a fasting blood glucose, or fasting blood sugar (FBS), test. This blood test measures the basal (base) sugar levels of the blood. Testing is usually performed in the morning after the patient has had nothing to eat or drink for eight hours or more. This test may take around ten minutes and results can be immediately available. A normal FBS is 70-100 mg/dl (3.9 - 5.6 mmol/L). The doctor may repeat the fasting blood sugar test or order additional tests to confirm an abnormal blood sugar reading.
Diabetes is a chronic condition which means it may not go away. It is possible, however, to reverse some of the effects of diabetes and go into a remission for those with Type II Diabetes. Remission in diabetes means that your blood sugar levels are within the normal range and you have not required medication to manage your blood sugar for six months or more.
Lifestyle changes like a healthy diet, daily exercise, and weight management can improve the way your body uses insulin and can improve the prognosis for someone diagnosed with diabetes.
Diabetes is a global health problem. Health officials expect that rates will only continue to increase. Risk factors such as family history of diabetes, obesity, and sedentary lifestyle increase likelihood that you may get diabetes and so it is important to be proactive in your health and talk to your doctor about your risk for diabetes. .
If you would like more information on diabetic screening, or want to talk about your risk with one of our board-certified physicians, click to schedule an appointment. My Virtual Physician treats conditions including hyperglycemia, diabetic screening, counseling and more. If you have any suggestions for additional topics you want to read about, let us know! Don’t forget to check out our podcasts for more and follow us on social media.
Colagiuri, Stephen; Davies, Daniel The value of early detection of type 2 diabetes, Current Opinion in Endocrinology, Diabetes and Obesity: April 2009 - Volume 16 - Issue 2 - p 95-99 https://doi: 10.1097/MED.0b013e328329302f
Harris, M. I., & Eastman, R. C. (2000). Early detection of undiagnosed diabetes mellitus: a US perspective. Diabetes/metabolism research and reviews, 16(4), 230–236. https://doi.org/10.1002/1520-7560(2000)9999:9999<::aid-dmrr122>3.0.co;2-w
Narayan, K. M., Chan, J., & Mohan, V. (2011). Early identification of type 2 diabetes: policy should be aligned with health systems strengthening. Diabetes care, 34(1), 244–246. https://doi.org/10.2337/dc10-1952
Stefanie:
Welcome, everyone! Thank you for joining us today.
My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states.
It is Talk Tuesday and we are continuing our weekly educational series, talking with our experts, exploring some common healthcare concerns that we see, and hopefully answering some questions you may have.
Today our physician expert is Dr. Salome Masghati, a practicing gynecologist and minimally invasive surgeon and one of our telemedicine providers. We are talking about a problem that may affect one in ten couples at some point, Infertility.
Dr. Masghati thank you for joining us today.
Let’s start by talking about what is Infertility?
Dr. Masghati:
Infertility is a diagnosable medical condition in which a couple has been unable to conceive a pregnancy despite unprotected intercourse.
Stefanie:
Can you tell us some of the causes of Infertility?
Dr. Masghati:
Infertility in women can have many different causes, such as abnormal ovulation, pelvic inflammation, endometriosis, hormone abnormalities, tubal scarring etc. Infertility in men is commonly caused by problems with sperm cells. Aside from these physiological causes, factors affecting fertility can include age, health status, and lifestyle factors such as stress, diet, or smoking. They work to keep you healthy later if you are exposed to a live virus. Marijuana use and heavy drinking have also been shown to cause decreased sperm motility in men.
Stefanie:
So when should a couple seek a medical opinion about getting pregnant? Is there a time frame, say?
Dr. Masghati:
The general rule of thumb is one year for women under the age of 35, and for women over the age of 35 they might seek a medical opinion sooner, after maybe six months of trying to get pregnant. Other reasons to see a doctor when planning a pregnancy might include history of miscarriages, men who have trouble maintaining erection or women with irregular menstrual cycles. Also couples who have had sexually transmitted infections and are now unable to conceive a pregnancy may need to see a doctor, and individuals who have been exposed to toxic chemicals or chemotherapy as in the case of a childhood cancer or something of that nature.
Stefanie:
When couples seek help for infertility concerns, what can they expect?
Dr. Masghati:
Usually the doctor will start with a history and physical, and then they may order blood or urine testing, hormone testing. The doctor may evaluate both partners to try to determine if there are any abnormalities, and then they will go over test results and recommendations with you. Some of these tests can be ordered by me through My Virtual Physician visits, but some need to be followed up in person with a physician in the office.
Stefanie:
And after this evaluation, what sort of treatment options might be recommended, or are available?
Dr. Masghati:
There are medications available for men and women that can increase chances of getting pregnant. Intrauterine insemination, or IUI, is a procedure in which a physician can insert sperm into the uterus at the time of ovulation to help with conception. And for other cases, fertility specialists may offer in vitro fertilization, known as IVF, which is a surgical procedure in which a woman’s eggs are retrieved, fertilized, and then transferred back into the woman’s uterus.
Stefanie:
What is the success rate of a procedure like in vitro fertilization?
Dr. Masghati:
Women under the age of 35 can expect about a 50% success rate for in vitro fertilization, but it is a very complex process that requires intense testing and monitoring and can be costly, anywhere for $20,000 - $50,000.
There is also the possibility to address infertility issues through functional medicine, which is a type of medicine where we look at the patient in a more holistic approach. Functional medicine and integrative medicine can be helpful to couples who have been unable to conceive.
Stefanie:
Dr. Masghati, you have shared some great information today and answered questions that I think many couples may have on their minds. I appreciate you joining us for Talk Tuesday and telling us what we need to know about infertility. For everyone else joining us as well, this has been Talk Tuesday with My Virtual Physician. If you would like to connect with one of our board-certified OB/GYNs, or for more information, you can check out our website at www.myvirtualphysician.com. We look forward to seeing you again and we hope you have a great week.
Starting a family is a goal for many couples. Unfortunately, one in ten couples may have some difficulty getting pregnant and require medical treatment. If you've been affected, you might be wondering about infertility: when is it time to see a doctor? My Virtual Physician has board certified physicians who specialize in infertility and are available for virtual doctor visits.
Infertility is a diagnosable medical condition in which a couple cannot conceive a pregnancy despite unprotected intercourse. It can be caused by many factors.
In women, most often, abnormal ovulation causes infertility. In men, usually problems with sperm cells, such as sperm count or function, cause difficulty conceiving.
Aside from these physiological causes, factors affecting a couple's fertility include their age, health status, and lifestyle factors such as stress, diet, or smoking.
According to the American College of Obstetricians and Gynecologists, women who are overweight, underweight, or exercise too much may have difficulty getting pregnant, and men who are heavy drinkers or smoke marijuana since these are known to lower sperm count and movement.
In some cases, doctors cannot determine the cause and refer to these cases as unexplained infertility.
Generally, it is time to consult your physician about getting pregnant if you are under the age of 35 and have been unable to conceive after one year of unprotected sex. Women over the age of 35 and those who have irregular menstrual cycles or have known abnormalities with their reproductive system, should talk with their doctor much sooner, after six months.
Infertility affects both people in the relationship. There is a 30% chance the infertility is related to male factors in a traditional couple, 30% related to female factors, and a 30% chance a combination of both factors. Therefore, anyone in the relationship may need to discuss options for starting a family. Here are some reasons to see a virtual doctor:
When you consult your physician about infertility, you can expect that they will begin your care with a complete history and physical exam. They may order blood testing, urinalysis, hormone tests, or other diagnostics to check for abnormalities. It may be necessary to have your partner undergo an exam and diagnostic testing also. Your physician may order an ultrasound or an X-ray as well.
After all of the tests, you will meet with your physician to discuss the results and go over treatment options and recommendations. After you decide on the treatment plan that is best for you, you will receive support and guidance in your process to get pregnant.
Medical treatment and new technologies can increase your chances of getting pregnant. One or both partners in a couple may undergo treatment.
Medications may be taken by mouth or injected. There are drug therapies for both men and women aimed at increasing egg production or sperm count. A list of medicines frequently prescribed for infertility treatment can be found here.
In some cases, blockages, scar tissue, or abnormal growths require surgical intervention. Procedures may be laparoscopic: meaning performed through small incisions in the abdomen for a minimally-invasive procedure.
Today, the two most common infertility treatments are intrauterine insemination (IUI) and in vitro fertilization (IVF).
IUI is a procedure during which a physician injects sperm into the uterus at the ovulation time. This method is least invasive and most cost-effective but has lower success rates. The estimated success rate is 10-20% for a single cycle of IUI, but additional rounds increase chances, and in three to six cycles, the success rate is up to 80%.
IVF is a complicated procedure requiring surgical retrieval of a woman's eggs, fertilization in a laboratory, and then transferring the fertilized eggs back into the uterus. Women under the age of 35 can expect a 50% success rate for IVF treatment, but this process requires intense testing and monitoring and can cost $20,000 to $50,000.
Starting a family can be challenging, and your physician may offer options to guide you through the process. Infertility is a medical condition that affects many couples, and there are treatments available.
Need to talk to a physician now? My Virtual Physician has Board-Certified OB/GYN's that are available for virtual doctor appointments and are able to answer any questions you have and guide you in the right direction. The online doctors at My Virtual Physician, not only address infertility and reproductive endocrinology, but also irregular periods and painful periods, and many more gynecological conditions.
If you still have questions or you would like to discuss your problem with our board-certified OB/GYN specialists, click below to schedule an appointment. My Virtual Physician treats conditions, including infertility, irregular periods, sexually transmitted infections, and more. If you have any suggestions for additional topics you want to read about, let us know! Don’t forget to check out our podcasts for more and follow us on social media.
It affects up to one in five adults, and it is a common ailment diagnosed by primary care physicians and specialists. Moreover, it can be a real pain in the neck, or chest rather. I'm talking about gastroesophageal reflux. This big word does not have to be a big deal. Simple lifestyle changes and, in some cases, medication can treat it. So just what is gastroesophageal reflux?
Gastroesophageal reflux is the backflow of acid and other contents from your stomach into the tube the connects the stomach to your mouth, called the esophagus. This reflux can occur naturally on occasion, but when it happens frequently, it can cause problems.
When the backwash of acid and undigested food particles flows back out of the stomach, it can damage the lining of the esophagus. You see, the stomach has a protective lining inside that protects the underlying tissues from the strong stomach acid and other substances that you may eat. Unfortunately, the esophagus does not have that same protection. The harsh back-flow can eat away the esophagus' smooth muscle tissue.
There is a valve at the bottom of your esophagus where it connects to the stomach. It is called the lower esophageal sphincter, or LES. This LES closes after food enters the stomach to prevent it from coming back up. Additionally, your diaphragm is a muscle above the stomach that also helps to support the valve. Sometimes the sphincter relaxes, and stomach contents can escape.
Normal reflux can occur after meals and does not last long. This event rarely occurs when lying down or during sleep.
Abnormal reflux lasts longer and causes troublesome symptoms. Many report feeling discomfort at night when they lay down, rather than just after meals. Chronic reflux causes damage to the digestive system tissues.
If you suspect that you have abnormal reflux or gastroesophageal reflux disease, read on to learn what you can do about it and where to find a quiz to see if you might have reflux.
Gastroesophageal reflux disease (GERD) is caused by the reflux of stomach acid and contents into the esophagus. This condition is related to several factors:
Proton pumps in the stomach wall create enzymes which make stomach acid to break down the food we eat. When they overproduce, reflux is more likely to occur. Coffee is known to increase stomach acid production. Stress also increases stomach acid production. Therefore these can be risk factors for GERD.
The lower esophageal sphincter (LES) closes off the bottom of the esophagus to prevent back-splash. When the muscle tone is relaxed, then the door is not fully closed, and juices can seep back out of the stomach. Smoking and drinking alcohol and caffeinated beverages both contribute to decreased LES tone. These are also risk factors for GERD.
Furthermore, chocolate and mint are known to relax the lower esophageal sphincter.
Moreover, pregnant women have increased progesterone levels. This hormone affects the LES as well.
Two factors that cause increased intra-abdominal pressure are obesity and pregnancy. These both put pressure on the abdominal organs and can lead to gastroesophageal reflux.
An article published in the Gastroenterology Clinics of North America found that obesity, defined as a BMI > 30, was a significant risk factor for reflux and esophagitis (inflammation of the esophagus). The study showed that over one-fourth of participants had weekly reflux symptoms.
A recent study on GERD in pregnancy showed that over 50% of women report reflux symptoms while they are expecting. This can be related to hormonal changes in pregnancy slow digestion and delay stomach emptying.
Reflux can be aggravating and cause symptoms such as:
Less likely but possible signs and symptoms include:
Knowing what we know about reflux and how it happens, there are some simple lifestyle changes you can make if you are suffering from GERD signs and symptoms.
Choose small proportions. Avoid high-fat meals because the fats require the stomach to produce more acid and take longer to digest. Spicy foods (like tomatoes and oranges) can also aggravate reflux.
Maintain a healthy weight.
Sleep habits: Firstly, also avoid eating within three hours of bedtime. Do not lie down after eating. Give your body time to digest the meal.
It can also be helpful to raise your head while resting to let gravity keep the stomach contents down. You can use extra pillows or even raise the head of your bed six to eight inches with bed risers or blocks.
Avoid toxins that could be aggravating your digestion, such as nicotine, alcohol, or excessive caffeine]
Over the counter proton pump inhibitors (PPIs) decrease stomach acid production and may provide some relief. Available options include:
Warning: Do not take these for more than 14 days without talking to your doctor.
There are some urgent signs and symptoms that warrant immediate medical attention. You should call your doctor or seek urgent care for these:
Less serious signs and symptoms that could be related to reflux but should be checked out by a doctor include:
Now that you know what is gastroesophageal reflux, you can make an informed decision about when it is time to talk to your doctor. If you would like to see if you might be suffering from GERD, take this online quiz by the American College of Gastroenterology.
If you still have questions or you would like to discuss your problem with a top-rated doctor, click to schedule an appointment. My Virtual Physician treats conditions, including heartburn, upset stomach, and more. And if you have any suggestions for additional topics that you want to read about, please let us know! And don’t forget to check out our podcasts for more! Share and follow us on social media.
Chang, P., & Friedenberg, F. (2014). Obesity and GERD. Gastroenterology clinics of North America, 43(1), 161–173. https://doi.org/10.1016/j.gtc.2013.11.009
Ramya, R. S., Jayanthi, N., Alexander, P. C., Vijaya, S., & Jayanthi, V. (2014). Gastroesophageal reflux disease in pregnancy: a longitudinal study. Tropical gastroenterology: official journal of the Digestive Diseases Foundation, 35(3), 168–172.
With much focus on the coronavirus this year, don't forget about another viral infection that threatens your health. Each year the Influenza virus affects 5-20% of Americans. This illness puts millions at risk of lost work and sick days, medical expenses, and possible health problems. A flu shot lowers that risk. You may be wondering, should you get a flu shot?
The Center for Disease Control and Prevention (CDC) recommends that everyone over the age of six months should be vaccinated against the flu virus this year. With a few exceptions, Americans need their shots around October or in early fall.
Many people worry about just how the flu shot will affect them. If you're one of these, keep on reading to find out what you should know about getting vaccinated this year.
The American Academy of Family Physicians (AAFP) recommends a yearly flu shot for everyone over six months old. This is because the flu vaccine can safely and effectively prevent severe illness.
Flu vaccines contain dead or weakened forms of the Influenza virus. Your cells begin to build up a natural defense system when they receive these parts of the virus. Then, your body creates antibodies. These proteins help your body fight infection. Antibodies work to keep you healthy later on if you are exposed to the flu virus.
The Journal of the American Medical Association (JAMA) recently looked at the best time to get your flu shot. In their study, researchers found that the U.S. flu season usually starts in December. After a flu shot, your body takes about two weeks to build up a response to the vaccine. Therefore, flu shots give the most protection when given in the fall, around October.
Vaccination is safe. Doctors have recommended flu vaccines for over 50 years. Over this time, a lot of research has evaluated the effectiveness and safety of immunizations. Certainly, the risk of serious reactions is low. Furthermore, manufacturers demonstrate the safety of their drugs before the FDA gives their approval.
The Advisory Committee on Immunization Practices (ACIP) warns some individuals to talk to their doctor about the flu shot if they have certain contraindications. This means a specific situation, condition, or factor that could make a treatment unsafe or even harmful.
For instance, egg allergy prevents some from getting a flu shot. This is a contraindication because manufacturers use eggs to make the vaccine. Therefore, the flu shot may contain trace amounts of ovalbumin (egg protein).
In addition to contraindications, there are precautions for some individuals. For example, those with a history of Guillain-Barre Syndrome or who have an illness with fever may want to discuss vaccination with their doctor.
The flu shot may cause reactions. These are typically mild and go away within 48 – 72 hours. They may include:
In some cases, more severe reactions occur. These could be signs of a rare allergic reaction to the vaccine. If these signs or symptoms arise, you must seek medical attention right away:
The risk of not getting vaccinated is getting sick. You could miss work or school, incur medical costs, or suffer mild to moderate health complications.
Most healthy adults deal with a minor case of the flu virus by staying home and taking over the counter medication to ease symptoms. The infection generally lasts 7-14 days.
On the other hand, those considered "high-risk" could suffer much more serious cases. Some possible complications include hospitalization and even death. Here are some factors that put you in the high-risk category:
In conclusion, you and your healthcare provider will decide if a flu shot is right for you. You must talk with your physician about your past history and risk factors to decide whether or not to be vaccinated.
Talk to your physician if you still have questions about the influenza vaccine. They can help you with additional information.
If you still have questions or you would like to discuss your medical condition with a specialist, click below to schedule an appointment. MyVirtualPhysician treats conditions like the common cold, flu-like illness, and more. If you have any suggestions for additional topics you want to read about, please let us know! Don't forget to follow us on social media.
Rubin R. Is It Possible to Get a Flu Shot Too Early? JAMA. 2018;320(22):2299–2301. DOI:10.1001/jama.2018.18373
Perhaps you know the feeling, that dull gnawing pain in your stomach. It could be a peptic ulcer. But maybe you are unsure about when to you see a doctor. Here is some helpful information if you’ve found yourself wondering, just what are peptic ulcers?
Peptic ulcers are sores or blisters that develop in the lining of the esophagus, the stomach, or the intestine. They can occur when the body’s natural protective lining is worn away or stops functioning properly and the underlying tissue is damaged.
So why does this happen and what should you do about it? Read on to find out.
An ulcer is an open blister or a sore. The term “peptic ulcer” describes one of these lesions located in the lining of the digestive system, also known as the gastrointestinal (GI) system.
Doctors commonly refer to peptic ulcers according to where they are located:
A normal healthy digestive system is lined with a protective mucous barrier. This mucosal lining prevents harmful substances such as acidic beverages, medication ingredients, and even stomach secretions from damaging the tissues underneath. Sometimes, this physical barrier is compromised and part of the GI tract is irritated.
Peptic ulcers form when the body’s natural protective mucus lining is worn away or is not functioning correctly.
The most common cause is a bacterial infection by Helicobacter Pylori or commonly known as H. Pylori. This organism grows in the stomach lining causing irritation that can prevent it from healing. Ulcers related to H. Pylori infection are seen more commonly in developing nations, but are seen here in the U.S. as well.
Another leading cause of gastric ulcers is the use of non-steroidal anti-inflammatory medications, known as NSAIDs, because these contain ingredients known to irritate the stomach lining. Recent research has found that aspirin users are twice as likely to develop stomach ulcers.
Other risk factors for developing these ulcers are lifestyle factors such as drinking alcohol, smoking cigarettes, and physiologic stress. These can impair the body’s natural defense.
Some patients experience epigastric pain that is the classic sign of a GI ulcer. Many patients describe the discomfort as a dull, gnawing sensation or even a burning in your abdomen. Some individuals may also associate the onset of pain with eating a meal. Meanwhile, others report symptoms including nausea, feeling bloated, or not being able to eat a full meal.
A recent study in the American Journal of Medicine reports that as many as two-thirds of individuals with peptic ulcer disease may not even have any signs or symptoms.
An endoscopy test passes a camera through the GI tract to look for ulcers. This is the best way to diagnose a peptic ulcer.
Talk to your doctor if you think you might have a peptic ulcer. They can treat you and may recommend medications. The most effective treatment today is proton pump inhibitors or PPIs. Usually, they are taken just once in the morning, these are a relatively safe therapy and there are many available over the counter. For example, you may recognize names such as Nexium or Prilosec.
Your physician may also prescribe other drugs to treat your condition such as antibiotics for an infection. Additionally, they can also make recommendations to reduce symptoms.
If you have been diagnosed with an ulcer already then there are a few more signs to be alert for. Serious complications of peptic ulcers include gastrointestinal bleeding or even perforation or tearing of the lining. Signs of these would require urgent medical attention and are reasons to go to an emergency room:
Pain, the classic symptom associated with a stomach ulcer, may or may not be a peptic ulcer. This means that if you have abdominal pain that is bothering you, let your physician know about it. Then they will discuss your symptoms, as well as the best treatment for you.
If you still have questions or you would like to discuss your problem with a specialist click below to schedule an appointment. MyVirtualPhysician treats conditions including abdominal pain, upset stomach, and more. If you have any suggestions for additional topics you want to read about please let us know! Don’t forget to follow us on social media.
Kavitt, R. T., Lipowska, A. M., Anyane-Yeboa, A., & Gralnek, I. M. (2019). Diagnosis and Treatment of Peptic Ulcer Disease. The American journal of medicine, 132(4), 447–456. https://doi.org/10.1016/j.amjmed.2018.12.009
Lukáš M. (2018). Therapy for peptic ulcer disease. Terapie peptického vředu. Vnitrni lekarstvi, 64(6), 595–599.
Narayanan, M., Reddy, K. M., & Marsicano, E. (2018). Peptic Ulcer Disease and Helicobacter pylori infection. Missouri medicine, 115(3), 219–224.
