Search Here
Stefanie (00:00):
The information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics address on talk Tuesdays or for any other medical problem.
Stefanie (00:41):
Welcome everyone. Thank you for joining us today. My name is Stefanie and I'm part of the team here at my virtual physician. We are direct to consumer multi-specialty telemedicine provider operating in multiple States. It's talked to is eight, and we are continuing our weekly educational series to talk with our experts, explore some common healthcare concerns that we see and hopefully answer some questions you may have today. Our physician expert is dr. Coleman. She is a general surgeon, and today we're going to talk about the flu vaccine. So Dr. Coleman, thanks for joining us again.
Dr. Coleman (01:14):
Thanks for having me back. Um, let's start by talking about current recommendations. What was the guideline for vaccination? Again, the center for disease control and prevention, or the CDC recommends that everyone over the age of six months be vaccinated against the flu virus. This year, Americans should get their flu shots around October. So I think now also the American Academy of family physicians recommends a yearly flu shot for everyone over six months old as well. This is because it can safely and effectively prevent severe illness from the flu. Okay.
Stefanie (01:50):
So you said the flu vaccine is safe. Can you talk more about that?
Dr. Coleman(01:54):
Yeah, so the flu vaccine contains either a dead or weakened form of the influenza virus. So when your body receives that part of the virus, it begins to build up some natural defenses and create antibodies. The antibodies are proteins in your body that help you fight off infection. They work to keep you healthy later if you're exposed to the actual live influenza virus. So it gives you a little, little part of the actual virus for your body to get familiar with and fight off. So vaccination is safe. Healthcare providers that administered flu vaccines for well over 50 years, over this time, there's been a lot of research to evaluate the effectiveness and safety of immunizations. So certainly there are some risks involved to certain people, but the risk of any life-threatening reactions is actually very small and manufacturers have demonstrated the safety of their drugs before being administered by getting FDA approval. Okay. So when would it not be safe to get a flu shot or who should not get a flu shot? Yeah, so the advisory committee on immunization practices or the ACP warns some individuals to talk to their doctor about getting a flu shot. If they have certain contraindications, this means specific medical conditions or particular situations that could make treatment unsafe or, or even harmful. So for instance, someone that has an egg allergy would prevent you from getting a flu shot because eggs are used in the manufacturing of the vaccine. So the, the flu shot may contain some trace amounts of egg protein. And if you're, you know, if you get an Anna Filactic reaction to eggs, you obviously don't want to inject yourself with something that's made with eggs.
Dr. Coleman (03:50):
So in addition to egg allergies, there's some other contraindications. So anyone that's had ganbare syndrome should discuss having any vaccinations with their physician before proceeding forward with the flu vaccine. And then if you've, if you've recently been sick, if you've had a pretty severe illness or you've had a really high fever, you probably shouldn't get a flu shot, right. Then, um, you should, you should get over whatever sickness you have going on before you get a flu shot to this may make you any better. Yeah. So just wait until you're healthy to get the flu shot.
Stefanie (04:29):
Um, that's, that's good information. So if it's safe for you to get a flu shot, are there any risks may cause some reactions they're typically mild and they usually go away within 48 to 72 hours. Usually they include things like injection site soreness. I just had my flu shot done last week and it hurts. I mean, I know it's, it's hard to move your arms sometimes. Uh, some people will get headaches, muscling, and a low grade fever, all completely normal, but things to be aware of, sometimes you can have more severe reactions and these could be signs that you have an allergy to the vaccine. If these signs and symptoms arise, then, then you need to seek medical attention right away. And that would be things like wheezing or difficulty breathing, any skin reaction or hives. Uh, so you may have a little bit of redness around the injection site, but if your whole arm turns red or you break out in a rash everywhere, where you have hives all over your body, that's a little concerning and you should go see somebody, any dizziness, weakness, or feigning that, you know, you can't really explain by, you stood up too fast or you haven't been drinking enough water, things like that.
Dr. Coleman (05:45):
If it, if it's related to when you got your flu shot, then that would be something you should go see somebody about. Awesome. Thank you. So what are the risks associated with not getting vaccinated? So not to means you're at risk of getting sick with the flu. You could miss school. If you're a student medical costs, if you have to go into the hospital or, or see your doctor more frequently, most healthy adults can deal with a minor case of the flu by staying home, taking some over the counter medications for symptoms and they'll, there'll be okay. It usually lasts about seven to 14 days. If you get vaccinated, theoretically, it reduces your risk of getting sick with the flu. It all sort of depends on what strain of the flu is going around and what, which one the vaccine contains. So you could still get sick with the flu, even if you get vaccinated, but it decreases your risk of getting sick.
Stefanie (06:49):
Got it. And what about more serious complications like being hospitalized? Is it possible to require hospitalization from the flu? It is possible. So those people that are considered high risk could suffer a much more serious cases of the flu. Some possible complications include and even death. Uh, some of the factors that put you in the high risk category would be anyone that's over the age of 60 pregnant women, children under the age of 12 and any individual that has underlying health conditions, such as heart disease, HIV, asthma, diabetes, things like that. Awesome. Well, thank you, dr. Coleman, you have shared some great information today and answered questions that I think many Americans have on their mind, especially with flu season, right around the corner. I appreciate you joining us or talk Tuesdays and telling us what we need to know about the flu vaccine for everyone else.
Stefanie (07:47):
Joining us as well. This has been Talk Tuesdays with my virtual physician. If you would like to schedule a consultation with one of our doctors or for more information, you can check out our website at www.myvirtualphysician.com. We look forward to seeing you again. We hope you have a great week. Thanks again, dr. Coleman, the information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics address I'm talk Tuesdays or for any other medical problems.
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.
Stefanie (00:00):
The information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics address on talk Tuesdays or for any other medical problem. [inaudible] welcome everyone. Thank you for joining us today. My name is Stefanie and I'm part of the team here at My Virtual Physician. 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 to talk with our experts, explore some common healthcare concerns that we see and hopefully answer some questions you may have today. Our physician expert is Dr. Coleman. She is a general surgeon, and today we are going to talk about breast cancer surgery. So thank you
Dr. Ginger Coleman (01:14):
Joining us today. Thanks for having me. Yeah. And welcome back. Okay. So after the biopsy, they told me that I have cancer. So now what, so there's a bunch of different types of cancer. So the first thing will depend on what kind of cancer you have and how big it is, and if lymph nodes are involved. So, so don't panic, there's, there's a lot of options for surgery and every option would be something that you would need to discuss with your personal physician and determine what the best course of action is for you and your particular type of cancer. But, but we'll discuss a couple common options. Um, there's something called breast conservation surgery also known as a lumpectomy or a partial mastectomy. So this is where a small ish incision is made. It's not necessarily right over where the area of cancer is. We try and hide the incisions.
Dr. Ginger Coleman (02:22):
So sometimes we may put it around the nipple. Sometimes we may put it and underneath the breast, sort of in the, in the fold, sometimes we gotta just make an incision across your skin and we try and hide it as best as we can, but it doesn't happen all the time. Essentially, once we make that incision, we remove a small portion of breast where the cancer is as well as some normal breast tissue surrounding it. And in order to do that, because if you had a lesion that wasn't palpable, it was just something abnormal seen on your mammogram. Obviously, we can't it in the, or so we have to have our radiologists localize it for us, what used to be done. And it's still done in a lot of places, but we're moving away from it is what's called a wire localization and you would go to mammography before surgery.
Dr. Ginger Coleman (03:20):
The radiologists would do another mammogram and they would find that area of concern. And then they stick a little wire into the lesion. So we're trying to get away from it because it's not real fun to be wheeled around the hospital with a wire sticking out of your breast, waiting to go to surgery. But that wire is directed to that area where you have cancer or the area of concern that needs to be removed. And they give us mammogram images to use in the operating room to make sure that we know where that is. So, so we'll excise that area more recently, they've moved to using things like radioactive seeds that can be placed by the radiologist and they can, they can be done a couple of days before surgery, some even up to a couple of weeks before surgery. So it's not something you have to come in that day and get done.
Dr. Ginger Coleman (04:10):
You can get it done kind of on your own time, leading up to surgery. And then in the operating room, we use a little, I call it the Geiger counter, but it's a little probe that beeps when you get close to the, the seed or, or whatever it is that they used, there's a whole bunch of different kinds. And, and so that helps locate the area of cancer. And then that gives us an idea and we remove that portion of tissue. And then, like I said, some normal breast tissue around it. And depending on the type of cancer you have will determine how much breast tissue we need to take. And depending on, you know, if you have DCIS or you have invasive cancer, that will also determine if we need to take any lymph nodes from your XLO also known as your armpit. Okay.
Dr. Ginger Coleman (04:59):
So then you said there were more than one type. So what's the other. Yes. And the other type is a mastectomy and that's where your whole breast is removed. There are different types of mastectomies. A simple mastectomy is probably what most people are familiar with. And that would be where all of your breast tissue and your nipple and areola are removed. And you have just a flat chest after that, on that side, there's something called a modified radical mastectomy. And that's a simple mastectomy, except during this operation, all of the lymph nodes in your Exela are removed that's surgery. There's some other mastectomies, a nipple-sparing mastectomy, and skin-sparing mastectomies that are also options. I won't really go into those, but, but really any mastectomy that's done can be followed with breastfeeding plastic surgeon, either during the same operation or at a later date. It all depends on the type of cancer you have and what other treatments that you need after surgery and understanding that there are risks and benefits of each type of surgery and what may be best for you may not be, you know, what you really desired to have done. There's if you need radiation after having a mastectomy, you don't really want to have reconstruction because you're not going to heal and you're going to have more problems and need more surgery. You may not have any complications, but do you want to risk it? So even after a mastectomy, you can get reconstruction, you can get it done that day, and we do that pretty frequently, but it all depends on you in particular, what's going on with you and what treatments that you need.
Stefanie (06:59):
Yeah. Um, so then you S you said lymph nodes. And can you talk to us a little bit about that or why they're removed?
Dr. Ginger Coleman (07:08):
Yeah. So your lymph nodes often are, are said to quote unquote, filter your blood. And so if you have breast cancer that is going to drain into your lymphatic system, and we'll go through those lymph nodes. And usually if you have breast cancer on the right side, you look in the right armpit for the lymph nodes and see if you can feel any that are, you know, big or thick and kind of mad at or anything. And even if they feel normal, it doesn't mean that there's not tumor in them. So if you find tumor in those lymph nodes, it's a sign of metastatic disease and it's more affiliated with invasive cancer. And so that's why it's important for us to evaluate the women, especially in invasive cancer. And you can do it in two ways. Again, there's two ways, there's something called a Sentinel lymph node biopsy, or you can have an auxiliary dissection.
Dr. Ginger Coleman (08:07):
So with a Sentinel lymph node biopsy, you can do this with either breast conservation or a mastectomy. If you do it with breast conservation, it's a separate incision, and it's not real big. We try and hide it in the, you know, one of the creases in your armpit or at the hairline, just to kind of hide the scar, but it is a separate incision. And we go through there to find the lymph nodes. If you do the lymph node biopsy with a mastectomy, it's all through the same incision. So you don't have two separate incisions prior to surgery. You usually go to a nuclear medicine department and get this radioactive tracer injected. And then in the operating room, we use a blue dye, methylene blue. I just often blue something and we inject and everyone does it a little bit different, but we always injected it underneath the nipple, or I'm sorry, underneath Ariel.
Dr. Ginger Coleman (09:03):
And then you do your surgery and, and the axilla is the last thing that you do. So by the time you get there, hopefully all that blue dye has made it swaying to your lymph nodes. And so we use that little Geiger counter thing again, and it helps you find that radioactive tracer, but then we're also looking for blue. So what we want to do is find the blue and radioactive lymph nodes and remove those. And the machine will give you a number and you want to take the highest number because that's theoretically the lymph node that drained first or the Sentinel node. And we usually take about three more or less. It kind of depends on what we see in there. If it's very obvious that all of your lymph nodes are involved, you may then end up with an axillary dissection and not just the Sentinel lymph node biopsy.
Dr. Ginger Coleman (09:57):
So an axillary dissection is actually where all of the lymph nodes are removed. Usually we do this with a mastectomy, so like the modified radical mastectomy, and it's all through the same incision. Sometimes you can do it after a lumpectomy or any other surgery that you've had, or Sentinel lymph node biopsy. If that biopsy came back with signs of invasive cancer that eat, that indicated you you'd need all of the lymph nodes removed. So then we would have to go back and do another operation, but usually we do it with a mastectomy. So it's all one surgery. And we just take out all of those lymph nodes. There are some nerves and blood vessels in the area that are important that we don't disrupt. They can cause some, you know, numbness or tingling of your arm or difficulty moving your shoulder, or even make your shoulder blades stick out.
Dr. Ginger Coleman (10:56):
But injuries to those nerves are not really common. Okay. So then you did your mastectomy or lumpectomy. So what happens after surgery? So depending on the type of surgery you had, you'll either go home that day or you'll stay overnight in the hospital. And usually nobody has to stay more than 23 hours or no more than a day. If you, if you had a lumpectomy and you don't have any serious medical conditions or anything that would be of concern, usually you just go home. So someone will, someone will need to drive you home. And we'll see you in clinic in a couple of weeks and let you know the pathology. If you had a mastectomy, you usually stay in the hospital, at least overnight, uh, you will have a drain or two, depending on if you had to have an axillary dissection or not. Um, and, and every surgeon is different with how they do it, but, but usually you will have at least wondering.
Dr. Ginger Coleman (11:58):
So we'll teach you how to take care of that. We keep you overnight to make sure that there's not a lot of bleeding out of the drain or anything that would be concerning to need to take you back surgery. Uh, if you do, okay, you go back home and then you see us in clinic and we'll take the drains out in clinic and talk about pathology. Uh, and, and if you haven't seen an oncologist already, we'll send you to one. Um, usually they're the ones that send you to us. So that's, that's usually pretty well organized, but that's when you would talk with them about the need for chemo or radiation. And sometimes if, you know, we do breast conservation surgery and maybe we didn't get all of the cancer, it'll be called, you know, you have positive margins. And so at that time, we would have to talk about going back for either re-excision of those areas that were positive and depending on your breast size and the type of cancer you have and all of that, it, it may end up being okay, well, now we need to talk about actually doing mastectomy because the pathology showed whatever it showed, but there is a possibility that you, that you would have to go back to surgery if you do breast conservation.
Dr. Ginger Coleman (13:15):
And it doesn't happen all the time, but it is, you know, one of the risks of trying to preserve the breast tissue.
Stefanie (13:23):
Um, thank you so much, dr. Coleman. I know it's a really hard topic to talk about. Cancer is always something that's pretty scary word. I appreciate you joining us for Talk Tuesday and telling us what we need to know about breast cancer screening and breast cancer surgery for everyone else. Joining us as well. This has been Talk Tuesdays with my virtual physician. You can schedule a consultation with one of our doctors by visiting our website at www.myvirtualphysician.com. We look forward to seeing you again, and we hope you have a great week Nation presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics address in Talk Tuesdays or for any other medical problems.
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.
Speaker 1:
The information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not a diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own health care professional about all topics address on Talk Tuesdays or for any other medical problem.
Speaker 1:
Welcome, everyone. Thank you for joining us today. My name is Stephanie and I'm part of the team here at My Virtual Physician. 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 to talk with our experts, explore some common healthcare concerns that we see and hopefully answer some questions you may have today. Our physician expert is dr. Coleman. She is a general surgeon, and today we are going to talk about breast cancer screening and breast cancer surgery. So thank you for joining us today. Thanks for having me. Yeah. And welcome
Speaker 2:
Back October was breast cancer awareness month. So we're going to be doing
Speaker 1:
Again a blog and an episode or two of Talk Tuesday on breast cancer screening. When would someone go in to get a mammogram or if they feel something or they have any history of breast cancer in their family, what's kind of the age range,
Speaker 2:
What to look for. Okay. So there's actually three organizations, probably more, but there's at least three organizations that have opinions on breast cancer screening, depending on which organization you listen to, it could be 40 years old, 45 years old or 50 years old, either way. Everyone agrees that by the age of 50, you should be getting a screening mammogram, most people, uh, and I believe most insurance companies go with the age of 40 breast cancer. Under the age of 40 is pretty rare. If, if you have
Speaker 1:
Breast cancer under the age of 40, usually it's associated
Speaker 2:
With some sort of genetic predisposition. There's the BRC mutation that predispose people to, to breast cancer at a younger age. But there's some other things that can, can run in families. Some other genetic diseases that predispose you at a younger age and typically cancer at a younger age is more aggressive and more advanced when it's found, because who in their thirties thinks that they're going to have breast cancer. So what we learned in residency was at the age of 40, you started getting your screening mammograms, and that's just, you have no symptoms. You have nothing going on. You're 40 years old. It's time to get a mammogram. Just like when you turn 50, you got to get a colonoscopy. It's just a way of life. Some people will come in. Well, I feel a mass I'm worried. And this also kind of depends on your age.
Speaker 2:
If you're younger, the chances of you having a mass that's breast cancer is pretty low. You, you may have these little hard nodules called fibroadenomas. They're pretty common in younger people and they grow and shrink in size with your menstrual cycle. And that's something that people usually will point out like, Oh, I noticed this, I know I was on my period last week and now I don't really feel it so much. And so that's, that's pretty common and we can actually do ultrasounds in clinic. I mean, not everyone, but if you're, if the clinic has an ultrasound, we can do an ultrasound because sometimes it's just breast cyst that can feel like a lump and they can hurt. And if it is a cyst, they can drain it in the office and, and hopefully give you some relief. So when you turn 40, get a mammogram, if you feel something that's concerning, you would need to go into your doctor, talk to them about getting an ultrasound or a mammogram.
Speaker 2:
And again, depending on your age, it may dictate what screening that they do. If you have a family history of breast cancer, then that would be something to coordinate with your doctor to get a screening done earlier. They usually recommend doing screening before 40, uh, it may be an MRI and mammogram alternating every six months starting at the age of 25 30. It just kind of depends on when your family member had breast cancer and what genetic mutation it is that you have. So I've had my screening mammogram and I got called back in for more images, do I have cancer? So not necessarily, this is something we actually deal with quite a lot. It really kind of depends on your age and your breast tissue density. It can be really hard to evaluate the breast tissue on a screening mammogram. If you have really dense breast tissue, there's actually, uh, States that have a requirement when they report on your mammogram, that they disclose to you that there are certain regions, depending on the density of your breasts, that they may not be able to see.
Speaker 2:
So they have to give you that information because then if you end up having breast cancer, but you've, you've had a screening mammogram, you know, why wasn't it caught well, and it, it can just really depend on the density of your arrests. So sometimes you'll get a call that you need to come back in and it's for a more formal or what we call a diagnostic mammogram. The difference in that is with a screening mammogram, you kind of just, you go into a facility, they do the mammogram and you go home. And in a couple of days, they either call you with the results or you go into your doctor's office and they give you the results, a diagnostic mammogram, you go into a facility, but the radiologist is, is physically there. And when they do the mammogram, they try and focus on that area that was questionable in your screening mammogram.
Speaker 2:
And so the radiologist can actually look at it in real-time and determine, okay, well, we need a different view here, or we need to zoom in here and take a better look at that so that you don't get called back in for even more. This is, I'm a little bit better idea of, of what they're looking at. And if it, if it is something that looks suspicious for cancer or not, some patients may actually end up needing an ultrasound to go with their mammogram or an MRI. It's all pretty personalized. So it all just depends on what your breast tissue looks like and what, what exactly it is, that's going on, what was seen, or if you're having symptoms and things like that. So it could just be that you have dense breast tissue, and it does not look abnormal when they do the more focused imaging, or could be something that, that is concerning for breast cancer. But being called back does not mean that you have cancer. You could, but they just need to get better pictures. Yeah.
Speaker 1:
Since so, after I got called in my mammogram showed an area concerning for breast cancer and I need a biopsy. Can you explain what that is?
Speaker 2:
Yeah. So when you need a biopsy, it doesn't necessarily mean that it's cancer again. So, so don't panic, but chances are, they saw something that are concerning and suspicious for cancer, and chances are it is, but I need a tissue sample to say for sure what it is. There's different types of breast cancer, there's DCIS, which maybe you've heard of, or there's invasive cancers by doing the biopsy. It gives you a little sample of tissue to be able to determine what type of cancer it is, what hormone receptors it has if it has any. And, and that helps you tailor your treatment, not only for surgery, but if you need chemo or other things, or even additional surgery, when you meet a bias, it can be done a couple of ways, the most common way, or at least the way that I'm used to it being done from when I was in residency is if you have a mask that can be felt if you came in because you had an that you found and you get a mammogram and they, they say, we need to biopsy.
Speaker 2:
If they can see it, then you can get a biopsy done with an ultrasound and you don't have to go through a mammogram again. If you can't see it on an ultrasound, then you got to get a mammogram again. So not, not super fun for everybody when they do it with under a mammogram, it's done by a radiologist typically, and it's called a stereotactic biopsy. So essentially you lay down on this table and you lay face down and there's, there's a little opening in the table. And the breast with the concerning area goes through this little hole in the table and kind of hangs blue so that the arm on this machine can get in the right position and orientation to access the delusion that the arm on the mammogram machine has a needle on it. And once the area is targeted, the needle goes in, they take a sample of the breast tissue that comes out, but there's also a clip that gets placed in the area that they biopsied.
Speaker 2:
So that on later imaging, you can say, okay, well, we already biopsy this area and everything was normal. Or this is where they had a biopsy before we don't see anything different. Or, you know, now there's something there that, that wasn't there before. And we need to re-investigate it. Sometimes you can't do the stereotactic biopsy and that's for reasons, you know, maybe you can't lay flat, maybe it's too uncomfortable, or you can't breathe. There are weight limitations. And depending on your age, I mean, it may just not be something that you're very capable of laying there because it's not, it's not a five-minute procedure. I mean, it's a 20-minute procedure or so. And it depends on where the lesion is. If it's really close to your chest wall, like the muscles underneath your breasts, they don't usually do the stereotactic biopsy. They can still do a biopsy under a mammogram. It's just done a little bit differently. This is all kind of targeted and oriented and one process. Whereas if they have to do it with, without the stereotactic part, it's done a little bit differently. Now there are some stereotactic biopsy machines where you can actually sit up. I don't know how many places have those. Like I don't, I'm not real familiar with how prevalent they are, but they do exist. So that maybe something that they could do.
Speaker 1:
Thank you so much, Dr. Coleman. I know it's a really hard topic to talk about. Cancer is always something that's a pretty scary word. I appreciate you joining us for Talk Tuesdays and telling us what we need to know about breast cancer screening for everyone else. This has been Talk Tuesdays with My Virtual Physician. You can schedule a consultation with one of our doctors by visiting our website: www.myvirtualphysician.com. We look forward to seeing you again, and we hope you have a great week.
Speaker 1 :
Information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not a diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics addressed on Talk Tuesdays or for any other medical things.
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
Speaker 1: The information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics address on talk Tuesdays or for any other medical problem.
Speaker 2: Welcome to Talk Tuesdays brought to you by my virtual physician, a direct to consumer multi-specialty telemedicine company that operates in multiple States.
Speaker 1: Thank you for joining us today. My name is Stephanie and I'm part of the team here at my virtual physician. We are a direct to consumer multi-specialty telemedicine provider operating in multiple States. It's taught Tuesday and we are continuing our weekly educational series to talk with experts, explore some common healthcare concerns that we see and hopefully answer some questions you may have today. Our physician expert is Dr. Ginger Coleman. She is a general surgeon and she's going to talk to us about peptic ulcers and what we need to know about them. So Dr. Coleman, thank you for joining us. Thank you for having me. Yeah. So can you start by explaining what is a peptic
Speaker 3: Or gastric ulcer? Yeah, so, um, the word peptic really just sort of means that it's in your digestive tract. So there's, there's two types of ulcers. Um, you can have gastric ulcers or do a Denal ulcers, um, that are in the first part of your small intestine that's connected to your stomach. Um, so peptic sort of encompasses both of those, um, entities. The gastric ulcers are probably the most common, um, and essentially what an ulcer is, is a little tear or break in the lining of your stomach or your small intestine. Um, those, your stomach has a barrier sort of like a mucus barrier that protects it from all of the coffee and other caustic things that you probably consume on a daily basis. And when you get a little tear, um, that you guess is supposed to kind of help protect it and heal, um, when that barrier fails is when you get an ulcer.
Speaker 3: Um, and there's, there's a couple of things that are related to those and can cause them, but essentially it's, it's just a failure of that protective barrier of your stomach and creates this little hole. Okay. So how do you, how does it happen? Why do people get them, um, the most common, um, cause of these that, that we really know about is actually a bacteria called H pylori that's Helicobacter, pylori, um, and it's a little, uh, bacteria that, that actually damages the lining of your stomach and also keeps that mucosal barrier, um, from healing. So it, it kind of just keeps perpetuating this, uh, ulcer. You can get rid of the bacteria and it should heal the ulcer. There are some other things that can cause it things like smoking, drinking, alcohol, um, caffeine, um, even stress, uh, patients that are in the hospital, maybe intubated, you know, on a ventilator or, um, have really severe burns.
Speaker 3: They can get different types of ulcers, but it's the same underlying process. It's, it's decreased blood flow to the area and it, and it damages that you co-sell lining. Okay. How would I know if I had it, the symptoms of an ulcer, some for some people they're pretty vague for a lot of people, they it's just, you have this abdominal pain, it's kind of this gnawing burning upper abdominal pain. Uh, a lot of times you can relate it to when you eat. Um, sometimes it'll hurt when you eat just shortly thereafter, maybe about 30 minutes. And sometimes it'll, it'll take a couple hours. Um, sometimes it feels better when you eat. So those kind of, um, help you differentiate whether it's in your stomach or in your small intestine, but it's not very specific. Um, but it is something to take note of, if you, if you realize that that's what's happening, some people will feel bloated, you can have nausea.
Speaker 3: Um, but most commonly what sends people to, uh, see a doctor is the pain. There may be some aspect of, you know, heartburn or reflux, but, but usually it's just that severe gnawing pain. Yeah. And so can also cause more serious damage or is it just painful? They can, um, they can cause a lot more damage actually. Um, as a surgeon, that's something that we see come through the ER from time to time, um, where you have an ulcer that gets so severe that it essentially erodes all the way through the stomach. And so it, it perforates, um, yeah, it's not very fun for anyone. Um, so it, it actually just sort of ruptures, it opens up whether it's the small intestine or the, or the stomach. Um, and so you get all of those gastric acids and juices sort of flowing through your entire abdomen.
Speaker 3: It can make you very sick. The ulcer can also erode into a blood vessel. So sometimes people will come in bleeding from these ulcers because it's eroded into a vessel that's in the area. Um, so they can be pretty severe and it is something worth, worth seeing a doctor for if you're experiencing some abdominal pain like that. Yeah. And how do you treat them? So predominantly no one will ever see a surgeon for a gastric ulcer. Hopefully, hopefully that is the case. They're, they're pretty much managed with, um, proton pump inhibitors or PPIs that you may have heard Nexium, Omeprazole, things like that. Um, and so it may not be something that you need long-term depending on sort of what caused the ulcer, but most of the time people stay on them for, for a long time. Initially you want to treat it for about six weeks with the proton pump inhibitor.
Speaker 3: There are some other medications you can give that kind of help coat the stomach, the lining of the stomach, and to relieve some of the pain of the ulcer, but also try and help protect that barrier. Um, you can treat the ulcer with medication and if it gets better than you can kind of assume that it's an ulcer, you don't necessarily have to see it to prove it. It's just sort of based on symptoms and ruling out other things. Um, but to definitively diagnose it and treat it, um, you need an endoscopy, which is where they put a camera in your mouth and go and look in your stomach and they can see where it is in the stomach. They can see if you have one, maybe it's just gastritis, which is just, you know, sort of diffuse irritation of your stomach. Um, when they do an endoscopy, they would look at where the ulcer is, how big it is and take biopsies of it to make sure that there's not any, uh, risk of cancer.
Speaker 3: Some of these can, can Harbor underlying malignancy. So, so that is important, but you don't have to do the endoscopy initially. Um, it's purely medical treatment. If it doesn't get better or you have recurrent ulcers that, that don't seem to go away. Um, if it's related to some other, um, diseases where you're prone to getting ulcers, um, that's when you may see a surgeon and may need an operation to remove that acid part, that asset to creating part of your stomach. Um, but usually it's just medicine. Yeah. And, um, but is there a way to treat it at home like yourself versus medicine?
Speaker 1: Do you cut back on caffeine or alcohol or that,
Speaker 3: So you can with it being affiliated, I mean, there's no proof per se, that caffeine causes ulcers may make it worse. Um, nicotine or tobacco smoking that all decreases the blood supply to well, to everything, but especially your stomach. So, so it gets less blood flow, which will make it worse. Um, alcohol can irritate it, it can make the pain worse. It also sort of affects that mucosal barrier. So taking medications like ibuprofen, Aleve, Naproxen, Motrin, anything like that, those are, those are big time medications that are associated with gastric ulcers. If you can stop them, you should stop them. Now, some people aren't able to just for other underlying conditions, but those are a big player in the development and recurrence of gastric ulcers. So stopping those nicotine caffeine, alcohol, all of those things may not cure it, but they can help at least decrease the pain and maybe prevent further injury or worsening of the ulcer.
Speaker 1: Awesome. What are some symptoms that someone would have if they need to seek medical attention immediately for a stomach ulcer?
Speaker 3: Yeah. So if you know, you have one and you're maybe already taking medication, maybe not either way, if you, if you know that you have a cynical, certain use, you experienced or pretty sudden onset of severe sharp pain in your abdomen, that that doesn't get better, that doesn't go away. That actually gets worse with moving and you, and you start to have a fever or things like that. You need to go to the emergency room. Um, other things would include vomiting, blood, or sort of what they call coffee ground emesis. It kind of actually looks like coffee grounds in cycled blood. Um, that's a concerning sign, uh, and then any darker, bloody stools that would be a sign of bleeding that's concerning that, that the ulcer may be involving a blood vessel. Okay.
Speaker 1: Well, thank you, Dr. Coleman, you have shared some really great information today and answered questions that I think many Americans have on their minds. I appreciate you joining us for Talk Tuesday and telling us what we need to know about ulcers and how to treat them when to seek attention, all of that. So for everyone else, joining us as well, this has been talked Tuesdays with my virtual. If you would like to schedule a consultation or find out 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.
Speaker 1: The information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics address on Talk Tuesdays or for any other medical problem.
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.
This week on Talk Tuesdays from my Virtual Physician, we have Dr. Daniel Kessler, a Family Practice Doctor.Before a manufacturer can introduce a new drug to the public, a lot of money goes into the research, development, testing, and marketing. Companies can patent their new medications, and are guaranteed exclusivity to make and sell them for five years. This allows manufacturers to recoup some of the cost associated with getting their new brand name drugs to market. After that time, the patent expires. This means other companies can come along and make and sell the same medication under a different name. This “copy-cat” medication is considered a generic medication.
In many ways a generic medication is like the brand name version. To be approved as a generic drug, the pharmacologic characteristics must be the same as the brand name. Generic medications are the same as the brand name when it comes to:dosages and strengthintended useeffects and side effectsroute of administration active ingredientsBy contrast, generic medications can be approved with different inactive ingredients. So different colors, additives, and fillers may be used to help with binding, flavoring, coloring, transporting, or preserving. That means that your generic medication will likely look different. Trademark laws in the U.S. prevent manufacturers from creating a generic that looks exactly like the brand name. The Federal Drug Administration (FDA) regulates generic drugs that are approved for sale in the United States. It provides a process that ensures the medications are safe, effective, and of sufficient quality. Keep in mind that the FDA also investigates complaints about generic and brand name medications including side effects. They can issue a recall any time there is a concern for safety. There are always risks and benefits associated with any medication. Everybody is different and some more sensitive to differences in the drugs.Because the inactive ingredients are not identical, some individuals may experience differences when taking a generic medication vs, a brand name, but this is not always the case. There have been reports of medications affecting patients differently. For instance, when they feel the onset of effects, how long the medication effects last, and even incidence of side effects. It is important to talk to your physician if you are concerned about a generic medication affecting you differently. Generic medications often cost substantially less than the brand name. Again, the company making the generic medication did not have to pass along the cost associated with getting a new drug to market. When a patient is going to be on a drug long term or even for a lifetime, choosing a generic medication can save thousands of dollars a year in medical expenses. Lower cost may mean better compliance for some patients.
The savings to the individual are important but it doesn’t stop there. When multiple manufacturers are able to make and sell a medication the competition can drive the cost down and makes healthcare more affordable for the public. Generic medications save our healthcare system millions of dollars every year. To learn more, schedule a consultation today!
In the United States, FDA-approved generic medications account for 90% of prescriptions filled. Your doctor or pharmacy may have asked you about your preference for a generic or brand name drug. This could have left you wondering: are generic medications the same as brand names?
Generic medications are not exactly the same as brand names. This is because generic medications can have different ingredients, look dissimilar, or have individual effects. In many ways, the FDA ensures that the medications are the same. But here is what you need to know about generic vs. brand name:
A lot of money goes into research, testing, and marketing before a company can introduce a new drug to the public. Then, they can patent their new medication and own the right to make and sell their product exclusively for five years. This short time allows manufacturers to recoup some of the costs associated with getting their new brand name drug to market.
The patent expires after that time. This means other companies can come along and produce the same medication under a different name. This “copy-cat” is considered a generic medication.
So you may be asking… what is the difference anyway? Well, in many ways a generic medication is like the brand name version. To be approved as a generic drug, the pharmacologic characteristics must be the same as the brand name. This means that generic medicines are the same when it comes to:
By contrast, generic medications can be approved with different inactive ingredients. So colors, additives, and fillers used to help with binding, flavoring, coloring, or preserving may not be the same. That means that your generic medication will likely look different. Trademark laws in the U.S. prevent drug makers from creating a version that looks exactly like the brand name.
The Federal Drug Administration (FDA) regulates generic drugs that are approved for sale in the United States. It provides a process that ensures the medications are safe, effective, and of sufficient quality. Keep in mind that the FDA also investigates complaints about all medications including side effects. They can issue a recall any time there is a concern for safety.
There are always risks and benefits associated with any medication. Everybody is different, and some are more sensitive to differences in the drugs.
Because the inactive ingredients are not the same, some individuals may notice differences when taking a generic medication vs. a brand name, but this is not always the case.
There have been reports of medications affecting patients differently.
For example, when the onset of effects is felt, how long the medication effects last, and even the side effects can vary when comparing drugs made by different companies or labs.
Keep in mind that some pharmaceutical companies produce both brand and generic forms of medication, so even some of the generics are very close to the original.
It is important to talk to your physician if you are concerned about a generic medication affecting you differently.
The FDA requires drug companies to prove generics are effective for treatment in the same way brand name medications are. Some generic medications have been on the market for years and shown to be as effective and a solid choice for some consumers.
Some individuals choose generic versions because they work just as well but cost much less than the brand name. Again, the company making the generic did not have to pass along the cost associated with getting a new drug to market.
So when a patient is going to be on a drug long-term or even for a lifetime, choosing a generic medication can save thousands of dollars a year in medical expenses. Lower costs may mean better compliance for some patients.
The savings to the individual are important, but it doesn’t stop there. When multiple manufacturers are able to make and sell a medication the competition can drive the cost down and makes healthcare more affordable for the public. Generic medicines save our healthcare system millions of dollars every year.
This answer may be different for each person. As with many choices in your health and medical care, you have to weigh the risks and benefits.
Is it worth it for you to spend more on a brand name medication? Cost is an important factor when deciding what is best. For example, when a person is on medication for a lifetime, opting for a generic version may save thousands of dollars in healthcare costs. On the contrary, generic medication for an acute illness that will resolve quickly could mean a different decision.
Today, many pharmacies routinely fill the generic versions for cost savings to the insurance companies and the customers. The FDA says that increasing the availability of generic drugs in the marketplace encourages competition in the pharmaceutical market which improves access to healthcare.
Although generic medications are not identical to their brand name counterparts, the FDA ensures that customers are getting safe, effective, quality options when they chose an approved generic. Although they may have different ingredients, appearances, and effects, the pharmacologic effects are the same. As with all medications, there are risks and benefits that should be weighed when making a personal choice.
If you would like to know more or have questions about your medications, our doctors are available for a virtual consultation. MyVirtualPhysician is a multi-specialty provider with physicians available for a consultation now. Click below to schedule an appointment. 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.
A cyst is a membranous sac or pocket. Cysts form in many places in the body. The term ovarian cyst refers to a cyst that has formed in or on one of the ovaries. Most ovarian cysts are small and harmless. In fact, they commonly occur in regular menstrual periods. A corpus luteum cyst or a follicle cyst may form each month on the ovary when the egg is released. These are called functional cysts. These normally shrink on their own in about 1 to 3 months. Pregnancy can cause a cyst to form. In early pregnancy, a cyst can form to help support the pregnancy as the placenta is forming. Occasionally, this cyst stays on the ovary until later in the pregnancy and may require removal. Ovarian cysts that continue to grow during pregnancy may twist or could cause problems during childbirth.
Ovarian cysts should be checked out by a healthcare provider if you are having symptoms and suspect that is what is going on. Pain or discomfort from an ovarian cyst could feel sharp or dull, and it could come and go. If a cyst breaks open (ruptures) it could cause sudden, severe pain. Also, if a large cyst breaks open it could cause heavy bleeding. If a cyst causes an ovary to twist it may also cause nausea and vomiting. Less common symptoms include Pain during or after sex, discomfort during exercise, unexplained weight gain, pelvic pain, dull low backache, or leg pain, painful periods, unusual vaginal bleeding, breast tenderness, bowel or bladder problems. It is important to talk to your physician if you are concerned about these symptoms. In about 5-10% of cases, an ovarian cyst may require surgical removal. This may be necessary if your cyst does not go away, grows larger, or causes pain. Follow us on Spotify to learn more!
On this Talk Tuesday, we are focusing on Postpartum Depression.
If you are suffering from Postpartum Depression, connect with us, and make an appointment with one of our Board Certified Doctors today! And if you like what you hear, make sure to follow us on Spotify. We upload a new podcast every Tuesday!
You’ve heard it said "the only thing constant is change.”
Healthcare is no different. Similarly, it continues to evolve as time goes on. Telemedicine is a great example. Patients now have convenient access to doctors and specialists in the privacy, safety, and comfort of their homes. Another example is the field of integrative holistic medicine. You might be asking, just what is integrative medicine? And how is it a change for the better?
Integrative holistic medicine, or just integrative medicine (IM), is a specialized approach that looks at the whole person. It is a different way to treat what ails us. This medical subspecialty takes into account the "whole body" and the many influences that affect a person's health. For example, these can include physical, mental, social, and spiritual factors.
This movement in healthcare combines conventional schools of mainstream medicine with alternative medicine. That is to say, it focuses on a holistic view of the patient which makes care personalized. Doctors in IM choose therapies that work best for each person and can be linked to better outcomes. Here are some basic principles of IM that they follow.
The doctor-patient relationship is collaborative. In other words, the two partners work together to achieve an outcome. Practitioners spend time with the patient to get to know about them. IM doctors may ask questions to learn more about the origin of symptoms. Likewise, they will explore the background behind the illness or injury.
This practice of spending more time to understand the root problem is helpful. Firstly, patients are empowered by information. Secondly, understanding the "why" behind their problems gives them hope.
Patients are considered more than just human bodies. Similarly, wellness and illness are more than the physical functions of the body.
Symptoms can be complex. For instance, they can involve physical, social, psychological, and spiritual manifestations. IM takes into account the whole body, mind, spirit, and community. Providers do this by working to understand how a person’s experiences may have caused illness. They are able to devise an effective treatment plan as a result. Importantly, they seek to treat the person and not just the illness.
Also, lifestyle and stress play a huge role in illness, health, and healing. Integrative holistic doctors understand this relationship and try to help patients manage their stress.
In the IM field, doctors seek the most natural path. This is to say that they prefer minimally invasive treatment. In IM, traditional western care is blended with more eastern philosophies to treat and manage a variety of conditions. For example, non-invasive therapies that may be recommended include yoga, meditation, and herbs.
The goal of integrative care is optimal wellness for the client. Prevention is key. This means that there is an emphasis on health, rather than on the illness.
The IM field focuses on what works for the patient. For example, care may include an evaluation of genetic factors that could be contributing to the current health status. The provider and patient then work together to sort out what might be causing illness. Providers try to figure out where the patient is coming from. With this more patient-centered approach, patients are often motivated to make changes and work towards the goals they set.
There are many benefits to choosing a provider with integrative holistic medicine expertise.
Studies show patients working with IM providers report improved mental and emotional wellbeing. This could be related to symptom relief and improved disease management that are reported also.2
IM treatment involves a customized regimen tailored to the individual. The doctor spends time getting to know the patient, and he or she feels more valued. A study on IM in pain management found that an individualized, relationship-centered approach, meeting the patients where they are, can help determine which modalities may be used synergistically3, optimizing the outcomes.
The IM field continues to evolve. Therefore, there are more clinical trials and research studies going on to examine some of the non-traditional approaches. You can trust that there will be good evidence-based study behind the treatment plan you are participating in.
Patients have more options working with an integrative holistic care provider. This is because non-traditional therapies give doctors and patients more tools to work with. By using treatments such as massage, biofeedback, or sound therapy, patients have access to more choices in their treatment.
In conclusion, this valuable care model has many benefits for patients. The integrative holistic medicine approach is a change in how some doctors are addressing patient care.
Highly personalized treatment and a focus on prevention are beneficial to patients. Additionally, the use of minimally invasive and natural therapies makes this field stand out from more traditional approaches.
IM does not exclude traditional methods, however. Think of it as an "add-on" to increase the success of treatment and increase benefits. Get away from the adage "a pill for the ill." Replace it with "medicate and meditate."
As times change and healthcare evolves, doctors must continue to meet the demands of today's patients. The future of medicine must recognize the complexity of the social, physical, developmental, and genetic influences on health and disease.1
Dr. Daniel Kessler of MyVirtualPhysician is double board-certified in Family Medicine and Integrative Holistic Medicine and holds full certifications in Functional Medicine. Dr. Kessler and other doctors are available for consultation. MyVirtualPhysician treats conditions including allergies, earaches, cold and flu symptoms, and more. If you want to schedule an appointment with our integrative holistic care practitioner at MyVirtualPhysician, you can click the buttons below to book an appointment. 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.
