Search Here
Syphilis is primarily a sexually transmitted disease caused by the bacterium Treponema pallidum (because syphilis is in the genus Treponema, it can also be called a “treponemal disease”; however, there are other treponemal diseases that are not syphilis). It is transmitted through the mucous membranes, broken skin, and direct mother-to-child infection during pregnancy. As such, unprotected sex (anal, oral, vaginal, or any other permutation that results in the exchange of bodily fluids) increases an individual's risk of contracting the disease. Similarly, risky sexual behavior and increased number of sexual partners also increase an individual’s risk of contracting syphilis (and other sexually transmitted diseases).
Syphilis typically presents in three distinct symptomatic stages, (described below) marked by potentially long periods of symptom-free remission between stages. If left untreated, the final stage is usually ultimately fatal. However, it can take up to several decades from the point of initial infection until an individual enters the third and final phase of the disease.
As mentioned above, syphilis commonly presents with three distinct symptomatic stages. These are commonly known as Primary, Secondary, and Tertiary syphilis. Each stage is marked by its own set of typical signs and symptoms of the underlying disease.
● Primary Syphilis usually presents as a single round, painless, firm lesion called a chancre. It usually appears around the genitals or anus, but can occur elsewhere on the body. It usually appears within three weeks of the time of the initial infection. Even if left untreated, the chancre will usually heal within three to ten days.
● Secondary Syphilis usually presents as a more diffuse non-itchy rash across the skin. One of the distinct features of secondary syphilis is that this rash often can involve both the palms of the hands and the soles of the feet. Even if left untreated, this phase will also usually resolve on its own.
● Tertiary Syphilis may occur multiple decades after the initial infection, if left untreated. It can cause diffuse damage throughout the individual’s body to multiple different organ systems, from bone to skin and so forth. However, what often ends up claiming the lives of the afflicted individuals is the damage done to their brain and cardiovascular system. If there is clinical suspicion of syphilis, the individual will still require additional laboratory testing to confirm the diagnosis.
Individuals infected with syphilis can still be accurately tested even if they do not have any active symptoms suggestive of syphilis. This is done by a combination of two blood tests:
1. A nontreponemal test, such as the Venereal Disease Research Laboratory (VDRL) or Rapid Plasma Reagin (RPR) test.
2. A treponemal test, such as the Treponema pallidum Passive Particle Agglutination assay (TP-PA), Enzyme Immunoassays (EIA), Chemiluminescence Immunoassays (CIA), or rapid treponemal assays.
A positive result for both the nontreponemal and treponemal tests is required for a diagnosis of syphilis. Additionally, if there is access to drainage or fluid from an open lesion, urinary discharge, or the tissue from a lesion, darkfield microscopy can be used to look for visual confirmation of the presence of Treponema pallidum (which appear as little white spirals under the microscope, hence their alternate classification as a “spirochete” bacteria).
As dismal and dire as untreated syphilis is, the good news is that syphilis is easily treatable and curable if caught before entering the tertiary syphilis stage of the disease. The mainstay of treatment is an injection of a long-acting form of penicillin called benzathine penicillin G. Because syphilis can be transmitted directly from mother to child during pregnancy, treatment with benzathine penicillin G is highly recommended for infected pregnant women to prevent congenital syphilis in the child. There is even evidence supporting additional treatment for pregnant women. However, because of the additional risks, this issue should be discussed with the woman’s obstetrician to decide on the best treatment plan and course of action.
Book Appointment Now Call For An Appointment
From a purely brass-tacks scientific perspective, syphilis is just the name given to a three-stage disease caused by the bacteria Treponema pallidum. It is essentially transmitted through mucous membranes or broken skin, which is why the overwhelming method of transmission is unprotected sexual contact and the risk goes up rapidly in proportion to riskier sexual practices and increased number of sexual partners. It is also worth noting that the sexual partners of people with a high number of sexual partners are also more likely to have an increased number of sexual partners themselves, thus compounding the increased risk of exposure to syphilis.
Syphilis can also be transmitted directly from an infected mother to her unborn child. The untreated disease usually progresses through three distinct stages, punctuated by periods of spontaneous remission (often mistaken for an actual resolution of the disease) in between. The first stage is usually a single, painless, firm lesion on the skin called a chancre (most commonly on the genitals or anus, but it can occur elsewhere). The second stage is usually a more disseminated rash across the skin, notable for its presence on the palms and soles of the feet. The third and final stage is usually characterized by diffuse systemic involvement, but most notably including severe damage to the central nervous system and cardiovascular system. This third and final stage may occur decades after the initial infection, and often results in the death of the individual.
The exact geographic origin of syphilis is still a widely debated subject. Some theories posit that it originated in the Americas and was brought back to Europe by Christopher Columbus’ crew. Others posit that it originated in Africa or the Old World. And others suggest that it was endemic globally. There is good evidence of treponemal disease (syphilis) in Native Americans prior to 1492, thus making the American origin plausible. However, there is also some evidence of treponemal disease in Europe prior to 1493 (when Columbus’ crew returned), although this evidence is not as strong and is disputed by many. There is also evidence that syphilis originated in either cattle or sheep and made a zoonotic transmission to humans. This, of course, raises the possibility of --to put it delicately-- let’s just say a rather unorthodox approach to “animal husbandry”. Although it is also plausible that the jump to humans could have happened through less disturbing means, such as butchering the carcasses of infected animals with broken skin.
Over the centuries, what we now call “syphilis” has gone by many names and has often been conflated and confused with other sexually transmitted diseases -- and even diseases such as leprosy and leishmaniasis. Our current name “syphilis” actually originated from a set of fictional novels written in 1530 by the Italian poet Girolamo Fracastoro called, “Syphilis sive Morbus Gallicus”. In these books, Fracastoro ascribes the origin of the disease to a curse placed on the people of ancient Greece because a shepherd named Syphilis refused to worship the god Apollo. As one might expect, there is rampant speculation about many prominent historical figures who are believed to have had syphilis, ranging from Leo Tolstoy and Friedrich Nietzsche, to Al Capone and Adolf Hitler.
The actual bacterium responsible for syphilis (Treponema pallidum) was not identified until 1905 by Fritz Schaudinn and Erich Hoffmann in Germany, and the first (moderately) effective treatment for syphilis did not come until 1910. It was an arsenic-based drug called arsphenamine and, while it was effective in the treatment of syphilis, it carried considerable downsides and adverse side effects -- as one would expect from a drug derived from arsenic! The real game changer for the successful treatment of syphilis came with the discovery of penicillin. Even though penicillin was discovered by Alexander Fleming in 1928, it was not mass produced and introduced to the American market until 1943.
While syphilis is a potentially fatal disease, the good news is that it can now be easily tested for and successfully treated with a single injection of long-acting penicillin. Recognizing the disease early is important and we will cover that in the next blog post.
Book Appointment Now Call For An Appointment
Both the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have recently reported drastically increased rates of syphilis and, correspondingly, congenital syphilis recently. The WHO estimates that 7.1 million people globally acquired syphilis in 2020. The table below from the CDC shows a 78.9% increase in syphilis cases generally over the 5-year period from 2018 to 2022. Even more concerning, over that same 5- year period there was a 183.4% increase in congenital syphilis (that is, syphilis transmitted from an infected pregnant woman to her unborn child), and a 937% increase from a decade ago.
Among the greatest risk factors for syphilis are high risk sexual behaviors and a high number of sexual partners. However, what is surprising about the data is that the incidences of chlamydia and gonorrhea have remained relatively flat over that same 5-year time period. This would seem to suggest that there has not necessarily been an increase in risky sexual behaviors, but rather that the prevalence of syphilis has been increasing within the general population.
There are many potential reasons for this. One of the most commonly cited explanations by health organizations is insufficient testing for syphilis. One much less credible explanation given is a shortage of long-acting penicillin (trade name Bicillin) over the past year. While that might explain a rise over the past year, it does little to explain the rising trend over the 10 years prior. Moreover, there are other alternative treatments for syphilis, such as doxycycline.
One thing that is important to know about the disease course of syphilis is that it often has long periods where the infected individual may have no symptoms at all, and these periods can be up to decades long! Consequently, infected individuals who are asymptomatic are less likely to seek medical attention for testing and treatment. This, in turn, means that infected individuals could potentially be unwittingly transmitting the disease to others for years at a time before their syphilis symptoms recur and prompt seeking medical treatment. Syphilis is further complicated
by the fact that it can present in all manner of symptoms that one might not necessarily associate with a classic STD, thus leading to failure to successfully recognize and treat it. For this very reason syphilis is often colloquially called “the great imitator” amongst the medical community.
Greater awareness amongst both the general population and medical providers, combined with developing better and more frequent testing protocols would likely go a long way towards stemming the rising tide of syphilis. Successfully squelching syphilis need not be a Sisyphean task.
Book Appointment Now Call For An Appointment
In recent years, the United States has witnessed an unsettling surge in cases of newborn syphilis, reaching levels not seen in the past three decades. According to the latest data from the Centers for Disease Control and Prevention (CDC), there has been a tenfold increase in newborn syphilis cases over the last decade, with more than 3,700 infants born with the infection in 2022 alone. Federal health officials are raising the alarm, emphasizing the urgent need for action to curb this concerning trend.
Syphilis, a sexually transmitted infection caused by the bacterium Treponema pallidum, can be transmitted from an infected mother to her unborn child, leading to congenital syphilis. The consequences of untreated syphilis in newborns can be severe, ranging from developmental issues to organ damage and even death. The rise in cases is a stark reminder of the importance of timely and accessible healthcare, especially for expectant mothers.
Amidst the alarming statistics, there is hope for a solution that is both convenient and effective: virtual primary doctor visits and online consultations. My Virtual Physician, a leading telemedicine service, offers a swift and secure way for individuals to address their health concerns, including the need for syphilis testing.
My Virtual Physician provides easy access to virtual primary doctor visits, allowing individuals to consult with healthcare professionals from the comfort of their homes. This eliminates barriers such as transportation issues or the need for childcare, making healthcare more accessible to everyone.
With My Virtual Physician, patients can receive electronic lab orders that are seamlessly sent to the nearest laboratory of their choice. This streamlined process ensures that individuals can get tested for syphilis promptly, without the need for additional paperwork or physical visits.
In addition to syphilis, My Virtual Physician offers comprehensive STD testing, including screening for HIV, hepatitis C, HSV, gonorrhea, and chlamydia. This holistic approach allows individuals to address multiple health concerns in a single telemedicine visit, promoting overall well-being.
As the nation grapples with the rising tide of newborn syphilis cases, it is crucial to embrace innovative solutions that can make healthcare more accessible and efficient. My Virtual Physician stands as a beacon of hope, offering a convenient avenue for individuals to address their health concerns promptly and responsibly. Through quick telemedicine visits and electronic lab orders, this service plays a pivotal role in the fight against syphilis and other sexually transmitted infections, ensuring a healthier future for all.
Don't wait – take control of your health today with My Virtual Physician and contribute to the collective effort to combat the alarming rise of newborn syphilis in the U.S.
The Covid-19 pandemic and technological advancement in healthcare delivery have introduced telemedicine in prenatal care. It might seem that telemedicine is here to stay and in a few years, will become a major approach in delivering health care to pregnant women.
With telemedicine, expecting mothers receive consistent and necessary care via videoconferencing, at-home monitoring, and consultation with remote specialists. These were said to improve health outcomes while allowing for less frequent antenatal visits.
However, certain challenges may affect the use and outcome of telemedicine to provide care to patients. Below are perceived barriers to telemedicine in prenatal care.
Book Appointment Now Call For An Appointment
Several factors affect the use and health outcomes of telemedicine. Patients and healthcare providers alike play a significant role in the provision and delivery. However, other non-human factors exist which may affect the successful outcome of virtual visits and at-home monitoring.
The following are perceived barriers to telemedicine in prenatal care:
Poor internet connection and slow speed result in loss of connection, poor audio and video quality, hence affecting the smooth interaction between patients and providers. Due to poor signal, online consultations can experience multiple interruptions leading to frustration, low patient satisfaction, and reduced use of the virtual approach to healthcare delivery.
In some cases, factors such as weather conditions, living in rural areas, and home interior can affect the network service in homes and workplaces, hence reducing the frequency, duration, and efficiency of virtual visits for healthcare delivery.
Lack of technological knowledge and skills is a challenge to the use and success of telemedicine in prenatal care. Unfamiliarity with communication technology is common to both patients and providers.
Healthcare providers who have little to no knowledge on how to use communication technology may not want to take up online consultations.
Likewise, patients may find it difficult to install and navigate the telemedicine software on their digital devices. In other cases, patients lack knowledge and training on how to use certain monitoring devices. Hence, they may find it difficult or impossible to interact and provide adequate information during online consultations.
The lack of certain equipment and instruments poses a challenge to the success of telemedicine in prenatal care. Some patients may not have certain instruments such as a fetoscope, weighing scale, sphygmomanometer, amongst others, resulting in non-availability of data to work with.
Consequently, this can lead to poor monitoring which may affect health outcomes of prenatal care via telemedicine.
While patients may enjoy convenience at home, they may be faced with discussing health concerns at the risk of being heard by family members and friends.
In-person visits provide the privacy of the doctor's office which may not be possible with audio and video calls from the homes of patients. This may affect the use of telemedicine in providing and accessing prenatal care.
In other cases, the patient may feel their conversations are being recorded and hence, lose trust in both the service and the healthcare provider.
Telemedicine switches up the order of the conventional hospital visit. The presence of family members, children, colleagues, and other persons may make engagement difficult. Activities in the background may cause distraction during virtual visits.
On the other hand, certain patients may feel disconnected due to a lack of social presence and physical contact with their healthcare provider. The online interaction may be alien to some patients and affect their ability to bond with their healthcare provider.
Nonverbal communication is as effective as verbal communication and in some cases, more. Virtual visits limit communication with body language and facial expressions. Healthcare providers can read these cues during in-person visits and act accordingly.
While telemedicine might be said to save cost, it does not come cheap. Patients may lack the financial ability to buy smartphones, airtime and data, and instruments and equipment.
Unfortunately, patients may not have insurance, or their insurance companies may not cover telemedicine healthcare services.
Healthcare providers are not left out as they also need airtime and data to call and interact with patients.
Telemedicine is a novel approach to access and delivery of prenatal care. Like the conventional in-person approach of care, it has its pros and cons.
Book Appointment Now Call For An Appointment
At My Virtual Physician, our team is committed to ensuring that patients get the best of health care as needed. We provide virtual care at any point in your pregnancy while you await your appointment with your local OB doctor. We are in network with many insurance health plans including Medicaid, Medicare, United HealthCare, and Blue Cross.
Did you know that My Virtual Physician is now accepting SilverSummit Health Insurance? That is great news for residents of Nevada’s Clark and Washoe counties. Members can now book an online doctor appointment with no out-of-pocket expense.
SilverSummit Healthplan provides the best Nevada Medicaid plans. Now they are adding even more value to their services by partnering with My Virtual Physician to give members virtual doctor visits. Residents of Nevada can access doctors to treat a wide range of problems, including:
My Virtual Physician’s caring doctors treat patients right in their own home through a video visit. The office provides appointments for Obstetrics/Gynecology (OB/GYN) or Primary Care Physician (PCP) services. And patients can book safely and easily through the patient portal.
Health insurance plans are similar because they usually cover the same services. But different plans may:
Some plans are Health Maintenance Organizations (HMOs). These give members a list of doctors to choose from in their network. Insurance will cover services from in-network doctors, but may not cover the same services with out-of-network providers. My Virtual Physician is thrilled to add SilverSummit to their accepted Insurance Plans lineup and accept new patients.
My Virtual Physician is still adding new insurance plans to the network. But even without insurance, visits are still less expensive than an in-office visit. And the office accepts many forms of payment. Patients also appreciate booking an online doctor appointment because it is more convenient. My Virtual Physician has late evening and weekend appointments for booking. Members of SilverSummit Healthplan can schedule an appointment now at www.myvirtualphysician.com or text the office staff with questions.
To meet the physicians, simply click “BOOK APPOINTMENT NOW” to book your visit. Or visitors can text message questions about the virtual/online doctor benefits.
My Virtual Physician has great news to share. Nevada’s favorite telemedicine provider is now in-network with Anthem Blue Cross Blue Shield (BCBS). Nevada residents looking for an online doctor may be able to book an appointment now with little to no out-of-pocket expense.
Anthem leads the health insurance industry with a strong desire to make healthcare easier and change lives. Anthem health plans serve more than 42 million families. That is why My Virtual Physician (MVP) is proud to join the Anthem Nevada provider network.
BCBS is known for offering members value-added services.
Anthem Nevada’s member support services are unmatched.
And when Anthem Nevada members need to see a doctor, that’s where MVP comes in. Their board-certified, expert doctors care for Nevada patients from the convenience and safety of home.
MVP offers Obstetrics/Gynecology (OB/GYN) and primary care services to residents of Nevada. Whether using insurance or paying out-of-pocket, My Virtual Physician’s pricing is competitive, and the patient care is unmatched.
Take a look at a few of the current online physician services they treat for Nevada residents:
Patients who need to see an online doctor can book now through a secure patient portal. My Virtual Physician is excited about the new Anthem Nevada partnership and is now accepting new patients. Virtual doctor visits are now easier than ever.
Residents of Nevada can find more information about Anthem BCBS in Nevada at www.anthem.com.
To meet our book an online doctor appointment with our physicians, simply click “Book Appointment Now” to book your visit. Or visitors can contact the office for questions about their virtual/online doctor benefits. My Virtual Physician is standing by to help.
One in five Americans face poor access to medical care. In some parts of the country, there are serious shortages of doctors and healthcare services. And this is the case for many women living in Georgia.
Georgia has been greatly affected by a nation-wide healthcare shortage. The need for care, specifically women’s healthcare, has increased dramatically over the past decade. Especially in the rural areas outside of major cities, Obstetrical and Gynecological (OB/GYN) services can be hard to find. Fortunately, My Virtual Physician (MVP) has been able to fill the need for some.
Why is there such a need for OB/GYN services in Georgia? And what can be done about the problem? Here's a closer look at the problem.
According to the Georgia Board for Physician Workforce, the state has:
Hence, the lack of doctors is part of the issue. Some women have no choice but to travel to other cities for care. And others even go without.
In many rural areas, there are no OB/GYNs. And in other parts of Georgia, facilities are closing. According to Becker’s Hospital Review, over 100 hospitals have closed during the past decade. Georgia ranked third for most hospitals closed, behind Texas and Tennessee.
To sum it up, a lack of doctors and hospitals is one piece of the puzzle.
Finding a doctor is one problem. But paying for services is another. Many women in Georgia do not have health insurance. Notably, Georgia's insured rate is ranked 48th in the nation.
Another problem is the state's low high school graduation rate. Lack of education is a barrier for access to healthcare. Women struggling with their health may not know where to go for answers.
Speak to one of our board certified OB/GYN virtual doctors today:
Birth control, sexual health, and menopause are sensitive topics. Women need doctors they can trust. OB/GYNs help women through complicated health changes.
OB/GYNs can treat common problems such as:
In addition to new or worrisome symptoms, gynecologists also provide preventative health services.
For example, OB/GYNs encourage women to have breast cancer screenings after age 45 and bone density scans every two years following menopause.
Without regular checkups, women may face major health concerns as time goes on.
Despite the dismal circumstances, care for women in Georgia and other states is changing.
Telemedicine providers offer a new solution. Board-certified OB/GYNs are treating women in Georgia virtually.
According to the American College of Obstetricians and Gynecologists (ACOG), patients can get the same quality care via telemedicine as they would in person. In some cases, patients say their online doctor experience is even better.
Online doctor appointments are affordable and easy to schedule. As well as that, virtual gynecology visits provide a greater sense of safety and security from the comfort of home.
It is getting easier for the women of Georgia to see top-rated doctors for the virtual gynecology care they need. Dr. Howard of MVP treats patients across the U.S., including Georgia. MVP is a multi-state, multi-specialty telemedicine provider that is quickly becoming the preferred choice for many.
Women who want an online gynecology appointment can text the office at 725-228-8277 or visit the patient portal to set up self-scheduled appointments.
My Virtual Physician offers comprehensive virtual gynecology services to address women’s healthcare needs. Our caring doctors can talk with you about your concerns and provide the experience you've been looking for.To talk with one of our expert physicians near you, book an appointment today.
Have you been looking for a Nevada healthcare provider that is in your Prominence Health Plan network? Look no further.
My Virtual Physician (MVP) is excited to announce a new partnership with Prominence Health Plan. Prominence is a respected plan provider that offers a broad network of hospital and healthcare services to its members. Together, MVP and Prominence are serving more individuals with the high quality online healthcare services they need.
Here’s what this new relationship can do for you.
Prominence Health Plan is a subsidiary of Universal Health Services (UHS), which was recognized by Fortune and Forbes as a top company in 2021.
Prominence focuses on providing their members with options for quality, convenient, cost-effective care close to home.
Prominence Health Plan began in Reno, Nevada as a commercial Health Maintenance Organization (HMO) in 1993. Since then, they have expanded to include Preferred Provider Organization (PPO) and Medicare Advantage (MA) service lines in multiple states including Nevada, Texas, and Florida.
What Does Prominence Cover?
Prominence Health Plan, like most insurers, offers different types of medical plans. Health insurance plans are similar because they cover many of the same services. Yet they can be different when it comes to:
If a plan is called a Health Maintenance Organization (HMO), the insurance plan gives members a list of doctors that are in the network. Choosing a provider that is not on the list may mean that the insurance will not cover any of the visit costs. Members are encouraged to choose an in-network provider so the services will be covered by the plan.
On the other hand, if a plan is called a Preferred Provider Organization (PPO) the member has more options. They can pick any doctor. But choosing an in-network doctor makes services more affordable because of discounts or additional coverage for using in-network providers.
It is easy to see why it is best if your doctor is in-network with your insurance plan. This is one reason why MVP is excited to announce that they have joined the Prominence Health Plan network.
MVP and Prominence have a lot in common.
They both started in Nevada.
They are both well-respected companies.
And both work to provide options for quality, convenient, cost-effective care close to home.
Prominence Health Plan and MVP are a perfect match.
MVP is a multi-specialty telemedicine team, treating patients across the US. They provide comprehensive online doctor visits to treat patients of all ages with care for obstetrical-gynecological, primary care, and pediatric services.
Virtual physician appointments are affordable and easy-to-schedule. Plus, they offer the safety and security of being seen from your home or workplace in convenient after-hours and weekend appointment times. Now with more in-network insurance coverage, MVP’s online physician services are better than ever.
MVP’s online doctors treat gynecological issues including:
As well as primary care concerns such as:
If you need to see a doctor and you’ve been looking for the best care at an affordable price, your search can stop here.
Many health concerns can be solved with a simple online consultation. The team at MVP is available now to meet with you.
Did you know My Virtual Physician is offering a promotion for September? Book now to get a free home blood pressure kit for new patients who complete an online consultation in the month of September. Don’t wait, grab your appointment spot now!
MVP’s founder Dr. Howard is a board-certified physician practicing in Las Vegas, Nevada. He is passionate about medicine and research. He has authored/co-authored several publications and is among the top 10% of scientific reviewers in the United States. Dr. Howard and his team are now accepting new patients.
Women looking for a great Obstetrics and Gynecology provider (OB/GYN) in Las Vegas, Nevada, may have trouble. There is an OB/GYN physician shortage in Las Vegas. And the situation is getting worse.
Factors such as physician burnout, population growth, and competition from other parts of the country have created a shortage of OB/GYNs in Las Vegas, Nevada. As a result, some may have difficulty finding the perfect provider to care for their reproductive health.
Women and their partners want an OB/GYN they can trust. Issues like birth control, childbirth, and menopause are delicate matters. Unfortunately, a shortage means there are not enough providers to meet Las Vegas’ needs. Thus, those doctors who are available may be overworked or stretched thin.
Here is why it’s hard to find a good OB/GYN in Las Vegas and what to do about it.
When there are too few doctors to meet a city's demands, it can be hard to find a provider to respond to each patient’s needs. According to NBC News, America is facing an OB/GYN shortage.
Las Vegas, overall, has the most severe OB/GYN workforce shortage.
Other parts of Nevada face an even more serious situation. Some counties lack even one OB/GYN provider. Hence, patients face delays in care. In some cases they are forced to look far away to find a doctor.
Here’s why it is hard to find OB/GYN care in Las Vegas.
And while Las Vegas OB/GYNs may have it rough, the patients suffer too.
OB/GYNs offer services that women need. They provide health counseling, sexually transmitted infection (STI) testing, and more. From puberty to menopause, women need a health expert they can trust. Many patients depend on OB/GYN advice.
Fortunately, Las Vegas residents can now find the best OB/GYNs, right in their neighborhood.
My Virtual Physician has an answer for the physician shortage crisis. Two of the best board-certified OB/GYNs in the nation are on staff and available for appointments near you in Las Vegas.
My Virtual Physician offers OB/GYN visits in Las Vegas with flexible scheduling through telemedicine. While most providers are busy and feel the pressure to treat many patients quickly, My Virtual Physician is different. Online video visits eliminate travel time and the feel of a busy waiting room. Virtual consultations provide a relaxed, personalized, and patient-centered care experience.
During the pandemic, many patients have had questions about staying safe. Some want to know if vaccination is right for them. Women in Las Vegas can now book a visit with My Virtual Physician to discuss their concerns and get real medical advice. Booking an appointment with an OB/GYN in Las Vegas has never been easier.
Are you looking for an OBGYN near you in Las Vegas? My Virtual Physician has two board-certified physicians licensed in Nevada who can address gynecological problems via video visits.
If you would like to talk with a board-certified OB/GYN, you can schedule your appointment online now. My Virtual Physician offers health screening, lab tests, and counseling to meet all of your healthcare needs.
More than 100 million Americans are living with abnormal blood sugar. Is it possible that you could be one of them? A simple A1c screening blood test shows when levels are too high. Elevated blood sugar means higher risk for diabetes.
A glycated hemoglobin, or hemoglobin A1C, test (HbA1c) is one screening test that checks blood sugar levels. Results show how much sugar is in the bloodstream over time. Testing is accurate since values are not affected by acute illness or stress. A1c screening is recommended for certain populations, including overweight adults and those with other risk factors.
Those thinking about blood sugar testing or wondering about risk factors should talk to their doctor. Here are some common questions about diabetic screening and A1c testing.
The A1c test can detect diabetes because it measures how much sugar, called glucose, is found in red blood cells. The red blood cells give a “glycemic history” of the past 120 days.
Everyone has sugar in their blood. But diabetics have higher levels. Blood sugar that is too high leads to cell and tissue damage.
When someone is diagnosed with diabetes, their doctor will also use the A1c test to monitor how the disease is being controlled.
A1c readings are measured in percentage. Here is what A1c results mean.
Higher blood sugar levels cause greater A1c values, and they equal greater risk for 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.
Here are the current recommendations for A1c screening.
The CDC suggests A1c screening to know a baseline for:
They further recommend that any woman who has ever had gestational diabetes should have an A1c check every three years even if results are normal.
The USPTF also says that adults over age 45 should be checked for diabetes using the A1c test. Furthermore, it recommends repeat testing every three years.
The ADA also recommends the A1c test, or other diabetic screening, for all adults at age 45 and over. Additionally, it advises overweight individuals with one or more risk factors to be screened, regardless of age. If results are normal, repeat screening is recommended every three years or less.
How to Get an A1C Test
If you meet some of these guidelines, you might be wondering how you can get a screening test.
A primary care doctor or other licensed provider can order this common blood test. Results take as little as a few business days.
Those who do not have a doctor to order the test, can still get this valuable screening. An online doctor or virtual physician can help. Telemedicine providers work with laboratory partners to treat patients without unnecessary trips to an office.
An online physician sends referrals and lab orders just like a brick-and-mortar doctors office. After going to a lab for blood work, virtual doctors offices schedule follow up video visits to go over the results, answer questions, and discuss treatment plans.
If you would like to talk with one of our board-certified physicians, book and appointment today. My Virtual Physician offers health screening, lab tests, and counseling to meet all of 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.
In the United States, colorectal cancer (CRC) is the third leading cause of cancer, after breast and lung cancer.
CRC almost always develops from precancerous polyps (abnormal growths in the colon or rectum). Screening tests can find precancerous polyps so they can be removed before they turn into cancer. Screening tests can also find CRC early, when treatment works best.
A screening test is used to look for a disease when a person has no symptoms. (When symptoms are present, diagnostic tests are used to find out the cause.)
Regular screening begins at age 45. The U.S. Preventative Services Task Force (USPSF) recommends adults age 45 to 75 be screened. For adults age 76 to 85, the Task Force recommends asking their doctor for screening recommendations.
Talk to a virtual doctor today!
Several screening tests can be used to find polyps and/or CRC (see Table 1 below). There is no single “best test” for any person. Each test has advantages and disadvantages. Talk to a virtual doctor about which test may be best for you and how often to be tested. Testing modality depends on personal preference, individual medical conditions, the likelihood of testing, and the resources available for testing and follow-up.
Table 1. Screening Tests for CRC
| Test Name | Description | Testing Frequency |
| Stool TestsGuaiac-based fecal occult blood test (FOBT) | Uses the chemical guaiac to detect blood in stool. Test provided by health care provider. At home, use a stick or brush to obtain a small amount of stool. Return the test kit to doctor or lab, where stool samples checked for presence of blood. | Once a year. |
| Fecal immunochemical test (FIT) | Uses antibodies to detect blood in stool. | Once a year. |
| FIT-DNA test (or stool DNA test) | Combines the FIT test with a test that detects altered DNA in the stool. This test requires an entire bowel movement be collected and sent to a lab, where it is checked for cancer cells. | Once every 3 years. |
| Flexible Sigmoidoscopy | During this test, the doctor inserts a short, thin, flexible, lighted tube into the rectum through the sigmoid colon (lower 1/3 of colon). The doctor checks for polyps or cancer there. | Every 5 years, or every 10 years with a FIT every year. |
| Colonoscopy | Similar test to flexible sigmoidoscopy, except the doctor uses a longer, thin, flexible, lighted tube to check for abnormalities inside the rectum and entire colon. During the procedure, the doctor can find and remove most polyps and some cancers. Colonoscopy is also used as a follow-up test if anything unusual is found during one of the other screening tests. | Every 10 years (for people who do not have an increased risk of colon cancer). |
| CT Colonoscopy (Virtual Colonoscopy) | Computed tomography (CT) colonography, also called virtual colonoscopy, uses X-rays and computers to produce images of the entire colon. These are displayed on a computer screen for the doctor to analyze. | Every 5 years. |
The screening testing frequencies above are general guidelines and may be different for you if you have certain risk factors for CRC, such as a family history of CRC or detection of high-risk lesion. Testing is generally more frequent for patients who are high risk. Your doctor will help you decide the optimal screening interval.
Connect with Our Online Doctors
If you would like to connect with a board-certified physician, book an appointment with a virtual doctor today. My Virtual Physician offers comprehensive medical services where you can discuss the best screening plan for you
Sexually transmitted diseases (STDs), also called sexually transmitted infections (STIs), are very common, with around 25 million new diagnoses made yearly in the United States. Young people, ages 15-24 years of age, appear to be the most prevalent group to acquire and spread STDs, accounting for about half of newly diagnosed cases in 2018 per the Centers for Disease Control (CDC). Notably, 1 in 5 people in the United Stated have had an STD.
Oral, vaginal and anal sexual encounters are the methods of transmission and these infections vary greatly in their symptoms, severity, curability and prognosis. Treatment has improved over the years and some lifelong conditions now do not preclude a good quality of life. However, some of these diseases can be quite quiet in terms of initial symptoms, and screening tests, or tests to check if a disease is present even when symptoms are not, are a critical way to help reduce transmission and consequences of these infections.
Bacterial Vaginosis, not categorized itself as a sexually transmitted disease, is a condition named for alterations in the normal balance of bacteria in the vagina, which can lead to an increased risk for susceptibility to STDs, as well as preterm labor. A fishy odor may be noted after vaginal intercourse, and pain, itching and burning in this area or during urination, as well as thin, grey-white vaginal discharge, are among associated complaints. Although many cases of bacterial vaginosis clear on their own, antibiotic treatment may be needed at times. Currently, there is no recommendation for routine screening for BV.
Two of the most predominant, but easily treatable STDs, include chlamydia and gonorrhea. Both can spread through oral, vaginal or anal sex. Though either condition may be asymptomatic, some suspicious findings include abnormal vaginal or penile discharge, burning while urinating and pain or swelling of the testicles. Chlamydia and gonorrhea can also reoccur if infectious sex continues, despite prior treatment. Also, having these infections increases a woman’s risk to develop pelvic inflammatory disease (PID), which is damage to the internal reproductive organs, making future fertility a challenge. If infected during pregnancy, risk for miscarriage, preterm labor, low birth weight or an infection in the fluid surrounding the fetus, called chorioamnionitis, increases. Newborns of untreated mothers may also suffer postnatal complications such as eye infections and pneumonia. Pregnant women < 25 years of age, or older pregnant women at increased risk of exposure to gonorrhea or chlamydia, are typically screened at their first prenatal visit. Similarly, it is recommended to screen all sexually active women < 25 years of age, yearly, for gonorrhea and chlamydia, and older women who have multiple sexual partners. All sexually active gay or bisexual men, should also be screened at least yearly, but more often depending on frequency of new sexual encounters/multiple partners. Testing for these diseases can be as simple as a urine sample ordered by a virtual physician, however it is prudent to discuss symptoms and history to determine the best course of screening.
According to the CDC, every 1 out of 6 people in the United States has herpes simplex virus (HSV) infection, oftentimes without knowing it. HSV can be divided into HSV 1, more commonly known as oral herpes, and HSV 2, known as genital herpes. Although designated as such, either can occur orally or genitally. Many people are infected with HSV 1 in their childhood, through non sexual mediated contact with infected saliva. Oral herpes results in cold sores or fever blisters, around the lip and mouth area. Genital herpes, likewise, can demonstrate sores throughout the genital region of infected individuals. Lack of active sores however does not negate infectious activity and the disease can still spread through unprotected oral, vaginal and anal routes. There is no curative treatment for HSV and the virus can go into a dormant phase where no symptoms occur for years, though patients are at risk for recurrent outbreaks, where an antiviral medication may be prescribed. Devastating effects can occur if left untreated during pregnancy, including life-threatening infection to the newborn. If there is history of infection or active infection at the time of labor, a Cesarean section may be indicated. The United States Preventive Services Task Force does not recommend routine screening for HSV in asymptomatic sexually active adolescents or adults, including pregnant women.
Syphilis is a bacterial infection spread through sexual contact, and is divided into distinct phases, first beginning as painless mouth/oral, genital or anal sore(s) several days to several months after initial exposure. This sore or sores will resolve after a few weeks, even without medication. Then a body rash develops, sometimes with swollen lymph nodes, general fatigue and a fever, later. There can be a long period of “latency”, or no symptoms, followed by the last stage classified by neurological, ocular and cardiac symptoms. This is a curable condition, but can cause life-long consequences if untreated, including dementia and blindness, and can lead to death. Screening is indicated for sexually active individuals on a yearly basis, but more often such as every 3-6 months for high risk features, such as multiple partners. This can be performed through a blood test, which may be ordered through a virtual physician’s visit.
Although there are other methods of transmission, typically hepatitis B may be acquired through the sexually transmitted routes mentioned above. Hepatitis C is less commonly sexually transmitted, but spreads through exposure of infected blood, such as in activities like sharing needles in illicit IV drug abuse. Both conditions, though incited by different viruses, have the same impact on the liver and symptoms can overlap, with fever, fatigue, yellowing of the eyes and skin, abdominal pain and changes in urine color. With the exception of individuals living in extremely low prevalence areas, it is recommended that hepatitis C screening be given to a person at least once after the age of 18 years. Additionally, although hepatitis B is a vaccine preventable illness, the USPSTF recommends screening by blood test, those individuals at high risk such as those who inject drugs or share needles, men who have sex with men and immunocompromised patients, such as those with HIV, as well as those living in areas with a 2% or higher prevalence of the hepatitis B surface antigen, regardless of vaccination status. This is especially important given that hepatitis B is a chronic illness that will need lifelong treatment and both viruses present a higher susceptibility to liver cancer.
HIV, or human immunodeficiency virus, eventually progresses to acquired immunodeficiency syndrome (AIDS). Fortunately, through screening and early detection, appropriate prophylactic and supportive agents can be provided to help maintain CD4 counts and stable immune status in order to prevent, or at least slow, this advancement. It is generally recommended that adolescents beginning at 13 years, through adulthood, into the 60s, be screened via blood test, at least once as part of routine health maintenance. For those in higher risk categories, such as individuals with multiple sexual partners, men who have sex with men and those who share needles, screening may be advised yearly or with more frequent intervals depending on individual circumstances. Once again, this is a blood test that may be ordered through a virtual doctor visit.
While prevention of any illness is optimal through regular visits with a physician, screening tests have proven to be useful in early detection of otherwise asymptomatic diseases, allowing for quicker treatment. In particular, sexually transmitted diseases are relatively easy to screen for through blood or urine samples. If you have questions or concerns regarding your need to be screened for these conditions, it is quite simple to schedule a virtual visit with one of our physicians at My Virtual Physician, and we can help determine which testing is right for you. In addition, depending on the results, oftentimes follow up guidance or medication can also be provided! Schedule a visit today!
Half of adults over the age of 50 are at risk for broken bones. Maintaining healthy bones is important for a long healthy life.
Osteoporosis (OP) is a condition of weakened bones. Thin bones are at risk for fractures. OP screening can be an important part of staying healthy. Early disease detection and treatment may prevent complications later. Broken bones are painful and costly. Luckily, screening tests like the Dual-Energy Xray Absorptiometry (DEXA) scan alert doctors of problems early.
DEXA scans or other OP screening tests are advised for some at-risk groups. To find out if you should be concerned about bone testing today, read on.
OP is more common in adults than you may believe. One health department called it a major public health threat.
OP screening may prevent:
People with OP may not know anything is wrong until they suffer an injury. With advanced bone disease, normal activities can cause bones to break. Studies have shown that many patients do not get the right treatment for low bone density (LBD) despite the great prevalence, complications, and costs of fractures related to bone disease.
Therefore screening tests for bone loss are important to your health. Doctors or specialists can diagnose problems with weak bones before they become serious.
OP affects one-in-three women above 50 years old. It is also a serious condition for men.
It is best to talk to a doctor about when to get a screening test. They can explain the test and treatment options. Physicians will also answer questions about what to expect.
Currently, we have a few recommendations for OP screening.
The NOF advises a DEXA scan of the hip and spine for:
Also, they also encourage testing in those with:
The ISCD has similar guidelines. They recommend DEXA scan of the hip and spine for the same groups above, but also in:
AACE recommends a DEXA scan for
The AACE says that the lumbar spine and proximal femur are the best sites for testing.
The USPSTF recommends screening for OP in women 65 years or older. Also in younger women with certain risk factors. At this time the USPSTF does not have a recommendation for men.
ACOG currently urges screening for women 65 or older and those under age 65 with risk factors for fracture. They also say physicians should screen patients using the FRAX tool to define their risk of a major fracture.
The FRAX® tool evaluates fracture risk in patients. Based on the score, a 9.3% or higher risk should be referred for a DEXA scan.
The DEXA scan is a quick and reliable test for measuring bone mineral density (BMD). It aids in the diagnosis of OP.
The scan usually takes around 15 minutes. And it doesn't hurt. First, the patient lies down on an open table.
Next, a scanner passes over the body. It sends two X-ray beams. And the machine tells how the rays pass through the bones. This shows how thick or thin they are. The results give the doctor a good idea of how healthy the bones are.
Like other medical tests, a DEXA scan is ordered by a healthcare professional. Typically, doctors or specialists can write a prescription or send a referral. Virtual doctors and online physicians can also arrange this test for their patients.
OP screening may be a part of your yearly check-up. Or it can be used to check on certain risk factors.
Thanks to telemedicine, it is now fairly easy to get this important test. An online doctor can tell you about OP screening and answer your questions. Online appointments are convent. Patients meet doctors from wherever they are, on a mobile device or smartphone.
My Virtual Physician offers screening consultations at little or no out-of-pocket cost. They can order blood tests, imaging or scans, X-rays, and more. And in some cases, same-day appointments are available.
Many screening tests are covered by health insurance or medical benefits. Check with your insurance to see if any out-of-pocket payment is required. Medicare pays for bone density testing every two years for adults over 65 with some risk factors.
My Virtual Physician offers full preventive care services for men and women. To talk with one of the top physicians, click to book an appointment now. The MVP caring experts help patients with screening plans that are tailored to their healthcare needs.
If you have ideas for other topics you want to read about, let us know! Don’t forget to follow us on social media.
Sources:
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.
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.
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.
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.
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.
MedPage Today published an article about the rise of telemedicine services in relation to the COVID-19 pandemic and why more people are favoring virtual doctor's visits. To read the rest of the article, click here.
