Soap and Water

I’d like to take a moment and think back to momma’s and papa’s.  Do we remember being told a hundred times… wash your hands?  Now, how often do we say it to our children? 

Let’s review why we wash our hands:

• When we wash our hands we clean them of germs that can make us sick.
• We stop passing the germs to each other
• We clean off dirt that can carry germs.
• Soap and water cleans as well as sanitizing gels (depending on time of washing hands)

When and Where to Wash Hands:

• If we have running water – use soap and water
• You do not need hot water, since the temperature to kill bacteria is too high for skin to survive.
• Soap doubles to effectiveness of washing hands
• Use sanitizing gel (Purell) when no water available

What about Cuts?

• Every cut every time – this should mean clean the wound with soap and water!
• After washing wound with soap for 5 minutes, apply pressure or bandage. Antibiotic ointment is NOT needed unless advised by your doctor.  If you want a lubricant, use Vaseline under the bandage.

Why not antibiotic ointment?

• The overuse of antibiotics have helped in creating “superbugs” which are bacteria and germs which don’t respond to our normal antibiotics.  Think of getting hit in the face… once, twice… by the third time I bet you duck!  Well, the bacteria learn too!
• If we are healthy otherwise, the body will heal itself if we support it with good hydration, nutrition and hygiene (for scrapes and cuts, major injuries should be evaluated by a doctor).

What is “MRSA”

• Methacillin Resistant Staphlococcus Aureaus: A superbug that is resistant to many antibiotics like penicillin.
• Staphlococcus (Staph) is a bacteria that we all have on our skin.  It is usually at balance with yeast/fungus that we all have on our skin.  Some people have this resistant strain of Staph on their skin.
• MRSA is more aggressive and can cause an infection quicker than regular Staph.  It is even more important to keep good hygiene if you have MRSA.
• You can avoid getting MRSA if you don’t share towels or personal items with people who have MRSA.  Since you most likely don’t know who does and does not have MRSA, make it a general rule not to share these items.
• Shower daily or every other day as routine.  If you or your children are in a sport or use a gym shower every time practice/workout  is done or you have had contact with shared spaces and equipment (mats especially)
• MRSA can still be treated with antibiotics.  If you know that you have had an infection caused by MRSA in the past, tell your doctor.  This is very difficult to rid your body of this bacteria, and you will most likely require different antibiotics with infections.

What do I do if I think I have MRSA?

• Talk to your doctor.  Tests can be run to determine if an infection is MRSA or if you are a “carrier” of MRSA.
• There are methods of treating MRSA even if you don’t have an active infection.  Each doctor may differ in ways to treat.
• Soap and Water still works on MRSA – so NO excuses!  Wash your hands!

 

New Year Health

Happy New Year!

As the new year begins, our resolutions start to fade, and reality returns, I am finally able to schedule some time for my blog.  : )

I hope everyone is having a great year, and has been able to make one positive change in their life.  It seems so simple that it couldn’t work, but one small change can make a great difference.  One less soda a day.  A few less cigarettes a day.  An extra bottle of water a day.  A salad with dinner.  Five minutes for yourself.  Five minutes for your spouse or kids.  Dinner together.  Walk to mailbox and back.  All these are simple, but they add up very quickly!

Health is not a moment in time.  It is the combination of the whole.  What is healthy?  Good numbers, labs, weight, diet… that’s part of it.  But a larger part of being healthy, is your mindset or outlook on life and health.  Moderation is the key, so we sometimes should eat that corndog at the fair, or watch TV all day for a movie marathon.  But we shouldn’t continue to do that everyday!  That’s where I feel many of us fall off track.

If healthy is a mindset, how we change ourselves?

• First of all, we need to forgive ourselves!  We live in a lot of guilt, and many focus on what we did wrong or didn’t accomplish.  Rather, we need to focus on what we did right, and did accomplish!  I challenge you to tell yourself something every night that you did well.  It helps the self esteem, and also gives you back the power.  If we continue to constantly ask others for approval, they control our self esteem.  It’s not a good plan for being healthy!
• Secondly, find motivation.  A child, friend, parent, or stranger all can inspire you to work harder and continue to strive to be better.  You can work as team, or keep them inside as a daily reminder.  I challenge you to tell someone every day what they did well.  It could be something simple like helped you carry some items or something bigger like helped you out of tight spot at work.  Reuniting with people connect us to ourselves in a very human way.
• Thirdly, Start small and reward yourself.  Setting goals that are able to be done has the best success.  Ask yourself for little goals each day, then reward yourself when you have been able to do this for 3 days, a week, 10 days, 3 weeks, a month… and so on.  Over time, it will become part of your normal day, and therefore part of your healthy lifestyle.
• Finally, Reflect on past issues and successes.  We are supposed to learn from the past, and we all have a past.  We have done some things well, and some things not so well.  If we can try and objectively evaluate them, we may be able to figure out how to keep doing some of the good things, and not repeat the rest!

I know I’m biased being a Family Medicine Doctor who has a special interest in preventative health, but I’m still a human and a mom.  I struggle with my goals as well, and this year, I’m trying to get more sleep.  Sleep allows us to heal and have better metabolism.  So, it’s difficult to lose weight, control moods, and feel yourself without proper sleep.  So, this year, when I can go to sleep earlier, I will try.  I won’t miss much, but I will gain the morning and hopefully a new side to my health.

Holiday Survival Guide

Hey everyone.  I’m so sorry that it’s taken me a while to post a new message, but like all of you, I get busy with the holidays too!  Which is why I thought we should probably spend some time talking about holidays and stress.  I did a lecture on “Conquering the Holidays – Stress and Diet Management,” and I wanted to share some of the ideas of the lecture.

Stress

1. Busy Schedules – stop complicating everything.  Cut back and learn to enjoy what the season has to offer.  Take your friends and family shopping with you.  Learn to say “no” to extra parties that creep up on you.  Shop at less places, or online.
2. Family Interactions – Some people are never goning to get along, and you will just have to accept it!  If you have nuclear families, try to remember that everyone is stressed and make the most out of what you have.  Focus on family members you can be comfortable, and just be polite.  The holiday will pass soon, and quicker if there isn’t an “incident”.
3. Expectations – we put too much pressure on ourselves.  We need to realize that we aren’t going to get complimented by someone who has never complimented us!  We look amazing, cook wonderfully, and our kids are the most awesome!  Just know it in your heart, don’t require someone else to tell you!  Also, the perfect gift doesn’t exist at a store.  Just get what you think they will like, give it to them with a smile, and walk away.

Diet Management

1. Carbs (Carbohydrates) – a lot of dinners have high carb meals, which are so tasty, but add to our waist, thighs and butt.  Go easy on the sides, but get enough to enjoy the season (especially your Aunt Whoever’s secret receipe you only get once a year).
2. Fats and Sweets – Cookies, Cakes and Pies – Oh My!  I love sweets as much as any gal, but these can kill us too!  My first suggestion is to split it with a friend (the season is partly about sharing!).  Secondly – have one, just not all or the whole sweet! And finally – stop and think why you are still eating.  Boredom?  Being antisocial to avoid the family? Nervous?  Only eat when hungry, and you won’t snack on the sweets all day and night.
3. Portions – whatever you think is a normal portion, cut it in half (more than likely).  We pig out like mad on holiday, so try to curb this by using smaller plates, spoons, or sharing.
4. Comfort – Check back up on Fats and Sweets, and remind yourself why you are eating.  A lot of these foods make us feel good, so we like to eat them.  Make sure you are hungry, not just using food as a “woobie”.
5. Alcohol is not always your friend – Beer and other alcoholic drinks add calories to your diet.  Also, nerves, family and alcohol usually isn’t a good combination.  Some like to use it to cope with the stress, but many take it too far and become the joke or the problem of the evening.  Don’t let yourself be that person.
6. Leftovers – The dreaded and most desired left overs.  I recommend only taking leftovers as a whole or none at all.  I mean, make a containerfor a lunch (meat, veggie, 1 maybe 2 other sides) and that’s it.  No big tubs of potatoes or cassarole.  If you can’t comfortably eat it in 2 meals, it’s too much.  Take the rest to a friend or someone who didn’t get a chance to enjoy the holiday like you did.

Basically, we make or break the holidays.  We have no one to blame but us (usually, there’s always some crazy event we might not have had anything to do with!)

Relax, enjoy the reason for the season, and spend some time with someone you care about.

For your happiness and Health – Dr. Wade

Cough and Cold

‘Tis the season!  Happy fall and sniffles!

As a primary care physician there are often the “cold” symptoms that present in the office, and everyone wants to know how to “get rid of it!”  As frustrating as it is, there is no magic pill, prescription or secret.  Let’s review a little about “colds” or upper respiratory infections (URI).

An upper respiratory infection is any infection affecting the nose, throat and sinuses.  You may call this pharyngitis (sore throat), congestion, sinusitis (sinus infection), “sinuses,” “swollen glands,” or a “cold.”  They usually all stem from a virus at the beginning.

When a virus attacks, the body recognizes that it is an enemy and a “war” starts.  This battle makes the nose, sinuses, throat and everything in between swell.  This swelling is called inflammation.  We can treat this with an anti-inflammatory, like ibuprofen (Motrin, Advil) or naproxen (Aleve).  Acetaminophen (Tylenol) may help with body aches or fever, but will NOT work against the swelling or inflammation.

As the “war” continues it produces secretions (“gunk,” phlegm, snot, drainage).  This irritates whatever it contacts, like sinuses, back of throat and bronchi (air tubes to chest).  We can treat this by thinning down the secretions, making them less irritating and easier to clear.  Guaifenesin (a main ingredient in Mucinex and Robitussin) is found in many Over-the-counter (OTC) cold medications, and will help the most with secretions.

Home remedies are very helpful, that’s why they have survived many generations.  Chicken soup is not just for the soul, it helps break down the secretions on the back of the throat.  It also brings warmth to the body, and replaces any lost electrolytes (salts) from sweating.  Gargling with salt water can work as anti-inflammatory on the throat, decreasing the swelling and the pain.  Teas can work in many ways to help with swelling and sooth the throat.  Vapors and steam help loosen the secretions.

Hydration of any kind is helpful since we require about 2-3 times more fluid when we are sick (the battle is making a lot of secretions, and requiring fluid to do that!).  Water is great to drink when you are sick.  Fruit drinks and sports drinks are NOT recommended.  If you don’t like water, or you feel that you have sweat so much that you need the electrolytes from sport drinks, water it down by half (half a bottle of gatorade with half water).  Water rich foods ARE recommended, like soups, applesauce, fruit, and smoothies.  Try to avoid salty dishes that will take away hydration like fries, chips, or ham.

Rest is the most important, but must be done right.  True rest means that you are not over exerting yourself and drinking fluids.  This doesn’t mean you can’t work or do homework, but it does mean that you shouldn’t go partying or drink alcohol.  You need to get 3-6 more hours of sleep than your usual, and possibly more.

Next time you have a “cold” and want to “get over it now,” try these steps first.  If they don’t work after 5-7 days, call your doctor.

1. Hydration – Water rich foods, soups and teas for hydration and nutrition (until your urine is light yellow, you still need more fluids!)
2. Ibuprofen
3. Guaifenesin
4. Rest – sleep longer, nap during the day, go to bed early!

For small children (under 6 years old), there are different guidelines.  Parents need to contact their doctor to ask about medications (which don’t work well in small children) and what to watch for to indicate dehydration and lung involvement (Pneumonia).

Family Medicine

Recently, I was talking with a community member about the office and I was excited to hear that they needed a family doctor.  I started to tell her about my interest in children’s health, prevention, nutrition… Then she cut me off and said that she had an OB/GYN for her “real issues,” and she just needed a PCP for her “colds” and stuff.  I walked away with a smile, after all, she’s still a potential patient. But I couldn’t help feeling disappointed.

What made me so upset?  I do treat “colds” and stuff.  But she said it like she didn’t think a PCP (Primary Care Physician) could handle her “real issues.”  PCP’s treat more patient’s than anyone in medicine.  They can handle about 75% of the medical concerns patient’s have.  I have taken great pride in being a PCP, because it gives me the ability to treat a wide variety of patient’s needs.  I am required to stay current on multiple topics, medications, and a large part of my job in mental or behavioral, not just medicines!

I take primary care very seriously, in that we are your primary resource.  First call!  If we cannot handle your concern, we will refer or assist you in navigating through the medical community.  In other words, we are your best advocate!

I understand that not everyone may have had the best experience with their current or past PCP.  Many PCP’s are busy, overworked, or just tired.  But, I ask that you do not judge all PCP’s from a bad experience.  Our practice tries very hard to answer everyone’s questions, get patient’s in for same day appointments (kids who are sick will be seen same day as long as a parent call before lunch), and make sure that all the paperwork is done properly the first time.

I am passionate about primary care, I’ve dedicated my entire life to primary care.  I consider it my purpose to help educate patients and community members about primary care, proper prevention, and appropriate care.

As a patient, you should demand better from your primary care and be willing to take responsibility for your choices.  As a doctor, we should strive to give the best care we are capable.  We should give patients options.  We should do all in our power to make sure they understand those options.  We are medical advisors.  We cannot do primary care without a heart or compassion.  And if you do, you may be the reason a patient feels that they only need a PCP for “colds” and stuff.

Stay healthy and respect each other.

Hypertension

Since it’s Monday, the beginning of many people’s work week, we are probably feeling a little stressed, tired, frustrated, or all the above.  So, let’s talk blood pressure!

• What is high blood pressure? Blood pressure is a number which tells us, the medical people, how much force the blood vessles are under when your heart beats (top number, or systolic) and when at rest (bottom number, or diastolic).  A long time ago, they did a study which took people off the street and tested their blood pressure (BP) and found the average (102/80) to be “normal.”  They created a range and decided if you are above 140/90, you are too high.  Since then, they have better toys and better studies.  The new recommendations are based on cell damage at different pressures.  The new recommendations found that at 120/80 the body is good, but high pressure could cause damage to the cells.
• Why do I care?  Many people have high blood pressure, and often I hear that it’s “no big deal,” or “I’ve had it forever,” or “Everyone in my family has it.”  Well, I think it is a big deal!  I’m sorry no one has been able to convince you otherwise that it should be treated.  And, I’m sorry your genetics stink!  But we can deal with all of this!  High blood pressure causes cell damage, that death to a part of your body.  It could be brain, heart, kidney, nerves, eyes, skin, or any other part.  I don’t know about you, but I like all my parts working properly!
• Why does blood pressure get high? Since the day we are born, our blood pressure will get higher.  At birth we have a lot of elasticity in our blood vessles (we are bendy and stretchy), that allows us to keep a low pressure.  But as we age, our vessles gets stronger and less flexible.  Think of a rubber band verse a garden hose.
• Why can’t the body fix it? The body is a closed system, no “release valves” for pressure.  The vessles will stretch and if they break or tear could lead to an anneurysm or hemorrhage.  The body tried to prevent this by making the blood vessles stronger and thicker.  A thicker blood vessle can’t bend well.  This is the cycle and why the earlier we find and treat blood pressure the better.  We can stop this process!
• How can I prevent high blood pressure?  Maintaining a proper weight, avoiding salt (including salt added to your meal, salty food, and processed foods), and exercising regularly will all help control blood pressure.  Stress management helps as well.  When we are stressed, our body gives off a stress hormones like adrenaline, cortisol and aldosterone which can raise pressures over a short time, and cause changes to affect long term.
• How do I get checked?  Your doctor will check your BP at most visits, and you should ask for the number.  Keep a record for yourself.  Check your pressure at the store or get a home BP monitor.  Take your pressure a few times a week when you are most calm (not upset, stressed or in unusual pain) to help show your baseline.  Discuss your readings with your doctor, especially if it is above 140/90.
• What are the symptoms of high blood pressure?  Usually there are no symptoms.  Sometimes patients will tell me they feel tired or “not myself” when their pressure is high.  Headache, chest pain, vision changes or low leg swelling can be symptoms.  More often than not, the only symptom is a major problem: Stroke, Heart attack or Death.
• What are treatments? Usually we recommend lifestyle changes like above. Along with that, medication is usually needed once diagnosed. There are a lot of options with once a day dosing, generic and affordable medication. Labs/blood work is sometimes needed to check kidneys and electrolytes, but that varies with different doctors.

So, here’s my suggestions:

• Take a deep breath and check your BP. 
• Talk to your doctor about your risks and current pressure.  If you don’t have a doctor, or you don’t feel like you can talk to your doctor, make an appt with me in Carrollton and we will talk!
• Evaluate how you are doing with diet and exercise, trying to make 1 small change each week.  The changes will add up!
• Don’t ignore it!  If you think you may have high blood pressure, have ever been told you have a high pressure, or know someone who does – talk to a doctor.  One (1) pill once a day may be the difference in your life!

Keeping calm… when your child isn’t.

Stress happens in life.  There’s no way around it.  Some would argue that you aren’t living if you don’t have stress.

Well, I have a 6 month old.  She beautiful, funny, and I wouldn’t trade a single moment with her… but she isn’t stressfree!  We are teething, and I understand frustration on a new level.  Teething for those who haven’t had the pleasure, causes a constant annoying itching and sometime pain on the gums of our little darlings.  They can have runny nose, fullness in the ears, and even fevers.  It can mimic a cold and cause our usual calm children to act uncontrollably fussy!  Babies can teeth as early as 3 months and well beyond a year.  Some theories state that the later the better for dental care.  Despite when it happens, the drool and the fussing will happen.  Here are some tips:

Teethers: Of course we got teethers at the baby shower.  There was a range: some people swore by, some that were generic and cheap for a bow or stuffer, and some that were in very cute packaging.  I probably have reviewed, researched or own almost every teether on the market.  I haven’t found any difference besides how cold they stay.  That’s it!  Price, size, shape… all dependent on what your child likes.  (They are fairly good to use as a cold pack to keep food cold in a cooler bag/diaper bag, though)  When it comes down to it in our house, I still reccommend a clean cold/frozen wash rag.  The rougher the better. 

Teething gel:  I wanted to stay organic and homeopathic.  Not because I don’t trust modern medicine, hey I’m a western medicine family doctor!  But, I try to put the least amount of products in my child at this stage of her life.  I tried the teething gel with camomile and fenil.  It didn’t work well for my child.  (Though the gripe water made from the same things worked well for hiccups?)  Ambesole has been working alright, most likely because it’s thicker and stays on longer?  It’s all the same, just dependent on what works for your child.

So, I don’t have the answers.  Medically, we tell patients that comfort is the goal.  As a mom, I’m not sure whose comfort I’m more interested in (baby or me), LOL.  Use a teething gel if you would like, but if the child is doing well with teethers and washrags, leave him/her be.  The teeth will come through, there’s no stopping them.  As long as the child sleeps, eats, and fills diapers, he/she is fine.  Get on the same wavelength with the rest of your “team,” and support each other.  Afterall, this is the beginning of “colds” and fevers and temper tantrums.  My best advice, use teething as your training wheels to see where your “team” could improve!

Sleep when you can, and try to stay healthy!

The power of friendship and peers

I hope everyone had a great weekend, and for that matter a great September.

The weather has been great, allowing us to enjoy the fall season to its full potential.  I encourage you to get out and explore a new festival, cheer on a school team (or profession, Ohio is finally having some good luck!), or relax in one of the areas fabulous parks!

This weekend, I was lucky enough to have a weekend get-a-way with some friends.  It was very nice to catch up, talk about our jobs and families, and what exciting things we have planned for the future.  After the weekend, I couldn’t wait to do it again. 

What made the weekend so special?  The location?  the hotel? No – the people.  We love to visit, especially with friends.  It’s not just a teen thing, but it does start about that time.  As humans, we need social interaction, for some more than others.  Not only do we get comfort from this, but we work through stress, form a sense of self, and in general know that we matter.  In general, they keep us healthy – physically, mentally and socially.  The effects spread to other personal relationships, professional relationships, and casual meetings.  Also to note, young people watch our relationships and learn. 

So, my advise to all is to chose your friends wisely, because they are a reflection of you.  They will mold you, as you will shape them.  Friends have many shapes, sizes, values, opinions, and relationships.  If we are lucky we have one great friend we can cherish as a true compass for life.  If you have more, count yourself very lucky.  Foster these relationships. 

Try your hardest to show the young in your life how a good friend treats another, because for some kids they don’t know.  They don’t have a good sense of who they are, like all of us as teens.  Scariest of all, they aren’t learning, and this grows into a huge social problem with time.  Respect of self, each other, mental stability, bullying, and lack of interest in school or the future can all be improved when you know another person cares directly about you.

Enjoy the weather of the season and call a friend.  Take time to talk, not text, with a live person.  : )

 

Seasonal Allergies

Hello all,
I have been trying to start this blog for a few weeks with the perfect topic and perfect blog… But, there is no such thing! So let’s talk about the most relevant to the season. Allergies!

Allergies are a hypersensitivity to something that shouldn’t bother your body. Usually as children they start, but can become worse or better through your life. Where you live, work, travel, or do activity all affect your allergies.

Allergies usually have symptoms of itchy eyes and nose, runny nose and sneezing, and coughing. These are often confused with the start of a “cold” but they don’t progress as a “cold,” usually. Headaches and sore throat sometimes will occur as well.

Allergies can come at any time of the year, dependent on the allergen, or thing that causes your allergy (pollen, mold, dander…etc.). Most Seasonal allergies are Spring and Fall and get better in the winter. But other allergies can be year round, and may get worse in the winter due to the “closed up” environment.

Some people are just annoyed with allergies, but some have symptoms which interupt their work, school and daily activities. If untreated, allergy symptoms may increase the risk of sinusitis and decrease performance at work or school. Also, allergies can increase the amount of sick days.

First line treatment to allergies is avoidance. If you know that you are allergic to something, stay away from it. This is easy to do for some people if the allergy is very specific, like cat dander, but for pollens and molds it’s a little more difficult.

For Seasonal allergy avoidance, I recommend staying in the airconditioning when possible, which filters some allergens. Exercising indoors or if you are outside, taking a shower immediately once done to wash any extra pollen away. Wearing a mask while doing outdoor activities may be beneficial as well.

Nasal Saline is a treatment that helps flush away the allergens in the nose. It can be a spray or a Netty Pot, and available at many local stores and pharmacies. It does not have a medication, only salt and water, and is safe for multiple uses through the day for most ages.

For medical treatment, I recommend that you discuss this with your doctor. There are many over the counter (OTC) and prescription treatments that range from sprays and pills and injections, and for many a combination of these are the most useful if avoidance and saline are not managing the problem.

Welcome to Carrollton

I wanted to thank everyone for being so nice and friendly to me and my family.  I am very excited to be joining the Carrollton area!

My general idea of medicine is a little different from some, I am told.  I believe that every patient has the right to make their own decisions about their health care.  My job is to advise them, so they have the knowledge to make the best decision for themself.  There needs to be a partnership, because I cannot make anyone take a medication or complete a treatment.  That has to be from the patient and an agreed upon plan.

For children, my mission is to make the doctor another place that they belong and feel that they matter.  When a child feels comfortable, then I know that we are creating a good relationship that healthy choices can be built.  We try to be a resource for both parents and children.  Whether it is nutrition, immunization, sickness and medication or questions about social pressures, STD’s and risk prevention, we will do our best to be open and provide the most up to date information for each patient.