Wednesday, May 15, 2019

Depression/Stop Smoking/Advance Directive: Did you Know Patient Centered Care can help?

The Patient Centered Care Team is committed to improving your health by fully identifying and striving to satisfy your healthcare needs.

ADVANCE DIRECTIVE
An advance directive is a form that you fill out to describe the kinds of medical care you want to have if something happens to you and you can't speak for yourself. It tells your family and the medical community including your primary care provider, what to do if you're badly hurt or have a serious illness that keeps you from saying what you want.
There are two main types of advance directives:
  • living will tells your family and your doctor what kinds of treatment you want to receive as you near the end of your life and if you can no longer speak for yourself. A living will is also called a treatment directive.
  • A medical power of attorney lets you name a person to make treatment decisions for you when you can't speak for yourself. This person is called a health care agent or health care proxy.
These involve tough choices to make, but you don't have to make them alone. Take your time. Share your questions or concerns with your Nurse Practitioner at Patient Centered Care. Set an appointment to discuss your plan (your family or a friend are welcome to attend).

SMOKING CESSATION
Smoking cessation (also known as quitting smoking) is the process of discontinuing tobacco smokingTobacco smoke contains nicotine, which is addictive and can cause dependence. Nicotine withdrawal makes the process of quitting often difficult.

After just 12 hours without a cigarette, the body cleanses itself of the excess carbon monoxide from the cigarettesThe carbon monoxide level returns to normal, increasing the body's oxygen levels. Just 1 day after quitting smokingthe risk of heart attack begins to decrease.

Stopping smoking will
(1)  Lower your risk for lung cancer and many other types of cancer
(2)  Reduce your  risk for heart diseasestroke, and peripheral vascular disease (narrowing of the blood vessels outside your heart). 
(3) Reduce heart disease risk within 1 to 2 years of quitting.

If you would like help to stop nicotine, contact Patient Centered care to arrange a consultation with a nurse practitioner to develop a plan.  The following websites may help you with your decision:


DEPRESSION
Many people think of depression as being sad, but it really is a complex medical condition different with each person.  People with depression experience many symptoms, including:
  • little interest or pleasure in doing things
  • feeling down or hopeless
  • trouble falling asleep, staying asleep or sleeping too much
  • feeling tired or having little energy
  • having a poor appetite, over eating or having weight change
  • difficult concentrating or making decisions
  • feeling bad about themselves, like they are a failure, or feeling guilty
If you or someone in your family may be experiencing these symptoms, reach out to the office for an appointment with a nurse practitioner.  Is it time to talk about your symptoms?


Patient Centered Care, PLLC  910-799-6262 (phone) 

Monday, April 2, 2018

WELLNESS WEDNESDAY: CHILD ABUSE PREVENTION


Child abuse and neglect are significant public health problems in the United States.

Each day more than five children die as a result of abuse or neglect. On average, a child abuse report is made every 10 seconds for a total of approximately 3.3 million child abuse reports annually. 


Child abuse and neglect includes all types of abuse or neglect of a child under the age of 18 by a parent, caregiver, or another person in a custodial role that results in harm, potential for harm, or threat of harm to a child.

There are four common types of abuse and neglect.

Physical abuse is the use of physical force, such as hitting, kicking, shaking, burning, or other shows of force against a child.
Sexual abuse involves inducing or coercing a child to engage in sexual acts. It includes behaviors such as fondling, penetration, and exposing a child to other sexual activities.
Emotional abuse refers to behaviors that harm a child’s self-worth or emotional well-being. Examples include name calling, shaming, rejection, withholding love, and threatening.
Neglect is the failure to meet a child’s basic physical and emotional needs. These needs include housing, food, clothing, education, and access to medical care

Guide to preventing child abuse
  • ·         Never discipline your child when your anger is out of control.
  • ·         Participate in your child’s activities and get to know your child’s friends.
  • ·         Never leave your child unattended, especially in the car.
  • ·         Teach your child to use their voice to allow them to prevent abuse in their own life.
  • ·     Ask questions; for example, when your child tells you he or she doesn’t want to be with someone, this could be a red flag.
  • ·         Listen to them and believe what they say.
  • ·         Be aware of changes in your child’s behavior or attitude and inquire into it.
  • ·         Teach your child what to do if you and your child become separated while away from home.
  • ·         Teach your child the correct names of his/her private body parts.
  • ·         Be alert for any talk that reveals premature sexual understanding.
  • ·         Pay attention when someone shows greater than normal interest in your child.
  • ·    Make certain your child’s school or day care center will release him/her only to you or someone you officially designate.


Unexplained injuries aren't the only signs of abuse. Depression, fear of a certain adult, difficulty trusting others or making friends, sudden changes in eating or sleeping patterns, inappropriate sexual behavior, poor hygiene, secrecy, and hostility are often signs of family problems and may indicate a child is being neglected or physically, sexually, or emotionally abused.

If you witness a child being harmed or see evidence of abuse, make a report to your state's child protective services department (link below) or local police (link below). When a child talks about abuse, listen carefully, assure the child that he or she did the right thing by talking to you, and affirm that he or she is not responsible for what happened.

http://patientcareofwilmington.com/      Patient Centered Care, PLLC  910-799-6262

Sunday, March 25, 2018

WELLNESS WEDNESDAY: E-Cigarettes


Definition: Electronic cigarettes (e-cigarettes) are battery-operated devices that heat a liquid usually containing nicotine, producing a vapor that the user inhales. E-cigarettes entered the market as consumer products without government regulation.

Conventional cigarettes burn tobacco and generate smoke, e-cigarettes have a cartridge containing a liquid (sometimes referred to as "e-liquid"), which contains nicotine and other constituents. The main components of the liquid vaporized is nicotine, propylene glycol or glycerol, and flavorings. A variety of other compounds have also been identified, some with carcinogenic potential.

The long-term health consequences of e-cigarette use are largely unknown but are likely to be less than continuing to smoke conventional cigarettes because e-cigarettes do not expose the user to many of the toxins in tobacco smoke. E-cigarettes expose users to nicotine as well as heated and aerosolized propylene glycol and glycerol and other compounds. The toxicity of chronic exposure to these and the other components of e-cigarettes is uncertain. We do not have long term data examining the health effects of e-cigarettes.

Nicotine Exposure: From e-cigarette use, as with cigarette smoking, increases heart rate and introduces levels of blood cotinine, a nicotine metabolite. The consequences of chronic inhalation of e-cigarette vapor are largely unknown, and levels of toxic and carcinogenic compounds may vary by e-cigarette liquid components and device used. We do know the potential adverse effects are related to nicotine exposure as well as exposure to other components in the vapor produced by the devices. There have also been documented emergency department visits for burns from electronic nicotine delivery systems (ENDS) due to device malfunction either while stored (eg, in a pocket) or during use, resulting in burns to the thigh, groin, face, and/or hand.

Passive Exposure: There is limited evidence on the health effects of passive vapor exposure and no conclusions can be drawn. Passive exposure to e-cigarette vapor produces small increases in serum cotinine, comparable with that from passive exposure to cigarettes. However, passive exposure to e-cigarette vapor is expected to be less toxic to bystanders than combustible cigarette smoke.

E-cigarettes are not approved by the US Food and Drug Administration (FDA) for smoking cessation and the FDA has not endorsed their safety or efficacy for smoking cessation. Using e-cigarettes is probably less harmful than smoking conventional cigarettes, but we do not know how safe they are to users or those around them. They continue the user's exposure to nicotine. The health consequences of vapor exposure are unknown, and there may be risks from inhaling e-cigarette flavorings on respiratory function.

WARNING: The typical 5 mL vial of e-cigarette liquid refill may contain a nicotine concentration of 20 mg/mL (100 mg/vial). The known lethal dose of nicotine is about 10 mg in children.
patientcareofwimington.com
https://www.facebook.com/PatientCenteredCareWilmington/


Wednesday, February 28, 2018

WELLNESS WEDNESDAY: COLON CANCER

Colorectal cancer (cancer of the colon or rectum) is the second leading cause of cancer deaths in the United States.  Greater than 50,000 people die from colorectal cancer every year.  This disease is highly preventable, by getting screened beginning at age 50.
Screening tests help prevent colorectal cancer by finding precancerous polyps (abnormal growths) so they can be removed. Screening also finds this cancer early, when treatment can be most effective.
·         Risk increases with age. More than 90% of colorectal cancers occur in people aged 50 and older.
·         Precancerous polyps and colorectal cancer don’t alwayscause symptoms, especially at first. You could have polyps or colorectal cancer and not know it. That is why having a screening test is so important. Symptoms may include—
o    Blood in or on the stool (bowel movement).
o    Stomach pain, aches, or cramps that do not go away.
o    Losing weight and you don’t know why.
·         Some people are at a higher risk than others for developing colorectal cancer. If you think you may be at increased risk, talk to your provider about when to begin screening, which test is right for you, and how often to get tested.
·         There are several screening test options. Talk with your provider about which is right for you.
o    Colonoscopy (every 10 years).
o    High-sensitivity guaiac fecal occult blood test (FOBT) or fecal immunochemical test (FIT) (every year).
o    Sigmoidoscopy (every 10 years, with FOBT or FIT every three years).
o    Sigmoidoscopy alone (every 5 years).
o    Stool DNA test (FIT-DNA) every one or three years.
o    CT colonography (or virtual colonoscopy) every five years.

Patient Centered Care, PLLC
910-799-6262

Tuesday, February 20, 2018

SHINGRIX, THE NEW SHINGLES VACCINE

Shingles is a painful rash that usually develops on one side of the body, often the face or torso. The rash consists of blisters that typically scab over in 7 to 10 days and clears up within 2 to 4 weeks. Some people describe the pain as an intense burning sensation. For some people, the pain can last for months or even years after the rash goes away. This long-lasting pain is called postherpetic neuralgia (PHN), and it is the most common complication of shingles. Your risk of getting shingles and PHN increases as you get older.  Many are wondering about the new Shingles Vaccine. 

Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia (PHN), the most common complication from shingles. CDC recommends that healthy adults 50 years and older get two doses of the shingles vaccine called Shingrix®, separated by 2 to 6 months, to prevent shingles and the complications from the disease.

Shingrix provides strong protection against shingles and PHN. Two doses of Shingrix is more than 90% effective at preventing shingles and PHN. Protection stays above 85% for at least the first four years after you get vaccinated. Shingrix is the preferred vaccine, over Zostavax®.

Healthy adults 50 years and older should get two doses of Shingrix, separated by 2 to 6 months. You should get Shingrix even if in the past you:  had shingles, received Zostavax or if you are not sure if you had chickenpox.  There is no maximum age for getting Shingrix.

Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. About 1 out of 6 people who got Shingrix experienced side effects that prevented them from doing regular activities.  Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.

You might have a reaction to the first or second dose of Shingrix, or both doses.  If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.  Severe allergic reactions to any vaccine are very rare

There are several ways shingles vaccine may be paid for:
 Medicare
Medicare Part D plans cover the shingles vaccine, but there may be a cost to you depending on your plan. There may be a copay for the vaccine, or you may need to pay in full then get reimbursed for a certain amount.
Medicare Part B does not cover the shingles vaccine.
Medicaid
Medicaid may or may not cover the vaccine. Contact your insurer to find out.
Private health insurance
Many private health insurance plans will cover the vaccine. Contact your insurer to find out. 
Vaccine assistance programs
Some pharmaceutical companies provide vaccines to eligible adults who cannot afford them. You may want to check with the vaccine manufacturer, GlaxoSmithKline, about Shingrix.

Friday, September 1, 2017

WELLNESS WEDNESDAY (ON FRIDAY): PREPARING FOR A HURRICANE

PREPARING FOR A STORM

  1. Go to the bank or ATM
  2. Make sure your car is filled with gas
  3. Charge all telephones, tablets, etc
  4. Be sure to have plenty of medications
  5. Plan on a minimum of 72 hours of food, water and supplies
  6. Put food and supplies you need in airtight plastic bags or containers.
  7. Fill your tub; you can use the water to flush toilets
  8. If you have a generator, be sure it is ready and working
  9. Have enough flashlights on hands.
  10. Stock up on batteries for flashlights, radios and kids video games
  11. Determine where you will go if you plan to evacuate. If you need to go to a shelter, find out where the shelter will be. Most shelters do not allow pets, so decide how you will care for them.
  12. Put an appliance thermometer in the refrigerator and freezer so that, if the power goes out, you can check that food stays at a safe temperature. Make sure the freezer is at 0°F or below and the refrigerator is at 40°F or below
  13. Have coolers on hand to keep refrigerated food cold if the power will be out for more than 4 hours. Purchase or make ice cubes and store in the freezer for use in the refrigerator or in a cooler. Freeze gel packs ahead of time for use in coolers.
  14. If your home is at risk for flooding; Move all valuables to higher levels.
  15. Prepare for high winds by boarding up windows and other glass and anchoring outside objects.
  16. Identify loose items located outside, such as lawn furniture, grills, toys, and yard equipment that should be brought inside before a storm.

THREE DAY SUPPLY KIT

Gather an easy to carry, watertight container – a large, plastic trash or line a sturdy cardboard box with a couple of trash bags. Place the following items and place them in your kit:
Water: 1 gallon per person per day. Fill plastic containers, such as soft-drink bottles.
Water purification kit or bleach (use eight drops of regular bleach per gallon of water.
Essential medications
First-aid book and kit that includes:
- 20 emergency bandages of various sizes
- One 5 x 9 sterile dressing
- One roll of self-adhering elastic bandage
- Four various-sized sterile gauze pads
- One roll of 3-inch cohesive bandage
- Waterless alcohol-based sanitizer and wipes
- Medical grade non-latex gloves
- Adhesive tape, 2-inch width
- Anti-bacterial ointment
- Cold pack
- Small scissors
- Tweezers
- CPR breathing barrier, such as a face shield
- Non-prescription drugs (e.g., aspirin or non-aspirin pain relievers)
Ready-to-eat, non-perishable foods, such as canned meats, granola bars, instant soup and cereals, fruits and vegetables, canned or box juices, peanut butter, jelly, crackers, granola bars, trail mix, bread and any special dietary items you and your family need.
Manual can opener
Baby supplies: formula, bottle, pacifier, soap, baby powder, clothing, blankets, baby wipes, disposable diapers, canned food and juices
Food, water, leash and carrier for pets
Sanitary Items:
- Large, plastic trash bags for waste and to use as tarps and rain ponchos
- Towelettes
- Bar soap and liquid detergent
- Shampoo
- Toothpaste and toothbrushes
- Feminine hygiene supplies
- Toilet paper
- Household bleach for cleaning
- Rubber gloves
Blanket or sleeping bag per person
Battery-powered, portable radio or portable TV and plenty of extra batteries
Flashlight and extra batteries
Extra pair of eyeglasses
Extra house and car keys
Fire extinguisher (ABC-type)
Cash and change
Seasonal change of clothing, including sturdy shoes

Call if you have questions:  910-799-6262

Sunday, August 13, 2017

WELLNESS WEDNESDAY: Solar Eclipse

What is a total solar eclipse?

A total solar eclipse occurs when the disk of the moon appears to completely cover the disk of the sun in the sky. Outside the path of totality, the continental U.S. and other nearby areas will see a partial eclipse, in which the moon appears to take a bite out of the sun's disk. Two to five solar eclipses occur each year on average, but total solar eclipses happen just once every 18 months or so.

What will I see during a total solar eclipse?
During a total solar eclipse, the disk of the moon blocks out the last sliver of light from the sun, and the sun's outer atmosphere, the corona, becomes visible. Through the time of totality, the area inside the moon's shadow is cloaked in twilight — a very strange feeling to experience in the middle of the day. Just before and just after totality, observers can see this cloak of darkness moving toward them across the landscape, and then moving away.

Where will the total solar eclipse be visible?
The path of totality for the Aug. 21, 2017, total solar eclipse is about 70 miles wide and stretches from Oregon to South Carolina. It passes through Idaho, Wyoming, Nebraska, Kansas, Missouri, Illinois, Kentucky, Tennessee, Georgia, North Carolina and South Carolina.

If you plan to observe the eclipse, first read this article: https://eclipse.gsfc.nasa.gov/SEhelp/safety2.html