Wednesday, February 28, 2018


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

Tuesday, February 20, 2018


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 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 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



  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.


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


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:

Wednesday, March 8, 2017


On Sunday, March 12 at 2 a.m., clocks move forward by one hour. We will lose an hour of sleep initially from Saturday night into Sunday morning, but the sun will rise later and daylight will extend into our evenings.

Daylight savings time (DST) was initially introduced to cut energy costs – if work hours were during the daylight, people would save money (on candle wax originally), and later on, electricity. DST was phased out but re-introduced during the Second World War.

Canada, Saskatchewan, parts of B.C. and Ontario and Quebec’s north shore don’t follow the time change. In the United States Arizona and Hawaii don’t observe daylight savings time. Other countries - China, India, Japan, parts of Australia and Africa (and several other nations) don’t follow DST.

The main purpose of Daylight Saving Time is to make better use of daylight. We change our clocks to move an hour of daylight from the morning to the evening. When evenings are lighter longer our roads are brighter during the drive home (although there is evidence of significant increases in accident rates on the Monday following daylight-saving time).

DST change can bring problems with (1) sleeping, (2) your metabolism takes a hit, along with your eating routine. You could be encountering more cravings for junk food or even a loss of appetite. Sleep specialist, say that sleep is just as valuable as a healthy diet, drinking less alcohol or exercising. Sleep regulates our appetites because it balances out hormones. As a sleep deprived nation, losing an hour of sleep can make a difficult struggle even worse.

Loss of sleep can affect performance, concentration, and memory the same as fatigue and daytime sleepiness. Light suppresses the secretion of the sleep-inducing substance - melatonin. It is important to expose yourself to the light during the waking hours as much as possible, and not expose yourself to bright light when it is dark outside.

Sleep hygiene is important to create sleep-friendly environments and enhance your chances of falling asleep, staying asleep, and sleeping soundly. Basic sleep hygiene includes reducing or eliminating caffeine and alcohol, exercising several hours before bedtime, creating calming rituals before bed to gradually relax yourself and wearing ear plugs and eye masks. It is also important to go to bed and rise at the same time every day. There is no evidence that diet will actually influence your circadian rhythm however, carbohydrates tend to make it easier to fall sleep.

So try to prepare for the change. Make the time change incrementally beforehand.
  1. Wake up 15 minutes early every day for 4 days before Sunday.
  2. Get some vigorous exercise midday Saturday. Exercise advances the body clock, just like bright light exposure.
  3. On Sunday, get up at your regular time –don't sleep in. Spend an hour outside in the sunshine.
If sleep continues to be a problem, reach out to your Provider for advice.  
Image result for images daylight savings

Wednesday, January 18, 2017

WELLNESS WEDNESDAY: Relocating an Elder Relative

As one of six adult children, my siblings and I recently had to make a hard decision, to relocate our Father to an elder residence . As a  retired Sergeant Major of the USMC, our 91 yo Father was the one who ran everything. Suddenly, we were faced with making the decisions; decisions we believed would provide closer monitoring and increased safety. Through this process, we became very familiar with the reality of the relocation stress syndrome.   


If you have ever moved (as we did often in our youth, as military dependents); you may remember the stress of the unknown and the many challenges a move presented.  That stress becomes exaggerated when an elder has to leave behind, not only their home, many f their belongings, but all that is normal to them.  In recent years, there has been increasing interest in the relocation stress syndrome (RSS), also known as transfer trauma.

RSS is recognized as a nursing diagnosis characterized by a combination of physiologic and psychologic disturbances occurring as a result of transferring a person from one environment to another. Symptoms of relocation stress syndrome include:
  • exhaustion
  • sleep disturbances
  • anxiety
  • grief and loss
  • depression
  • disorientation
With some elders, these symptoms are exacerbated by dementia, mild cognitive impairment, poor physical health, frailty, lack of a support system, and sensory impairment. For these elders, the resulting confusion, depression and agitation have led to increased falls, undesirable weight loss and self-care deficits.

Studies have shown RSS can be minimized if we:
  • Involve them in the decision and planning process
  • Provide an opportunity to ask questions and discuss concerns.
  • Honor an individual’s preferences and allowing them to maintain control.
  • Safeguard their possessions
  • Involve them in setting up the new room or apartment
  • Make the new home resemble (as much as possible) the old home
  • Helping them become acclimated
If you are facing RSS for yourself or a loved one, reach out to your medical provider; or if you do not have a medical home, call our office for assistance 910-799-6262.

Wednesday, December 28, 2016

WELLNESS WEDNESDAY: Post Holiday Blues - It's Real

Did you have a wonderful Christmas?  But are now feeling  blue and finding it difficult to function normally in your daily routine?  It is not only during the holidays that sadness or depression can increase. After the holidays, many people feel a letdown.

Symptoms of holiday letdown include:

  1. Fatigue from overextending ourselves, hectic schedules
  1. Loneliness from the sudden emptiness when family friends have all gone home
  1. Sadness when life returns to normal drudge
  1. Reduced motivation since the energy of the season has disappeared
It is not hopeless! After the holidays we can:

  1. Prolong the joy. Bring the positive feelings and uplifting mood into the new year. Plan a party or get-together. Throw a Super Bowl Party or Valentine dinner.
  2. Continue the gift giving. Pay-it-forward during your daily life. Give the gift of time to an elderly neighbor, offer to babysit for a young parent, serve food at a local shelter.
  3. Embrace the winter. Even though you may want to stay indoors out of the winter weather, you can find activities to tackle that you won't want to do when the weather improves in the Spring and summer. Clean your garage or closets. Organize drawers.
  4. Enjoy your inside time. Treat yourself to a movie binge. Catch up on your reading. Choose activities that meet your interests.
  5. Eat away blues. Choose foods that boost serotonin – the feel good neurotransmitter - such as bananas, poultry, dairy produce and peas.
  6. Put Christmas away. Pack up the Christmas tree and decorations, before you go back to work. Leaving them up is a constant reminder of things that need to be done.
Please contact a provider if you need help with controlling the holiday blues.