Wednesday, September 28, 2016

Wellness Wednesday: Managing Stress

Understanding the types and sources of stress, short term and long term, internal and external, are an important part of stress management. Stress is our body's reaction to the demands of the world and stressors are events or conditions in our surroundings that may trigger the stress.

Main Types of Stress:
Acute stress, known as the fight-or-flight response, is a quick and often an intense response. Acute stress will not likely cause a problem for a healthy person; however, severe acute stress can cause mental health problems such as post traumatic stress disorder or symptoms, such as tension headaches, stomach problems or even serious health issues, such as a heart attack.

Mild acute stress can actually be good for us, motivating and energizing us. The problem occurs when stressors pile up and don't resolve. This develops into chronic stress and can lead to chronic health problems. Effective stress management involves identifying and managing both acute and chronic stress.
Stress Management:
Effective stress management starts with identifying sources of stress and developing strategies to manage them. One way to do this is to make a list of situations, concerns or challenges that trigger your stress response.
  1. External Triggers:
  • environmental (we are experience that with world events today)
  • life changes (marriages, divorces, deaths)
  • unpredictable events (demotion at work, cut in pay)
  • social (relationships with family, co-workers, friends)
  • workplace (deadlines, emails, phones)
Strategies to manage external stressors include lifestyle factors such as eating a healthy diet, being physically active and getting enough sleep. Not all stress stems from things that happen to us. Often a stress response is self-induced. Those feelings and thoughts that pop into your head and cause you unrest.
    2. Internal Triggers:
  • fear
  • uncertainty
  • loss of controlled
  • belief
Fear, attitude and expectation are our lifetime companions. It may take some effort to make changes. Strategies to manage internal stressors include re-framing your thoughts and choosing a positive mindset, challenging negative thoughts, using relaxation techniques, and talking with a trusted friend or counselor.

Recognizing a problem is the first step toward solving it. By identifying and understanding the source of your stress, you are better able to manage it. Manage it, not eliminate it may be the only goal because stress is a fact of life.  

Patient Centered Care, PLLC provides psychiatric diagnostic evaluation and medication management.  Psychiatric Nurse Practitioner, Tamatha Arms provides excellent, personalized care in a pleasant setting.  Call us  for help managing your life stressors.  

Monday, September 26, 2016

Do you know what a Nurse Practitioner is?

You’re definitely not alone if you don’t know what a Nurse Practitioner (NP) is. Even though NPs have been around for 50 years now, many people in the U.S. still aren’t sure what we do.   NPs are nurses who have received medical training.  Part of the confusion can be due to the many letters you see behind an NP name -- and there are many.  With every degree or specialty certification, the NP will receive new initials which represent new qualifications and expertise the NP has earned.  

The minimum education for an NP is a 4 year Baccalaureate Nursing Degree, 2 year Master's Degree, and optional 1.5 - 4 year Doctoral Degree.  The highest degree an NP can achieve is a doctorate degree.  That degree could be a PhD (Doctor of Philosophy) or a DNP (Doctorate of Nursing Practice).  There may also be initials designating the degree, such as MSN (Master of Science in Nursing) or MPA (Master of Public Administration).  The degree designation might  follow their name; however,  some choose to lead with their professional designation, APRN (Advanced Practice Registered Nurse) or NP (Nurse Practitioner).   

The credentials for the American Certification Credentialing Center (ANCC) certified NPs is NP-BC preceded by a letter indicating the particular specialty,
·  Family nurse practitioner:    FNP-BC
·  Adult nurse practitioner:      ANP-BC
·  Adult-gerontologic primary care NP: AGPCNP-BC
·  Acute care nurse practitioner:           ACNP-BC
·  Adult-gerontologic acute care NP:    AGACNP-BC
·  Pediatric nurse practitioner (primary care):   PNP-BC
·  Gerontological nurse practitioner:     GNP-BC
·  Psychiatric and mental health nurse practitioner:    PMHNP-BC 

The American Association of  Nurse Practitioners (AANP) certified NPs are granted the designation of NP-C, or nurse practitioner-certified
·  Family nurse practitioner:     FNP-C
·  Adult-Gerontologic nurse practitioner:   A-GNP-C
·  Adult nurse practitioner:    ANP-C
·  Gerontological nurse practitioner:    GNP-C

The most important part of any initials are the NP.  That lets you know you are with a Nurse Practitioner.  There are more than 222,000 NPs in the US.   Nurse Practitioners and physicians both diagnose, treat, and manage acute and chronic diseases; order and interpret lab and diagnostic tests; and prescribe medications.  The care and knowledge each profession uses overlaps and is complementary. 

Depending on the state, some NP’s may (1)  practice independently (or autonomously), (2)  practice collaboratively with a physician, or (3) work under the direct supervision of a physician.   Patient Centered Care, PLLC (PCC) is a Nurse Practitioner owned primary care practice, following patients age 13 yo and older, in Wilmington, NC.   PCC is an autonomous NP practice.  The NPs collaborate with physicians (although they are not present in our office).    Our website is
or follow us on facebook:
PCC providers are:  
Deborah Adams-Wingate, MSN, AGNP-C
Tamatha E. Arms, DNP, PMHNP-BC, AGNP-C

Hope this clears up any confusion related to Nurse Practitioners.  If you still have questions, contact us.  If you are looking for safe, high-quality, knowledgeable, cost-effective, and sensitive care which emphasizes YOU as a person, give us a call 910-799-6262.

Wednesday, September 21, 2016


September is recognized as Prostate Health Month as well as Prostate Cancer Awareness Month.
Prostate Health Month provides an opportunity to increase awareness around the health issues that are associated with a man’s prostate: BPH (Benign Prostatic Hyperplasia), prostate cancer and prostatitis.   You should know what your prostate is and what it does.

BPH is the medical term for an enlarged prostate (the prostate is the male sex gland that produces the fluid for semen [3].   The prostate is small, about the size of a walnut and surrunds the urethra, a tube that takes urine from the bladder to the oenis.  The urethra also carries semen during ejaculation.  The prostate gland grows during puberty and then doesn't change much until age 40 when  it begins growing again and may continue to grow with age.  An enlarged prostate is not cancerous and is the most common prostate health problem among men over 50.[1]  Half of all men between the ages of 50 and 60 will develop it, and by the age of 80 about 90% of men will have BPH.[2]

Symptoms may include:
  • Frequent, often-urgent need to urinate, especially at night
  • Need to strain or push to get the urine flowing
  • Inability to completely empty the bladder
  • Dribbling or leaking after urination
  • Weak urine stream
Prostate cancer is the most common cancer in men. It is the 2nd leading cancer killer of men, behind lung cancer. It is generally very slow growing and most men die with prostate cancer (meaning that they die of some other cause) rather than from it.  There are almost 2.8 million men living with prostate cancer in the USA.
In its early stages, prostate cancer usually doesn’t cause symptoms.   As the disease progresses, symptoms may develop that can be similar to the symptoms for BPH and/or prostatitis.
Symptoms can include:
  • Chronic pain in the hips, thighs, or lower back
  • Difficulty urinating
  • Painful / burning urination
  • Blood in the urine / semen
  • Trouble getting an erection
While no one knows how to prevent prostate cancer, there may be ways to reduce your risk:
  • Eat healthy – and choose a low-fat diet
  • Eat plenty of fruits, vegetables, and whole grains
  • Maintain a healthy weight
  • Stay physically active
  • Don’t use tobacco
  • Get regular checkups
Prostatitis is the most common prostate problem for men under 50 and about 50% of all adult men will be treated for it in their lifetime.  Prostatitis is an inflammation of the prostate that may be caused by an infection.
Symptoms of prostatitis are similar to those of BPH and prostate cancer. They can include:
  • Occasional discomfort in the testicles, urethra, lower abdomen, and back
  • Discharge from the urethra, especially during the first bowel movement of the day
  • Blood or urine in ejaculate
  • Low sperm count
  • Sexual difficulties
  • Fever
  • Aching muscles
  • Chills
  • Fatigue
  • Frequent and/or painful urination

[1] NIH Publication No. 14-3012. Prostate Enlargement: Benign Prostatic Hyperplasia. August 2014.
[2] American Urological Association Guideline: Management of Benign Prostatic Hyperplasia (BPH). P4. Revised 2010.
[3] American Urological Association Guideline: Management of Benign Prostatic Hyperplasia (BPH). P9. Revised 2010.

Wednesday, September 14, 2016

Wellness Wednesday: Cola Vs Water

Water vs Cola - Which should you choose?

Did you know the active ingredient in cola is phosphoric acid?  Phosphoric acid leaches calcium from bones and contributes to Osteoporosis.  Truck drivers carrying cola syrup also use hazardous materials place cards reserved for highly corrosive materials.  Many distributors use it to clean their vehicles.


  • 75% of Americans are chronically dehydrated
  • In 37% of American, the thirst mechanism is so weak, it is mistaken as hunger
  • Even mild dehydration can slow down metabolism by 3%
  • One glass of water shuts down midnight hunger pangs for almost 100% of the dieters investigated in a University of Washington study
  • research indicates that 8-10 glasses of water a day could significantly ease back and joint pain for up to 80% of sufferers
  • Drinking 5 glasses of water daily decreases the risk of colon cancer by 45%, plus it can slash the risk of breast cancer by 79%, and one is 50% less likely to develop bladder cancer
  • As little as  2% drop in body water can trigger fuzzy short-term memory, trouble with basic math, and difficulty focusing on the computer screen or on a printed page
  • Cola is an effective pest control in a garden; the smell attracts crawling bugs and the acidity kills them
  • Cola on a frozen window shield will turn the ice to slush
  • Cola will remove scale and build up on kitchen items; and remove burned on foods
  • Tinfoil dipped in cola will remove rust
  • Cola will remove grease stains and blood off fabric (could cause a stain itself though)
  • Cola will remove oil stains from concrete
  • Let cola sit briefly on tile to clean grout

Sunday, September 11, 2016


MindBodyHealth: WELLNESS WEDNESDAY: OVARIAN CANCER: September is Ovarian Cancer Awareness Month.  Ladies, be sure to speak with your Provider to evaluate your risk for ovarian cancer.   O...

Wednesday, September 7, 2016


September is Ovarian Cancer Awareness Month.  Ladies, be sure to speak with your Provider to evaluate your risk for ovarian cancer.  

Ovarian cancer is a type of cancer that begins in the ovaries. Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat and is frequently fatal. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully. Surgery and chemotherapy are generally used to treat ovarian cancer.

Early-stage ovarian cancer rarely causes any symptoms. Advanced-stage ovarian cancer may cause few and nonspecific symptoms that are often mistaken for more common benign conditions, such as constipation or irritable bowel.
Signs and symptoms of ovarian cancer may include:
  • Abdominal bloating or swelling
  • Quickly feeling full when eating
  • Weight loss
  • Discomfort in the pelvis area
  • Changes in bowel habits, such as constipation
  • A frequent need to urinate
If you have a family history of ovarian cancer or breast cancer, talk to your doctor about your risk of ovarian cancer. Your doctor may refer you to a genetic counselor to discuss testing for certain gene mutations that increase your risk of breast and ovarian cancers. Only a small number of women are found to have genetic mutations that can lead to ovarian cancer.

It's not clear what causes ovarian cancer.
Certain factors may increase your risk of ovarian cancer:
  • Age. Ovarian cancer can occur at any age but is most common in women ages 50 to 60 years.
  • Inherited gene mutation. A small percentage of ovarian cancers are caused by an inherited gene mutation. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes were originally identified in families with multiple cases of breast cancer, which is how they got their names, but women with these mutations also have a significantly increased risk of ovarian cancer.
  • The gene mutations that cause Lynch syndrome, which is associated with colon cancer, also increase a woman's risk of ovarian cancer.
  • Estrogen hormone replacement therapy, especially with long-term use and in large doses.
  • Age when menstruation started and ended. If you began menstruating before age 12 or underwent menopause after age 52, or both, your risk of ovarian cancer may be higher.
  • Never being pregnant.
  • Fertility treatment.
  • Smoking.
  • Use of an intrauterine device.
  • Polycystic ovary syndrome.