Family Medicine Archives - Page 3 of 3

National Bike Month – Stay Safe and Fit

Posted on May 9, 2018 by Joann Ariola

National Bike Month begins on May 14^th and culminates with Ride to Work Day on May 18, 2018.

Communities nationwide will participate in this week-long recognition good health and bring attention to the need of lessening toxic emissions that motor vehicles are having on our environment.

According to Bicycling Magazine, more than half of all Americans live less than 5 – 10 miles from work. By utilizing the extensive miles of bike lanes to and from your work destination, you could probable arrive at your destination in less than an hour.

Riding a bicycle to work can be a fun and effective way to get fit. Cycling is beneficial for the cardiovascular system because it increases oxygen intake and stimulates the heart. Studies show that riding can increase energy levels by 20 percent and in one hour burn up to 488 calories when pedaling at 12 to 14 miles per hour.

Although a bicycle is an excellent fitness tool, it is also considered a vehicle. Therefore, the rules of the road must be obeyed and a bicycle should be operated safely to prevent injuries and accidents. Statistics show that bicyclists face higher risks in crash-related injuries and deaths than drivers in a motor vehicle.

Follow these basic riding tips to ensure your safety and reduce the risks:

Always ride in the same direction as traffic and do not weave in between other vehicles.
Obey traffic laws and signals.
Do not listen to music or speak on cell phones while riding.
Wear a proper fitting helmet.
Never pass another vehicle on the right.
Always keep your hands on the brakes.
Stay aware of dangerous road hazards such as potholes and broken glass.
Use hand signals to show motorist where you are going.

So suit up, remember to wear your helmet and cycle your way to health and a cleaner environment!

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Is There a Benefit to Wearing a Fitness Tracker?

Posted on May 2, 2018 by Joann Ariola

Generally speaking, if you are inactive your risk of experiencing obesity, low energy, diabetes and hypertension is higher. To combat these health issues, you can incorporate a brisk walk or run into your weekly activity. The addition of this type of movement to your day may prevent or, in some cases, reverse health issues.

One of the ways some are finding it beneficial to keep track of their activity level is by wearing a “fitness tracker.” Surprisingly, one of the first reports you may receive from your tracker is that you are not as active as you thought you were.

Most fitness trackers are a good way of monitoring your steps, calories, distance travelled, caloric intake, as well as your heart rate and sleep patterns. They can be viewed as your “conscience” for personal accountability and motivation for a relatively low cost.

Some of the benefits of a fitness tracker include:

Encouraging physical activity – If you check your tracker and see that you are behind in your steps for the day, you may “step” up your game a bit and take a walk.
Measuring your heart rate – This feature can give you hard data on the effort you exert while doing a particular workout and/or task. It can give you a hint on the condition of your cardiovascular system by allowing you to see just how quickly your heart rate increases.
Providing insights on your sleep patterns – Sleep has a definite influence on your overall health. Fitness trackers that log sleep activity can help you address whatever is lacking in your sleep cycles.
Encouraging healthy eating – Fitness trackers can come equipped with apps that help you track your food and may help with weight loss.
Promoting interaction – Some fitness trackers allow the user to interact with other users, create group challenges and receive rewards for meeting goals.

There really isn’t a downside to tracking your activity, unless you take your fitness tracker off and it remains lost at the bottom of a drawer.

Lead Poisoning an Ongoing Risk for Children Living In New York City

Posted on April 11, 2018 by Yogaalakshmi Sundararajan M.D.

Lead poisoning is an ongoing risk for children living in New York City. According to NYC Environment & Health Data 2016, 300 children in New York City were found to have dangerously high lead levels in their blood.

While the rate of lead poisoning has generally declined since 2008, it is important to know you and your family’s risk of lead exposure or how harmful it can be to your health.

Lead is harmful when ingested or inhaled. Lead that gets into your body can travel to many organs by the bloodstream It can stay in certain organs for up to 25 years. Children absorb more lead from digestion than adults (up to 70 percent versus 20 percent in adults). Because children have a growing brain they are more prone to develop serious health complications caused by lead. Lead poisoning can lead to intellectual disabilities, decreased IQ, seizure disorders, behavioral problems, peripheral neuropathy (nerve disease), hearing loss and brain damage. These effects go on to adulthood.

Lead poisoning is more common among urban than rural children, low-income than middle-income children, and children who live in older housing. Children with Sickle Cell Disease are at an increased risk for medical problems from lead poisoning.

Lead is a metal present in the environment; it can be found is various places such as:

Lead based paint: Dust produced as lead based paint deteriorates or during renovations, particularly in houses built before 1978

Water pipes: Decay of old lead based pipes, fixtures or solders connecting drinking water pipes

Places of work: Parents working in industries such as construction, plumbing, mining, smelting may be exposed to and bring home particles containing lead

Other sources: Candy, make up, glazed ceramic pots, pewter pots, herbal medicine from other countries

Lead testing is recommended for those who may be at risk for lead poisoning; this includes:

All children at 12 and 24 months. (this may change based on local recommendations)
All pregnant women (pregnant women exposed to lead may potentially put their unborn child at risk)
Children and adolescents between 6 months and 16 years of age who enter the United States as an immigrant or refugee
Parents with certain occupations or hobbies (e.g., smelting, soldering, auto body repair)
People who live in or visit a home or child care facility with an identified lead hazard
People who live in or visit a home or child care facility that was built before 1960 and is in poor repair or was renovated in the past six months.

There are steps you can take to prevent or reduce levels of exposure to lead:

Run tap water before drinking or cooking: While the NYC water system from the upstate reservoir is essentially lead-free, older piping and fixtures may put lead into running water. It is recommended to run your tap for at least 30 seconds until the water is cold.
Take care to read or research imported consumer products: Take caution with imported toys, jewelry, pendants, skin-lightening creams, camphor, ceramic ware or pottery, cosmetics and religious powders (Kajal, Kohl, Surma, Tiro, Sindoor), Georgian and Bangladeshi spices, as they may not meet the standards set in place by S. regulatory and health agencies.
Make sure your home is safe: Make certain that your place of residence is currently not exposed to lead

According to the New York Department of Health, a new program to test lead in drinking water is now available for New York State residents. To learn more about this program, visit

https://health.ny.gov/environmental/water/drinking/lead/free_lead_testing_pilot_program.htm

If you are concerned about lead exposure for yourself or your family, please make an appointment to see your doctor as soon as possible.

To schedule an appointment with a Family Medicine doctor at Jamaica Hospital Medical Center, please call 718-206-6942.

Yogaalakshmi Sundararajan M.D. Family Medicine

What You Need to Know About Birth Control Pills

Posted on March 23, 2018 by Marina Bissada, DO

Birth control pills are a hormonal type of oral contraceptive that needs to be taken every day to prevent pregnancy. They work by stopping ovulation so that the fertilization of an egg by sperm cannot occur.

Most women are prescribed combination birth control pills which contain two types of hormones- estrogen and progestin. There are progestin-only pills available as well. These are often recommended for women who have medical reasons for avoiding estrogen. Most combination birth control packs contain pills for every day of the month (depending on the pack). The three first weeks of the pack are pills with hormones. The final week contains placebo pills or sugar pills (no hormone). This last week of having no hormones allows your menstrual period to occur.

The pill is generally safe when taken as prescribed; however, if you are considering this form of contraception, there are a few things you should know:

How effective are birth control pills?

When taken correctly, birth control pills are about 91% effective. It is important to take the pill at the same time every day to improve efficacy. If you are forgetful, there are some easy ways to remember to take your pill every day. You can set an alarm on your phone or put your pills next to your toothbrush or in other places you are likely to see them every day. If you decide that you want to become pregnant; birth control pills can be stopped at any time and periods typically return within three months.

What are some benefits of taking birth controls pills other than preventing pregnancy?

In addition to preventing pregnancy, oral contraceptive pills (OCPs) are great at helping women with irregular and/or painful periods regulate their cycles and minimize pain. OCPs can also help decrease the symptoms of PMS (premenstrual syndrome), which involve mood changes related to menstrual cycling. Another added benefit of taking OCPs is, they can also help improve cystic acne in many women. Lastly, studies have found that taking birth control pills may reduce the likelihood of endometrial and ovarian cancer.

What side effects are likely to occur?

Women may experience side effects with birth control pills but they usually go away after 2-3 months. Some common side effects are spotting between periods, changes in libido, or nausea. Doctors sometimes advise that you stick with the pill for this duration of time to see if the side effects will subside. If they don’t or you experience more serious effects such as increased blood pressure or blood clots, speak to your doctor. Serious side effects are generally rare and many people have to try different birth control pills until they find the right one for them.

What should I do if I forget to take my pill?

If you missed one pill, take your pill as soon as you remember. It’s okay to take two pills on the same day or within 24 hours. If two or more pills are missed in the 1st week, take the most recent missed pill as soon as possible (discard the missed pill). Continue taking your daily pills according to the pack. If you missed two or more pills, you may be at risk of becoming pregnant: resume taking your daily pills and avoid having sex without condoms, or use another backup birth control method for at least seven days of hormonal pills. Emergency contraception should be considered if you missed pills within the first week and had sex without a condom in the previous five days. If the forgotten pill is during days 15-21 of a 28-day pack, then skip the placebo pills. The Centers for Disease Control and Prevention (CDC) provides recommended actions for late or missed OCPs. https://www.cdc.gov/reproductivehealth/unintendedpregnancy/pdf/248124_fig_2_3_4_final_tag508.pdf

Who should not take birth control pills?

Talk to your doctor if any of the following pertain to you:

Are over 35 years old and smoke more than 15 cigarettes per day
Have hypertension
Have a history of Venous thromboembolism (blood clots)
Have a history of, or current, breast cancer
Have liver cirrhosis or failure
Suffer from migraines with aura at any age

It is important to remember, that while OCPs are very effective at preventing pregnancy, they do not prevent sexually transmitted infections (STIs). If you are having sex with a new partner, or you are concerned about infections, it is important to use condoms in addition to OCPs. It is recommended that you also get tested for STIs at your doctor’s office.

If you have questions about contraception or family planning and would like to schedule an appointment with a family medicine doctor at Jamaica Hospital Medical Center please call, 718-206-6942

Marina Bissada D.O. Family Medicine

Baby Boomers Encouraged To Get Hep C Testing

Posted on March 9, 2018 by Radeeb Akhtar, MD MPH

Hepatitis C is a virus that affects the liver. It can be a short-lived infection, however more often; it is a chronic silent disease that leads to liver failure and sometimes liver cancer after many years.

Your risk of being infected with hepatitis C is increased if you:

Were born from a mother with the virus
Received body piercings or tattoos from non-sterile instruments
Had unprotected sexual contact with multiple partners
Received blood transfusions, blood products or organ donations before 1992
Are on long-term hemodialysis treatment
Work in health care or public safety and were exposed to blood through a needle stick
Were treated for a blood clotting problem before 1987
Shared needles, syringes, or other equipment to inject drugs

Baby boomers or people born between the years 1945-1965 are recommended to get tested once, regardless of exposure history or risk. If you were born between these years, please ask your doctor to order this blood test for you.

If you have hepatitis C, a cure can be possible with the appropriate treatments. Recent research has produced new medications that can essentially cure hepatitis C from the blood and liver. These newer medications have few side effects and are usually taken once daily for 8 or 12 weeks for most uncomplicated hepatitis C infections.

Contact your primary care doctor about how to start the process. Once cured, you are likely to regain improved liver function and reduce the risk of liver failure and liver cancer in the future.

If you have concerns about your risk for hepatitis C or have questions about testing and treatment, please call 718-206-6942 to schedule an appointment with a Family Medicine doctor at Jamaica Hospital Medical Center.

Radeeb Akhtar, MD MPH, Family Medicine

Learn The ABCDE’s of Moles

Posted on February 16, 2018 by Ambika Nath DO

Skin cancer is one of the most commonly diagnosed forms of cancer in the United States. It can present in all ethnicities and skin tones. Almost all skin cancers are found on skin exposed to sun, ultraviolet light, tanning lights, or sun lamps.

Most forms of skin cancer can be treated successfully when detected early. Unusual growths on the skin such as moles can serve as warning signs; therefore, paying attention to changes and abnormalities is crucial in early detection.

When observing changes in the skin, knowing what is considered ‘normal’ is vital. For example, a normal mole is solid and uniform in color, and can range from tan, brown, dark brown, or flesh colored. They are usually round or oval in shape with well-defined edges, and may be flat or raised. However, moles that have developed into skin cancer are sometimes irregularly shaped, scaly or have a variation in color.

The ABCDE rule can help you remember what to look for when checking your moles.

A for Asymmetry

If you fold the mole in half, does it look the same on both sides? If it looks the same on both sides, then it is symmetrical. If both sides look different, the mole is asymmetrical and should be monitored.

B for Border

Look at the border of the mole. Normal moles have a smooth edge. Moles of concern may have a blurry or jagged border.

C for Color

Note the original color of the mole. Has it changed by becoming darker, lost some color, or have multiple colors? (Note that some moles tend to darken during pregnancy or while taking birth controls pills.)

D for Diameter

How large is the mole? Moles that are bigger than 1/4 inch in diameter should be shown to your health care provider.

E for Evolving

Has the mole changed in shape, size, or color? If so, alert your primary care provider.

Doctors advise that you seek medical care if:

Your mole changes size, especially if it grows very quickly or becomes larger than a pencil eraser (6mm).
Your mole changes in color or develops more than one color.
Your mole, or the skin near the mole, becomes painful, sore, red, or swollen.
Your mole becomes scaly, sheds skin, oozes fluid, or bleeds.
Your mole develops irregular borders.
Your mole becomes hard or soft, or develops raised areas.

There are several steps you can take to protect your skin against cancer: Avoid the sun during peak hours, wear sunscreen (with an SPF of at least 30, reapplying every 2-3 hours) and wear sunglasses and protective clothing when spending long periods of time outdoors. Additionally, it is important to remember that ultraviolet radiation from artificial tanning beds is a known carcinogen. Using them can increase your risk of skin cancers such as melanoma by 59%, and even more with each use.

If you notice changes in your skin that are abnormal, it is important to speak with your doctor right away. Early detection is key when treating skin cancer.

If you have questions or concerns about unusual growths on your skin, you can schedule an appointment with a Family Medicine doctor at Jamaica Hospital Medical Center by calling, 718-206-6942.

Ambika Nath DO, Family Medicine

Flu Vaccines are Important and Safe for Pregnant Women

Posted on January 19, 2018 by Radeeb Akhtar, MD MPH

Influenza or Flu is a viral illness that appears most frequently during the winter and early spring. The effects of the flu can range from a mild cold-like illness to becoming severely sick, requiring hospitalization.

Women who are expecting are at an increased risk of developing severe flu-related illnesses due to the many changes in the immune system, heart and lungs that occur during pregnancy.

Influenza can be harmful to both mother and developing baby. Complications from the flu can increase chances for premature delivery and is also linked to neural tube defects in growing fetuses.

The CDC highly recommends that pregnant women receive the flu shot. For 2015-2016, it is estimated that the vaccine prevented about 5 million influenza illnesses and 3,000 related deaths.

A flu shot given to a pregnant woman protects mother and baby. Research shows that mothers, who are vaccinated, will pass on some immunity to their child after birth. This reduces the risk of illness for the newborn. The CDC finds that “The flu shot given during pregnancy has been shown to protect both the mother and her baby for several months after birth from flu.”

The vaccine is safe to get during any trimester. There is an excellent safety record for the millions of pregnant women who received the flu shot. We highly recommend vaccination for all pregnant women, and it is considered part of routine prenatal care.

It is important for others living in the household to get the flu shot to further protect the newborn. Babies usually get their first flu shot at the age of 6 months, so until then, they are at an increased risk of getting influenza from their environment. If an unvaccinated infant gets the flu, it can be severe and require medical management.

If you are pregnant and experiencing flu symptoms such as fever, body aches or a sore throat, call your family doctor immediately or seek medical attention.

To schedule an appointment with the Family Medicine Department at Jamaica Hospital Medical Center, please call, 718-206-6942

Radeeb Akhtar MD. MPH. JHMC Family Medicine

Asthma Medications-Dr. Andrew Flowers Helps You To Understand Treatment Options

Posted on December 8, 2017 by Andrew Flowers MD

Do you or someone you know have asthma? If so, you may want to know what treatment options are available and how they can help to manage the condition.

First, you need to understand what asthma is as well as its symptoms. Asthma is a chronic disease that when it is not controlled can make it difficult to breathe. When an asthma attack happens, you may experience coughing, wheezing, chest tightness, or breathlessness. A person may find it difficult to breathe as a result of the narrowing of the airways caused by swelling, mucus production, and the tightening of the muscles around the airways.

Although many people have asthma, it can mean very different things from person to person. You may experience mild or moderate symptoms daily or weekly. Your doctor will consider these factors when deciding which treatment options are most suitable for your care.

The goal of asthma treatment is to control the disease and to prevent symptoms from interfering with your day-to-day activities. Your doctor determines control of your asthma by the following:

How often you experience daytime and nighttime symptoms.
How often you use your rescue inhaler.
How often you have to go to the doctor for treatment of your symptoms.
How much your symptoms interfere with your daily life.

Individuals with poor control of their asthma are usually put on controller medications to manage their condition. Controller medications are to be taken every day to prevent symptoms from occurring and to decrease the severity of symptoms when they do occur.

Controller medications should be used long-term, whether you feel bad or good on a daily basis, as prescribed. Consistency is very important when taking these medications. Another form of treatment your doctor may prescribe is prescribing a rescue medication. These are to be used on a short-term basis to help you feel better quickly when experiencing coughing, shortness of breath, or wheezing. Here are a few examples of each type of medication.

Check out American Lung Association’s guide on how to use your inhaler:

With a spacer:

Without a spacer:

When taken as directed, these medications can significantly decrease the burden of asthma on your daily life. Do not hesitate to go to a doctor if home medications are not providing relief.

In addition to taking your medication, it is important to know your asthma triggers and be able to identify symptoms early.

Talk to your doctor about your Asthma Action Plan and ways to better take control of your asthma. To schedule an appointment with the Family Medicine Department at Jamaica Hospital Medical Center, please call, 718-206-6942

Andrew Flowers MD, Family Medicine

How To Check Your Blood Pressure at Home

Posted on November 17, 2017 by Radeeb Akhtar, MD MPH

High blood pressure or hypertension is considered “the silent killer.” There are several reasons why it is referred to as such.

Most people with high blood pressure actually feel normal; however, if the disease goes undetected and is left untreated, it can lead to heart attack or stroke. In the United States today, heart attack and stroke are leading causes of death.

It is important to get your family, friends, and even yourself checked. You can visit your doctor or check at home.

It can be easy to measure blood pressure at home- here’s how:

Purchase an automatic, cuff-style, upper-arm monitor. Automatic machines usually cost from $20-$40, and are available at many pharmacies or online.
Get ready to measure! Do not smoke, drink any caffeinated drinks, or exercise 30 minutes prior to measuring.
Sit with your back supported, feet flat on the floor, and legs uncrossed.
Place the cuff onto your arm. This arm should be resting at the level of your heart or just below the chest. The cuff should be above the elbow.
Push the button to begin measurement. Relax, breathe, and do not talk during measurement.
Blood pressures are measured as two numbers: a top number (systolic) and a bottom number (diastolic). Write down both numbers, the time of day you measured, and the date(“141/88, 7:00 PM, 11/13/2017” )
Repeat measurement after 1 minute. Write this number down also. Keep a blood pressure diary with all your measurements.

According to the recently updated high blood pressure guidelines of the American College of Cardiology (ACC), a blood pressure less than 120/80 is normal. Numbers above this measurement are considered elevated and are cause for concern. The ACC has provided the following categories to further define blood pressure measurements and levels:

Elevated: Systolic between 120-129 and diastolic less than 80
Stage 1: Systolic between 130-139 or diastolic between 80-89
Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg
Hypertensive crisis: Systolic over 180 and/or diastolic over 120

If your results are greater than 130 for the top number or greater than 80 for the bottom number, it is highly recommended that you see your doctor to receive a comprehensive medical examination.

If your blood pressure exceeds 180/120, the American College of Cardiology advises that you seek medical attention immediately, as this is critical.

Checking your blood pressure is important for heart health. There are also lifestyle changes that you can apply to your daily life to help you manage blood pressure levels and your health. Lifestyle changes can include maintaining a healthy weight by eating a well- balanced diet, exercising regularly, reducing sodium intake, limiting the amount of alcohol you consume and quitting smoking.

To schedule an appointment with the Family Medicine Department at Jamaica Hospital Medical Center, please call, 718-206-6942.

Radeeb Akhtar MD. MPH. JHMC Family Medicine