We all deal with anxiety at times- it’s part of being human and serves a purpose in keeping us alert when something could have a bad outcome. But sometimes people develop feelings of anxiety that are too frequent, unrelated to a specific event, are out of proportion to a given event, or just don’t go away. More than 18% of Americans seek treatment for anxiety as adults. Unfortunately, only 41% of Americans with mental health symptoms seek medical care each year. Obviously these are terrible statistics in the abstract but when you imagine people actively suffering without access to care or not knowing how to get it, even though we have tools to help, it really brings it home. Don’t ignore your mental health! It’s just as important as your physical health and is interdependent with it. People with chronic physical illnesses are more likely to develop mental health problems and people with mental health problems have physical health ramifications if not physical health causes. Bottom line- these feelings of anxiety or panic are manifested physically in our bodies as part of our “fight or flight” response. So when anxiety is happening too often, this response really takes a toll on us. We can end up with problems like insomnia, headaches, muscle tension, trouble concentrating, as well as the irritability and worry or panic that comes with the feelings of anxiety.
A panic attack can happen when people have a constant low to moderate level of anxiety they are dealing with that will then explode in a panic attack. This includes feelings of doom, shortness of breath, heart palpitations, nausea, sweating and shaking. These attacks often come with no warning and are not related to a stressful or worrisome event. They can wake you up from sleep, happen at work or school, or even while trying to relax with family or friends. These attacks are terrifying and if you have not experienced one before you need to seek immediate medical attention to be sure that you are not in fact experiencing a heart attack, pulmonary embolism, or allergic reaction. Yes, panic attacks are that bad. Your body gives you signals that your life is at stake!
If you are experiencing symptoms of anxiety we want to help. There is a chance your anxiety symptoms are being caused by a thyroid, heart or lung issue so let’s make sure not to miss those. If your diagnosis is in fact an anxiety disorder, there are medications we can prescribe and monitor that can really help as well as excellent therapists who can teach you to manage symptoms. Let us know about your story, especially if these symptoms are interfering with your life- whether relationships, work, family responsibilities or health. We want to help you to live your healthiest life possible- physically and mentally. Kelly Goodman Group
In addition to its known benefits of improving bone and heart health, adding a natural supplement of Vitamin D may boost our immune system. So, we know that certain groups of people are deficient in D- like darker complexions, higher body fat, and indoorsy types. Fat cells absorb Vitamin D and keep it out of circulation so those of us who have any extra weight (and females have a higher body fat percentage anyways) are likely deficient. Also, if you have a darker complexion or use sunscreen outside it’s really difficult to absorb enough of the sunlight in our skin to make this vitamin. While we are still sorting out the ideal level of Vitamin D in our bodies, there is decades of evidence that this vitamin our bodies produce naturally is essential in achieving and keeping our optimum level of overall health. Our bodies make Vitamin D in our skin when we are exposed to sun. We’ve all been spending less time outside, and people who live in the northern half of the US (or similar latitudes around the world) don’t get enough sunlight.
You know how milk says “Vitamin D” on the label? Well, that’s because we can’t absorb calcium without Vitamin D so the milk producers add it to the milk. We have a tough time using that calcium to build bones without enough D. So while we all know calcium is essential to build and maintain bones and avoid osteoporosis in our later years, that calcium is not useful unless it has its helper- Vitamin D. This means people who follow a vegan diet are also at risk of low D (in addition to B12 and iron).
High blood pressure, heart attacks, strokes, and heart failure are all linked to low levels of Vitamin D as well. Huge clinical trials are being done right now so that we can determine how much of an impact supplementation has on improving heart health.
What we are also realizing is that we have Vitamin D receptors on our immune system cells. People with low D levels are more likely to have auto-immune disorders and increased risk of infection in general. Remember how people with Tuberculosis were sent to sanatoriums to go sit in the sun? And how cod liver oil has been used for centuries for general health? Well sitting in the sun and drinking cod liver oil both increase your Vitamin D level- they were on to something!
Come in and see us at any of our Kelly Goodman Group locations and we can check your Vitamin D level (our Nurse Practitioner draws your blood herself). Once we know your level we can advise you on how best to supplement this essential vitamin and prescribe a prescription strength Vitamin D if needed. Say no to colds and flu this fall and yes to bone and heart health!
Did you see the hashtag #FatSideStories on Twitter last week? A very sad story about being treated cruelly by health care providers was quite common. This really broke my heart. As a health care provider, it can be tough to talk to patients about weight because it is a sensitive subject for so many people. It doesn’t have to be. Let me tell you- this is one reason I love being a Nurse Practitioner. I feel that we really approach healthcare from a team perspective and without judgement. While we have the “expert” opinion to share with patients, we still want to be on the same personal level with them in terms of mutual respect. So, if someone comes to me to with a desire to discuss weight loss, I want to sort out what their story is. What is their day to day lifestyle that is keeping them from losing weight? If they come in with diabetes or blood pressure that is out of control, and weight is a factor, we will be discussing weight and the positive effect of even mild weight loss on those disease states. But if someone comes in for a cough, or STD/STI testing, or anything else unrelated to weight, there will be no discussion of a patient’s weight. When it is appropriate to have a discussion about weight, there is no judgement. If someone needs to lose weight because it is contributing to a chronic condition, we will talk about it. But it is not from a place of lecturing or scorn. It is an opportunity to gather some information from both the patient and the provider, and together come up with some options for treatment that the patient feels will work with their lifestyle, their family, and their personal beliefs and culture. There is no room for judgement in an honest and open relationship between patient and provider. It serves no purpose- whether the touchy subject is weight, sex, drugs, self harm, or anything else that is sensitive to someone. Our goal is to help people achieve their best possible health. So please don’t put off healthcare because you don’t want to deal with the lectures. Come see us instead. No lectures, no judgement, just health.
Are you experiencing recurrent UTI/bladder infections? Although most women (50% by age 32 according to Cleveland Clinic) experience a urinary tract infection, for some people these become a recurring concern. Studies claim anywhere from 20% to 40% of women who get one UTI will develop another. And of course they seem to come at inopportune times- the day before a big work event, on vacation, or with a new sexual partner. So what do you do when that first stab of pain occurs or the burning starts with urination? First, give us a call to stop by for a quick appointment that same day- even on your way to work! We can check a urine sample in office and start you on a safe antibiotic that has low resistance in our area and very low chances of side effects. We can send out a sample for culture to be sure we know exactly what it is and make any necessary adjustments to treatment to be sure it doesn’t come back. We can also prescribe medication that effectively numbs the urethra and soothes the pain (although it does turn your urine bright orange… can anything be subtle?).
So maybe this is your first UTI. In that case just be sure to use best practices to avoid another one: stay hydrated, empty your bladder regularly (including after sex), and wipe front to back after elimination and/or defecation.
But what if this is your second infection in recent memory? Or even your third or fourth? What then? Well you have some options. Let’s get a culture to determine if the germ is resistant to the medications you’ve been taking and simply was never treated effectively. Depending on the severity and frequency of infections, we can start you on various types of antibiotic regimens. However, many people would prefer to try to avoid the use of antibiotics whenever possible or are looking for more natural alternatives. In this case, please consider the use of two supplements. One is D Mannose and the other is lactobacillus.
We’ll start with the D Mannose– this can be used to treat an active mild infection and to prevent future infections. In fact a controlled study showed that patients treated with D Mannose went much longer (200 days vs 52 days) between repeat infections than those treated with an antibiotic (Bactrim orTMP/SMX- a sulfa type of antibiotic). This substance naturally occurs in fruits like red berries (such as cranberries) and fruits like apples and peaches. But it’s difficult to get enough through food sources alone to have an impact on urinary health. D Mannose helps keep the bacteria from attaching to the side of the bladder and so it can then be flushed out easily.
The other preventive treatment is lactobacillus aka probiotics. We hear so much about the countless benefits of probiotics for our immune system and digestive system. In this case, the lactobacillus family of probiotics (indicated by a lower case “L.” on the ingredient list) has been shown to reduce recurrences of UTIs by half, almost as much as an antibiotic regimen. If you also suffer from vaginal yeast infections this could be a wonderful way to reduce chances of another yeast infection or bladder infection.
Click on our website Kelly Goodman Group or give us a call at any of our locations to make an appointment. Stop going to Urgent Care over and over and come to Promenade Primary for your UTI so we can try to make it your last one!
Fatigue, muscle aches, rash, red eyes, mild fever. Is it Zika?
Now that the Zika virus has been transmitted by local mosquitos in Florida, we are all wondering when it will come to Washington DC. This city was built on a swamp and we have all experienced the mosquitos here. Our area has the right type of Aedes mosquito and we have lots of international travelers here, given that we are the nation’s capital. Two weeks ago we looked at risk factors for contracting Zika virus, as a resident of the District of Columbia. What happens if you have done your best to protect yourself but are starting to feel ill? How do you know if it’s Zika or just a run-of-the-mill virus? First, call us to schedule an appointment. We can test for Zika- we will draw your blood here and send it to a national laboratory for testing. Second, be on the safe side and only take Tylenol (acetaminophen) even if you’ve only been in the continental US. Given that Dengue has the same symptoms as Zika, and increases bleeding risk, don’t take Advil/Motrin (ibuprofen). If you have been out of the country recently we will discuss your risk factors, test for similar viruses such as Dengue fever and Chikungunya and determine the proper treatment for you. Above all, the treatment for Zika is supportive rather than curative- meaning lots of fluids, lots of rest, and time. The symptoms of the virus can last 2-7 days. Keep in mind that many, if not most, people who have Zika do not have any symptoms at all. That means that Zika can spread more easily, as infected people can remain active and exposed to mosquitos that will transmit the virus by biting an infected person and then an uninfected person and transferring the virus. Keep protecting yourself with insect repellent as needed and safe sex practices.