May is National Foster Care Month

May has been designated as National Foster Care Month.  With the efforts of advocates, child welfare professionals and support groups around the country, the total number of children in foster care has decreased over recent years.  However, there are still over 400,000 children in foster care in the United States.  As someone who has adopted four children out of foster care, and, along with my wife and family, have helped care for over two dozen other children over 15 years, I can say that it is extremely rewarding to help these children get started on a better life.

So what can you do?  Well, it it is possible, consider fostering children.  You can contact your local Division of Youth and Family Services (DYFS) center, or your county Foster Parents Association (in Morris County, New Jersey the website is http://sp.morrisfpa.org/default.aspx) or a national site such as http://www.fostercaremonth.org/Pages/default.aspx.  They are always accepting of donations of money, clothes and toys as well.   Consider getting involved!

Tick season

As the warmer weather approaches, ticks become more active.  Ticks can become active anytime the temperature is above freezing, but are usually active when the temperature is above 50 degrees Fahrenheit (10 degrees Celsius).  They numb the skin, so most people do not feel the tick embed itself in their skin, and they can be quite small-the size of a poppy seed in the case of nymphs (the most common deer ticks to find on people). 

Ticks usually attach to dark, warm areas, so it is important to check yourself thoroughly, including the groin area, buttocks, behind the knees, the hairline and everywhere else.  It usually takes at least 12 hours or so to pass along any infection, including Lyme disease, so there is no reason to panic.  To remove it, use fine-tipped tweezers to grasp the tick close to the skin and pull up with even pressure without twisting or jerking the tick.  It can take up to a minute for the tick to disengage its mouth parts.  Do not squeeze them, as this will cause them to dump their stomach contents into you and increase the chance of infection.

Do NOT use vaseline, alcohol, matches or any other to remove ticks-they don’t work and may make the tick regurgitate. 

Most tick bites will not transmit Lyme disease (less than 5% in most areas, but if you are not sure, or having any symptoms such as a rash or joint pain, you should consult your doctor.  The best way to prevent tick bites is to protect yourself by wearing long sleeves and long pants tucked into your socks, or to use a DEET-based repellent on exposed areas.

Organ Donor Awareness Month

April is Donate Life Month, or Organ Donor Awareness Month.   There are over 113,000 people in the United States on transplant lists, many of whom will die before they can receive an organ.  In fact, an average of 18 people die every day due to the lack of available organs.  One organ donor can help save up to 8 people.  The main problem is that there aren’t enough people willing to donate organs upon their death, or forget to fill out that spot on their driver’s license.  The United States is one of the only countries that have an opt-in program, where you have to say that you want to donate.  Most countries in Europe have an opt-out program, where you are assumed to want to donate unless you indicate that you do not want to donate.  These countries have significantly fewer patients dying while on a transplant list.

There are many reasons people are afraid of organ donation.  They worry that their body will be desecrated or deformed, or that their families will be left with an expense for the donation, or that they are too old.  People worry that they may not receive aggressive medical care because their parts are wanted for donation.  None of these are true.  This is direct from organdonor.gov:

Learn The Facts

These facts may help you better understand organ, eye, and tissue donation:

Fact: Anyone, regardless of age or medical history, can sign up to be a donor. The transplant team will determine at an individual’s time of death whether donation is possible.

Fact: Most major religions in the United States support organ donation and consider donation as the final act of love and generosity toward others.

Fact: If you are sick or injured and admitted to a hospital, the number one priority is to save your life.

Fact: When matching donor organs to recipients, the computerized matching system considers issues such as the severity of illness, blood type, time spent waiting, other important medical information, and geographic location. The recipient’s financial or celebrity status or race does not figure in.

Fact: An open casket funeral is usually possible for organ, eye, and tissue donors. Through the entire donation process, the body is treated with care, respect, and dignity.

Fact: There is no cost to donors or their families for organ or tissue donation.

Fact: Every state provides access to a donor registry where its residents can indicate their donation decision.

Fact: Federal law prohibits buying and selling organs in the U.S. Violators are punishable by prison sentences and fines.

Fact: People can recover from comas, but not brain death. Coma and brain death are not the same. Brain death is final.

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What can you do?  Strongly consider signing up for organ donation.  It can help save many lives.

Autism Rates

The Centers for Disease Control and Prevention recently released a new estimate of the number of children who have autism or autism spectrum disorders.  It is now thought that up to 1 in 88 children have autism or a related disorder, up from the previous estimate of 1 in 110.  This is thought by many to be due to the increased numbers of children being recognised with symptoms through wider screening and better diagnosis. 

So, what should parents do?  They should pay attention to their child’s developmental milestones such as when they start smiling at faces, when do they start rolling/crawling/walking.  If there are any questions, they should talk to their medical provider.

Statins, Diabetes and Memory Loss

The FDA has recently decided to add new warnings to the group of drugs known as statins (these include Lipitor, Crestor, Zocor/simvastatin, Pravachol/pravastatin, Mevacor and others).  The statin drugs have been shown to have a very small affect on memory, as well as slightly increasing overall sugar levels.  However, they have also been shown to significantly lower the risk of heart disease and second heart attacks.

So, what does this mean?  It shows that everything we do in life has possible drawbacks, but that we have to weigh the risks and benefits of everything we do.  The statin drugs’ benefits far outweigh the very small risks in most patients, and so most patients should remain on their medications.  It also means that we should continue to check blood work on patients who need to be on these medications, including blood sugars.

Highest level of Quality

Changebridge Medical Associates, PA has recently received word that we have received the highest recognition from the National Committee for Quality Assurance, a not-for-profit organization dedicated to improving health care quality. 

This Level 3 recognition from the NCQA indicates that we are meeting the highest level of quality as part of the Patient Centered Medical Home (PCMH) project.  PCMH involves organizing care around patients, working in teams and coordinating and tracking care over time, all of which is done to help patients live healthier and more productive lives.

Changebridge Medical Associates would like to thank everyone, especially our patients, for helping to make his possible.

Toxic Substances in Food

There have been a lot of news reports about various toxic substances in the foods that we eat and drink.  Recently, there were articles about arsenic in apple juice (September 2011) and in certain baby formulas (February 2012).  The arsenic in these baby formulas seem to have come from the rice used to make the formula. 

Arsenic is commonly found in nature and is called organic arsenic.  Manmade arsenic is called inorganic, and is much more dangerous.   Rice products could give a person a significant amount of organic arsenic if eaten in large amounts.

What can you do about this?  The most important thing is to read the labels required on commercially-prepared foods.  Do not assume that “organic” or “all-natural” equal “completely safe”.  Some untrustworthy people will use these terms to try and sell their products.  Do your research as you should with any dietary plan.  If you have a question about a food product, talk to your physician, nutritionist or other health care providers with whom you are comfortable.

February is American Heart Month

Everyone knows that February 14th is Valentine’s day, but not everyone knows that February is also American Heart Month.  Most people don’t realize that more people will die of heart disease than of all the cancers put together.  40% of people will die of heart disease.  In fact, half of men and a third of women will find out they have heart disease when they have the heart attack that kills them.

So what can you do to help yourself?  Regular exercise (30 minutes a day if possible) will help.  Diet is another large part:

• Choose lean meats and poultry without skin and prepare them without adding saturated and trans fat.
• Select dairy products that are no-fat or lower in fat.
• Cut back on foods high in cholesterol.
• Cut back on food and drinks with added sugars.
• Pick foods lower in salt/sodium.
• If you drink alcohol, drink in moderation-no more than one drink per day if you’re a woman and two drinks per day if you’re a man.
• Keep an eye on your portion sizes.

If you are having any symptoms of a heart problem, such as palpitations, an irregular heart beat, chest pressure or pain, or any other unusual symptoms, see your physician as soon as possible.

When should I get a pap exam?

By: Sandra Hoenig, M.D

With Cervical Cancer Awareness month coming to an end, now is the perfect time to think about getting your annual womens health exam. Cervical cancer is a slow growing cancer caused by certain strains of HPV (human papilloma virus), a very common sexually transmitted infection. Since the widespread use of pap exams over the past few decades, the rate of this cancer has dropped by over 50%.

According to the American College of Obstetricians and Gynecologists (ACOG) there are several ways to avoid cervical cancer:

• Monogamy
• Practicing safe sex
• Getting pap exams
• Girls and young women ages 9—26, receiving the HPV vaccine

ACOG recommends starting pap exams at age 21 which allows doctors to detect any abnormal cervical cells. Detecting any abnormalities will permit doctors to monitor or treat thereby preventing the spread to cervical cancer. How often pap exams should be performed depends on several factors including age, history of abnormal paps and history of HPV. Since HPV is a sexually transmitted disease that has also been linked to cancers of the penis and anus, the HPV vaccine is also recommended and approved for boys and young men.

If you have any questions as to when and how often you should be screened for cervical cancer, please discuss with your family physician or gynecologist.

PLAN AHEAD FOR ANNUAL EXAMS NOW

Family Health, Dental, Eye and Other Visits Can Be Scheduled in Advance

By: Dr. Sandra Hoenig, M.D, Changebridge Medical Associates
Did you make a New Year’s resolution or a list of things to accomplish in 2012? Lose weight, quit smoking, and exercise top many such lists. These are all sound goals and we encourage beginning any of these with a thorough physical exam. With or without a resolution, it’s a good time to plan your family’s annual health exams including visits with your family physician, dentist, and ophthalmologist.
Scheduling all of your annual exams early in the year makes it convenient, saves time and ensures that you will not miss something important.

How often should you have a physical or other exam?

The New York Times Health Guide offers a handy by the age’s exam check list for adults to ensure individuals:

• Screen for diseases
• Assess risk of future medical problems
• Encourage healthy lifestyles
• Update vaccinations
• Maintain a relationship with a doctor in the event of an illness
It’s important to note that schedules for health maintenance/well visits differ from appointments needed by people with preexisting conditions that need to be monitored and treated. For these, always follow the schedule set by your doctors.
It’s also a good idea to keep records of your medical appointments, prescriptions, receipts, insurance information and more. eHow has a good plan for this.
We wish you a healthy New Year and encourage you to make these appointments now. Staying healthy starts with you and your family physician is your first line of defense.
We will blog again soon about self-examinations that can alert you to any changes in your health that you should bring to the attention of your doctor.
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Changebridge Medical Associates is located at 170 Changebridge Road, Suite C-3, Montville, NJ 07045. For more information, call 973-575-5540 or visit the www.changebridgemed.com. Bloggers Dr. Arnold I. Pallay, Dr. Frank Iannetta and Dr. Sandra Hoenig are board-certified, residency-trained physicians from top medical schools in the U.S. They will blog regularly about health tips, trends, events and breaking news. Please feel free to comment on our blog. The HNT Program is a responsible, long-term approach to weight management and is highly regarded in the obesity research community, which is offered at Changebridge Medical Associates.