Chronic Disease Management: Strategies for a Comfortable Lifestyle

Concierge Medicine, Disease, Health Basics, Healthy Living

Chronic diseases, including heart disease, diabetes, arthritis, and respiratory diseases, pose significant challenges to millions of individuals worldwide. Managing these conditions effectively not only prolongs life expectancy but also significantly enhances the quality of life. Our primary care doctors in Jupiter are here with strategies that can aid in comfortable lifestyle management for individuals navigating chronic illnesses.

Understanding Chronic Diseases

Before diving into the strategies, it is essential to understand what chronic diseases are. These are long-term medical conditions that are generally progressive, meaning they can worsen over time. They often require a multifaceted approach to management to help patients lead fulfilling lives.

Strategies for a Comfortable Lifestyle

  1. Education and Awareness

Knowledge is power — understanding your condition, its symptoms, potential complications, and management strategies can be empowering. Leveraging resources like therapy groups, online forums, and educational workshops can be beneficial.

2. Tailored Nutrition Plans

A well-rounded nutrition plan is often the cornerstone of managing chronic diseases. Collaborate with a dietitian to create a nutritionally balanced meal plan that caters to your individual health needs.

3. Regular Physical Activity

Engaging in physical activity that is appropriate for your condition can help in maintaining a healthy body weight and improving overall wellbeing. Even light activities such as walking or yoga can make a considerable difference.

4. Stress Management

Chronic diseases can often be exacerbated by stress. Mindfulness, meditation, and other stress management techniques can aid in keeping symptoms at bay. Learn to identify stress triggers and work on strategies to manage them effectively.

5. Medication Management

Being consistent with your medication regimen is vital. Organize your medications using pill organizers and set reminders to take your medicines as prescribed.

6. Regular Health Check-ups

Consistent monitoring of your health through regular check-ups can help in the early identification of any potential issues and manage them promptly.

7. Leveraging Technology

Utilize technology to aid in disease management. Apps that track physical activity, diet, and medication can be incredibly handy.

8. Emotional Support

Living with a chronic disease can sometimes be isolating. Support groups, family, friends, and therapy can offer the emotional sustenance required to navigate the daily challenges posed by chronic diseases.

9. Adequate Sleep

Ensure that you are getting sufficient and quality sleep as it plays a crucial role in the healing and regeneration processes of the body.

10. Personalized Care Plans

Collaborate with your healthcare provider to develop a personalized care plan that is holistic and considers all aspects of your health, including physical, mental, and social wellbeing.

Managing a chronic disease is a continuous journey, often characterized by ups and downs. While the goal is to create a comfortable and fulfilling lifestyle, it is essential to remain patient with yourself during the process. By implementing the above strategies, you pave the way to not just manage your chronic disease but to thrive in spite of it. Remember, a happy and comfortable life is not only possible but within your reach through comprehensive and compassionate chronic disease management.

What Diabetes Does to Your Eyes and What You Can Do About It

Disease, Health Basics, Healthy Living, Lifestyle, Preventative Health

Diabetes is a chronic condition that affects millions worldwide. While many are aware of its impact on blood sugar levels and its potential complications related to the heart, kidneys, and nerves, our concierge doctors in Jupiter want you to understand its link to vision. In fact, diabetes is one of the leading causes of blindness in adults. But how does this condition affect the eyes, and what can you do to protect your vision?

The Connection Between Diabetes and Eyesight

Our eyes are incredibly intricate and sensitive organs. The clear lens at the front and the retina, a thin layer of tissue lining the back of the eye, play vital roles in our ability to see. When blood sugar levels surge, as they often do in diabetes, these structures can be adversely affected.

Diabetic Eye Diseases

There are several eye conditions tied to diabetes:

  • Diabetic Retinopathy: This is the most common diabetic eye disease. High blood sugar levels can cause damage to the blood vessels in the retina, making them leak or hemorrhage. Over time, this can lead to vision impairment or blindness.
  • Diabetic Macular Edema (DME): A consequence of diabetic retinopathy, DME involves swelling in the macula, the part of the retina responsible for clear, sharp vision.
  • Glaucoma: Diabetes doubles the risk of glaucoma, a condition where increased pressure inside the eye damages the optic nerve.
  • Cataracts: Those with diabetes are more likely to develop cataracts at a younger age and the progression can be faster than in those without diabetes.

Preventing Eye Complications

Thankfully, you’re not powerless against these potential complications. Here are steps you can take:

  • Regular Eye Check-ups: Schedule a comprehensive eye exam at least once a year. Early detection is the key to successful management and treatment.
  • Control Blood Sugar Levels: Monitor your blood sugar levels diligently and follow your doctor’s advice regarding medication, diet, and exercise.
  • Manage Blood Pressure and Cholesterol: High blood pressure and cholesterol can exacerbate eye problems in diabetics. Regular check-ups and medication can help keep these in check.
  • Avoid Smoking: Smoking can accelerate complications related to diabetes, including those that affect your eyes.
  • Protect Your Eyes: Use sunglasses with UV protection and avoid activities that risk eye injury.
  • Know the Symptoms: Be aware of vision changes such as blurry vision, floaters, frequent prescription changes, or any vision loss. Report these to your ophthalmologist immediately.

Treatment Options

If you’re diagnosed with a diabetic eye disease, treatment options can vary based on the severity of the condition:

  • Laser Therapy: Used for diabetic retinopathy to reduce the leakage of abnormal blood vessels.
  • Vitrectomy: A procedure to remove the gel-like substance inside the eye, often used when there’s bleeding or significant scar tissue from diabetic retinopathy.
  • Injections: Medications can be injected into the eye to reduce swelling and improve vision.
  • Surgery: In advanced cases of glaucoma or cataracts, surgical interventions might be necessary.

Diabetes doesn’t necessarily mean you’ll have eye problems, but it does increase the risk. With proactive measures, regular check-ups, and early detection, many diabetic eye diseases can be managed or even prevented. Protecting your eyes starts with understanding the link between your health and your vision, and taking action to ensure both remain in optimal condition.

The Top Benefits of Concierge Medicine for Those with Chronic Illness

Concierge Medicine, Disease

Living with a chronic illness can be an arduous journey, filled with numerous medical appointments, complex treatment plans, and the need for continuous support. In such circumstances, having a reliable and personalized healthcare experience becomes essential. Our concierge doctors in Jupiter have a healthcare model that offers tailored and overs comprehensive services to patients, focusing on quality, accessibility, and patient satisfaction. Here are a few reasons why individuals with chronic illnesses should consider embracing concierge medicine for a more fulfilling and manageable healthcare experience.

  1. Personalized and Holistic Approach: One of the primary advantages of concierge medicine is the personalized care it provides. Patients with chronic illnesses often require individualized treatment plans that consider their unique medical history, lifestyle, and preferences. Concierge medicine doctors have smaller patient loads, enabling them to devote more time and attention to each individual. This personalized approach allows them to better understand their patient’s needs, creating holistic treatment plans that address not only the medical condition but also the patient’s emotional and mental well-being.
  2. Accessibility and Availability: For those living with chronic illnesses, sudden health complications or concerns can arise at any time. With traditional healthcare models, getting an urgent appointment can be challenging, leading to unnecessary stress and delays in treatment. Concierge medicine, on the other hand, ensures enhanced accessibility and availability. Patients can often reach their concierge doctor 24/7, allowing them to receive timely medical advice and attention when they need it the most.
  3. Reduced Waiting Times: In conventional medical settings, long waiting times are a common frustration for patients. For individuals managing a chronic illness, these waiting times can be physically taxing and detrimental to their well-being. Concierge medicine practices limit the number of patients they accept, resulting in significantly reduced waiting times during appointments. Patients can expect to be seen promptly, without feeling rushed during their visits.
  4. Comprehensive Care Coordination: Chronic illnesses often require the expertise of various specialists and healthcare providers. Coordinating these different aspects of care can become cumbersome and disjointed in traditional healthcare settings. Concierge medicine doctors typically take on the role of care coordinator, ensuring seamless communication and collaboration between specialists and healthcare teams. This streamlined approach to care helps prevent medical errors, ensures efficient treatment plans, and provides patients with peace of mind.
  5. Preventive Medicine Emphasis: Preventing complications and managing symptoms are essential aspects of managing chronic illnesses effectively. Concierge medicine doctors place significant emphasis on preventive care, focusing on regular health screenings, lifestyle modifications, and personalized preventive measures. By proactively addressing health concerns, concierge medicine can help individuals with chronic illnesses lead healthier lives and minimize the risk of disease exacerbation.
  6. Extended Appointment Times: Time is a valuable resource in healthcare, and having more extended appointment times is a luxury that concierge medicine provides. Patients with chronic illnesses often require more time to discuss their concerns, understand treatment options, and build a trusting relationship with their doctor. With concierge medicine, patients can enjoy extended appointment durations, fostering open and transparent communication with their healthcare provider.

For those dealing with chronic illnesses, concierge medicine offers a refreshing alternative to traditional healthcare models. By prioritizing personalized care, accessibility, and comprehensive support, concierge medicine empowers patients to take charge of their health and well-being. Though the concept of concierge medicine may have been seen as exclusive in the past, its increasing popularity and availability are making it a viable option for many individuals. Ultimately, choosing concierge medicine can lead to a more fulfilling and manageable healthcare journey for those living with chronic illnesses.

Should You Worry About Catching Bird Flu?

Disease

Since the outbreak of the novel coronavirus, SARS-CoV-2, we’ve all learned a lot more than we ever wanted to know about viruses and how they work, including how they mutate and how they can spread from animals to humans.

So the recent widespread outbreaks of bird flu have made some people a bit anxious, mainly because it has been reported in a number of mammals.

Our concierge primary care doctors in Jupiter want to explain why you shouldn’t be overly concerned, although there is an element of risk. Here’s what scientists are saying.

Background

According to the Centers for Disease Control and Prevention (CDC), although avian influenza A, popularly known as “bird flu,” viruses usually do not infect people, “there have been some rare cases of human infection with these viruses.”

Infected birds shed the virus through their saliva, mucus, and feces. Bird flu can transmit to humans when a virus from one of these sources gets into a person’s eyes, nose, or mouth, or is inhaled, either from unprotected contact with infected birds or with surfaces contaminated with these viruses.

Some infections in humans, however, haven’t been traced directly to this type of transmission—in other words, no one knows how these “very rare” cases happened. That means some cases may have passed from human to human.

But historically, other types of bird flu have been responsible for several flu pandemics in America’s history, including the devastating H1N1 flu pandemic in 1918-1919, which killed 50 million people worldwide. (The current strain is Type A H5N1, which is not related.)

Recent Outbreaks

The current H5N1 flu virus was first identified in 1959 and can be found in wild birds in all 50 states, along with backyard flocks in most states, including one in a backyard flock in Florida last month, according to the CDC.

In the last year, 58 million birds were slaughtered because of the H5N1 bird flu. In addition, it began transmitting to mammals, including hundreds of wild sea lions in Peru and a farm of minks in Europe. The U.S. Department of Agriculture (USDA) also reported last month that the virus has been detected in skunks, bears, a raccoon, and red foxes.

Most of these mammal infections were probably stand-alone cases in which the mammal ate an infected bird, Jürgen Richt, professor, and director of the Center on Emerging and Zoonotic Infectious Diseases at Kansas State University, told USA Today.

The exception could be the October mink outbreak, he said, in which the virus transmitted from mammal to mammal. And because humans have never been exposed to H5N1, we don’t have any immunity to it—just as we didn’t to the SARS-CoV-2 coronavirus.

“If this virus has mammalian adaption and can transmit between mammals, humans are immunologically naive . . . and humans are mammals,” Richt said.

Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), said last month that avian influenza’s spillover to mammal species must be monitored closely, but that the risk to humans remained low for the moment.

“But we cannot assume that will remain the case, and we must prepare for any change in the status quo,” he said.

Low Chance

Still, most virologists aren’t yet alarmed, because the virus would need to mutate in a certain way in order to spread to humans.

“It’s a series of events, each of which is fairly improbable,” Anice Lowen, a virologist and associate professor at Emory University School of Medicine, told NBC News.

“This is why I say the risk to humans is presently low,” she said. “The evolutionary barriers are high. It’s a numbers game,” she added, meaning the large numbers of outbreaks around the world are in the virus’s favor, but it would need to undergo a complicated string of mutations to be able to pass to humans.

Nevertheless, the mink farm infestation caught scientists’ attention, even though none of the workers at the farm became ill.

CNN reports that researchers found multiple mutations of the virus in the minks, including one that made it better at replicating in mammals.

“But it’s when it starts to spread from one mammal to the next mammal to the next mammal, it’s in those environments where we think it’s most likely that it will pick up these changes that allow us to switch hosts, and that’s why we get concerned,” Richard Webby, an infectious disease researcher at St. Jude Children’s Research Hospital in Memphis, Tennessee, told CNN. Webby is also the director of WHO’s Collaborating Centre for Studies on the Ecology of Influenza in Animals and Birds.

Staying Safe

Of course, we can’t predict the future, and as we saw with COVID-19, viruses have a way of getting out of hand.

So the CDC recommends a few precautions, such as never handling a dead bird without gloves and a mask.

Songbirds don’t (yet) appear affected, nor do such wild birds as crows or pigeons, so backyard birders don’t need to worry. And the CDC says it’s safe to eat poultry and eggs that are properly handled and cooked.

“The chances are not zero that you could get this, and anything you can do to further reduce that risk is a good thing,” Webby told CNN.

“But you probably really have to work hard to be infected with this virus,” he said.

Here’s to Your Heart Health

, , , Disease, Health Basics, Healthy Living, Nutrition, Preventative Health

In recognition of American Heart Month in February, our primary care concierge doctors in Jupiter thought we’d share some facts with you about your heart, and what you can do to keep it healthy.

Surprising Heart Facts

First, from the Cleveland Clinic, here are a few interesting things you may not know about your heart.

Your heart is about the size of your two hands clasped together.
It beats 100,000 times a day.
The beating sound is the clap of valve leaflets opening and closing.
A woman’s average heartbeat is faster than a man’s by almost eight beats a minute.
Every cell in your body gets blood from your heart, except for your corneas.
The heart pumps blood through 60,000 miles of blood vessels.
A normal heart pumps approximately four tablespoons of blood with each beat.
Each minute, your heart pumps 1.5 gallons of blood.
Your heart has its own electrical supply and will continue to beat when separated from your body.
Heart cancer is very rare because heart cells stop dividing early in life.

About Heart Disease

Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the U.S. About 697,000 people in the U.S. died from heart disease in 2020 (the most recent figures available). And every year about 805,000 people in the U.S. have a heart attack; over 600,000 of those are first heart attacks.

According to the Centers for Disease Control and Prevention (CDC), the term “heart disease” refers to several types of heart conditions.

The most common type of heart disease in the U.S. is coronary artery disease (CAD), which affects blood flow to the heart. Decreased blood flow can cause a heart attack. In 2020, about 20 percent of deaths from CAD occurred in adults below the age of 65, known as an “early cardiac event.”

Common Symptoms of Heart Disease Include:

Heart attack: chest pain or discomfort, upper back or neck pain, pain in the jaw or throat, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, a cold sweat, and shortness of breath
Arrhythmia: fluttering feelings in the chest (palpitations)
Heart failure: shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck veins

The Cleveland Clinic’s Dr. Curtis Rimmerman, a cardiologist, emphasizes that symptoms of a heart attack can vary widely, but adds that the discomfort is usually unrelenting, typically lasting five minutes or more.

“Regardless of where the pain is, people typically can’t find a position that relieves the pain,” he says. “Nor do they find relief by taking a drink of water, popping antacids or taking deep breaths.”

That means it’s time to call 911, he adds.

Increasing Risk

Unfortunately, about one in every five heart attacks are “silent”—that is, the damage is done, but the person is not aware of it.

That’s why it’s important to know your risk factors and what you can do about them.

About half of all Americans (47 percent) have at least one of the three key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.

In addition, several other medical conditions and lifestyle choices also put people at a higher risk for heart disease, the CDC reports, including:

diabetes
overweight and obesity
unhealthy diet
physical inactivity
excessive alcohol use

In addition, a 2021 study published in the journal Heart found that those who used illicit substances, including amphetamines, cocaine, and cannabis, were far more likely to experience an early cardiac event than those who didn’t.

And another study, published in the Journal of the American Heart Association (AHA) in 2020, found that the chances of developing cardiovascular disease (CVD) were 19 times higher in women who consumed one or more sugary drinks a day. This included everything from fruit juices to soft drinks (not diet) to coffee with sugar.

Lowering Risk

Some risk factors cannot be controlled, such as age or family history of heart disease, but you can take steps to lower your risk by changing the factors you can control.

Have your blood pressure, cholesterol, and triglycerides checked regularly.
Ask us whether you should be tested for diabetes.
Quit smoking.
Limit the alcohol you consume to one drink a day.
Learn how to manage stress levels by finding healthy ways to cope with stressful events.

In addition, there are two other ways that have been shown to dramatically reduce your risk for heart disease.

The first is exercise. According to the Cleveland Clinic, regular moderate-intensity exercise for at least 150 minutes is the single most important—and free—key to heart health.

The second is diet, specifically a plant-based diet. This doesn’t necessarily mean going totally vegetarian, just making plant foods vs. animal foods the main component of your diet.

“I’ve seen people whose diabetes, angina, or blood pressure goes into remission [on a plant-based diet],” Andrew Freeman, a cardiologist and the co-founder of the Nutrition and Lifestyle Work Group at the American College of Cardiology, told The Washington Post.

“I’ve seen autoimmune diseases go away when you cut inflammation,” he said. “The best way to do that is with a plant-based diet, and people get better.”

What to Know About the New COVID-19 Variant

, , , , COVID, Disease, News, Preventative Health, Vaccinations

As our concierge primary care doctors in Jupiter have said more than once over the past couple of years, we may be done with COVID-19, but the coronavirus isn’t done with us.

It’s still spreading, it’s still sickening and killing people, and it’s still learning how to survive. That’s why the latest report from the Centers for Disease Control and Prevention (CDC) didn’t surprise many health experts.

Late last month the CDC estimated that about 40 percent of current cases of COVID-19 are caused by the latest omicron relative, known as XBB.1.5. In December, XBB.1.5 more than doubled its share of COVID-19 cases each week, rising from about four percent of new infections in the first week to about 41 percent by the end of the month.

“For a few months now, we haven’t seen a variant that’s taken off at that speed,” Pavitra Roychoudhury, director of COVID-19 sequencing at the University of Washington School of Medicine’s virology lab, told CNN.

Latest Mutation

Mehul Suthar, who studies emerging viral infections at the Emory University School of Medicine in Atlanta, told USA Today that XBB.1.5 appears to be about five times more contagious than earlier omicron variants, which were five times more contagious than the original virus.

“The numbers start adding up,” he told the paper.

For you who are trying to keep up with the “scrabble variants,” (so-named because these letters tend to produce higher scores in Scrabble) the XBB.1.5 is related to the XBB variant, which is a recombinant of the BA.2.10.1 and the BA.2.75 sublineages.

While scientists still aren’t sure whether the XBB.1.5 causes more serious illness than its predecessors, NBC News reports that studies performed in the lab have found that XBB appears to be more contagious.

“It’s clear that there are immune evasive properties of XBB,” Isaach Bogoch, an infectious disease physician and epidemiologist at the University of Toronto, told NBC News.

In other words, the virus is evolving to get around the antibodies we’ve built up from vaccines and infections with previous strains.

Improving its Abilities

CBS News reports that the XBB.1.5 variant also contains an additional mutation called S486P, which Chinese scientists say appears to offer a “greatly enhanced” ability to bind to cells. In addition, XBB is resistant to various monoclonal antibody drugs used to treat infections.

“The mutation is clearly letting XBB.1.5 spread better,” Jesse Bloom, a computational virologist at the Fred Hutchinson Cancer Center, told CNN.

“It’s got a better ability to get into cells,” Roychoudhury added.

“We’re projecting that it’s going to be the dominant variant in the Northeast region of the country and that it’s going to increase in all regions of the country,” Dr. Barbara Mahon, director of the CDC’s proposed Coronavirus and Other Respiratory Viruses Division, told CBS News.

The question is how much of this spread is due to XBB.1.5’s enhanced abilities and how much can be attributed to the increased travel and social gatherings over the holidays.

To Worry or Not?

Another looming question is whether it will make people sicker. The data so far are unclear.

While XBB.1.5 shows an ability to evade immunity, Bogoch told NBC News that even if cases begin to rise significantly, he doubts there’ll be the dramatic spike in hospitalizations or deaths we saw in previous waves.

In addition, other parts of the immune system can work to protect against the virus, and vaccines along with prior infections should offer some protection from severe disease.

“We might certainly have a wave, but it’s just much less likely to be as deadly or overwhelming to healthcare systems compared to earlier waves before we had this degree of hybrid immunity,” he said.

Still, experts worry that the falloff in vaccination boosters could create problems.

“We aren’t in 2020, but people still do need to take this seriously and protect themselves,” the CDC’s Mahon told NBC.

Get Protection

One way to protect yourself, which most people are resisting, is to wear masks in public because it’s safer to avoid getting infected at all, Suthar told USA Today.

“The ‘it’s OK if I get infected’ attitude is not the most viable,” he said, adding that he still wears a mask when in public indoor spaces.

And all of the experts are concerned that less than 15 percent of the population has received the latest boosters against the coronavirus. Although they aren’t designed for the XBB.1.5 variant, they will offer some degree of protection.

Michael Osterholm, who directs the University of Minnesota’s Center for Infectious Disease Research and Policy, told CNN he sees reason for hope from the updated bivalent boosters, which target the original coronavirus as well as the omicron strains BA.4 and BA.5.

“They still provide a level of immunity that may not prevent you from getting infected but may have a significant impact on whether you become seriously ill and die,” he said.

“I mean, right now, the most recent data we have shows that for those who have the bivalent vaccine, they have a three-fold lower risk of dying than those who don’t,” he added.

Could You Have Hidden Thyroid Problems?

Disease, Lifestyle, Medications

Has your sex drive decreased recently? Have you been constipated lately? Do you have brain fog or unusual fatigue? Are you unusually sensitive to heat or cold?

You could have a thyroid problem and not even know it. The World Health Organization (WHO) estimates that 750 million people in the world have some form of thyroid disease, and as many as 60 percent of those are undiagnosed.

Because January is Thyroid Awareness Month, our concierge primary care doctors in Jupiter want to take this opportunity to share some facts you may not know about this critical gland in your body.

About Thyroid Disease

Many people go through their lives feeling “blah” or “not right” or putting up with symptoms they think is just a part of life, when in fact a malfunctioning thyroid is the real issue.

This gland, shaped like a butterfly, is located at the front of the neck, just below the Adam’s apple. It produces a hormone (thyroid stimulating hormone, or TSH) that influences nearly all the metabolic processes in the body. So when something goes wrong, this little gland can produce big problems.

The U.S. Department of Health and Human Services (HHS) reports that women are more likely than men to have thyroid disease. One in eight women will develop thyroid problems during their lifetime. Anyone over age 60, especially women, is at higher risk of developing thyroid disease, along with anyone who has diabetes.

In women, thyroid disease can cause several issues specific to their sex, including problems with the menstrual period, problems with getting pregnant, and problems during pregnancy.

In general, the two main types of thyroid disorders result from either underproduction or overproduction of TSH, and the symptoms of each are generally opposites of each other, although thyroid dysfunction can have hundreds of possible symptoms.

These two main disorders, hyperthyroidism, and hypothyroidism can result from many different causes, and can also be inherited.

Symptoms of Each Type

Hyperthyroidism results from the overproduction of thyroid hormones, thereby speeding up every process in the body. The heart beats faster, food is digested more rapidly, the kidneys process urine more quickly, etc.

Some of the symptoms of hyperthyroidism can include:

-increased perspiration
-insomnia
-increased appetite
-weight loss
-nervousness/anxiety
-irritability
-hand tremors
-muscle weakness, especially in the upper arms or thighs
-hair loss/fine brittle hair
-heart palpitations/irregular heartbeat/racing heart
-sensitivity to heat
-carpal tunnel syndrome
-more frequent bowel movements
-light or less frequent menstrual cycles

Hypothyroidism is the more common type of thyroid disease, in which the thyroid doesn’t release enough thyroid hormone. As you might expect, with this type of thyroid problem every process in the body slows down.

Some of the symptoms of hypothyroidism can include:

-fatigue
-sensitivity to cold, especially cold hands and feet
-constipation and gas
-pain, stiffness, or swelling in joints
-brain fog/memory problems
-weight gain
-irregular or heavy menstrual periods
-hoarseness
-dry skin
-poor appetite
-lowered libido
-puffy/swollen face
-fluid retention/bloating
-thinning hair or hair loss
-muscle weakness
-depression

There can also be other symptoms, and they vary from person to person. Often they are dismissed as stressed, feeling “run down,” or simply aging. So you can see why so many people have undiagnosed thyroid dysfunction.

Simple Treatments

Another type of thyroid issue that frequently has no symptoms is thyroid cancer. According to the American Society of Clinical Oncology (ASCO), thyroid cancer is the most common form of cancer in women between the ages of 20 and 34, and the only symptoms may be difficulty swallowing, or sometimes throat pain accompanied by a persistent cough.

Approximately one percent of Americans are diagnosed with thyroid cancer in their lifetimes, representing about two percent of all cancer cases in the U.S. The good news is that this cancer is highly treatable, even in advanced stages.

And treatment for an over- or underactive thyroid is simple, safe, and effective. This includes anti-thyroid drugs, radioactive iodine, and beta-blockers to help control symptoms.

If you are experiencing any of these symptoms, it’s important that you let us know so you can get treatment. Untreated thyroid disease can damage many organs of the body, including the heart and kidneys.

Keeping it Healthy

Here are some steps you can take to keep your thyroid healthy.

  1. Be sure the salt you use is iodized. Many of the specialty salts do not contain iodine. The thyroid requires iodine to function properly, but the recent popularity of such specialty salts as sea salt and Himalayan salt has reduced the amount of iodine in some diets. Too little iodine can result in hypothyroidism.
  2. Avoid uncooked cruciferous vegetables, including broccoli, cauliflower, cabbage, Brussels sprouts kale, watercress, and kohlrabi. These particular vegetables contain substances called goitrogens that interfere with the efficient synthesis of thyroid hormones. Cooking inactivates these substances, making them safer to eat.
  3. Opt for more seafood in your diet, especially crab, shrimp, lobster, clams, and mussels. All of these are rich sources of iodine.
  4. Avoid processed foods. Although high in sodium, processed and packaged foods do not contain iodized salt.

These guidelines can help maintain the health of your thyroid. But do not try to self-treat a suspected thyroid problem, especially with iodine supplements, which can make symptoms worse.

Are You Sick? How to Tell Which Virus You Have

, , , , , , COVID, Disease, Health Basics, Preventative Health, Vaccinations

As most of us have shed our pandemic masks in favor of returning to less restricted socializing, some of the viruses we didn’t have to deal with for the last two winters have resurfaced—with a vengeance.

According to the Centers for Disease Control and Prevention (CDC), seasonal flu activity is “elevated across the country.” The respiratory virus RSV is 10 times higher than normal, and more than 40,000 new cases of COVID-19 are being reported daily.

So if you’re sick, our concierge primary care doctors in Jupiter want to help you figure out which of these highly contagious viruses may be causing your symptoms, and what to do about them.

The ‘Tripledemic’

The flu season began six weeks earlier than normal this year, with at least 880,000 reported cases as of the end of October, including 6,900 hospitalizations and 360 flu-related deaths. This is the highest number recorded since the 2009 H1N1 swine flu pandemic.

“The Southern Hemisphere has had a pretty bad flu season, and it came on early [there],” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Bloomberg News. So officials weren’t especially surprised when it hit early and hard here, too.

At the same time, the respiratory syncytial virus, or RSV, has been flooding children’s hospitals with cases. And while the media’s attention has largely been focused on children, RSV can also hit older adults and those who are immunocompromised.

Meanwhile, COVID-19 cases have leveled off, but as of the end of November, the CDC was reporting 281,000 new cases and 2,222 deaths a week, with cases expected to rise this winter.

And, of course, without universal masking, colds are also making a comeback. To make matters worse, it is possible to be infected with more than one virus at the same time.

Similar Symptoms

With all these viruses hitting at once, it’s doubly difficult to know which one you have, because all of them have overlapping symptoms.

“At this stage of the pandemic, it’s really difficult to differentiate between the flu, COVID, common colds, and even seasonal allergies,” Céline Gounder, an infectious disease specialist, epidemiologist, and senior fellow at the Kaiser Family Foundation, told CNBC’s Make It.

“I, even as an infectious disease specialist who’s been practicing for a couple of decades now, cannot differentiate just on an exam,” she said. “You really need to do a test.”

Early on, it was easier to tell the difference at least at least with COVID-19, because of such distinctive symptoms as loss of smell and taste and red eyes or toes. But Gounder explained that because most people now have some degree of immunity, either through vaccination or infection or both, our bodies aren’t reacting the same way. Second, the newer variants are behaving differently than the original strain.

Ways to Tell

It helps to know which virus you have because they are not treated the same. With COVID-19, you can receive antiviral therapies, which can short-circuit the severity of the illness. But the antiviral treatments you can get for the flu are different.

As for RSV, Vandana Madhavan, clinical director of Pediatric Infectious Disease at Mass General for Children, told HuffPost that doctor’s offices are overrun right now, and if you bring your child in for mild symptoms that might otherwise get better at home, there’s a risk they could pick up something else while they’re there.

So how do you tell? As Gounder pointed out, there’s no way to know for sure, but here are some typical symptoms of each.

Common cold:

  • sore throat
  • runny or stuffy nose
  • coughing
  • sneezing
  • headaches
  • body aches

Flu:

  • sore throat
  • runny or stuffy nose
  • muscle/body aches
  • cough
  • fever or chills
  • headache
  • fatigue

COVID-19:

  • sore throat
  • runny or stuffy nose
  • muscle/body aches
  • cough
  • fever or chills
  • headache
  • fatigue
  • diarrhea
  • nausea/vomiting
  • difficulty breathing or shortness of breath

The CDC notes that this list does not include all possible symptoms. Symptoms may change with new COVID-19 variants and can vary depending on vaccination status.

RSV:

  • runny nose
  • decrease in appetite
  • coughing
  • sneezing
  • fever
  • wheezing

The CDC reports that these symptoms usually appear in stages and not all at once. In very young children with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties. Almost all children will have had an RSV infection by their second birthday.

What To Do

With any type of respiratory virus, it’s important to keep from spreading the virus to others, especially those who may be immunocompromised or are otherwise at higher risk. There are tests for COVID-19 and the flu, but not for the common cold or RSV.

Stay home if you are sick and get in touch with us if you have any questions.

Call 911 if you see any signs of an emergency, especially with COVID-19, including:

  • trouble breathing
  • persistent pain or pressure in the chest
  • new confusion
  • inability to wake or stay awake
  • pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
  • if you think it may be an emergency

As the number of cases of all these viruses rise, it’s smart to take precautions. Wear a mask in crowded, poorly ventilated places, wash your hands frequently, eat well, and get plenty of sleep. 

And get your flu vaccine and a COVID-19 booster if you haven’t had one recently (there is no vaccine for RSV or the common cold).

BREAST CANCER

What to Know During Breast Cancer Awareness Month

Breast Cancer, Cancer, Disease, Preventative Health

Long-time cancer-screening activist Katie Couric, 65, announced last month that she’d been treated for breast cancer. Within days came the news that WNBA star Tiffany Jackson had died of the disease at age 37.

These two stories help to highlight Breast Cancer Awareness Month in October, both the importance of screening and the fact that even young women can this deadly disease.

So our primary care concierge doctors in Jupiter want to offer you some facts you may not have known about breast cancer and what to look out for.

Some Little-known Facts

  • Breast cancer is the most common form of cancer in women in the U.S., except for skin cancers, according to the American Cancer Society (ACS). And contrary to common belief, 85 percent of American women who are diagnosed have no family history of the disease.
  • This year, about 287,850 new cases of invasive breast cancer will be diagnosed in women, with about 51,400 of those being ductal carcinoma in situ (DCIS). Nearly all women with this early stage of breast cancer can be cured.
  • About 43,250 women will die from breast cancer.
  • But it’s not just women. The ACS reports that in 2022, about 2,710 new cases of invasive breast cancer will be diagnosed in men, and about 530 of them will die from it.
  • And Yale Medicine reports that breast cancer is the most common form of cancer in women ages 15-39.

Screening Guidelines Vary

Although different organizations offer different guidelines for cancer screening, in general, regular cancer screening can catch cancer before someone has symptoms. This allows a small, localized area to be removed, hopefully before it can spread.

The U.S. Preventive Services Task Force (USPSTF), for example, recommends mammography screenings every two years (biennial) for women ages 50 to 74 years, while the ACS recommends such screenings annually for women ages 50 to 54 and every other year after that.

As for the standard clinical breast exam, the International Agency for Research on Cancer (IARC) states: “There is inadequate evidence that clinical breast examination reduces breast cancer mortality.” The American College of Physicians agrees. Even the ACS doesn’t recommend clinical examination to screen for breast cancer, preferring to emphasize mammography as the preferred method of detection.

The American College of Obstetricians and Gynecologists (ACOG) says, “Decisions between screening with mammography once a year or once every two years should be made through shared decision-making after appropriate counseling.” In other words, the benefits of annual mammography for those with average risk haven’t been firmly established, so it’s up to the woman and her doctor to decide on the frequency.

Different Outcomes

Katie Couric co-founded the organization Stand Up to Cancer after the death of her first husband, Jay Monahan, from colon cancer, so she was an advocate for regular cancer screenings. Still, her diagnosis stunned her.

Couric told CNN that she went for a mammogram in the summer, which found her breast cancer.

“I think those words, ‘It’s cancerous or you have cancer’ do stop you in your tracks,” she said. But her doctor told her it was treatable, so she underwent a lumpectomy in July, followed by radiation.

Unfortunately, as in the case of Tiffany Jackson, breast cancer is more likely to be found at a later stage among women under the age of 45, and is often more aggressive and difficult to treat.

She was originally diagnosed with stage three breast cancer in 2015 and thought her treatment had been successful.

But studies show that women who are first diagnosed before age 35 have between a 13-38 percent risk of recurrence that spreads to other parts of the body, while in women ages 50 and over, that risk is between 4-29 percent.

What To Do

Besides having the recommended mammographies, for both men and women of all ages, it’s important to know the risk factors for the disease as well as the early signs.

Risk factors include:

  • getting older
  • having dense breasts
  • a family history
  • hormonal changes
  • excess alcohol consumption
  • environmental factors, including exposure to radiation
  • obesity and overweight
  • beginning periods before age 12 and menopause after age 55
  • becoming pregnant at an older age or never being pregnant
  • taking hormones, including birth control pills and hormone replacement therapy
  • physical inactivity
  • night-shift work
  • smoking

It’s important to become familiar with your breasts, so you’ll know what symptoms to look for.

Warning signs include:

  • new lump in the breast or underarm (armpit)
  • thickening or swelling of part of the breast
  • irritation or dimpling of breast skin
  • redness or flaky skin in the nipple area or the breast
  • pulling in of the nipple or pain in the nipple area
  • nipple discharge other than breast milk, including blood
  • any change in the size or shape of the breast
  • pain in any area of the breast

The CDC cautions, “Keep in mind that these symptoms can happen with other conditions that are not cancer,” so don’t panic if you see any of them. But do contact us right away if you do see such changes.

Remember, the sooner breast cancer is caught, the easier it is to treat.

Latest on COVID-19 Omicron Boosters

, , , , COVID, Disease, Lifestyle, Preventative Health, Vaccinations

The Centers for Disease Control and Prevention (CDC) earlier this month approved two new booster vaccines specifically formulated to target the BA.4 and BA.5 omicron subvariants of the SARS-CoV-2 coronavirus, so our primary care concierge doctors in Jupiter want to bring you up to date on the latest information.

What’s different about this vaccine?

The COVID-19 vaccines that have been in use since they were first rolled out in 2021 were all designed to target the original strain. They also effectively reduced hospitalizations and deaths against the different variants that emerged in the following months, including the widespread delta variant.

As the newest omicron subvariants emerged and are now responsible for 90 percent of COVID-19 infections, vaccine makers Pfizer-BioNTech and Moderna developed new, more tailored versions to specifically target them.

The new formula is defined as “bivalent,” meaning it protects against both the original strain as well as the highly contagious BA.4 and BA.5 subvariants. They are the first updated COVID-19 vaccines to be cleared by the U.S. Food and Drug Administration (FDA).

“The updated COVID-19 boosters are formulated to better protect against the most recently circulating COVID-19 variant,” said CDC director Rochelle Walensky.

“They can help restore protection that has waned since previous vaccination and were designed to provide broader protection against newer variants,” she added. “This recommendation followed a comprehensive scientific evaluation and robust scientific discussion.”

Tests in mice have shown they produce a good immune system response to omicron’s BA.4 and BA.5 subvariants.

Are they safe?

Some have questioned the safety of the new versions of the shots because they haven’t been tested in humans, only in mice. But the new vaccines have merely been “tweaked” to “change the recipe,” as the University of Colorado’s UCHealth website explains.

The original Pfizer and Moderna vaccines have been fully tested in humans, and more than 600 million doses in the U.S. and millions more around the world have been given safely. The advisors and experts at both the FDA and the CDC have determined that the newly formulated booster shots are safe.

UCHealth infectious disease and COVID-19 expert Dr. Michelle Barron compared the new boosters to the flu shot, which is updated every fall as vaccine makers guess which strains of the flu will be circulating, and change the recipe to match. But the vaccine itself is not entirely new, she explained.

“We don’t test the flu shot each year. We just change it slightly,” Barron said.

“This new COVID-19 booster just tweaks the formula. The technology is the same. The safety of the vaccines will be exactly the same because it’s not a new vaccine,” she explained.

Who can get them?

The Pfizer vaccine is authorized for anyone ages 12 and older; the Moderna vaccine is authorized for adults 18 and older.

Like the previous coronavirus vaccines, the new boosters are free to the public. They will be available to anyone who has already had their primary vaccine series from any authorized U.S.-approved company regardless of how many boosters they’ve already received.

Public health officials recommend that those who are pregnant or have been pregnant recently should also get the updated boosters because they are at a slightly increased risk of more severe illness and death from COVID-19.

For those who recently received a booster of the previous vaccines, the FDA has set a minimum waiting period at two months, but advisers to the CDC recommend waiting longer: at least three months for those at high risk, or as long as six months for everyone else.

It’s also recommended that anyone who has recently recovered from a COVID-19 infection should wait at least three months to be vaccinated, not only to boost the effects of the vaccine but also to avoid the possibility of a rare side effect, heart inflammation, that sometimes affects teen boys and young men.

“If you wait a little more time, you get a better immunologic response,” CDC adviser Dr. Sarah Long of Drexel University told CBS News.

According to the CDC, side effects are expected to be similar to those associated with the current vaccine, including headache and muscle soreness, occasional fatigue, and redness and swelling at the injection site.

What about other vaccines?

As we head into the fall flu season, several of our clients have asked whether they can get a coronavirus vaccine along with a flu vaccine. The answer is yes, one in each arm.

In fact, health officials have recommended this protocol, and the government is preparing to launch a campaign that will urge Americans to do just this, due to the possibility of the high spread of flu and COVID-19 this season.

As for the Jynneos monkeypox vaccine, the CDC suggests that adolescent and young adult men consider waiting four weeks after receiving the monkeypox vaccine before receiving a Moderna, Novavax, or Pfizer COVID-19 vaccine, because of the risk of inflammation of the heart muscle (myocarditis) or inflammation of the tissue surrounding the heart (pericarditis).

However, the agency adds that the monkeypox vaccination “should not be delayed” due to recently receiving a coronavirus vaccine.

If you have any questions about whether or not to get the new booster, don’t hesitate to contact us for advice.

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