Every year, more than 500,000 people go to emergency rooms for problems associated with kidney stones, according to the National Kidney Foundation (NKF). And if you’ve ever had one, the intense pain you experience will ensure you’ll never want to have another one.

Preventing Kidney Stones

Every year, more than 500,000 people go to emergency rooms for problems associated with kidney stones, according to the National Kidney Foundation (NKF). And if you’ve ever had one, the intense pain you experience will ensure you’ll never want to have another one.

Our concierge family practice doctors at MD 2.0 in Jupiter want to give you the facts on this common disorder and tell you how to prevent them.

How common are kidney stones?

According to the NKF, kidney stones are becoming more common. The prevalence of kidney stones in the U.S. increased from 3.8 percent in the late 1970s to 8.8 percent in the late 2000s. This increase was seen in both men and women and in all races. Kidney stones are found in children as young as five years.

The NKF attributes the rise in kidney stones to several factors, mostly related to our increased consumption of high-salt foods, including chips, fries, sandwich meats, and even some sports drinks.

The lifetime risk of kidney stones is about 19 percent in men and nine percent in women, the NKF reports. In men, the first episode is most likely to occur after age 30, but it can occur earlier.

What is a kidney stone?

A kidney stone is a hard object made from chemicals found in urine, which contains various wastes. When there is too much waste in too little liquid, crystals begin to form and attract other elements that harden into a solid object (called “stones”).

The stone begins in the kidney, and it can either remain there or travel down the urinary tract into the ureter. If it’s not small enough to pass out with the urine, it can cause a back-up of urine in the kidney, ureter, bladder, or urethra, causing pain, as well as serious complications.

Although genetics play a role in whether you are predisposed to develop kidney stones, they can also occur in conjunction with other diseases such as obesity, diabetes, high blood pressure, and various infections. The NKF says other possible causes include too much or too little exercise, weight-loss surgery, drinking too little water, or consuming food with too much salt or sugar.

Symptoms of a kidney stone

The symptoms of a kidney stone can mimic those of other diseases and conditions, which is why they need to be confirmed medically. But in general, typical symptoms of a kidney stone include:

• severe pain on either side of the lower back
• vague pain or stomach pain that doesn’t go away
• blood in the urine
• nausea or vomiting
• fever and chills
• urine that smells bad or looks cloudy.

Because these symptoms can be a sign of other serious problems, it’s important to see us if you experience any of them. In addition, a kidney stone that has grown too large to pass through the ureter can not only damage the kidney, it can prove to be fatal.

How to avoid kidney stones

The best way to avoid kidney stones is to drink a lot of fluid, at least 64 ounces a day. Adding lemon or lime juice (but not sugar) can help acidify the urine and guard against stone formation.

“Nothing, nothing, trumps fluids,” Dr. Ralph Clayman, a professor of urology at the University of California, Irvine, told CNN.

“If you’re drinking three quarts a day and making two-and-a-half quarts of urine a day, that’s the best way you can protect and defend either against getting a kidney stone or, if you’ve had them, defend against getting them again,” he said.

The NKF also recommends you stay well hydrated, especially when you’re engaging in activities that cause heavy perspiration: saunas, hot yoga, or heavy exercise, for example. The more you sweat, the less you urinate, which allows for stone-causing materials to settle and bond in the kidneys and urinary tract.

The popular belief that consuming dairy products contributes to stone formation turns out to be a myth; in fact, the opposite is true. Eating or drinking three servings of calcium a day helps lower your risk. Soy and almond milk, however, contain high levels of a compound called oxalate, a known contributor to the formation of kidney stones, so consumption of these products should be limited or avoided if you’re prone to kidney stones.

The NKF also recommends avoiding such oxalate-rich foods as nuts, seeds, legumes, beets, tea, and chocolate.

Finally, high-sodium food and drinks can contribute to the formation of stones, so not only should you avoid salt, but also processed foods (which are high in sodium), as well as canned and pickled foods.

If you think you have a kidney stone, see us as soon as possible. We can confirm whether your symptoms signal a kidney stone or another problem. We can also prescribe pain medication and/or alpha blockers that will relax the muscles in the ureter. Most kidney stones eventually pass, but large stones may require surgery.

temperatures

How To Stay Safe in Scorching Temperatures

We’re not even halfway through summer yet, and we’ve already seen record-high temperatures here in south Florida, which can bring dangerous health impacts. The two most serious are heat exhaustion and heat stroke. Our concierge doctors in Jupiter want to remind you of ways you can keep your family safe as temperatures soar.

 

What to watch for

The Red Cross warns that some people are more at risk of developing a heat-related illness. These include: people aged 65 and older, who are less likely to sense and respond to changes in temperature; people with chronic medical conditions, who may be taking medication that can worsen the impact of extreme heat; infants and young children; and, outdoor workers and athletes, who may be more likely to become dehydrated, particularly in extreme heat.

When keeping an eye on the weather forecast, here’s what the various warning terms mean:

  • Excessive Heat Watch: Conditions are favorable for an excessive heat event to meet or exceed local Excessive Heat Warning criteria in the next 24 to 72 hours.
  • Heat Advisory: Heat Index values are forecasted to meet locally defined advisory criteria for the next one-to-two days
  • Excessive Heat Warning: Heat Index values are forecasted to meet or exceed locally defined warning criteria for at least two days.

 

Consequences of extreme heat exposure

Such excessive heat as we’ve been experiencing recently can lead to life-threating heat exhaustion and heat stroke. Most people have heard these terms, but may not fully understand what they mean. We want to explain the differences between the two, because the treatments for each are different.

Heat exhaustion

The Centers for Disease Control and Prevention (CDC) says muscle cramping might be the first sign of heat-related illness. It lists the warning signs of heat exhaustion as:

  • heavy sweating
  • weakness
  • cold, pale, clammy skin
  • fast, weak pulse
  • nausea or vomiting

If you or someone you’re with experiences these symptoms, you should move to a cooler location, lie down and loosen your clothing, apply cool, wet cloths to as much of your body as possible, and sip water. If you have vomited and it continues, seek medical attention immediately.

 

Heat stroke

The signs of heat stroke are:

  • high body temperature (above 103 degrees)
  • hot, red, dry, or moist skin
  • rapid and strong pulse
  • possible unconsciousness.

 

This is a medical emergency. Call 911 immediately. While waiting for the ambulance, move the person to a cooler environment, and try to reduce the person’s body temperature with cool cloths, or if possible, a cool bath. Do NOT try to give fluids.

 

Staying safe in the heat

Here are steps you can take to avoid experiencing either of these serious conditions.

  • Limit outdoor activity. The sun is hottest from 11 a.m. (D.S.T.) to 3 p.m., so try to stay indoors, or at least in shaded areas, during those times. If you must be outdoors, take frequent breaks, preferably in air-conditioned environments, and, if possible, take cool showers or baths to cool down.
  • Dress appropriately. Wear loose, lightweight, light-colored clothing. Wear a hat with a wide brim.
  • Drink water frequently, from two to four cups of water every hour. Don’t wait until you’re thirsty to drink, because by then you’re already started to dehydrate. Monitor urine color: If your urine is dark, you’re not drinking enough water. Urine should be light yellow or clear. And avoid alcoholic drinks, which can not only impair judgment regarding time spent in the heat but also dehydrate you.
  • Never leave children or pets in cars for any amount of time. Also check on animals frequently, ensuring they have access to shade and plenty of cool water.
  • Check on family, friends, and neighbors who do not have air conditioning, who spend much of their time alone, or who are more likely to be affected by the heat.

 

Keep these safety tips in mind as you enjoy the outdoor fun in summer, and check with us if you feel more bothered than usual by the heat. This could be a sign of a medical condition that warrants investigation.

primary care jupiter fl

The Danger In Ultra-Processed Foods

Sausages. Mayonnaise. Pizza. Potato chips. Bacon. Even whiskey, gin, and rum. All these foods and many more share two common traits: All were “processed” into their familiar form by humans, and all have been implicated in an increased risk for early death.

Our concierge primary doctors in Jupiter want to make you aware of the latest studies on the dangers of consuming these foods as the primary part of your diet.

The difference in these studies is that they don’t just address so-called “junk” foods like cookies and fast foods, but many of the items that all of us have in our kitchens and rely on as staples of our diet.

 

The studies

Published last month in the journal BMJ, one study followed more than 100,000 adults in France for five years. They found that those who ate the most processed foods were 23 percent more likely to experience a heart condition or stroke than those who consumed the lowest amounts.

The second study, also published in BMJ, tracked 20,000 Spanish adults over 20 years. Those who ate the most processed foods were 62 percent more likely to die during the study period than those who ate the lowest.

“High consumption” was defined as four or more servings of ultra-processed foods daily, with health risks rising 18 percent for each additional daily serving.

While researchers cautioned that correlation doesn’t prove causation, both studies controlled for such other possible risk factors as lifestyle, demographics, physical activity, weight, and overall health in drawing their conclusions. They also noted that their findings correspond to other earlier studies showing an association between highly processed foods and higher risks of obesity, high blood pressure, high cholesterol, and some cancers.

 

The cause

Researchers classified foods into roughly three categories:

  • “unprocessed or minimally processed” foods included fruits, vegetables, milk, eggs, legumes, meats, poultry, fish and seafood, yogurt, white rice and pasta, and natural juices;
  • “processed” foods included cheeses, breads, beer, wine, ham, and bacon;
  • “ultra-processed” foods included potato chips, pizza, cookies, chorizo, sausages, mayonnaise, chocolates and candies, artificially sweetened beverages, and whisky, gin, and rum.

 

They also created a separate category called “processed ingredients,” which included salt, sugar, honey, olive oil, butter, and lard.

The problem seems to stem from the processing, which changes foods from their natural state into something that will last longer on our shelves. These tend to be high in poor-quality fats, additional sugar, salt, and preservative chemicals, and low in vitamins and fiber. The common factor can be summed up in the phrase “convenience foods”; that is, foods that are quick and easy to prepare at home.

Dr. Andrew Freeman, a cardiologist who was not involved in the study, told CBS News, “I like to say: The longer the shelf life, the shorter your life.” Freeman directs cardiovascular prevention and wellness at National Jewish Health in Denver.

 

The solution

The takeaway in both these studies, as well as preceding ones is, the closer to a food’s natural state that you can eat, the better the effect on your overall health.

Freeman told CBS News that the most heart-healthy diet is one rich in whole foods, particularly plant-based foods like fruits and vegetables, legumes, whole grains, and nuts. He added that, for affordability and convenience, fresh-frozen vegetables were perfectly acceptable.

Simply switching from sodas to water is another good choice, as well as substituting fresh fruit for sweets. Options for quick snack foods include such treats as homemade sweet potato chips, and oven-“fried” vegetables like cauliflower and broccoli, as well as celery and carrot sticks cut up and stored in water.

If you have any questions about a healthy eating plan, please let us know. We can help you substitute a healthy diet for foods likely to negatively impact your health.

heat summer

Beware the Danger of High Temperatures

May 30th is Heat Safety Awareness Day, so our concierge family doctors at MD 2.0 in Jupiter want to take this opportunity to acquaint you with this important health concern. The fact is, heat is a killer, and we here in south Florida need to pay particular attention to the danger high temperatures can present.

Heat exhaustion, heat stroke, and dehydration are some of the leading weather-related killers. For example:

  • A 1980 heat wave killed more than 1,250 people.
  • In 1995, a heat wave in Chicago took more than 700 people (the deadliest weather event in Chicago history).
  • In August 2003, a record heat wave in Europe claimed an estimated 50,000 lives.

 

Some people are more susceptible to negative effects from the heat. These include:

  • people 65 and older, who are less likely to sense and respond to changes in temperature;
  • people with chronic medical conditions, who may be taking medication that can worsen the impact of extreme heat;
  • infants and young children; and,
  • outdoor workers and athletes, who may be more likely to become dehydrated, particularly in extreme heat.

It’s vital to know the difference between heat exhaustion and heat stroke, the warning signs for each, and what to do in the event you or someone else experiences them. You should also know how to avoid these serious conditions.

 

Heat exhaustion

The Centers for Disease Control and Prevention (CDC) says muscle cramping might be the first sign of heat-related illness. It lists the warning signs of heat exhaustion as:

  • heavy sweating
  • weakness
  • cold, pale, clammy skin
  • fast, weak pulse
  • nausea or vomiting

If you or someone you’re with experiences these symptoms, you should move to a cooler location, lie down and loosen your clothing, apply cool, wet cloths to as much of your body as possible, and sip water. If you have vomited and it continues, seek medical attention immediately.

 

Heat stroke

The signs of heat stroke are:

  • high body temperature (above 103 degrees)
  • hot, red, dry, or moist skin
  • rapid and strong pulse
  • possible unconsciousness.

This is a medical emergency. Call 911 immediately. While waiting for the ambulance, move the person to a cooler environment, and try to reduce the person’s body temperature with cool cloths, or if possible, a cool bath. Do NOT try to give fluids.

 

Stay safe in the heat

Following are steps you can take to avoid experiencing either of these potentially deadly conditions.

Limit outdoor activity. The sun is hottest from 11 a.m. (D.S.T.) to 3 p.m., so try to stay indoors, or at least in shaded areas, during those times. If you must be outdoors, take frequent breaks, preferably in air-conditioned environments, and, if possible, take cool showers or baths to cool down.

Dress appropriately. Wear loose, lightweight, light-colored clothing. Wear a hat with wide brim.

Stay hydrated. Drink water frequently, from two to four cups of water every hour. Don’t wait until you’re thirsty to drink, because by then you’ve already started to dehydrate. Monitor urine color: If your urine is dark, you’re not drinking enough water. Urine should be light yellow or clear. And avoid alcoholic drinks, which can not only impair judgment regarding time spent in the heat but also dehydrate you.

Check the car. Despite all the awareness and warnings in the last few years, more children—51—died in hot cars in 2018 than any year on record. It happens to the most conscientious parents who simply have too many things on their minds. When transporting children, place something necessary—a purse or briefcase—next to the child. Keep car doors locked and never allow children to play in a car. And countless numbers of pets die when owners leave them alone in a hot car “just for a couple minutes.” Never leave pets alone in a closed car, even for a few minutes.

 

Check with us to see whether any medical conditions might make you more susceptible to heat.

Obesity Is a Little-Known Cancer Risk

When you think of ways to prevent cancer, you think of stopping smoking, avoiding the sun, getting regular screenings, and so on. But one way that might not occur to you is losing weight.

Therefore, our concierge family practice doctors in Jupiter thought you should know that there are 13 different types of cancer linked to overweight and obesity.

The risk

A recent article in The Washington Post reported that, although smoking is the number one preventable cause of cancer, killing more than 500,000 people in this country every year, “obesity is poised to take the top spot, as Americans’ waistlines continue to expand while tobacco use plummets.” It also appears that the more overweight a person is, the higher the cancer risk.

According to the National Institutes of Health (NIH), the types of cancer that may be influenced by overweight include:

  • esophageal
  • thyroid
  • colon
  • renal
  • liver
  • melanoma
  • multiple myeloma
  • rectal
  • gallbladder
  • leukemia
  • lymphoma
  • prostate in men
  • post-menopausal breast and endometrial in women

Being overweight also makes it more difficult to survive once a cancer is diagnosed.

The American Cancer Society (ACS) says that excess body weight is thought to be responsible for about eight percent of all cancers in the United States, as well as about seven percent of all cancer deaths. In addition, having too much belly fat, regardless of body weight, is linked with an increased risk of colon and rectal cancer, and is probably linked to a higher risk of cancers of the pancreas, endometrium, and breast cancer in post-menopausal women.

The reasons

Despite the apparent links, researchers are not certain of the reason that increased weight raises the risk of cancer. But they do have some theories. The ACS believes that timing of weight gain plays a role.

“Being overweight during childhood and young adulthood might be more of a risk factor than gaining weight later in life for some cancers,” the ACS says. “For example, some research suggests that women who are overweight as teenagers (but not those who gain weight as adults) may be at higher risk for developing ovarian cancer before menopause.”

The Post reports that researchers are homing in on the “visceral” fat that surrounds internal organs as the culprit.

“Rather than being a harmless glob, this fat is a ‘metabolically active organ’ that produces hormones such as estrogen, which is associated with a higher risk of breast and some other cancers, according to the American Institute for Cancer Research. . . . The fat also secretes proteins that drive insulin levels higher, which may spur cell growth and increase the possibility of cancer. And it can cause chronic inflammation, another risk factor for the disease, according to the group.”

“It’s a complex interplay of metabolism, inflammation, and immunity,” Jennifer Ligibel, a breast oncologist at the Dana-Farber Cancer Institute, told the paper. “It creates an environment that is more permissive for cancer.”

It’s also possible that lifestyle choices which cause overweight—poor diet and lack of exercise—are themselves contributing factors.

The upshot

While the effect of losing weight on reducing cancer risk is still uncertain, the ACS believes reducing body weight is a good move.

“Some body changes that occur as a result of weight loss suggest it may, indeed, reduce cancer risk. For example, overweight or obese people who intentionally lose weight have reduced levels of certain hormones that are related to cancer risk, such as insulin, estrogens, and androgens.”

To improve cancer odds, Ligibel of Dana-Farber told The Post that even a five percent reduction in body weight produces a beneficial result on blood sugar and inflammation.

We know dieting is difficult, but the results are well worth it, not only in reducing the risk of cancers and heart disease, but in improved quality of life overall. If you are overweight, please see us for tips and advice on simple ways to slim down.

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