Flu Season Preparation: Creating a Personalized Flu Prevention Plan

Flu season can bring about a flurry of sniffles, coughs, and body aches which are often accompanied by a flurry of doctor’s appointments and sick days. It tends to peak between December and February but can last from October to as late as May. Preparing for this time of year is essential in not only protecting your own health but also the health of those around you. The key to this preparation is crafting a personalized flu prevention plan. Our primary care doctors in Jupiter have some tips on how you can create yours:

Step 1: Know Your Risk

Some individuals are at a higher risk for severe flu and complications. This includes young children, pregnant women, individuals with chronic health conditions, and people aged 65 and older. Understanding your risk will help you take the necessary precautions.

Step 2: Get Vaccinated

The annual flu vaccine is the most effective way to prevent flu. It is advisable for everyone six months and older to get a flu vaccine every year. Make sure to consult with your healthcare provider to find the right flu vaccine for you.

Step 3: Practice Good Hygiene

Good hygiene is a powerful tool in preventing the flu. Make sure to:

  • Wash your hands frequently with soap and water for at least 20 seconds.
  • Cover your mouth and nose with a tissue or your elbow when coughing or sneezing.
  • Avoid touching your eyes, nose, and mouth.


Step 4: Boost Your Immune System

Maintaining a strong immune system can help ward off the flu. Ensure you are:

  • Eating a balanced diet rich in fruits, vegetables, lean proteins, and whole grains.
  • Getting regular exercise.
  • Sleeping for 7-9 hours each night.
  • Managing stress through mindfulness practices like meditation or yoga.


Step 5: Avoid Close Contact

Avoid close contact with individuals who are sick, and if you are feeling unwell, stay home to prevent spreading the flu to others.

Step 6: Seek Medical Advice

If you’re at high risk for flu complications or have severe flu symptoms, contact your healthcare provider. Antiviral drugs can be a treatment option.

Step 7: Create a Sick-Day Plan

Have a plan in place for managing sick days whether it’s for you or your family. Know your employer’s policies on sick leave and have a plan for childcare if necessary.

Conclusion:

Facing the flu season unprepared can be daunting. However, by understanding your risk and having a personalized flu prevention plan in place, you can significantly reduce the likelihood of falling ill. Remember, a little preparation now can save a lot of trouble later. Your health and the health of those around you is worth the effort.

COVID tests: When and Where to Order the Next Batch of Free Ones

With the winter months approaching and the memories of last year’s challenges still fresh, it’s heartening to see the Biden administration taking proactive measures to ensure Americans have access to at-home COVID-19 testing. Our primary care doctors want you to have the latest information. Here is everything you need to know.

More Funds for At-home Tests

In a recent announcement, the administration unveiled a $600 million plan aimed at boosting the production of these critical tests. This move will not only replenish federal stockpiles but also help circumvent the supply chain problems that led to shortages in the past. What’s more, these tests will be manufactured right here in the USA by twelve manufacturers scattered across seven states. This means hundreds of jobs and, most importantly, 200 million over-the-counter tests for Americans.

Where to Order?

For those wondering where to get these tests, the original COVIDTests.gov website will once again be your go-to place. Here, every household can order up to four free tests.

Availability Dates

Mark your calendar for September 25. Starting from this date, the tests can be ordered and will be shipped directly to your doorsteps for free, courtesy of the United States Postal Service.

Updated Vaccines: What You Need to Know

In addition to the at-home tests, there’s more good news on the vaccine front. Last week, the CDC gave its endorsement to new COVID-19 shots suitable for everyone aged 6 months and older.

For those looking for places to get vaccinated, the government’s vaccines.gov website will list available locations, including pharmacies, health centers, and some doctor’s offices. And while the list price of each shot hovers between $120 to $130, federal assurances mean that these shots will remain free for most Americans, whether through private insurance, Medicare, or Medicaid. The CDC is also collaborating with health departments, clinics, and some pharmacies to ensure that even the uninsured or underinsured get their shots free of charge.

Flu Shot and COVID-19 Vaccine: Together?

One of the most common questions is whether one can get the flu shot and the COVID-19 vaccine simultaneously. The answer is a resounding yes. According to the CDC, there’s no difference in effectiveness or side effects whether you get both vaccines together. If you do decide to go this route, consider getting one shot in each arm for comfort. Remember, it’s recommended that almost everyone aged 6 months and up gets their flu shot, ideally by the end of October.

In conclusion, as we prepare for the colder months, these proactive measures and clear guidelines will certainly help in ensuring the health and safety of all Americans. Stay safe and stay informed!

Understanding Different Heat Illnesses

As the temperatures rise during the warmer months, many of us enjoy spending more time outdoors. However, with the increase in temperatures comes the potential risk of heat-related illnesses. Our primary care doctors in Jupiter want you to be informed about the different types of heat illnesses to prevent them and to provide proper care if someone is affected.

1. Heat Stroke

What it is: Heat stroke is the most severe form of heat illness and is a medical emergency. It happens when the body’s temperature rises rapidly, and it can’t cool down.

Symptoms:

  • High body temperature (above 103°F)
  • Hot, red, dry, or damp skin
  • Fast, strong pulse
  • Headache
  • Dizziness
  • Nausea
  • Confusion
  • Losing consciousness (passing out)

What to do: Call 911 immediately. While waiting for medical professionals, move the person to a cooler place and try to reduce their body temperature with cool cloths or a cool bath. Do not give the person anything to drink.

2. Heat Exhaustion

What it is: Heat exhaustion is a warning that your body can no longer keep itself cool. If left untreated, it can escalate to heat stroke.

Symptoms:

  • Heavy sweating
  • Cold, pale, and clammy skin
  • Fast, weak pulse
  • Nausea or vomiting
  • Muscle cramps
  • Tiredness or weakness
  • Dizziness
  • Headache
  • Fainting

What to do: Move to a cool place, loosen your clothes, put cool, wet clothes on your body or take a cool bath. If the person is fully conscious, they can sip water. If the symptoms worsen or last longer than an hour, seek medical attention.

3. Heat Cramps

What it is: Muscle spasms or pains that occur due to intense exercise in hot weather.

Symptoms:

  • Muscle cramps, usually in the legs or abdomen
  • Heavy sweating

What to do: Stop the activity and move to a cool place. Drink water or a sports drink. Wait for the cramps to go away before you do any more physical activity.

4. Heat Rash

What it is: Skin irritation from excessive sweating.

Symptoms:

  • Red clusters of small blisters that look like pimples on the skin
  • Usually appears on the neck, chest, groin, or elbow creases

What to do: Stay in a cool, dry place. Keep the rash dry and avoid using ointments or creams as they can keep the skin warm and moist, worsening the condition.

5. Dehydration

What it is: A lack of enough water in the body, often caused by too much sweating.

Symptoms:

  • Dry mouth and throat
  • Dark yellow urine
  • Not urinating much
  • Feeling dizzy or lightheaded
  • Feeling tired
  • Dry skin

What to do: Drink plenty of fluids, preferably water. If dehydration is severe and accompanied by symptoms like confusion, rapid heartbeat, or rapid breathing, seek medical attention immediately.

Prevention Tips

  • Stay Hydrated: Drink plenty of water throughout the day. Avoid drinks with caffeine or alcohol as they can dehydrate you.
  • Dress Appropriately: Wear lightweight, light-colored, loose-fitting clothing. Use a wide-brimmed hat or an umbrella for shade.
  • Stay Cool: Avoid direct sunlight whenever possible, especially during the hottest parts of the day. Use fans or air conditioning to cool down.
  • Limit Outdoor Activities: Do strenuous activities during the cooler parts of the day, such as early morning or late evening.

By understanding the signs and symptoms of heat-related illnesses and taking preventive measures, you can safely enjoy the warm weather without the health risks. Always listen to your body, and if you or someone around you is showing signs of a heat illness, take it seriously and seek medical attention if needed.

Learn About this Devastating Mental Disease and How to Stay Ahead

Alzheimer’s disease is a neurodegenerative disorder that affects the brain, causing progressive cognitive decline, memory loss, and behavioral changes. It is the most common cause of dementia and is characterized by the accumulation of abnormal proteins in the brain.


June is recognized as Alzheimer’s and Brain Awareness Month, a time to raise awareness about this devastating disease and to support those who are affected by it. Our concierge primary care doctors in Jupiter want to discuss some important facts about Alzheimer’s disease, as well as tips for maintaining brain health and reducing your risk of developing the disease.

Facts about Alzheimer’s disease:

  • Alzheimer’s disease affects more than 6 million people in the United States, and that number is expected to triple by 2060.
  • There is no cure for Alzheimer’s disease, but early detection and intervention can help manage symptoms and improve quality of life.
  • Alzheimer’s disease is more common in older adults, but it can also affect younger people.
  • Genetics, lifestyle factors, and environmental factors may all play a role in the development of Alzheimer’s disease.
  • There are several different types of dementia, and Alzheimer’s disease is just one of them.

Tips for maintaining brain health:

  • Stay physically active: Regular exercise can help improve blood flow to the brain and promote the growth of new brain cells.
  • Eat a healthy diet: A diet rich in fruits, vegetables, whole grains, and lean protein can help support brain health.
  • Stay mentally active: Engage in activities that challenge your brain, such as puzzles, reading, or learning a new skill.
  • Stay socially connected: Social interaction can help reduce the risk of cognitive decline.
  • Manage chronic health conditions: Conditions such as high blood pressure, diabetes, and obesity can increase the risk of developing Alzheimer’s disease, so it’s important to manage these conditions through lifestyle changes and/or medication.

In conclusion, Alzheimer’s disease is a complex and devastating condition that affects millions of people worldwide. By raising awareness and taking steps to maintain brain health, we can work to reduce the impact of this disease and improve the quality of life for those affected by it.

Surprising Facts About Skin Cancer

You may think you already know everything about skin cancer. But because May is Skin Cancer Awareness Month, our concierge primary care doctors in Jupiter want to share some facts about this often-deadly disease that you may not be aware of.

Brief Skin Cancer Recap

Let’s start with some facts about skin cancer you may already know:

  • Basal cell carcinoma is the most common form of skin cancer, followed by squamous cell carcinoma. Both can easily be cured if caught in time, but they can be disfiguring and expensive to treat.
  • Malignant melanoma is the most deadly type of skin cancer. It represents only about three percent of all skin cancers diagnosed but is responsible for the most deaths. That’s because of its tendency to spread to other parts of the body, including vital organs. But when diagnosed early, its five-year survival rate is 99 percent.
  • The most preventable cause of skin cancer is exposure to ultraviolet (UV) light, either from the sun or from artificial sources like tanning beds.
  • About 90 percent of non-melanoma skin cancers and 85 percent of melanoma cases are associated with exposure to UV radiation.
  • One bad sunburn in childhood doubles the risk for melanoma later in life. Having five or more sunburns doubles your risk for melanoma. A single indoor tanning session increases your risk of melanoma by 20 percent.
  • Even if it’s cool and cloudy, you still need protection, because ultraviolet (UV) light can penetrate clouds.

Odd Skin Cancer Facts

There are other facts about skin cancer that you might never have heard before.

1. For example, did you know that more men than women die of melanoma? The American Academy of Dermatology (AAD) says that one reason may be that men know less than women about skin cancer and that they use sunscreen less than women do.

Men’s skin is also more prone to penetration by UV rays than women’s because they have thicker skin with less fat beneath. A man’s skin also contains more collagen and elastin, making men’s skin more likely to be damaged by UV light.

2. On the other hand, one study found a greater association between white wine consumption and a higher risk of melanoma in women. Those who drink a glass of white wine each day showed a 13 percent increased risk of invasive melanoma (meaning it’s gone deeper than the top layer of skin), while those who drank the most white wine had an increased risk of 50 percent or higher than those who don’t drink any alcohol.

3. UV rays can penetrate glass in windows, both at home and in the car. This helps explain why left-sided facial cancers, especially in men, are more common. It’s all about the position we drive in, with the left side of the body exposed to more UV light. Windshields are treated to block UV rays, but side, back and sunroof windows aren’t. Also, be aware that UV rays can not only penetrate glass, but also can “bounce” under beach umbrellas and reflect off of concrete surfaces.

4. It’s extremely rare for a mole to transform into a melanoma, according to Dr. Ashfaq Marghoob, a dermatologist with the Memorial Sloan Kettering Cancer Center. While melanoma can develop in a preexisting mole, nearly 70 percent do not. At the same time, the presence of many moles can identify those who are at an increased risk for developing melanoma somewhere else on their skin.

That’s why it’s important to apply sunscreen to all parts of the body.

“Some people use sunblock only where they have moles because they think the moles themselves are dangerous,” he says.

5. Caffeine may protect against skin cancer. One study found that women who drank more than three cups of coffee daily were 21 percent less likely to develop basal cell carcinoma (BCC), the most common type of skin cancer. Men were 10 percent less likely to develop BCC.

6. Melanomas are not necessarily brown. Some have no color or are pink or appear as simple bumps on the skin. That’s why it’s important not to try to diagnose skin cancer on your own.

“Be aware of isolated or pink spots, especially if the spot looks different than any other marks on the skin,” Marghoob says. “Pay attention to any spot or mark that has an uneven texture, shape, border, or distribution of colors,” he added. “In addition, any spot that has changed in some way should prompt a visit to your doctor.”

Avoiding Skin Cancer

To avoid getting skin cancer, the most common cancer in the U.S. and around the world, the AAD recommends these steps.

  • Seek shade. The sun’s rays are strongest between 10 a.m. and 2 p.m. If your shadow appears to be shorter than you are, stay in the shade as much as possible.
  • Wear sun-protective clothing, such as a lightweight long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses with UV protection. For more effective protection, choose clothing with an ultraviolet protection factor (UPF) number on the label.
  • Apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher to all skin not covered by clothing. Broad-spectrum sunscreen provides protection from both UVA and UVB rays.

If you have any questions about how to protect yourself from the sun or notice new or suspicious spots on your skin or any spots that are changing, itching, or bleeding, let us know.

Surviving Spring Allergies Without Gaining Weight

With the fresh air of the ocean and year-round warmth, you might be surprised to find that Florida is one of the top hot spots in the country for spring allergies. You might also be surprised to learn that some of the over-the-counter (OTC) allergy medications you automatically reach for to stop the resulting sneezing and sniffling can cause you to gain weight.

So our concierge primary care doctors in Jupiter want to tell you the differences between the various types of antihistamines and suggest other ways of battling spring allergies.

‘Pollen Storm’

As NBC News reported last month, a growing number of adults in their 30s, 40s, and 50s who’ve never had allergies before are experiencing them now.

“What I see is people coming in for the first time, especially over the last five, seven years or so,” Dr. Clifford Bassett, an allergist at NYU Langone Health in New York City, told NBC.

“They will always say, ‘I don’t understand how this is happening to me,’ ” he added.

The culprit appears to be climate change, the network reported. As CO2 levels rise, plants and trees produce more pollen, coupled with earlier spring blooms from trees. This is driving a longer season, with more severe reactions from sufferers.

“The pollen season right now is about three weeks longer than it was 30 years ago, and there’s about 20 percent more pollen in the air,” Dr. Neelu Tummala, an ear, nose, and throat specialist and co-director of the Climate Health Institute at George Washington University, told the network.

Dr. Stanley Fineman, an allergist at Atlanta Allergy and Asthma and a spokesperson for the American College of Allergy, Asthma & Immunology, calls the phenomenon a “pollen storm.”

“The pollen counts, particularly this season, have been much, much higher than we’ve seen in the past,” he told NBC.

COVID, Cold, or Allergies?

And since the dawn of the SARS-CoV-2 pandemic, now people are wondering whether their stuffy or runny nose, loss of taste or smell, and itchy, watery eyes are symptoms of COVID-19.

For instance, the loss of the senses of taste and smell can also happen with allergies and colds when the nasal passages become blocked.

In the past, doctors would say that if you’ve never had allergies before, your symptoms are likely something else, such as a cold or other type of virus. But because more people are now experiencing allergies, that’s not necessarily a reliable indicator.

Experts generally agree, however, that fever, chills, and body aches typically indicate viruses, while the telltale symptom of allergies is itching.

“The biggest symptom I would suggest is the itchiness of the eyes, nose, and throat,” Bassett said. “You don’t get itchiness if you have a cold or if you’re having a sinus infection.”

Nevertheless, it’s best to get tested if you’re experiencing new symptoms.

“We’ve definitely had patients come to our clinic who thought they were having allergies, but they had COVID instead,” Dr. Michelle Pham, an allergist, and immunologist at USCF Health in San Francisco, told NBC.

The Risk of Weight Gain

Depending on the severity of your symptoms, there are several ways to treat allergies.  One of these is oral antihistamines.

But a 2010 Yale University Study that found those who regularly took antihistamines weighed more than those who didn’t gave some allergy sufferers pause. The researchers cautioned that it wasn’t clear whether those who were already overweight were more prone to allergies, and thus more likely to take antihistamines.

According to the non-profit Obesity Medicine Association, however, “Histamine decreases our hunger by in part affecting the appetite control center in our brains, and it makes sense [that] an anti-histamine would have the opposite effect. These drugs can interfere with the ‘I’m full’ signal coming from the rest of our bodies and lead to overeating.”

In fact, some antihistamines—particularly cyproheptadine—are prescribed for children and pets to increase appetite.

But not all antihistamines have this effect. The Cleveland Clinic explains that so-called first-generation antihistamines were approved in the 1930s, but had more serious side effects, including drowsiness, dry mouth, and rapid heart rate. The second-generation antihistamines, approved in the 1980s, carry far fewer side effects. They also don’t relieve nasal congestion the way many first-generation antihistamines do.

What To Do Instead

If you want to try to do without antihistamines, first, avoid exposing yourself as much as possible to pollen.

  • Avoid outdoor activity in the early morning when pollen counts are highest.
  • Keep windows closed, in the home and car.
  • Wear a mask, hat, and sunglasses if you need to be outdoors.
  • Use a vacuum equipped with a HEPA filter.

Next, rinse frequently with a saline nasal spray or a neti pot to clean out pollen in your sinuses.

Finally, try switching to second-generation antihistamines. These include:

  • azelastine (Astelin)
  • loratadine (Claritin, Alavert)
  • cetirizine (Zyrtec)
  • desloratadine (Clarinex)
  • fexofenadine (Allegra)

If OTC medications aren’t working, be sure to let us know. There are prescription approaches that may help.

Keep in mind that, even if your allergies have been manageable in the past, with the stepped-up pollen levels accompanying global warming, you may need more intensive therapy.

“Before, you could get away with just using an intranasal steroid,” Tummala told NBC, “and now you have to do a neti pot rinse and then the steroid,” she said.

Yes, COVID-19 Remains a Threat

Our primary care concierge doctors in Jupiter dislike being the bearers of bad news, but it’s important to know that the COVID-19 virus is still active, still mutating, and still killing people: as many as 250 Americans a day, primarily those who are immunocompromised and older adults.

That equals roughly 90,000 of us every year. This figure is well below the height of the pandemic when 4,000 Americans a day were dying. But the number isn’t insignificant if it impacts you or someone you love.

It’s also important to remember that, even if an infection doesn’t result in death, the long-term consequences even for younger, healthy people can be severe and/or debilitating.

Newest Variant

The latest omicron subvariant, XBB.1.5, now accounts for nearly 80 percent of COVID-19 cases being diagnosed in the U.S., according to the Centers for Disease Control and Prevention (CDC).

In addition, the World Health Organization has identified a new subvariant, XBB.1.16, known as Arcturus. The CDC reported last month that it is now responsible for about seven percent of coronavirus infections, up from about four percent the previous week.

The good news is that Arcturus doesn’t appear to be any more deadly than previous omicron variants. While a change in the spike protein might mean it could spread more rapidly, there’s no indication that cases will be more severe.

“We’ve seen this in the past,” Paul Hunter, a professor of medicine at the University of East Anglia in Britain, told The Washington Post.

“You look at the virus and it’s got mutations that should make it more virulent, but then, in reality, you don’t see that,” he said.

“It will probably become the dominant variant for a while in the U.S. and Europe and most countries around the world, but I don’t see it driving up severe infections more than we’ve seen in recent waves,” he added.

Still Dangerous

That doesn’t mean Arcturus or the currently dominant XBB.1.5 are benign, however.

COVID-19 remains the third leading cause of death in the U.S. Florida is currently seeing 17 new cases every day per 100,000 population, the highest in the nation (Kentucky is second, at 13 new cases per day per 100,000).

These numbers are likely undercounted because so many people have abandoned getting officially tested for COVID-19, are testing at home and not reporting positive cases, or not getting tested at all.

And it’s not just older Americans who are impacted. The CDC reported last month that the 18-29-year-old age group “has accounted for the largest cumulative number of COVID-19 cases compared to other age groups.”

NBC’s Today Show recently reported on a new study by Cedars Sinai Hospital in Los Angeles, which found that the age group hit hardest by post-COVID-19 heart attack deaths was people between 25 and 44. This cohort saw a 29.9 percent relative increase in heart attack deaths over the first two years of the pandemic.

“Young people are obviously not really supposed to die of heart attack,” Susan Cheng, a cardiologist at Cedars Sinai and co-author of the study, told Today in February.

“They’re not really supposed to have heart attacks at all,” she said.

In addition, a National Center for Health Statistics survey showed that nearly 20 percent of adults who had a COVID-19 infection continue to have the debilitating symptoms of long COVID.

Remember the Vulnerable

Unfortunately, most of America seems to have moved on from the pandemic. People are going about their lives as if SARS-CoV-2 was just a bad dream they’re happy to have awakened from.

“Get all the shots you wish, take all the precautions you wish, but the health of us out there are done sacrificing for the weakest of health or brain,” wrote one anonymous commenter last month on The Post website.

This attitude of “stay home forever” rankles journalist Jeanine Santucci, as she recently wrote in USA Today.

A young mother with type 1 diabetes, she is at higher risk from COVID-19. She is fully vaccinated and has loosened her self-quarantine over the past three years, now seeing friends outdoors unmasked if they have a negative COVID-19 test. She ventures out in public with an N95 mask and a portable air purifier but resents the general lack of masking in indoor public spaces.

But she called the “stay home if you’re at risk” approach “cruel” and unfair.

“The main reason I am still taking this seriously, and I hope you will, is that our country’s most vulnerable people deserve to be part of society,” she said.

Protect Yourself and Others

“With the removal of mask mandates in health care settings and essential places such as pharmacies, public transit, and grocery stores, immunocompromised people are made outcasts,” Santucci added.

“But simply putting on an N95 when you go out makes us safer. It shows us you care that we’re alive.”

Given the prevailing attitudes from both government and the general public that if you want to avoid getting COVID-19 you’re pretty much on your own, we recommend continuing to take precautions when you’re in public spaces.

This means any place that is not well-ventilated, including your own home if you have visitors whose infection status is unknown. Wear a mask in crowded settings, and stay up to date on your vaccinations.

As Santucci wrote, “I hope you’ll take into consideration just how much is at stake for you, and the fact that you’re also making a risk calculation for vulnerable people like me when you do.”

Is Exercise Better Than Drugs for Mental Health?

If our primary care concierge doctors in Jupiter could prescribe a single treatment for a host of different health concerns, it would be exercise.

For example, one study published in the journal BMJ compared exercise alone versus drug therapy alone and found that for heart disease, diabetes control or prevention, stroke rehabilitation, and treatment of heart failure, regular physical exercise was just as effective as prescription medications in treating many of these conditions.

And according to the Mayo Clinic, some of the disorders that benefit from regular exercise include:

  • Heart disease – In addition to strengthening the heart muscle and lowering blood pressure, exercise can help you be more active without experiencing chest pain or other symptoms.
  • Diabetes – Regular exercise can not only help insulin more effectively lower your blood sugar level, but also help control weight and boost energy.
  • Asthma – Exercise has been shown to control the frequency and severity of asthma attacks.
  • Back pain – Regular low-impact aerobic exercise can help increase the strength of your back muscles and improve endurance and muscle function.
  • Arthritis – Exercise is the primary approach to reduce pain, help maintain muscle strength in affected joints and reduce joint stiffness.

What About the Brain?

It makes sense, then, that the benefits of exercise would also impact the brain.

And that’s just what a new study, published in February in the British Journal of Sports Medicine, revealed. Researchers from the University of South Australia correlated data from 1,039 studies involving more than 128,000 volunteers.

They found that physical activity was 1.5 times more effective for managing depression than either counseling or the leading medications typically prescribed for the disease.

The review showed that exercise interventions that were 12 weeks or shorter were the most effective at reducing mental health symptoms, showing how quickly physical activity can make a difference, Science Daily reported.

“Our review shows that physical activity interventions can significantly reduce symptoms of depression and anxiety in all clinical populations,” lead researcher Dr. Ben Singh said in a statement.

“We also found that all types of physical activity and exercise were beneficial, including aerobic exercises such as walking, resistance, training, Pilates, and yoga,” he said. 

“Importantly, the research shows that it doesn’t take much for exercise to make a positive change to your mental health.”

Even a Little Bit Helps

This last finding is important because one of the hallmarks of depression is a lack of energy. So asking them to engage in the Centers for Disease Control and Prevention’s (CDC) recommendation of 150 minutes of moderate physical activity every week is akin to asking them to climb a mountain with a broken leg.

Another study, published this month in the journal JAMA Psychiatry, offers similar reassurance that any regular movement can make a difference.

For this study, the researchers looked at 15 studies involving more than 190,000 subjects.

They found that people who engaged in brisk walking for a total of 2.5 hours a week had a lower risk of depression than those who didn’t exercise at all. 

“Most benefits are realized when moving from no activity to at least some,” the study authors wrote. 

“Our findings, therefore, have important new implications for health practitioners making lifestyle recommendations, especially to inactive individuals who may perceive the currently recommended target [of 2.5 hours a week] as unrealistic,” they added.

How Does it Work?

There are several reasons exercise has such a positive effect on depression and anxiety, according to Dr. Antonia Baum, an assistant clinical professor of psychiatry and behavioral sciences at George Washington University, who was not involved in these studies.

It can improve blood circulation to the brain and have a positive impact on inflammation and the body’s immune response, she told U.S. News, noting the connection between heart health and depression. There may also be intangible benefits such as getting stronger or feeling empowered or gaining a sense of well-being.

Yet another recent meta-review of 41 studies involving 2,265 people with depression found that almost any type of exercise substantially reduces symptoms of depression, The Washington Post reported.

“We found large, significant results,” said study leader Andreas Heissel, an exercise scientist at the University of Potsdam in Germany.

Although more exercise produced greater results, “Something is better than nothing,” Heissel noted.

Small Moves

Jennifer Heisz, a neuroscientist and an associate professor in the Department of Kinesiology at McMaster University in Ontario, Canada, who was not involved in these studies, was even more encouraging.

“Any movement, every movement, every step counts,” she told U.S. News.

“It doesn’t have to be as much as you need for physical health,” she added. “You can get by with half of that, and this is very consistent with the literature.”

Heisz suggested that people try to move a little every day, even if it’s just a five- or 10-minute walk, or a two-minute movement break every half hour for those who sit all day.

“That’s how simple we need to get, especially for people who are not moving at all, and to acknowledge that there is this additional barrier of motivation for people who are suffering from depression,” she said.

One final word: It’s important not to try to treat depression yourself. We can help guide you through different approaches or even recommend other professionals that can help.

If you have thoughts of harming yourself, dial or text the new national suicide hotline number 988 for immediate help.

Progestin-Only Birth Control Slightly Increases Breast Cancer Risk

Our family practice concierge doctors in Jupiter have heard from some of our patients that they’re concerned about a new study regarding the safety of certain contraceptives.

In fact, many observers think this study’s findings are reassuring, and should not unduly alarm women.

According to the Centers for Disease Control and Prevention (CDC), among women ages 15 to 49 in the U.S., about 14 percent of those using contraception use oral contraception, and around 10 percent use long-acting devices like IUDs.

Contraceptive Risks and Benefits

Since their inception, birth control pills have been associated with various risks to the women who take them.

In 1960, the U.S. Food and Drug Administration (FDA) approved the first birth control pill, Enovid. It combined two types of hormones designed to prevent ovulation: estrogen and progestin. According to Planned Parenthood, it contained far more hormones than were needed to prevent pregnancy, which is why it was also responsible for occasional severe side effects and increased the risk of heart attacks and strokes.

Later forms of the pill, as it came to be called, used much lower formulations, but they are still implicated in a slightly increased risk of breast cancer, heart attack, strokes, blood clots, and liver tumors.

Many see these risks as being outweighed by the benefit of preventing unwanted pregnancies. In addition, studies have found a decreased risk of ovarian, endometrial, and colorectal cancers in long-term users of the pill, as compared with non-users.

Birth control pills are also prescribed for women with excessive bleeding and/or painful periods, apart from their use in pregnancy prevention.

Another UK study of more than 46,000 women who were followed for up to 39 years showed that their use of the pill not only didn’t increase their risk of mortality but also appeared to have increased longevity.

The New Study

Progestin-only formulations in various forms of birth control were thought to lower the risks of complications because estrogen is known to increase the incidence of the most common side effects.

Progestin-only pills thicken the mucus in the cervix, preventing sperm from reaching an egg. One form of the progestin-only pill can also stop ovulation.

“We’ve known for a while that estrogen and progestin birth control pills, oral contraceptives, have a slightly increased risk of breast cancer,” Dr. Jennifer Ashton, a board-certified OB-GYN, and ABC News chief medical correspondent said on “Good Morning America” when the new study was released.

“What we didn’t know is the newer forms of progestin-only pills, IUDs, injectable implants, what their associated risk, if any, was in comparison,” she explained.

The study that made the news last month was published in the journal PLOS One. Researchers in the U.K. analyzed data on nearly 10,000 women who had been diagnosed with invasive breast cancer between 1996 and 2017.

They then compared these subjects’ profiles with more than 18,000 women who did not have breast cancer.

“On average, 44 percent of women with breast cancer and 39 percent of matched controls had a hormonal contraceptive prescription, with about half the prescriptions being for progestagen-only [i.e., progestin-only] preparations,” the study authors wrote.

Explaining the Results

The findings “suggest that the 15-year absolute excess risk of breast cancer associated with the use of oral contraceptives ranges from eight per 100,000 users (an increase in incidence from 0.084 percent to 0.093 percent) for use from age 16 to 20 to about 265 per 100,000 users (from 2.0 percent to 2.2 percent) for use from age 35 to 39.”

In other words, those who use the progestin-only forms of contraceptives have about the same slight risk of breast cancer as women who use the combination pill.

They also found that the longer a woman is off hormonal birth control, the lower the risk.

Claire Knight, a senior health information manager at Cancer Research UK, which provided core funding for the study, told CNN that hormonal contraception is a personal choice, as “there are lots of possible benefits to using contraception, as well as other risks not related to cancer.

“Women who are most likely to be using contraception are under the age of 50, where the risk of breast cancer is even lower,” she explained.

Reassuring Users

Gill Reeves, a co-author of the study and professor of statistical epidemiology at the University of Oxford, told The Washington Post that “it may be reassuring to know that these newer contraceptives that women are using in increasing numbers do not have any untoward effects that might be unexpected. 

“They do seem to behave pretty much like traditional contraceptives,” she added.

Ashton, who was not involved in the study, stressed that it’s important to recognize how slightly the use of hormonal contraceptives raises the risk of breast cancer.

“It’s about individualizing the risk-benefit and option risk for the woman,” she told GMA.

“If you talk to any OB-GYN, they will say, we have a line: ‘Pregnancy is much higher risk than any associated risk with birth control pills or hormonal contraception.’ ”

“For anyone looking to lower their cancer risk, not smoking, eating a healthy balanced diet, drinking less alcohol, and keeping a healthy weight will have the most impact,” Knight told CNN.

All the experts suggest that women discuss the risks and benefits with their doctors.

What to Know About the Newest Migraine Drug

Our primary care concierge doctors in Jupiter have a great deal of sympathy for our patients who suffer from migraines. It can be a debilitating condition and is often difficult to treat. So we welcome any new drug that can help relieve the pain. 

The latest such treatment is a new nasal spray that the U.S. Food and Drug Administration (FDA) approved earlier this month. In a clinical trial, the drug was found to provide relief from migraine pain in as little as 15 minutes.

According to health experts, nearly 40 million Americans suffer from migraines.

“They often interfere with daily functioning, keeping patients away from their work and unable to enjoy time with their loved ones,” neurologist Leah Croll at the Lewis Katz School of Medicine at Temple University, told ABC News.

“The faster we can bring relief to people suffering from a migraine attack, the sooner we can give them back that lost time,” she said.

What is a Migraine?

A migraine is not technically a headache, but a neurological disorder that includes a constellation of symptoms, with a painful, long-lasting headache at the center. Its main symptom is a severe throbbing pain or pulsing sensation in the head, which feels like a very bad headache, usually on one side of the head, but in a third of migraine attacks, both sides are affected.

It is often—but not always—preceded by what is known as an “aura,” strange tricks of vision that can encompass anything from a blind spot in the vision to flashing or shimmering lights to wavy or zigzagging lines.

Migraines are also usually, but not always, associated with such symptoms as nausea, vomiting, and extreme sensitivity to lights and noises, and can also include a pins-and-needles sensation in the arms and legs or a weakness or numbness on one side of the face or body.

One or two days before the onset of a migraine, patients often experience subtle body signals (called “prodrome”) that can alert them to an upcoming migraine. These changes can include neck stiffness, constipation, increased thirst and urination, food cravings, frequent yawning, and mood swings from depression to euphoria.

It is also possible to have many migraine symptoms, especially the aura, without a headache. The primary signs of a migraine, however, are the extreme incapacitation associated with the headache pain involved.

The Nasal Spray Advantage

According to the National Institute of Neurological Disorders and Stroke, migraines are caused by the activation of nerve fibers in the wall of brain blood vessels. 

Calcitonin gene-related peptide (CGRP) is a chemical messenger in the brain that controls pain and inflammation. The newly approved drug, Zavzpret, works by blocking CGRP’s pain signals, according to its maker Pfizer.

Pfizer says Zavzpret (generic name “zavegepant”) is the “first and only” CGRP nasal spray for treating migraines with or without an aura. A March study published in the journal Lancet found the drug began working to treat symptoms in as little as 15 minutes, offer normal functioning in 30 minutes, and provided some relief for up to 48 hours for 24 percent of migraine sufferers.

The rapid relief Zavzpret provides offers an advantage over existing oral treatments, Dr. Emad Estemalik, a headache specialist at the Cleveland Clinic, told NBC News.

“A lot of patients, when they have migraines, they’re throwing up, for instance, so they may not be able to hold oral medication,” he said. “That’s where an intranasal comes as an advantage.”

Kate Mullin, a board-certified neurologist at the New England Institute for Neurology and Headache who helped conduct the trial for Pfizer, explained to ABC News that at least 60 percent of migraine sufferers also experience nausea, making it difficult to swallow pills.

“You can’t absorb oral medications when you’ve got what’s called gastroparesis of migraine,” she said.

“Your gut pretty much falls asleep and is not in a place to absorb mediations effectively for many migraine sufferers,” she added. “A nasal spray helps bypass the gut altogether to optimize absorption.”

Some Reservations

As with all drugs, of course, there are side effects to Zavzpret.

The FDA listed the following side effects reported by participants during the clinical trial:

  • taste disorders (18 percent)
  • nausea (four percent)
  • nasal discomfort (three percent)
  • vomiting (two percent)

Still, those who treat migraines welcomed the addition of the new drug to the migraine arsenal. 

Elizabeth Kraus, Phar.D., Neurology Clinical Pharmacy Specialist at Corewell Health, told Prevention that while she’s not overly impressed with the 24 percent success rate, Zavzpret may be better for those whose migraines tend to progress rapidly, those who don’t do well with oral medications, and individuals who struggle with severe nausea.

Amit Sachdev, M.D. M.S. medical director in the Department of Neurology at Michigan State University told Prevention that he, too, wasn’t happy with the 24 percent success rate.

“I would like to see a more broad effect, but the current trial results wouldn’t keep me from thinking of this medication [for patients],” he said.

Kraus concurred.

“If I can give someone something that will act fast and have a more lasting effect . . . That’s what I care about,” Kraus said.

The new drug is expected to be released in July of this year.

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