Category Archives: Health & Wellness
Strains, Sprains and Broken Bones
By: AKBER AHMAD, M.D.
Imagine you’re walking the dog — you suddenly trip over a stone, fall and twist your ankle. You feel a sharp pain and your ankle starts to swell. You’re hurt, but is it a strain, sprain or broken bone? Should you apply ice, head to the emergency room, get an X-Ray?
Mild strains and sprains can often be treated at home, while broken bones should always be evaluated by your healthcare provider. Here’s how to handle each kind of injury.
Types of Injuries
Strains are damage to muscles and tendons when a joint is pulled or stretched too far. Strains are most common in the lower back or leg muscles, but can also occur in the wrist, ankle and other parts of the body. Pain, swelling and muscle spasms are usual symptoms of a strain.
Sprains are when ligaments are overstretched or torn. (Ligaments are fibrous tissue that connect two bones together in your joints.) Sprains often happen to ankles, knees and wrists. Symptoms include swelling and pain – similar to a strain – but usually also bruising.
Breaks are a fracture, chip or complete break in a bone. With a broken bone, you’ll probably experience sudden and severe pain, swelling and bruising, and you may not be able to move or put weight on the injury.
Diagnosing the injury
Mild sprains and strains can often be treated at home, but if you have more severe symptoms, consult your healthcare provider. If you suspect a broken bone, it needs to be evaluated.
A physical exam may be enough to identify the injury, but your provider may also recommend medical imaging, such as an X-Ray, MRI or CT scan, which produce detailed images of tissue and bones.
Treatment
Rest, ice, compression and elevation (RICE) is often the best treatment for sprains and strains. RICE relieves pain, limits swelling and speeds healing. Start RICE right after the injury and do all four parts at the same time:
- Move the injured area as little as possible.
- Apply ice to reduce inflammation. Cover the injured area with an ice pack wrapped in a thin towel for about 15 to 20 minutes, three to four times a day.
- Using a pressure bandage helps prevent or reduce swelling. Use an elastic bandage and wrap the injured area snuggly, but don’t cut off your circulation.
- Raise the injured area above the level of your heart. Prop up a leg or arm while resting it.
Using RICE, you may soon see improvement in an injury. But if your symptoms continue after a few days or if they get worse, contact your healthcare provider.
Dr. Ahmad cares for patients in the Arnold office. He is certified by the American Board of Internal Medicine and earned his medical degree from the Medical College of Virginia/Virginia Commonwealth University.
Introducing Dr. Margaret Wang
People sometimes ask if I have always wanted to be a doctor. No, but it is certainly one of the top-rated dreams for an Asian immigrant.
Growing up in Beijing in the ‘80s, I rarely visited the pediatrician, and my family usually depended on traditional Chinese medicine. For example, whenever a runny nose and a fever set in, I would be given a sweetened herbal medication called Ban Lan Gen and be forced under a stack of blankets until my pajamas were soaked with sweat, which means that the fever had broken and I would soon recover.
When it comes to medicine, the average Chinese person seems quite torn between their traditional medicine and Western practices. Not many are well-versed in traditional medicine — featuring powerful potions and genuine side effects — but every Chinese person has been steeped in a unique mixture of culture, tradition filled with anecdotes and myths, and a dependence on nature and a distrust for the man-made.
I myself harbor a great interest in acupuncture and toxicology. While I studied at Georgetown University School of Medicine, I took a class on alternative and complementary medicine, which taught me traditional Chinese medicine is not to be trifled with, and that Asian people who are scared of strong Western medications should exercise equal caution over Chinese potions.
Although I share in this cultural understanding about the human body and health, my systematic training in Western medicine remains the pillar of my practice as an internist. This can sometimes be challenging with Asian patients. They often see little value in preventative care and regular checkups, which I appreciate as the basis of sound medical care. Patients can also give pushback about starting a medication, because they believe — and rightly so — that everything with an effect has a side effect.
In the end, it comes down to communicating outside of typical Western medical care — more in the realm of preference, philosophy, and faith. These human discussions provide an important context for medical care and is what makes primary care most interesting for me. Not all doctors share this view, but that is okay. I think it enhances my effectiveness and benefits my patients.
2024 marks my tenth year practicing as an internal medicine doctor. I first spent some time as a hospitalist and at an urgent care center, but I seem to have settled in the right spot at MPCP, for which I am truly thankful. And if you’ve read this article to the end, I wish you a blessed new year.
Dr. Wang is a Maryland Primary Care Physicians partner and is certified by the American Board of Internal Medicine. She received her medical degree from Georgetown University School of Medicine. She cares for patients in MPCP’s Columbia office.
Naloxone: A Powerful Tool to Fight Opioid Overdose
By: ANDREA C. CUNIFF, M.D.
The opioid crisis continues in Maryland and has gotten worse as the powerful drug fentanyl is increasingly mixed into illegal drugs. From 2022 to 2023, the state saw 2,583 fatal overdoses, and fentanyl was involved in about 81% of those deaths.
In response, there has been a growing use of naloxone (commonly known by the brand name NARCAN®), a medication approved by the Food and Drug Administration that rapidly reverses opioid overdose. It has been used to save lives in Maryland. Healthcare officials encourage its distribution and use by the public.
What is naloxone?
Naloxone is an opioid antagonist: it attaches to opioid receptors in the body, reversing and blocking the effects of opioids, including heroin, morphine and oxycodone. Naloxone can quickly restore normal breathing to a person whose breathing has slowed or stopped because of an opioid overdose. However, it only reverses opioids and will not work on other drugs like cocaine or methamphetamine.
How naloxone is given
Naloxone should be given to any person who shows signs of an opioid overdose. It can be administered as a nasal spray or an injection. Learn how to respond to an overdose with guidelines from the Maryland Department of Health.
Signs of opioid overdose
- The person’s face is extremely pale and/or feels clammy to the touch
- Their body goes limp
- Their fingernails or lips have a purple or blue color
- They start vomiting or making gurgling noises
- They cannot be awakened or are unable to speak
- Their breathing or heartbeat slows or stops
Source: Substance Abuse and Mental Health Administration
Who can give naloxone?
Naloxone is widely used by police officers, emergency medical technicians (EMTs) and non-emergency first responders. In Maryland, anyone can administer naloxone and training is not required, but your healthcare provider or pharmacist can advise you how to use it.
You can buy naloxone at a pharmacy without a prescription. Free naloxone may also be available from Overdose Response Programs located throughout the state.
What to keep in mind
Naloxone works for about 30 to 90 minutes, but many opioids remain in the body longer than that, so a person can still experience the effects of an overdose after naloxone wears off. If you administer naloxone to an overdose victim, you should still call 911 as soon as possible for immediate medical attention.
Side effects from naloxone are rare, but some people might have allergic reactions to it. Overall, naloxone is a safe medicine and has the potential to save many lives.
In the state of Maryland you are protected under the Good Samaritan Law. This means you will not be arrested or prosecuted if you administer naloxone while you are under the influence of alcohol or illicit drugs, or are in possession of illicit drugs at the time of administration.
More about naloxone
Dr. Cuniff treats patients in the Annapolis office. She is certified by the American Board of Family Medicine and earned her medical degree from the University of Maryland School of Medicine.
Colorectal Cancer Screening Awareness
March is Colorectal Cancer Screening Awareness Month
The American Cancer Society recommends regular screening starting at age 45. Even if you have been screened before, you will need to screen again when your healthcare provider recommends. Click here for more information about colorectal cancer screening.
