Category Archives: Family Health
What To Do? Emergency Department vs. Urgent Care vs. Your Doctor’s Office
By: RAFEENA BACCHUS, M.D., MEDICAL DIRECTOR
Having an illness or injury often results in a good deal of anxiety and worry. You want medical attention and relief from your symptoms as quickly as possible. But where should you go to get the best, most appropriate and cost-effective care? The following are the most widely used treatment options and suggestions about when each might be best suited to meet your particular medical needs.
The emergency department
Most emergency departments are part of hospitals, although there are free-standing emergency departments in Bowie and Queenstown. The ED is designed and equipped to handle serious or life-threatening emergencies. It is always open, including nights, weekends and holidays. Patients are seen according to how sick or injured they are. The most serious cases jump to the front of the line, even if they arrive later than everyone else. Physicians in the ED are trained to look for life-threatening conditions, and the tests you will receive in the ED will help them decide if you have any of these.
The emergency department is the right place to go if you have a serious or potentially life-threatening illness or injury: chest pain, sudden weakness on one side of your body, a new seizure, severe headache, persistent heavy bleeding, poisoning, or a large broken bone.
The emergency department is probably not the right place to go if you have a milder illness or a longstanding issue. You are likely to wait longer for treatment. The emergency department doctors do not have access to your medical records. Your visit will be much more expensive — as much as 4-6 times as expensive! Remember, they have to keep all that life-saving equipment available all the time. That’s great if you need it, but it’s just an extra charge if you don’t.
Urgent care centers
There are lots of these in our area. They often have extended hours, including evenings and some weekend hours. They are designed and equipped to handle medical problems that need attention the same day but are not life-threatening. Patients are usually seen in the order they arrive, so your wait will depend on how many other people go to the urgent care center at the same time you do. Many urgent care centers have X-ray and blood testing equipment.
An urgent care center is the right place to go if you have a new illness or injury that occurs when your doctor’s office is closed, such as sprains and strains, painful urination, ear pain, severe cough or wheezing.
An urgent care center is probably not the right place to go if your doctor’s office is open or if you have a serious or life-threatening condition. A visit to an urgent care center is more expensive than a visit for the same condition at your doctor’s office. The provider in the urgent care center does not know you and will not have access to your medical records. Urgent care centers are not equipped with life-saving equipment or providers trained to treat life-threatening illnesses or injuries.
Your doctor’s office
No one knows you like your own doctor. Your doctor is equipped to treat many illnesses and injuries, and can arrange any testing you may need. Your primary care doctor has your medical records and knows your medical history. Patients are seen by appointment. Maryland Primary Care Physician offices reserve appointments for patients who need same-day treatment. Many MPCP offices have evening and/or Saturday hours for your convenience. Call or check our website, mpcp.com, for a list of hours at your doctor’s office.
Your doctor’s office is the right place to go if you have a new problem, such as sinus pain, ear pain or flu, cuts or other wounds, sprains or strains, cough, or a flare up of an old problem, such as back pain or migraine headache, or an ongoing problem that may require more testing or treatment, such as persistent stomach problems or joint issues. You will pay the lowest copay at your primary care doctor’s office, and many times you will be able to get an appointment the same day you call. For extra convenience, all MPCP offices offer telemedicine visits after hours, in addition to evening and weekend appointments at some sites.
Your doctor’s office is the wrong place to go if you have a serious or life-threatening condition. If you need care in the next hour, go to the emergency department.
If you’re not sure what to do, call your primary care provider
Even when the office is closed, there is always someone on call who can direct you to the care you need. If you ever need to go to the emergency department or an urgent care center, take a list of all your medications and allergies with you. Let the staff know who your primary care provider is, and schedule a follow up appointment if needed.
Dr. Bacchus is a MPCP partner and is certified by the American Board of Internal Medicine. She sees patients in the Columbia office and serves as MPCP’s Medical Director.
Hypothyroidism
By: NISHA ABRAHAM PARAMBIL
The thyroid gland is a small gland, but it plays a significant, complex role in your body. When it does not work properly, it can seriously impact your health.
Located in your neck under your voice box, the thyroid gland controls several things, including your metabolism, body temperature and heart rate.
Hypothyroidism (also known as an underactive thyroid) is a common disorder where the thyroid does not release enough thyroid hormone. This causes your metabolism to slow down. Symptoms of hypothyroidism can include fatigue, weight gain, and cold intolerance. In extreme cases, it can cause life-threatening conditions, such as low body temperature, coma and heart failure.
Hypothyroidism affects people of all ages, but it is especially common among women over 60.
What causes hypothyroidism?
The most common cause of hypothyroidism is an autoimmune condition called Hashimoto’s disease, which causes your body’s immune system to attack and damage your thyroid gland. Other causes include thyroiditis (inflammation of the thyroid), iodine deficiency and thyroid surgery.
How it is diagnosed
Symptoms of hypothyroidism can be similar to other conditions. The main method to diagnose hypothyroidism is with a blood test. If your thyroid is enlarged, your healthcare provider may be able to feel it during an exam. If you have symptoms of hypothyroidism, ask your provider about testing.
If you have hypothyroidism
Hypothyroidism is a life-long condition. It cannot be cured, but it is very treatable. It is typically managed with medication that replaces the hormones your thyroid gland is not making.
Many people with hypothyroidism struggle with gaining weight, so adopting healthy habits is important. Daily exercise can help raise your metabolism, reduce your fatigue and decrease muscle pain.
MPCP’s endocrinology staff specializes in diagnosing and treating glandular conditions like hypothyroidism. You can also learn more with this helpful resource:
Hypothyroidism (Underactive Thyroid) — National Institute of Diabetes and Digestive and Kidney Diseases
Dr. Parambil is an endocrinologist who diagnoses and treats disorders of the endocrine glands, such as diabetes, pituitary disease, hypothyroidism, hyperthyroidism and osteoporosis. See the MPCP Specialists webpage to learn more.
Headaches: When to Call the Doctor
By: TRANG M. PHAM, M.D.
Headaches are our most common form of pain and a major reason for trips to the doctor. While most headaches are just a temporary nuisance, sometimes they can warn you about a serious health problem that needs immediate attention.
Causes of headaches
Headaches happen when nerve endings in your body react to triggers and send pain messages to your brain. Chemical activity in your brain, the nerves or blood vessels surrounding your skull, or the muscles of your head and neck can play a role in headaches.
A primary headache is caused by problems with pain-sensitive nerves in your head and is not a symptom of another medical problem. Primary headaches can be triggered by lifestyle factors, such as stress, alcohol (especially red wine), certain foods (such as processed meats with nitrates), poor sleep and poor posture.
A secondary headache is related to medical conditions that trigger pain-sensitive areas in the neck and head, including a neck injury, eye problems, and infections in your jaw, teeth, or sinuses. More serious causes of secondary headaches can be brain tumors, aneurysms, and meningitis.
Types of headaches
There are many types of headaches, but three of the most common are tension, cluster, and migraines.
Tension headaches are the most common kind and are often brought on by stress and tight muscles. Symptoms include:
- Gradual start
- Head usually hurts on both sides
- Pain is dull or feels like a band or vice around the head
- Pain may involve the back part of the head or neck
- Pain is mild to moderate
- Typically, does not cause nausea, vomiting or sensitivity to light
Cluster headaches usually occur in a series that may last weeks or months. They are more common in men than women and may be caused by alcohol use, smoking cigarettes, bright light, exercise/exertion, hot weather or water, and foods with nitrates, such as bacon or lunch meat. Symptoms of cluster headaches include:
- Severe pain on one side of the head, usually behind one eye
- The eye that is affected may be red and watery with a droopy lid and small pupil
- Swelling of the eyelid
- Runny nose or congestion
- Swelling of the forehead
Migraines mostly affect women. The average migraine lasts from four hours to three days, but severe attacks can last longer, badly impacting your work, family, and social life. In addition to headache pain, migraines can include:
- Nausea and vomiting
- Lightheadedness
- Sensitivity to light and other visual symptoms, such as flashing spots, wavy lines, and blurred vision
Treatment depends on the headache
Effective treatment depends on what type of headache you have. It may include:
- Avoiding known triggers, such as certain foods and beverages
- Stress management
- Changing eating habits
- Exercise
- Resting in a quiet, dark place
- Over-the-counter medications or prescriptions from your healthcare provider
Migraine and cluster headaches may need specific medicine management:
- Preventive medicines: Prescribed by your healthcare provider and taken daily to reduce the onset of headaches.
- Abortive medicine: Prescribed by your healthcare provider and acting on specific nerves and blood vessels in the head to stop a headache in progress.
- Rescue medicines: Over-the-counter pain relievers to stop the headache.
When you should call your doctor
Most headaches can be treated with over-the-counter medicine and will go away on their own. But there are times when they can be a symptom of serious medical conditions, such as a blood clot, aneurysm or tumor in the brain, concussion, encephalitis, meningitis, or stroke. Call your healthcare provider immediately if you experience a sudden, severe headache with:
- Fever
- Nausea
- Vomiting
- Convulsions
- Shortness of breath
- Confusion
- Muscular weakness
- Double vision
- Change in level of consciousness
If headaches are an unpleasant part of your life, contact your MPCP healthcare provider to discuss what can be done to help you feel better.
Dr. Pham is a MPCP partner and cares for patients in the Pasadena office. She holds her medical degree from Jefferson Medical College and is certified by the American Board of Family Medicine.
Move Over Lyme Disease, Here Comes Babesiosis
By: TIMOTHY KLEPPER, M.D.
Tick season is here, and we’re hearing the usual warnings about Lyme disease. But due to a mild winter and spreading tick population, there’s a new threat to watch out for: babesiosis (bah-bee-see-oh-sis).
Both Lyme disease and babesiosis are parasitic diseases carried by deer ticks, also called black-legged ticks. The CDC reports a significant increase in reported cases of both this year in the eastern U.S.
Lyme disease and babesiosis differ in their symptoms and health risks. Here’s a side-by-side comparison of the two, and what you need to look out for.
| Babesiosis | Lyme disease | |
| Likelihood of infection | Low, especially if tick is attached for less than 36 hours | Low, especially if tick is attached for less than 36 hours |
| How soon symptoms start | 1-4 weeks after tick bite | 3-30 days after tick bite |
| Symptoms | Mild to severe flu-like symptoms: fever, chills, sweating, loss of appetite, nausea, tiredness
In severe infections: yellowish skin or eyes, pale skin, dark urine, shortness of breath, nausea and vomiting, abdominal pain, neck stiffness, sudden mood changes |
Circular bulls-eye rash around the tick bite
Early infection: flu-like symptoms: tiredness, muscle pain, joint pain, headaches, fever, chills |
| Risks | Can be life-threatening, especially if you have a weak immune system or don’t have a working spleen. May cause anemia, enlarged spleen, fluid buildup in your lungs, blood clotting problems, kidney or liver failure | Late infection: neck stiffness, pain and swelling in your joints, numbness or pain in your limbs, memory problems, difficulty concentrating, heart problems. Usually not life-threatening |
| When you should see a doctor | If you were bitten by a tick and have flu-like symptoms, especially if you have a weak immune system | If you were bitten by a tick and have an expanding red rash around the bite or have flu-like symptoms |
| Usual treatment | Combination of anti-parasitics and antibiotics Antibiotics | Antibiotics |
How to prevent tick bites
The best way to avoid getting sick with babesiosis and Lyme disease is to not get bitten. Remember the ABCs of prevention:
“A” stands for avoid. You want to avoid areas ticks are found, such as where there are low bushes, leaf litter and tall grass.
“B” stands for bug spray. Use it when you’re outdoors and think you’re going to be exposed to tick bites. The CDC recommends a bug spray that contains either DEET 30% or picaridin. You also could use a spray that has oil of lemon eucalyptus in it.
“C” stands for cover up. Wear protective clothing. If you have clothing over your skin, ticks won’t be able to bite you.
What to do if you’re bitten by a tick
Use tweezers to grasp the tick as close to your skin as possible, then pull the tick off with steady pressure. Then wash your hands and the area of the bite with soap and water. Sometimes, the mouthparts of the tick will break off and stay in the skin. If you can remove them easily, use the tweezers to pull them out. If you can’t remove them easily, just let the skin heal. Your body will break down the remaining mouth parts over time.
Remember, your chances of getting a tick disease are much lower if you remove the tick within 36 hours of being bitten.
Dr. Klepper is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Family Medicine. He cares for patients in the Queenstown office.
