Category Archives: Health & Wellness
Is Zika coming to Maryland?
A Q & A by: Jerry Levine, M.D., FACP, MPCP Medical Director
Q: What is Zika?
A: Zika is a virus spread mainly by Aedes aegypti mosquitoes, a species found in Maryland and many other states. These mosquitoes, when they bite people infected with Zika virus, become disease carriers and spread the virus by biting other people. In some cases, Zika can also be transmitted between sexual partners.
Q: Where does Zika come from?
A: Before 2015, Zika virus outbreaks occurred in areas of Africa, Southeast Asia, and the Pacific Islands. Since then, Zika has spread to parts of South and Central America, Mexico and the Caribbean.
See which countries have reported Zika: http://1.usa.gov/1Qq5Iow
Q: Is Zika in Maryland?
A: At the time this article was written, there were dozens of confirmed cases of Zika virus in Maryland, but all of those people were infected while traveling overseas. So far, no one has gotten Zika in Maryland, but the imported cases may result in local spread of the virus.
See Zika cases in the U.S.: http://1.usa.gov/1PiUIcc
Q: Are people with Zika contagious?
A: At this time, the Zika virus is not believed to be airborne and is not primarily spread from person to person, which means there’s little to no risk of becoming infected with the virus from simply being near an infected person. However, Zika can be transmitted sexually.
Q: How dangerous is Zika?
A: Most people infected with Zika virus won’t experience any symptoms or will only have mild symptoms. Common symptoms include fever, rash, joint pain, muscle pain, headache or conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week. Hospitalization is rarely needed, and so far there have been only two deaths from Zika reported in the U.S. – an elderly man with other health issues and a baby born infected with the virus.
The main danger from Zika is that pregnant women can pass it to their unborn children. The CDC has confirmed that the virus can cause severe defects in unborn children, including microcephaly, which leaves babies with abnormally small heads and often with brains that do not develop properly. The CDC strongly advises that women who are pregnant or plan to become pregnant soon don’t travel to Zika-infected areas.
Q: If Zika comes to Maryland, what can I do?
A: There is no medicine or vaccine to prevent or treat Zika virus disease, so prevention is key. If Zika is reported in Maryland, take these steps to protect yourself and your family:
- Use insect repellents containing DEET, picaridin, IR3535, para-menthane-diol, and lemon eucalyptus oil.
- When weather permits, wear long-sleeved shirts and long pants.
- Use air conditioning or window/door screens to keep mosquitoes outside.
- Aedes mosquitoes typically lay eggs in standing water, so empty water from containers outside your home such as buckets, bowls, bird baths, flower pots, old tires and vases.
Q: What should I do if I think I have Zika?
A: The risk of getting Zika is presently very low in Maryland. However, if you travel to an area with Zika and develop a fever, rash, joint pain, or red eyes within two weeks of returning, see your doctor. Be sure to tell your doctor where you traveled. Zika can’t be cured, but your symptoms can be treated to make you more comfortable.
Dr. Levine is an MPCP partner and sees patients in the Columbia office. He received his medical degree from New York Medical College, completed his residency program in Internal Medicine at University of Maryland Medical Center, and is certified by the American Board of Internal Medicine. Dr. Levine currently serves as MPCP’s Medical Director and Vice President.
What To Do? Emergency Department vs. Urgent Care vs. Your Doctor’s Office
By: Jamie Harms, M.D.
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: 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, www.mpcp.com, for a list of hours at your doctor’s office.
Your doctor’s 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 most times, you will be able to get an appointment the same day you call.
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.
Don’t forget: Good communication is important to make sure you get good care. 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.
Primary care quicker, less costly than the ER
A study by a New York health insurer claims 90% of conditions commonly seen in emergency rooms ─ like sinus infections, sprains and sore throats – could be treated faster and at a lower cost elsewhere. Excellus BlueCross BlueShield reports that in 2013 emergency room visits in the state for these conditions were nearly 8 times more expensive than a primary care office, 3.5 times higher than an urgent care center, and 15 times costlier than telemedicine. Patients in ERs also had the longest wait times for treatment. The report concludes: “the best method of care for nearly all of these cases is for patients to see their primary care doctors.”
Maybe Not So Safe: New Evidence On E-Cigarettes
When e-cigarettes were introduced in the U.S. in 2006, they were promoted as a safer alternative to smoking. Users inhale nicotine-infused vapor, without the mix of carcinogenic chemicals found in regular cigarettes.
E-cigarettes and vaporizers (which produce large, fluffy clouds of vapor) have gained popularity among current and former smokers, as well as those who have never smoked, including teenagers. The idea that e-cigarettes are safe is so widespread that some smokers are switching from cigarettes to e-cigarettes.
Since e-cigarettes are relatively new, there isn’t much research linking them to specific diseases. However, most doctors would probably agree that sucking clouds of nicotine-laden vapor (propylene glycol or vegetable glycerin) into your lungs is probably not a good idea.
But now, two recent studies suggest e-cigarette users risk harming their airways, suffering bacterial infections, and compromising their immune system.
Airway inflammation: In experiments with mice, researchers at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System found that mice exposed to e-cigarette vapors were more likely to suffer inflammation of their airways. They also observed that e-cigarette vapor appeared to make bacteria – including the antibiotic-resistant MRSA “superbug” ─ more dangerous. Twenty-five percent of mice infected with MRSA died after exposure to e-cigarette vapor, compared to zero mice that weren’t exposed. In fact, the vapor seemed to make bacteria thrive.
The study did not link e-cigarette vapor to specific diseases. However, scientists noted that some of the physiological changes observed in the mice are also found in the airways and blood of cigarette smokers, while other changes are found in people with cancer or inflammatory lung diseases.
Bacterial infection: In a second study, researchers at Johns Hopkins Bloomberg School of Public Health exposed mice to e-cigarette vapor and then subjected them to Streptococcus pneumoniae, bacteria responsible for pneumonia and sinusitis, or the virus for Influenza A. Mice exposed to e-cigarette vapor were significantly more likely to develop compromised immune responses to both the virus and the bacteria, which in some cases killed the mice.
Since e-cigarettes have not been fully studied, it isn’t known what their long-term effects may be, but public officials aren’t waiting to find out. At least 38 states place restrictions on the sale of e-cigarettes to minors, and more than 100 cities have prohibited the use of e-cigarettes in public places. Also, the FDA Center for Drug Evaluation and Research has proposed regulating them as tobacco products.
More research is needed, but the two studies cited in this article do suggest that e-cigarettes are not the safe alternative to smoking people once thought they were.
Dr. Patricia Jett is a Maryland Primary Care Physicians, LLC partner and practices in MPCP’s Annapolis office. She is certified by the American Board of Family Medicine. She received her medical degree from the University of Maryland School of Medicine and completed her residency program in Family Practice at Franklin Square Hospital Center.
A New Prescription: Treating Disease with Exercise
The next time your doctor reaches for his prescription pad, don’t be surprised if he recommends exercise instead of medication. A growing number of healthcare providers are encouraging patients to think of physical activity as their new medication.
A study published in the British Medical Journal found that exercise affects outcomes for some serious medical conditions about equally as well as prescription drugs. For example, exercise provided better outcomes in patients rehabilitating after a stroke, and for people with coronary heart disease and pre-diabetes, exercise and drugs had about equal outcomes.
This is not to say that patients should throw their prescriptions away. Medication is necessary for the successful treatment of many conditions. However, the study supports the idea that many patients would benefit from their doctors prescribing exercise.
In general, people who are physically active tend to live longer and are at lower risk of heart disease, stroke, Type 2 diabetes, depression and some cancers, according to the Centers for Disease Control and Prevention. And since obesity is linked to serious health problems, exercise leading to weight loss can also help reduce the risk for conditions such high blood pressure, heart disease and stroke.
This isn’t surprising. Our bodies are meant to move, so incorporating exercise into our day allows them to work optimally. That includes our brains: physical activity improves sleep, mood, cognition and the ability to concentrate.
Exercise isn’t the answer to every health problem, but it can play an important role in the treatment and prevention of disease. Talk to your doctor about how a “prescription” for exercise can help you.
Exercise Rx for Better Health
The CDC recommends weekly exercise and strengthening activities for adults. This can include physical activities such as labor, yardwork and housework. Also, you don’t have to do all of your exercise at once; you can spread your activity out during the week. You can even break it up into smaller chunks of time during the day, as long as you do at least 10 minutes at a time.
The following options will give you the activity levels you need for better health.
Option 1
150 minutes of moderate-intensity aerobic activity (such as brisk walking) every week
AND
Weight training/muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).
Option 2
75 minutes (1 hour and 15 minutes) of vigorous-intensity aerobic activity, such as jogging or running every week
AND
Weight training/muscle-strengthening on 2 or more days a week.
Harriett Neverdon, Family Nurse Practitioner-Certified, sees patients in MPCP’s Columbia office. She received her Bachelor of Science in Nursing degree from Towson University and her Master of Science in Nursing degree from University of Maryland School of Nursing. She is board certified by the American Association of Nurse Practitioners in Family Practice.
