Tag Archives: columbia

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.

COVID-19 Vaccines: To Get or Not to Get, That Is the Question

By: RAFEENA BACCHUS, M.D., MEDICAL DIRECTOR

Vaccine hesitancy, whether due to vaccine fatigue, misinformation or genuine concern for side effects, is very common these days. Headlines from trusted news sources and even not-so-trusted sources come at us fast and can be misleading. So how do you know if the vaccine is right for you?

First and foremost, know that your concerns are valid and that these concerns should be discussed with your trusted physician. There are many reasons why the vaccine is important for some to receive and other times when the benefits may not outweigh the risks and therefore should be avoided.

So, let’s address some of the common concerns providers have heard.

  1. Blood Clots
    The largest global study recently published by the Global Vaccine Data Network, after just shy of 1 million doses of vaccines given, showed a statistically significant increased risk of a type of blood clot in the brain after immunization with viral-vector vaccines such as the one developed by the University of Oxford and made by AstraZeneca. It showed that these vaccines were linked to a threefold increase in cerebral venous sinus thrombosis, a type of blood clot in the brain; identified in 69 events, compared with an expected 21. This vaccine was never given the U.S. In the same study, mRNA vaccines (Pfizer and Moderna) showed as small increase in observed ration of blood clots related to low platelet counts but not to statistically significant levels.

    Several smaller studies have investigated the potential link between mRNA COVID-19 vaccines and have also not found any clear associations.

  2. Heart Conditions
    Myocarditis is inflammation of the heart muscle and has been seen with both mRNA and viral-vector vaccines in several studies. Though cases are rare, they are mostly seen in adolescent and young males. The severity of myocarditis can vary; however, most will have resolution of symptoms. The risk of myocarditis is 5-10 per million vaccine doses. The rate of myocarditis with COVID-19 infection is 40-80 cases per million people infected with COVID.
  3. Neurological Disorders
    In the same study done by the Global Vaccine Data Network referenced above, Guillain-Barre Syndrome, a syndrome that affects the nerves, was observed to occur at a statistically significant increase in cases with viral vector vaccines. This was NOT observed with mRNA vaccines. However, inflammation and swelling in the brain and spinal cord  was observed after both viral-vector and mRNA vaccines. Seven cases of acute disseminated encephalomyelitis after vaccination with the Pfizer mRNA vaccine were observed, versus an expectation of two.

As with any vaccination, there are many potential side effects. However, it is important to note that severe side effects are very rare. In some cases, your provider may recommend against vaccination due to an underlying medical condition. On the other hand, for those in the majority, these vaccines are safe, effective, and lifesaving. Be sure to discuss with your MPCP provider when making these important health care decisions. We are here to support you any way we can.

Article Sources
K. Faksova et al., Vaccine, https://doi.org/10.1016/j.vaccine.2024.01.100
CDC. Clinical Considerations: Myocarditis after COVID 19 Vaccine. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/myocarditis.html. February 24, 2024

 

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.

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, www.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.