Tag Archives: queenstown

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.”

Gardening as Exercise

by Clare Ross, CRNP

Working in the garden on a pleasant day is certainly good for the soul, but how about your body ─  does it count as exercise?

Yes, indeed. Gardening is similar to other moderate to strenuous forms of exercise like walking and bicycling. Gardening works all the major muscle groups: legs, buttocks, arms, shoulders, neck, back and abdomen. Tasks that use these muscles build strength and burn calories.

Digging, lifting bags of mulch and pushing wheelbarrows all provide strength training similar to weight lifting, which leads to healthier bones and joints. Yet there is minimal jarring and stress on the body, unlike aerobics or jogging.

Gardening can help keep you limber since there can be a great deal of stretching involved, like reaching for weeds or branches, bending to plant or extending a rake.

It takes at least 30 minutes of exercise several days a week to really receive any health benefits from gardening. However, you can break that time up into shorter active periods throughout the day. So you can do a little weeding in the cool of the morning and go back out to the garden in the evening to prune and trim.

Gardening can also help you burn calories and lose weight. The number of calories burned depends on several factors, including your size and the task you are performing, but the National Gardening Magazine provides these examples:

Activity Calories Burned Per 30 Mins.*
Watering 60
Planting seedlings 160
Weeding 180
Trimming shrubs (manual tools) 180
Digging & tilling 200
Gardening with heavy power tools 240

* Based on a 180-pound person. Lighter people generally burn fewer calories, and heavier people typically burn more.

If you’re new to gardening, start slowly and build up the length of time of your workouts. Avoid injuries by using your legs to lift heavy loads. Don’t stretch too far to reach awkward shrubs; this will prevent muscle strain. Vary your tasks and your movements and make use of the major muscle groups to get the most benefit. Make sure you incorporate a little stretching before and after gardening and take things slowly on hot days. Drink plenty of water if you are outside for more than 30 minutes. Use gloves and wear long sleeves to prevent cuts and scratches.

After you are done, have a hot shower to soothe your muscles, wash off any possible poison ivy residue, and check for ticks. And as with any other form of exercise, check with your doctor first if you’re not used to strenuous activity.

So go out into your garden, enjoy the lovely spring weather, and get some exercise!

Clare Ross, Certified Registered Nurse Practitioner, sees patients in the Queenstown office. She is board certified by the American Nurses Credentialing Center in Family Practice, and joined MPCP in 1997.

Rethinking Drinking: What’s the Healthy Choice?

James Chamberlain, M.D.

I am often asked questions about alcohol use, such as how much is safe and are there any health benefits. I tell my patients that drinking in moderation is fine. Alcohol is a part of our social fabric and there is nothing inherently bad about it. I tell my patients they don’t have to give up their glass of wine with dinner or a beer or two at a party, as long as they aren’t driving home. But I remind them that there are well-known downsides to excessive alcohol use and I urge caution for anyone who chooses to drink.

Clearly, the key is moderation. According to the Mayo Clinic, that is one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

Examples of one drink include:

  • Beer: 12 fluid ounces
  • Wine: 5 fluid ounces
  • Distilled spirits (80 proof): 1.5 fluid ounces

Risks of Heavy Drinking

Heavy drinking is defined as more than three drinks on any day or more than seven drinks a week for women and for men older than age 65, and more than four drinks on any day or more than 14 drinks a week for men age 65 and younger. Binge drinking is four or more drinks within two hours for women and five or more drinks within two hours for men.

Heavy drinking can increase your risk of serious health problems, such as:

  • Certain cancers, including breast cancer and cancers of the mouth, pharynx, larynx and esophagus
  • Pancreatitis
  • Sudden death if you already have cardiovascular disease
  • Heart muscle damage (alcoholic cardiomyopathy) leading to heart failure
  • Stroke
  • High blood pressure
  • Liver disease
  • Brain damage and other problems in an unborn child

When to Avoid Alcohol

In certain situations, even moderate drinking may pose health risks. Ask your doctor whether you should avoid alcohol if:

  • You’re pregnant or trying to become pregnant
  • You have liver or pancreatic disease
  • You have heart failure or you’ve been told you have a weak heart
  • You take prescription or over-the-counter medications that can interact with alcohol
  • You’ve had a hemorrhagic stroke (when a blood vessel in your brain leaks or ruptures)
  • Any time you are going to get behind the wheel
  • In combination with a variety of medications – always consult your doctor about the “drug interaction” potential of your medication with alcohol

Warning signs of problem drinking

  • You feel guilty or ashamed about your drinking
  • You lie to others or hide your drinking habits
  • Your friends or family members are worried about your drinking
  • You need to drink in order to relax or feel better
  • You “black out” or forget what you did while you were drinking
  • You regularly drink more than you intended to
  • You have had problems in relationships, with work or with the law related to drinking
  • You have had medical problems related to alcohol use

Are There Benefits?

Over the years, several studies have suggested possible benefits for moderate alcohol use, including:

  • Reducing risk of developing and dying from heart disease
  • Lowering risk of ischemic stroke (when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow)
  • Reducing risk of diabetes
  • Slight reduction in overall mortality for moderate drinkers when compared to non-drinkers

The key again is moderation. Many people find it difficult to stay under one or two drinks a day. A glass of wine or a beer each evening followed by heavier drinking on weekend nights is too much. It’s the average consumption per day that matters. If you know you will be drinking on the weekends it’s best to avoid those weeknight drinks. And everyone should be aware of the signs of problem drinking and seek help if they find themselves unable to control their alcohol use.
Talk to your family doctor if you are concerned about your drinking. We can help you figure out if it’s a problem and get you the help you need if it is.

Additional resources:
http://www.mayoclinic.org/diseases-conditions/alcoholism/basics/symptoms/con-20020866
https://ncadd.org/learn-about-alcohol/signs-and-symptoms

James Chamberlain, M.D.Dr. James Chamberlain is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Family Medicine. He received his medical degree from University of Maryland School of Medicine in 1985 and completed his residency program in Family Practice at The Medical University of South Carolina in 1988. Dr. Chamberlain sees patients in the Queenstown office.

Caregivers: Don’t Forget to Take Care of Yourself

8 Tips from Thomas Walsh, M.D.

Whether you’ve recently become caregiver to an aging or ill family member –or have been tackling the responsibility for some time– you must make your own health a priority. The caregiving role can be very rewarding, but it can also tax you both physically and emotionally. After becoming a primary caretaker myself, I learned several lessons and have a keen interest in this issue.

Here are 8 tips I suggest to my patients for reducing stress and staying healthy as a caregiver:

  1. Slow down. When you are trying to juggle many responsibilities, you often rush through things and are distracted. This can lead to accidents and injuries. You don’t want to burn yourself while cooking, slip in the tub, etc. Studies show that household and car accidents are more common among those with a high stress level.
  2. Use your freezer. Trying to “eat right” or prepare healthy meals when you’re caregiving is tough. Accept offers for meals from friends and try to cook ahead and freeze meals to have on hand. A big pot of soup is great to freeze in batches. Stockpile healthy snacks like almonds, yogurt and fruit to grab on the go.
  3. Make exercise a priority. Again, finding time for this is tough, but you need to keep your energy up and relieve stress. If you are caring for someone with mobility issues, you’ll also need to stay strong for tasks like lifting. Try to find at least 30 minutes a day for a workout you enjoy.
  4. Sleep to recover. Disrupted sleep definitely saps energy and can lead to more anxiety. Adults need 7-8 hours of sleep per night so try to adopt good sleep habits- a dark room, no electronics, no caffeine or alcohol close to bedtime.
  5. Stay organized. Another way to reduce stress is to know where things are when you need them. Starting a  file for medical/insurance papers, or financial information, for your loved one will help keep them in one place. A large calendar for family appointments/events can help with daily planning.
  6. Ask for help. Try to develop a support network and say “yes” if people offer to drive, sit with your loved one, or take care of errands. Look for professional resources such as adult day care facilities. Several organizations, such as the Administration on Aging (which has an elder care locator by state) and the National Alliance for Caregiving (www.caregiving.org) provide great information.
  7. Have “the conversation”. Make sure you understand what your family member wants in case you become responsible for making decisions for them. It may be uncomfortable- and stressful. However, you should know the ins and outs of power or attorney, a living will, or healthcare proxy. If you don’t, find an eldercare expert or attorney to help.
  8. Lastly, go easy on yourself. Don’t feel guilty for taking time to exercise or care for your own emotional well-being. Studies show that caregivers’ health often deteriorates over time due to stress and lack of sleep, poor diet, etc. Your doctor can also help with keeping you healthy and suggesting resources in the community.

As a reminder for how to tackle the caregiving role, I often use what I call the “airplane analogy”: Right after you board a commercial airplane, the flight attendants will review the important safety instructions. If the cabin loses pressure and the oxygen masks drop down, they stress, “If you are traveling with a small child or someone who needs assistance, put your own mask on first, then help the person that needs assistance.” Caregivers need to live by this rule: Take care of yourself first or you will not be able to help the person who needs assistance.

Thomas Walsh, M.D.

Dr. Thomas Walsh is an MPCP Partner and Clinical Director of the MPCP Queenstown office.