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What You Should Know About Lyme Disease

by Janice Rutkowski, M.D.

Lyme disease is caused by an organism which resides in deer ticks. The northeastern United States is a prevalent area for the disease, with over 20% of ticks affected. Lyme disease is most frequently seen in the summertime; and you do not have to go camping or hike in the woods to contract the disease;  even gardening can expose you to the organism.

The typical case of Lyme disease begins after an incubation period of 3 to 32 days with a red rash exhibited in 75% of individuals, though 25% have no sign of the illness. The rash starts as a flat red spot and expands to form a large round or oval lesion, sometimes with a bright red outer border and partial clearing in the center – this is the classic “bull’s eye lesion”. It’s usually not painful, but within days of the onset, the disease can spread in the bloodstream and cause severe headache, pain in joints and profound fatigue. These symptoms can resolve on their own within weeks without treatment, but can lead to meningitis, nerve disorders, chronic arthritis, and cardiac abnormalities.

The diagnosis of Lyme disease is made by a doctor’s exam and a blood test, though the blood tests are often negative. Treatment includes antibiotics and if diagnosed early, is curative. See your doctor immediately if you are concerned you have been bitten by an infected tick or show signs or symptoms indicative of Lyme disease.

To learn more about what to do after a tick bite to prevent Lyme disease click on this link courtesy of UpToDate.com: http://www.uptodate.com/contents/what-to-do-after-a-tick-bite-to-prevent-lyme-disease-beyond-the-basics

Janice Rutkowski, M.D.Dr. Rutkowski is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Internal Medicine. She received her medical degree from the University of Limoges in 1981 and completed her residency program in Internal Medicine at Maryland General Hospital in 1984.

Are You at Risk for Developing Kidney Stones?

by Janice Rutkowski, M.D.

The lifetime risk of having kidney stones is about 12% in men and 7% in women. If one develops, another one is likely to occur at a rate of 40% within 5 years and 75% within 20. There is a 2-fold increase in the risk of stones in obese vs. normal weight individuals. Of all the kidney stones one can have, calcium oxalate is by far the most frequent. There are many factors which interplay in the development of this problem, some of which are amenable to correction.

Prevention of calcium oxalate kidney stones can be accomplished quite simply by increasing the water intake to over 2 quarts a day which can reduce the incidence by 50%! Avoiding foods which encourage stones such as vitamin C >1gm/day, a lot of protein (poultry, fish, meat, and dairy products), fructose which can occur in sodas (among other food items), spinach, nuts and rhubarb. Increased intake of calcium in supplements or in enhanced products such as orange juice does not seem to promote stone formation.

Janice Rutkowski, M.D.Dr. Rutkowski is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Internal Medicine. She received her medical degree from the University of Limoges in 1981 and completed her residency program in Internal Medicine at Maryland General Hospital in 1984.

Holidays Got You Anxious?

by Janice Rutkowski, M.D.

During the holidays, many people look forward to spending time with friends and family, but there is also a great deal of anxiety associated with various preparations, travel and time commitments. There may be an inability to sleep properly, exercise wanes and diets can be abandoned. How do we decide if this is “normal” stress from the holidays or is there more involved?

There are many kinds of anxiety disorders and these may have to be treated differently depending on the cause and symptoms. These include generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and social phobia. Modalities of treatment may include medication and/or counseling. Your physician should be able to diagnose the condition and determine appropriate treatment.

When should you seek medical help? If the level of anxiety is interfering with your day-to-day activities, the symptoms have been present for over 2 weeks, symptoms are worsening over time or interpersonal relationships are suffering as a result, you should make an appointment with your doctor to discuss therapeutic options.

Janice Rutkowski, M.D.Dr. Rutkowski is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Internal Medicine. She received her medical degree from the University of Limoges in 1981 and completed her residency program in Internal Medicine at Maryland General Hospital in 1984.

ADD in Adults

by Janice Rutkowski, M.D.

add-160ADD & ADHD* are similar disorders that often first present in childhood, but can extend into adulthood as well. It is estimated that a full third of children with ADD will continue to be affected later in life. Since this disorder was not well understood in the past, many individuals were un-diagnosed. But the onset of the internet and better understanding of disordered human behavior, have helped many patients realize they may have a problem.

Most adults with ADD find they have difficulty with organization and planning, are easily distracted, feel a sense of restlessness or anxiety, and lack ability to resist impulses to stray from a task or project. Unfortunately, this inability to stay on task can lead to problems at school, in the workplace, and in personal relationships. Serious consequences such as divorce, job loss and substance abuse can be more common for those with ADD/ADHD.
However, there are several treatment options to help! The first step is talking with your doctor. While there is no one test to diagnose the condition, detailed information from the patient and sometimes family members can be very useful. A physical, including blood work and an EKG, should be done to ensure there are no other health issues causing the symptoms.

Treatment is usually very effective with a combination of diet, behavioral therapy and stimulant drugs, such as Adderall or Ritalin. There are many newer medications as well and your doctor will work with you to find the most effective. Some drugs come in extended-release form so you do not have to take multiple doses during the day, and some non-stimulant drugs are also available. Side effects may include sleeplessness, loss of appetite, mood changes or heart rhythm abnormalities. But most patients tolerate the therapy quite well and are amazed at the difference in their work and home life.

So, please talk with your doctor if you are concerned you might have ADD or ADHD- or the symptoms- so you can work together to treat it effectively.

*ADD stands for Attention Deficit Disorder. ADHD is Attention Deficit Hyperactivity Disorder.

Janice Rutkowski, M.D.Dr. Rutkowski is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Internal Medicine. She received her medical degree from the University of Limoges in 1981 and completed her residency program in Internal Medicine at Maryland General Hospital in 1984.