The Flu: What To Do If You Get Sick

You may have the flu if you have some or all of these symptoms:

Fever of 100.4F or higher*, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue and sometimes diarrhea and vomiting.
*It’s important to note that not everyone with flu will have a fever.

What should I do if I get sick?
Most people with the flu have mild illness and do not need medical care or antiviral drugs. If you get sick with flu symptoms, in most cases, you should stay home and avoid contact with other people except to get medical care. If, however, you have symptoms of flu and are in a high-risk group, or are very sick or worried about your illness, contact your health care provider (doctor, physician assistant, etc.).

Certain people are at high risk of serious flu-related complications (including young children, people 65 and older, pregnant women and people with certain medical conditions). This is true both for seasonal flu and novel flu virus infections. If you are in a high-risk group and develop flu symptoms, it’s best for you to contact your doctor early in your illness. Remind them about your high-risk status for flu.

CDC recommends that people at high risk for complications should get antiviral treatment as early as possible, because benefit is greatest if treatment is started within 2 days after illness onset.  If you think you have the flu and would like a prescription for the antivirals an appointment is not necessary, just log-on to the patient portal and request a prescription or call the office at (352) 394-4237 and select triage. If the phone is busy just leave us a message and we will send it to the pharmacy, we have on file for you.

Do I need to go the emergency room if I am only a little sick?
No. The emergency room should be used for people who are very sick. You should not go to the emergency room if you are only mildly ill. If you have the emergency warning signs of flu sickness, you should go to the emergency room. If you get sick with flu symptoms and are at high risk of flu complications or you are concerned about your illness, call your health care provider for advice. If you go to the emergency room and you are not sick with the flu, you may catch it from people who do have it.

What are the emergency warning signs of flu sickness?

In children:
* Fast breathing or trouble breathing
* Bluish skin color
* Not drinking enough fluids
* Not waking up or not interacting
* Being so irritable that the child does not want to be held
* Flu-like symptoms improve but then return with fever and worse cough
* Fever with a rash
In addition to the signs above, get medical help right away for any infant who has any of these signs:
* Being unable to eat
* Has trouble breathing
* Has no tears when crying
* Significantly fewer wet diapers than normal

In adults:
* Difficulty breathing or shortness of breath
* Pain or pressure in the chest or abdomen
* Sudden dizziness
* Confusion
* Severe or persistent vomiting
* Flu-like symptoms that improve but then return with fever and worse cough

How long should I stay home if I’m sick?
CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or other necessities. Your fever should be gone without the use of a fever-reducing medicine, such as Tylenol®. You should stay home from work, school, travel, shopping, social events, and public gatherings.

What should I do while I’m sick?
Stay away from others as much as possible to keep from infecting them. If you must leave home, for example to get medical care, wear a facemask if you have one, or cover cough

Men: Stop Avoiding Your Health

53% of men say health is just not something they talk about.

 You could probably guess that men are much more likely to talk to each other about the upcoming football game or presidential election than prostate cancer or their family history of cardiovascular disease. But if men don’t talk about their health concerns even to those closest to them, then how does it impact their overall health? A survey by the Cleveland Clinic reveals the truth about men and their sometimes not-so-healthy habits.

 In an effort to raise awareness about men’s health and gain insight into behaviors and attitudes surrounding health topics, the Cleveland Clinic launched their “MENtion It” campaign. They surveyed men ages 18 to 70 about their health, their understanding of health screenings, and the social settings in which they discussed their health concerns with other people.

 Results from the survey found that men talk about current events, sports, and work much more often than their health (not surprising!). Only 7% of men surveyed said they talked about health with a male friend. If health does come up in conversation between men, it is likely regarding an injury, such as bragging rights from being able to tolerate the pain from a broken arm.

 The survey found that most men (60%) see a doctor once a year for a check-up, but only 42% of men talk to their doctor when they have a serious health concern, including gastrointestinal issues, problems in the bedroom, or urinary issues. These issues are considered more private, which is why 48% of men said they would turn to a spouse or significant other rather than their friends, parents, or siblings.

 The survey also tested knowledge about health screenings and found that most men don’t know the correct age to start to get them. Some common misconceptions about health screenings are listed below.

Cardiovascular Disease and Coronary Artery Disease
 Men surveyed thought cardiovascular disease or coronary artery disease screening isn’t needed until age 40. The American Heart Association actually recommends screening as early as age 20.

Blood Pressure
 Age 35 is when men should start thinking about blood pressure monitoring; in reality, this should start at age 20 as well, according to the American Heart Association

Prostate Cancer
 Most men believed prostate cancer screening should start at age 42, when in fact the Urology Care Foundation suggests screening should begin at age 55.

Colorectal Cancer
 Most men thought colon or rectal cancer screening should begin at age 42; this should in fact start at age 50, based on recommendations from the CDC.

 While it may not be a popular topic, discussing health and staying educated on important prevention strategies is important for men’s health. If you have any health concerns that you are keeping bottled up, mention them to your friends or family, and most importantly, call your doctor.

This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

Yoga's Benefits Go Straight to the Heart

As popular as it has become, yoga still doesn't get the respect it deserves. It is a serious exercise regimen and every bit as good for the heart as other forms of exercise, according to recent analysis.  And because yoga is a lot less boring than riding a stationary bike, it may even be better than typical exercise when it comes to good heart health.  The authors of the analysis looked at 32 randomized controlled trials of how yoga affected risk factors for heart disease such as high cholesterol or high blood pressure.

First, the researchers reviewed trials comparing people who used yoga as a form of exercise to people who did not exercise. Yoga participants had lower body mass index (BMI), blood pressure (both systolic and diastolic) and cholesterol (both LDL and total) and had higher HDL (good) cholesterol.  They also had lower triglycerides and heart rate, and were more likely to lose weight during the trial. In fact, the only outcomes recorded where yoga did not lead to measurable improvements were fasting blood glucose and glycosylated hemoglobin.

In trials comparing yoga's effects to the impact of other types of aerobic exercise, such as cycling or brisk walking, the results were even simpler: there was no significant difference between yoga and other exercise. The researchers caution that many of the trials were of rather short duration and had small numbers of participants, so it's possible that the results of larger or longer trials might be different.

Yoga may even have an edge over traditional forms of exercise. It tends to be more acceptable to patients with physical disabilities, including people with joint pain, heart problems and the elderly. It also requires no special equipment and can be performed either alone at home or as a part of a class. Add in that yoga is a lot less boring than a regimen of sit-ups and tummy crunches, and you're left with an exercise that you're more likely to keep doing. And the best exercise in the world won't help you if you don't do it.

Despite its growing popularity, yoga still carries a whiff of flakiness or new-age eccentricity for some who aren't familiar with it. This study should help dispel that idea. Plain and simple, yoga is good exercise.

The study is published in the European Journal of Preventive Cardiology.
 January 7, 2015

This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

More Dangerous Than Smoking

 

Smokeless tobacco appears to be even worse for your health than lighting up.

 If you are among those who believe that using smokeless tobacco, such as chewing tobacco, keeps you safe from the cancer risks that come from smoking, think again. Not only is this untrue, but smokeless tobacco users have higher levels of cancer-causing chemicals in their bloodstream than do regular cigarette smokers, according to a recent study.

 There are at least 28 cancer-causing compounds in smokeless tobacco. Dip, chew, snuff, snus — none of them are safe. It's just that their dangers aren't as well known as that of cigarettes because there haven't been as many studies done on their potential to cause harm as have been done on smoking.

 Researchers looked at levels of a compound called NNAL in the current study. NNAL is a breakdown product of the carcinogen NNK, which is only found in tobacco and tobacco products. NNAL measurements are commonly used to gauge a person's exposure to NNK.

 The level of NNAL was nearly three times higher in users of smokeless tobacco as it was in cigarette smokers. And levels of cotinine, a breakdown product and biomarker of nicotine, were also higher in users of smokeless tobacco than in smokers, as was the level of lead in their blood.

 The study looked at data on nearly 24,000 adults who were part of the National Health and Nutrition and Examination Survey (NHANES) from 1999 to 2012. Despite the study's large size, it only found 488 people who exclusively used smokeless tobacco (did not also smoke), while there were nearly 7,000 exclusive cigarette smokers.

 The FDA and NIH are currently collaborating on a a large longitudinal study, the Population Assessment of Tobacco and Health (PATH) Study, designed to give more specific information on the effects of smokeless tobacco over time.

 Baseball Hall of Famer Tony Gwynn died in 2014 from cancer of the salivary gland. Gwynn blamed his cancer on decades of chewing tobacco, though a consulting physician on the team that treated him strongly disagrees. Another doctor isn't so sure, noting that cancer tends to occur in the part of the mouth where you chew tobacco.

 Cancer of the salivary gland is so rare that little is known about its causes, and smokeless tobacco has not been linked to it. About all that's certain here is that doctors would not be having this disagreement if Gwynn had chewed gum instead of tobacco.

 Smokeless tobacco is not a safe alternative to smoking. Users run the same risks of gum disease, heart disease and addiction as cigarette users and an even greater risk of oral cancer.

 The study appears in Cancer Epidemiology, Biomarkers & Prevention.
 December 4, 2015

 Source: www.TheDoctorWillSeeYouNow.com

 This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

Why We Miss So Many Heart Attacks in Women

Heart disease is the leading cause of death in women in the United States. Yet researchers and clinicians have been slow to acknowledge that heart disease is different in women than in men. Women don't feel the same as men when they are having a heart attack. And the causes and risk factors for heart problems in women are also different. In fact the symptoms of a heart attack in women are often very different from those experienced by men. Women — and too often their doctors — often don't even realize that they are having a dangerous cardiac event, according to a recent Scientific Statement published by the American Heart Association.

The purpose of the statement is to highlight the differences in causes, symptoms, treatment, and outcomes of heart disease in women, compared with men's heart disease. The differences are important because the strategies for treating heart disease in men may not all be applicable to women. The authors suggest that because of these issues, heart disease in women is under-diagnosed, under treated, and opportunities for prevention are often missed.

Symptoms, Often Missed and Mistreated
The classic symptoms of heart attacks are chest pain or discomfort. However, women often do not experience classic chest pain. They may instead complain of shortness of breath, nausea/vomiting and back or jaw pain. They may break out in a cold sweat or complain of pressure, squeezing, or fullness in the chest that lasts for several minutes, or eases and then returns.

The problem is that when a woman comes in for urgent or emergency care with these subtler symptoms and without chest pain, they are often treated less aggressively than patients with classic symptoms, or they may be misdiagnosed entirely and their symptoms attributed to anxiety or other non-cardiac causes. Women themselves often fail to realize that they are having a heart attack, so they put off seeking care, believing their discomfort will pass. Such delays can lead to more disability and a greater likelihood of death.

Different Causes and Risk Factors
In men, heart attacks are often caused by blockages in the coronary arteries, the blood vessels that nourish the heart muscle itself. These blockages are caused by plaque build-up. It takes considerably less plaque to cause to a heart attack in a woman, leaving women at higher risk from plaque build-up than are men.  As the AHA statement points out, women may also have heart attacks without any significant blockage. Instead, their heart attacks may be caused by a spasm or a tear in an artery, making the risk of heart attack may be harder to predict from tests, such as cardiac catheterization, that focus on the amount of plaque built-up in veins and arteries.

The kinds of risk factors that can bring on a heart attack are also different for women. For example, high blood pressure is more strongly associated with heart attacks in women than in men. And when a young woman has diabetes, she is at four to five times higher risk of heart attack than a young man with a similar condition.

Depression, anxiety, and stress can contribute to the development and outcome of heart attacks in women — and men. Women and their health care providers must stay on top of these sorts of risk factors, and also may need to address them at younger ages than is the case in men.

Racial Disparities Among Women
There are also differences in the risk of heart attack among women themselves. African American women at any age have a higher incidence of heart attacks than white women, and young African American women who have heart attacks are more likely to die in the hospital than are white women. One reason for this may be the fact that, according to the statement, African American women are less likely to be given treatments such as cardiac catheterization than white women.

 Finally, African American and Hispanic women have more of the heart disease-related risk factors that are so frequently overlooked in women in general such as diabetes, high blood pressure, and obesity, raising their overall risk for a heart attack. In fact, these risk factors are present in many of the women of color who have a heart attack, yet they receive no preventative treatments.
 The best thing women can do to protect themselves is to be aware of the risk factors for heart disease, particularly those most likely to affect them. Recognize your risk factors such as high blood pressure, diabetes, depression, and stress. Keep in mind that any health issues or behaviors — such as consuming too much sugar — that put you at risk are also opportunities for interventions to reduce that risk.

 It is important women make sure their health care providers take their concerns seriously and offer therapeutic interventions to decrease the likelihood that they will have heart attacks.
 Of course, the ultimate responsibility is yours: you have to take these heart risks seriously and change your lifestyle to reduce your risk, whether this means quitting smoking, losing weight or changing your diet. The AHA statement, published in its journal, Circulation, is meant to make women aware that heart disease and heart attacks often affect women differently from the classic chest pain commonly identified as a heart attack. If troubling symptoms occur, seek medical care; don't assume your symptoms are too minor to be signs of heart disease.

This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

Protect Your Heart: Hold The Salt And Hold The Sugar

By now, you probably know to "hold the salt" to protect your heart.  In fact, the American Heart Association just released new stricter salt recommendations lowering the daily-recommended amount from 2500 mg to 1500 mg.  However, researchers are also suggesting that you "hold the sugar".  Although heart disease claims more lives in America each year than cancer or stroke, many people may not be aware how reducing salt and sugar consumption can benefit their heart health.

Americans typically consume more than 2 times the recommendation of 1,500 mg of salt per day, with about 77% of daily salt intake coming from packaged, processed, fast, and restaurant food.  Excess salt can elevate blood pressure and increase the risk of stroke, heart attack, and kidney disease.  Even decreasing salt intake by only 400 mg per day can be beneficial to your heart health.

Consuming a high amount of added sugars in processed, packaged, or prepared foods, and soda pop or sugary drinks has recently been linked to an increased risk of cardiovascular disease by researchers at Emory University in Atlanta.  It appears that higher consumption of added sugars can increase the risk of heart disease.  Excess sugar specifically appears to cause low levels of "good" cholesterol (HDL-C) and high levels of triglycerides, a type of fat that is in the blood.  Although larger long-term research trials are needed on the relationship between added sugar and heart disease, the Emory researchers support dietary guidelines that would recommend limits on consumption of added sugars.

Here are some tips for reducing your salt and sugar intake:

• Read food and beverage labels and keep track of your daily consumption of sugar and salt
• Find recipe-makeovers for your favorite meals that contain less salt and less added sugar
• Consult a nutritionist for help planning menus and meals
• Learn what foods are best to select when dining out
• Ask your doctor's office for educational material and resources in your area
• The American Heart Association and American Diabetes Association have helpful guides on their websites

This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

 

Remember Your New Year's Resolution!

So, it has been just over a month since you made that New Year’s Resolution, but do you even remember what it was?  We all have good intentions when we make them, but let’s face it, life just gets in the way! Only 8% of those who make a New Year’s resolution end up keeping it; the rest of us are done with them by the end of March.  We tend to fail, not for lack of trying, but for setting unrealistic expectations and time frames.

Stop thinking “New Year’s Resolution” and start thinking “my goals for this year”! It is important for you to make your goals specific, attainable, relevant, measurable, and set to a time limit.  Losing weight is always in the top 5 resolutions, and one of the first to be broken.  Instead of thinking “losing weight”, make a goal to eat healthier (eat 4 servings of fruit and veggies a day), limit desserts to 1 per week and eat a normal portion size.  These changes will help you lose the weight you want by establishing easy, achievable daily goals.  Fall off the wagon one day?  Don’t worry about it, just start again!  Think of getting healthy like the stock market.  Your goal in investing is not to get rich quick, but to secure long term wealth, or, in this case health.

If you need help achieving your goal of obtaining a healthy lifestyle, we are here to help!  Our patients lose thousands of pounds each month, and best of all they keep them off.  Our providers and staff can help you identify the physical and emotional triggers that have stopped you in the past and give you a personalized wellness plan to get you on your way to better health once and for all. Come and join us for our “New Goals for a New Me” until the end of March and receive your free consultation and start your wellness program for only $75. That’s a 50% savings! Call now for your free consultation (352) 394-4237.

Happy New Year!

            Happy New Year from Total Family Healthcare!

NEW YEAR, NEW ME, it's possible!

 

 

 

 

 

 

 

Happy Holidays!

Happy Holidays From Dr. J and the entire staff of Total Family Healthcare!

Get your Flu Shot!

This is just a reminder that Flu Season is upon us and it is time to protect yourself and your family. The Center for Disease Control recommends that everyone 6 months of age or older should receive a flu vaccination every season. If you have already received your flu shot from a pharmacy or other medical provider, please  give us a  call with the date and location you received it so we can update your medical record. If you still need a flu shot, please call the office at (352) 394-4237 and schedule your vaccination before you get the flu bug!

Holiday Hours!

How to Survive Halloween!

A cocker spaniel weighs about 24 pounds. You know what else weighs 24 pounds? The massive amount of candy the average American gobbles down each year, a big chunk of that falling to our waistlines in the days before and after Halloween. Fun size? I don't think so—unless it's fun being size 16. These stats could very well turn you as white as a ghost:
• Three miniature Reese’s Peanut Butter Cups—the kind you find in office candy bowls and trick-or-treat-bags—fill your belly with more sugar than a glazed doughnut.
• Half a pack of Skittles has more sugar than a scoop of Haagen-Dazs Cookies and Cream Ice Cream.
• Nine Twizzlers carry as many calories as a Wendy’s Double Stack Burger.

These are some spooky treats. And Halloween is only the beginning of the eating season: Thanksgiving and Christmas are just around the corner. If you want to see your feet come January, start by conquering the sugar fest that’s nearly upon us. Here's your plan for surviving the scariest night of the year for your waistline. 

 
WORST “FUN SIZE” CANDY BAR
Butterfinger Bar (fun size bar)
100 calories 4 g fat (2 g saturated) 10 g sugars
Again, fun for whom? Your cardiologist? By calling it “fun,” food marketers are cleverly pulling your attention away from the fact that candy bars are flab-inducing logs of concentrated fats and sugars. And Butterfinger is the worst offender— there's no quicker way to swallow 100 calories. 
Eat This, Instead! 3 Musketeers (fun size bar) 63 calories 2 g fat (1.5 g saturated) 10 g sugars

SURVIVAL TIP #1: Toss the candy bowl
Alabama researchers found that people who have snacks within reach when they're watching TV consume more calories per day overall. But instead of simply relocating the bowl to another table, limit the potential for mindless munching by keeping the candy bagged and in the cupboard. 

SURVIVAL TIP #2: Consume drinks before treats
Drinking 16 ounces of water before a meal fills the stomach, supressing hunger, and helps you lose weight, according to a study presented at the National Meeting of the American Chemical Society. Use this strategy to help control your candy cravings. Just don't substitute a sugary beverage for the water or this strategy will backfire: A can of soda has more sugar than two Hershey’s Take 5 bars.

WORST FRUITY CANDY
Brach’s Airheads (3 pieces)
140 calories 1.5 g fat (1 g saturated) 19 g sugars
Here’s the basic formula for an Airhead: Sugar and filler carbohydrates, artificial colors and flavors, and partially hydrogenated oils— a source of trans fat. Don’t get me wrong. It’s not like our Eat This Instead, Dum Dums, are nutritional paragons, but they do have two noteworthy advantages over Airheads: They have no heart-wrecking oils, and they're hard candy. That means they dissolve slowly on your tongue, letting you enjoy the sweetness over time. 
Eat This, Instead! Spangler Dum Dum Pops (3 pops) 77 calories 0 g fat 15 g sugars

SURVIVAL TIP #3: Work out on Halloween morning
Lifting weights reduces levels of blood sugar by 15 percent for more than 12 hours after you’ve left the gym, according to research from Syracuse University. Why does that matter? Some of the sugar you consume will stay in your blood stream, providing energy to your cells, instead of pitching a tent in your belly.

SURVIVAL TIP #4: Switch to dark chocolate
It won’t necessarily save you calories, but dark chocolate boasts a bevy of health benefits that milk chocolate can’t claim. Flavonoids in the cocoa help keep your arteries soft, decreasing your risk of cardiovascular disease . Keep a bar on hand to nibble on any time you have a craving. Seek out those bars with at least 60% cocoa.




WORST MINIATURE CANDY BARS
Twix Miniatures (3 pieces) 150 calories 8 g fat (6 g saturated) 15 g sugars
Twix has the worst saturated fat profile of any candy in your kid’s trick-or-treat bag. Think about it like this: Each one of these bite-sized candies carries 10 percent of the saturated fat you should consume in an entire day. Switch to Tootsie Rolls and you’ll cut your calories by more than half and trim your total fat intake by a whopping 81 percent.  Eat This Instead! Tootsie Roll (3 pieces)
70 calories 1.5 g fat (0.5 g saturated) 9.5 g sugars

SURVIVAL TIP #5: Chew gum
Sort through any trick-or-treat bag and you’ll undoubtedly discover a handful of Super or Dubble Bubble—those small pink cubes wrapped in old-fashioned, end-twisted candy papers. Instead of plowing through the chocolates and taffies, throw a big gob of the gum in your mouth. The chewing suppresses cravings, and each piece has only about 15 calories. 
SURVIVAL TIP #6: Don’t hand out your favorite candy
If your favorite candy is Milk Duds, and you’re handing out Milk Duds all night, doesn’t it seem likely that you’re going to wind up with a pound of chocolate and caramel in your stomach by night’s end? Of course! And that’s not even factoring in how many Duds you’ll plow through as they sit on the counter in the days leading up to Halloween. Choose something less tempting.



WORST CHEWY CANDY
Brach’s Milk Maid Caramels (4 pieces)
160 calories 4.5 g fat (3.5 g saturated) 16 g sugars
"Milk Maid” sounds a lot like "Milk Made,” doesn't it? Very clever, Brach's! This candy contains a couple milk derivatives (whey and “lipolyzed butter fat”), but it hardly constitutes a dairy product. Plus, 90 percent of the fat is saturated. That’s bad news for your heart. If you enjoy the challenge of fighting chewy candy out of your teeth, switch over to Now and Later and save more than 100 calories per serving.  Eat This, Instead!  Now and Later (4 pieces)
53 calories 0.5 g fat (0 g saturated) 10 g sugars


SURVIVAL TIP #7: Keep the candy-calorie load to 400
The fewer calories you take in during candy season, the better off you’ll be heading into turkey season. So if you worry that you risk overindulgence, set a caloric limit and hold yourself to it. Four hundred is a good number—indulgent yet not overly destructive. That means you could eat every “Eat This Instead” on our list, and have 65 calories left for one of your personal favorites. 

SURVIVAL TIP #8: Don’t skip dinner
A healthy dinner will take the edge off your candy craving, not to mention temper the blood-sugar rush that converts your body into a flab factory and puts you at risk for diabetes. What you want is a meal rich with fiber and lean protein—think chicken breast with vegetables. 



WORST NOVELTY CANDY
Reese’s Pumpkin 
170 calories 10 g fat (3 g saturated) 16 g sugars

This one should send your gimmick radar into the red zone. It’s simply an oversized peanut butter cup shaped like a pumpkin. What price novelty? Nearly two-thirds more calories than a regular Reese’s peanut butter cup! Grab two bite-size Reese's instead—you'll save more than half the calories, fat, and sugar. Eat This, Instead! Reese's Bite Size Peanut Butter Cups (2 pieces)
72 calories 4 g fat (3 g saturated) 6 g sugars

SURVIVAL TIP #9: Take it outside
The worst thing you can do on Halloween night, after most of the trick-or-treaters have cleared off the street, is set your candy bowl by the door where you can grab a handful every day on your way out. Noshing 300 extra candy calories a day will add a pound of flab to your frame in less than two weeks. Instead, set the bowl on the porch before you go to bed. The leftover candy will be gone by morning, guaranteed. 

SURVIVAL TIP #10: Remember: Halloween is a one-day event
A study in the journal of Nature Neuroscience found that eating junk food doesn’t just satisfy cravings—it creates them. That’s right; junk food is addictive. Limit your sugar.

Symptoms of Breast Cancer



An important way to fight breast cancer is to be aware of how your breasts normally look and feel, and know what changes to look for. Finding breast cancer as early as possible gives you a better chance of successful treatment. But knowing what to look for is not a substitute for screening mammograms and other tests, which can help find breast cancer in its early stages, even before any symptoms appear.

 

Below are some common breast symptoms and what they might mean. If you have any of them, get checked right away.

 

A lump in your breast
A lump or mass in the breast is the most common symptom of breast cancer. Such lumps are often hard and painless, though some may be painful. Not all lumps are cancer, though. There are a number of benign breast conditions (like cysts) that can also cause lumps. Still, it’s important to have your doctor check out any new lump or mass right away. If it does turn out to be cancer, the sooner it’s diagnosed the better.

 

Swelling in or around your breast, collarbone, or armpit
Breast swelling can be caused by inflammatory breast cancer, a particularly aggressive form of the disease. Swelling or lumps around your collarbone or armpits can be caused by breast cancer that has spread to lymph nodes in those areas. The swelling may occur even before you can feel a lump in your breast, so if you have this symptom, be sure to see a doctor.

 

Skin thickening or redness
If the skin of your breast starts to feel like an orange peel or gets red, have it checked right away. Often, these are caused by mastitis, a breast infection common among women who are breast feeding. Your doctor may prescribe antibiotics to treat the infection. If your symptoms don’t improve after a week, though, get checked again, because these symptoms can also be caused by inflammatory breast cancer. This form of breast cancer can look a lot like a breast infection, and because it grows quickly it’s important to diagnose it as soon as possible.

 

Breast warmth and itching
Like skin thickening and redness, breast warmth and itching may be symptoms of mastitis – or inflammatory breast cancer. If antibiotics don’t help, see your doctor again.

 

Nipple changes
Breast cancer can sometimes cause changes to how your nipple looks. If your nipple turns inward, or the skin on it thickens or gets red or scaly, get checked by a doctor right away. All of these can be symptoms of breast cancer.

 

Nipple discharge
A discharge (other than milk) from the nipple may be alarming, but in most cases it is caused by injury, infection, or a benign tumor (not cancer). Breast cancer is a possibility, though, especially if the fluid is bloody, so your doctor needs to check it out.

 

Pain
Although most breast cancers do not cause pain in the breast, some do. More often, women have breast pain or discomfort that is related to their menstrual cycle. This type of pain is most common in the week or so before their periods, and often goes away once menstruation begins. Some other benign breast conditions, such as mastitis, may cause a more sudden pain. In these cases the pain is not related to the menstrual cycle. If you have breast pain that is severe or persists and is not related to the menstrual cycle, you should be checked by your doctor. You could have cancer or a benign condition that needs to be treated.

 

Again, while benign breast conditions are much more common than breast cancer, it is important to let your health care team know about any changes in your breast so they can be checked out right away.

October is Breast Cancer Awareness Month

Once a month adult women of all ages are encouraged to perform breast self-exams at least once a month.  Forty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.

While mammograms can help you to detect cancer before you can feel a lump, breast self-exams help you to be familiar with how your breasts look and feel so you can alert your healthcare professional if there are any changes.



How should a breast self-exam be performed?

Using the pads of your fingers, move around your entire breast in a circular pattern moving from the outside to the center, checking the entire breast and armpit area. Check both breasts each month feeling for any lump, thickening, or hardened knot. Notice any changes and get lumps evaluated by your healthcare provider.

 

Visually inspect your breasts with your arms at your sides. Next, raise your arms high overhead. Look for any changes in the contour, any swelling, or dimpling of the skin, or changes in the nipples. Next, rest your palms on your hips and press firmly to flex your chest muscles. Left and right breasts will not exactly match —few women's breasts do, so look for any  dimpling, puckering, or changes, particularly on one side.

 

When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and your right arm behind your head. Using your left hand, move the pads of your fingers around your right breast gently in small circular motions covering the entire breast area and armpit. Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast.

Get Ready for the Holidays Special!

Farewell Dr. Cruz

Our family here at Total Family Healthcare offers their best wishes to Dr. Edgar Cruz as he embarks on his new endeavor of opening his own medical practice. During the next 3 months, Dr. Cruz will be transitioning to a new location here in Clermont, Florida. His last day of employment with Total Family Healthcare was September 18th, 2015. The credentialing process can be lengthy and tedious, but if you would like to locate Dr. Cruz in the near future, please call (586) 322-6240.

Here are the answers to some of the questions you might have.



Where is Dr. Cruz Going?
Dr. Cruz has decided to open his own family medicine practice here in Clermont, the location for his practice has not been chosen yet but we can let you know as soon as he tells us.

Why is Dr. Cruz leaving Total Family Healthcare?
Dr. Cruz has decided to open his own family medicine practice here in Clermont where he can integrate his professional talents with his Christian and Biblical values and principles.

How will I be able to find Dr. Cruz when he leaves Total Family Healthcare?
He has given (586) 322-6240 as a contact number.

What if I have outstanding labs or need a prescription refill?
Don't worry, nothing has changed, all outing labs or orders will still be sent to Total Family Healthcare and placed in your medical chart. You will be notified if you need to follow-up with a provider. Prescription refills work the same way, visit your patient portal and submit a refill request or just give us a call (352) 394-4237.

How can I transfer my records from Total Family Healthcare to Dr. Cruz's new office?
That's easy, just go to your patient portal fill out a medical records request form and the records will be sent directly to his new office once he has given us a location.

What insurances will Dr. Cruz accept?
Dr. Cruz is currently in the credentialing process with all the major carriers, you can check with his new office by calling (586) 322-6240.

Do I have to follow Dr. Cruz to his new location?
No, you always have the right to see any healthcare provider you like. If you would like to remain a patient of Total Family Healthcare our other providers will be happy to see you.

Do I have to leave Total Family Healthcare?
No, you always have the right to see any healthcare provider you like. If you would like to remain a patient of Total Family Healthcare our other providers will be happy to see you.

What if I don't want to follow Dr. Cruz or stay at Total Family Healthcare?
You always have the right to see any healthcare provider you like. If you would like your medical records sent to another provider just go to your patient portal and fill out a medical records request form and the records will be sent directly to any providers office you request.

Total Family Healthcare will continue their commitment and support to all of our patients, as well as our community. Visit our website www.totalfamilyhealthcare.com if you would like to leave us a message or receive an invitation to sign-up for the patient portal. Or as always, please feel free to contact our office at (352) 394-4237, with any healthcare needs, questions, or concerns.

Use Family Meal Time to Fight Obesity

Remember when, if you wanted to get something to eat you were home by the time mom got the food on the table? Only about one-quarter of families with children sit down to dinner together every night. And it’s not just the family bond that’s being threatened: Children who don’t eat with their families are more likely to become obese later in life, according to a new study in the Journal of Pediatrics.

The researchers analyzed data from the Project Eating and Activity in Teens study, which tracked the dining habits and body mass index (BMI) of middle- and high-school students, then followed up again 10 years later when they were young adults. After a decade, more than half of the 2,117 study participants were overweight or obese — and their childhood frequency of family meals emerged as a significant factor in their weight-gain.

Specifically, the young adults who’d eaten just one or two family meals a week as kids were 45 percent less likely to be overweight, compared to those who never dined with their parents. Sitting down to three to four family meals per week reduced the kids’ odds of full-blown obesity by half.
What’s being served at those family sit downs may play a role. Past research has linked a higher frequency of family meals with greater intake of fruits, vegetables, and whole grains; that may be because more forethought goes into family dinners. You sit down and think, ‘What could I serve?’, so you’re more likely to put a fruit and a vegetable on the table.

However, the study didn’t ask the kids what they were eating, so a family meal could have meant takeout. This means that other factors, like the family connection that mealtimes foster, are likely at play.  Family meals present a safe, predictable environment where you can talk with family members. That sense of stability may give kids a greater sense of control in daily life, helping them regulate their emotions, as well as their food intake.

And when dinner is grilled chicken and green beans? By watching parents eat — and enjoy — children may feel encouraged to do the same, even when they’re deciding what to eat on their own. Parents are modeling communication and how to connect with one another, as well as modeling healthy eating and recognizing satiety cues.

To make the most of your family meals, here are a few suggestions for turning dinnertime into an opportunity for healthy living:

Start small
Three or four weekly meals as a family are better than one or two—but if your schedule only allows Sunday night dinner, that’s a great place to start. Aim to make it a can’t-miss appointment by putting it on the calendar, and tell your kids (and spouse) it’s non-negotiable.

Think beyond dinner
Dinner is the classic time for togetherness, but it’s not the only way your family can connect over a meal. If breakfast or lunch is more convenient for your clan, consider making those mealtimes your family’s main focus.

Eliminate distractions
Banish smartphones, tablets, and TV’s from the table — that way, you can really focus on promoting conservation and connection. Dinner should be about interacting with the family…not catching up on emails or texting friends.

Stay positive
Save the serious discussions for another time. Try to make it a positive atmosphere; don’t use it as a place to lecture or vent about getting homework done. Have each family member share a high point for the day. That way, the experience is about connection, not discipline, and your kids will be more willing to come back to the table night after night.

Keep it together
No one eats alone!  So if your kid gets home late after practice, make a point to sit down with him or her during a meal, even if the rest of the family can’t join in.  That’s a great way to make the meal count as more than “just get food in the person”.

Why it is Important to Bring Your Prescription Bottles to Your Office Appointment?

The best way you can help to prevent errors is to be an active member of your health care team. That means taking part in every decision about your health care. Research shows that patients who are more involved with their care tend to get better results.

Make sure that all of your doctors know about every medicine you are taking. This includes prescription and over-the-counter medicines and dietary supplements, such as vitamins and herbs.  Do not assume that everyone has all the information they need. Bring all of your medicines and supplements to your doctor visits. "Brown bagging" your medicines can help you and your doctor talk about them and find out if there are any problems. It can also help your doctor keep your records up to date and help you get better quality care. Make sure your doctor knows about any allergies and adverse reactions you have had to medicines. This can help you to avoid getting a medicine that could harm you.

Ask for information about your medicines in terms you can understand—both when your medicines are prescribed and when you get them:

• What is the medicine for?
• How am I supposed to take it and for how long?
• What side effects are likely? What do I do if they occur?
• Is this medicine safe to take with other medicines or dietary supplements I am taking?
• What food, drink, or activities should I avoid while taking this medicine?
• When you pick up your medicine from the pharmacy, ask: Is this the medicine that my doctor prescribed?
• Ask for written information about the side effects your medicine could cause. If you know what might happen, you will be better prepared if it does or if something unexpected happens.

The phones are not working in the office right now. Bright House is working on the problem and will restore service as soon as possible. If you need to reach us during this time please log-on to the patient portal to send us a message.

 Here is a link to the portal: https://totalfamilyhealthcare.secure.force.com/portal