What is a Physician Assistant?

Did you know that October 6-12, 2023 is National Physician Assistant Week? To all physician assistants within District Medical Group and across the nation, “Happy Physician Assistant Week! We appreciate you.”

Parte 2: Terapia de salud/Behavioral Health Therapy

Gracias por acompañarnos estamos aquí en DMG estamos en el Departamento de Salud Mental y comportamiento y quiero saber qué es lo que tienes ahí platícame Qué significa eso Este es un corazón se es una actividad que hago con mis pacientes

Terapia de salud/Behavioral Health Therapy

Muy buenas tardes gente la Tricolor aquí me encuentro con arlín en dmg Sears y nos va a estar platicando de su rol aquí tan importante para los niños nombre serlín yo trabajo aquí desde el 2019 mi error es que integrar el cuidado…

¿Qué es un trabajador social y cómo apoya a los pacientes y familias de DMG CRS?

Hola qué tal Muy buenos días Nos encontramos otra vez en dmg aquí me encuentro con Gabriela Gabriela Muchísimas gracias por tomarte un tiempo de tu vida tan ocupada aquí y vamos a empezar Qué es una trabajadora social una trabajadora es más una persona para poder ayudar a esas familias agarrar los recursos…

Cómo los trabajadores sociales de DMG CRS apoyan a nuestros pacientes y sus familias

(DMG CRS) Los trabajadores sociales médicos se aseguran de que los pacientes y sus familias tengan acceso a la atención y el apoyo adecuados. Nuestros trabajadores sociales facilitan el tratamiento médico centrado en la familia durante las citas en persona y de telesalud.

How to Reduce Your Risk of a Heart Attack

Andree Jones, DO, primary care sports medicine physician, shares risk factors for a heart attack and how to reduce your risk of heart disease.

Healthy Nutrition Habits for Your Child

DMG Children’s Rehabilitative Services (DMG CRS) registered dietitian, Dominica Dieffenbach, RDN, shares why starting your child off with healthy nutritional habits is critical to their future health.

Reducing Your Risk of Cervical Cancer

The early stages of cervical cancer don’t have any symptoms, and that’s why it’s so important to get your well-woman exam annually. If you are aged 21-30, pap smears are recommended every three years

Tips for Getting Children with Special Needs Vaccinated

By Troy Nelson, MD, pediatrician and medical director at DMG Children’s Rehabilitative Services

special needs vaccine

Whether it’s childhood immunizations or vaccinations for the flu or COVID-19, getting a vaccine is an anxiety-causing process for many children.  If your child has special needs or a complex medical condition, getting vaccinations can be more stressful for both you and your child.

Here’s some tips for supporting children with special needs getting vaccinated.

Before the appointment:

  • Ask for an appointment on a day and time that is not busy in your pediatrician’s office.
  • See if your child’s provider recommends pre-medicating with an over-the-counter pain reliever or using a topical numbing cream or spray.
  • Be honest with your child and explain to them what will be happening. For some children, it might be appropriate to prepare a couple days in advance; for others it might be the day of the appointment.
  • If possible, ask if your child can receive their vaccination in the car instead of going into the clinic.

Day of and during the appointment:

  • Try to remain calm before and during the appointment. Children pick up on nervous or anxious energy, especially from their family. If you are calm, your child is more likely to remain calm.
  • Bring your child’s favorite stuffed animal or doll with them for comfort.
  • If your child has a favorite provider, nurse, or medical assistant at your pediatrician’s office, ask for that person to be present to support your child.
  • Ask that your child be vaccinated in a quiet exam room, away from noise, the waiting area, and other people.
  • If appropriate, encourage your child to take some deep breaths.
  • If able, help your child relax by asking them to shake their arms and legs in a silly way.
  • Walk around with your child after the vaccination to distract them instead of sitting.
  • If multiple vaccinations are being administered, ask the provider to take a break in-between if it will help your child.
  • Reassure your child that they will be fine, and you and the provider will be there to support them.
  • Reward your child. If your child is having more than one vaccination in a single appointment, you may want to reward them after each vaccination with a sticker or other small item they like.

As pediatricians, our goal at DMG CRS’ primary care clinic is to make every child’s appointment positive and comforting.  Partnering with parents or guardians is key to this goal and making your child feel confident and safe with their medical providers.  We’re here to listen and support you in managing your child’s health and wellness.

The Importance and Safety of Childhood Vaccinations

By Pamela Murphy, MD, pediatrician in the Spina Bifida Clinic at DMG Children’s Rehabilitative Services

childhood vaccinations

Contents:

As a pediatrician, I am asked frequently about childhood vaccinations. Are they safe? Do they cause one disease while trying to prevent another? As a parent or guardian, it’s our responsibility to provide safe care for our children and asking questions and getting the facts from credible sources are part of that responsibility.

U.S. public health officials and physicians have been combating misconceptions about vaccine safety for more than twenty years. Despite these efforts, childhood immunization rates have fallen in the past two decades resulting in resurgences of vaccine-preventable diseases such as whooping cough (pertussis) and measles. For example, in 2010, California saw more cases of whooping cough than any year since 1947, according to research published by the American Academy of Pediatrics.

August is Immunization Awareness Month. Let’s look at what childhood vaccinations are recommended when and address the most common misinformation about childhood vaccinations.

Recommended Childhood Vaccinations

The Centers for Disease Control and Prevention (CDC) has easy to review children’s vaccines schedules by age group on their website.  All the vaccinations listed below are available at DMG CRS’ primary care clinic.

Early Childhood: Birth to Age 6

  • Chickenpox/varicella
  • Hepatitis A
  • Hepatitis B
  • Diphtheria, tetanus, and pertussis (DTaP)
  • Haemophilus influenzae type b (Hib)
  • Influenza (flu): recommended annually from age six months and on
  • Measles, mumps, and rubella (MMR)
  • Pneumococcal conjugate disease (PCV13)
  • Polio (IPV)
  • Rotavirus (RV)

Children: Ages 7-18

In addition to any vaccines missed that were recommended during early childhood, the CDC recommends the following vaccines for kids ages 7-18:

  • Flu (annually)
  • Human papillomavirus (HPV)
  • Meningococcal conjugate (MenACWY)
  • Tdap (the DTaP booster)

If your child has certain health conditions that put them at increased risk for serious diseases, your pediatrician may also recommend the following vaccinations be administered:

  • Pneumococcal
  • Serogroup B meningococcal (MenB)

COVID-19 Vaccine

The CDC also recommends children ages six months and older receive the COVID-19 vaccination, and children ages five and older also get the booster. The COVID-19 vaccination is not available at DMG CRS. For more information on COVID-19 vaccinations for children, including locations providing these vaccinations, visit the Maricopa County Public Health website.

Childhood Vaccinations: Debunking the Myths

 According to PublicHealth.org, the following are the top three myths about childhood vaccinations.

 

Myth #1: Vaccines increase the risk of autism.

This hypothesis originated in 1997 from study by a British surgeon who concluded that the MMR vaccine was increasing autism in children in the United Kingdom. The article “has since been completely discredited due to serious procedural errors, undisclosed financial conflicts of interest, and ethical violations.” The physician author lost his medical license, and the paper was retracted.

Myth #2: Infant immune systems can’t handle so many vaccines.

The cells in the immune system are constantly being replenished, making it near impossible for a baby’s immune system to be overwhelmed by immunizations. In fact, babies are exposed to numerous bacteria and viruses every day; vaccines are minor in comparison.

Myth #3: Natural immunity is better than vaccine-acquired immunity.

While in some cases, catching a disease and getting sick (i.e., “natural immunity”) results in a stronger immunity to the disease than a vaccination, the risks outweigh the benefits. For example, if a child were to catch the measles, they would face a one in 500 chance of death from symptoms; in contrast, having a severe allergic reaction to the MMR vaccine is less than one-in-a-million according to the CDC.

 

As families travel more, especially internationally, the risk of contracting vaccine-preventable diseases increases. Even if the disease is not prevalent in the United States, it may be in other countries. COVID-19 gave us a strong example of how quickly a virus can spread from one continent to the next.

DMG Children’s Rehabilitative Services’ (DMG CRS) primary care clinic specializes in medical care of all children. We know that, especially if your child has a complex condition, getting vaccinations can be challenging and concerning. Your child may have increased anxiety resulting from their medical conditions making getting immunizations even more scary for them. You may have questions about how vaccinations fit into your child’s therapy plan. Our pediatric primary care providers are here to answer your questions and provide compassionate, experienced, and individualized care to support the health of your child and your family.

Discover DMG Children’s Rehabilitative Services

More than 25 medical specialties in one location. DMG Children’s was specifically designed to make it easy for pediatric patients- regardless of mobility or condition- to receive care.

Benefits of Breastfeeding for You and Your Baby

By Troy Nelson, MD, pediatrician and medical director, DMG Children’s Rehabilitative Services

mother and baby

Contents:

The baby formula shortage in the United States has prompted the need to find solutions to decrease the risk of a shortage impacting the country again. According to a recent article by NPR, often overlooked in the race to fill the gap is the most natural alternative: mother’s milk.

The American Academy of Pediatrics (AAP) recommends “exclusive breastfeeding for about six months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for one year or longer as mutually desired by mother and infant.” Despite this recommendation, 2018 data published by the Centers for Disease Control and Prevention (CDC) revealed that only one in four babies born in the United States met this target; in Arizona, 50 to 60 percent of babies met this target.

So, why do mothers stop breastfeeding? According to the CDC, how long a mother breastfeeds is impacted by:

  • Issues with lactation and latching
  • Concerns about infant nutrition and weight
  • Mother’s concern about taking medications while breastfeeding
  • Unsupportive work policies and lack of parental leave
  • Cultural norms and lack of family support
  • Unsupportive hospital practices and policies

The Surgeon General’s Call to Action to Support Breastfeeding as well as medical experts in women’s health and pediatrics continue to push education about the benefits of breastfeeding. Let’s look at the benefits to you and your baby.

Benefits of Breastfeeding for Mom

According to HealthyChildren.org, an AAP website, breastfeeding provides emotional, mental and physical health benefits to a mother, including:

Release of good hormones: During breastfeeding, hormones such as prolactin and oxytocin are released which produce peaceful, nurturing, and relaxing sensations that promote bonding with your infant.

Quicker uterus recovery: Oxytocin, released during breastfeeding, helps return the uterus to its regular size more quickly and can reduce postpartum bleeding.

Potential reduced risk of disease: Some studies have found that breastfeeding may reduce the risk of developing breast and ovarian cancers, cardiovascular disease, rheumatoid arthritis, and type 2 diabetes.

Natural contraception: Exclusive breastfeeding delays the return of the mother’s menstrual period, which can help extend the time between pregnancies.

Less expense: Formula can cost four to ten dollars a day or $1460-$3650 annually.

Ease of preparation:  Human milk directly from the mother is the right temperature, so no taking time to warm bottles of formula.

Ease of travel:  Whether you are going out to run an errand or for the day, no need to bring a bag of temperature-controlled formula.

Environmentally friendly: You get the satisfaction of knowing you are not contributing baby formula cans and packaging to landfills.

Benefits of Breastfeeding for Your Baby

Breast milk provides a baby with ideal nutrition and supports growth and development. According to the CDC, the benefits of breast milk for your baby include:

The best source of nutrition for most babies, because as the baby grows, the mother’s milk will change to meet the baby’s needs.

Shared antibodies from the mother with her baby

Supports proper brain development through docosahexaenoic acid (DHA), a polyunsaturated fatty acid found in breast milk

Helps protect babies against some short- and long-term illnesses and diseases and decreases the risk of:

  • Allergies
  • Asthma
  • Ear infections
  • Obesity
  • Sudden infant death syndrome (SIDS)
  • Stomach viruses or illnesses
  • Type 1 diabetes

If you have questions about breastfeeding or want more information, please contact your women’s health provider or pediatrician. We’re here to help you make the right decision for you and your baby and provide the support and resources needed for you to care for your newborn.

Top Five Risk Factors of Death in Men

Did you know that in 1920, women outlived men by one year, and today, the Centers for Disease Control and Prevention (CDC) reports that women survive men by five or more years.

Mental Health and Your Child

By Megan Aros-O’Malley, PhD, pediatric psychologist at DMG Children’s Rehabilitative Services

mental-health-child

May is Mental Health Awareness Month. Unfortunately, children in the United States are currently facing a mental health crisis. Data from the Centers for Disease Control and Prevention (CDC) indicate that one in five children has a mental or behavioral health condition such as anxiety, depression, attention-deficit/hyperactivity disorder, autism spectrum disorder, or disruptive behavior disorder. However, only about 20 percent of these children received care from a mental health provider.

Parents are often the first to recognize that their child is struggling emotionally and/or behaviorally. A few signs that a mental health difficulty could be arising include (but are not limited to):

  • Persistent worries or anxiety
  • Persistent behavioral acting out, aggression, or disobedience
  • Hyperactivity or constant movement beyond regular playing
  • Difficulty paying attention
  • Marked decline in school performance
  • Inability to cope with setbacks and problems
  • Severe mood swings
  • Threatening to kill or harm oneself and/or self-injury
  • Strange thoughts, beliefs, or unusual behaviors

Untreated mental health conditions can have many short- and long-term impacts on children’s development, social and behavioral functioning, and home and school life.

Fortunately, help exists. DMG Children’s Rehabilitative Services (DMG CRS) Behavioral Health clinic has pediatric psychologists and counselors available to meet the mental health needs of children of all ages. DMG CRS behavioral health providers collaborate with families to develop a comprehensive treatment plan that can include services such as consultation, psychotherapy, and/or psychological testing. Furthermore, with more than 25 pediatric medical specialties on-site, DMG CRS behavioral health providers are skilled at partnering with other pediatric specialists to provide whole-child care that incorporates physical and mental health domains.

Four Types of Food that Increase Your Risk of Type II Diabetes

By Misty Cox, FNP-C, WHNP, family nurse practitioner

food-higher-risk-diabetes

Contents:

November is National Diabetes Month, and the timing is perfect as the holiday season means a lot of food and celebrations. The holidays are busy and many of us get out of healthy routines such as exercise, eating a balanced diet, and more.

Type 2 diabetes, unfortunately, does not take the holiday season off, so here’s four types of foods to avoid or moderate your intake of this holiday season and throughout the year. These four food types increase your risk of type 2 diabetes:

Heavily processed carbohydrates

Foods made with white flour, white sugar, and white rice are low in bran, fiber, vitamins, and minerals; examples include breads, muffins, cakes, crackers, and pasta. According to a 2007 study published in the Journal of the American Medical Association (JAMA), a diet high in heavily processed carbohydrates increased the risk of type 2 diabetes by 21 percent compared to those who ate a whole foods-rich diet.

Drinks sweetened with sugar

Sodas, sweet tea, fruit drinks, and lemonade can lead to weight gain and increase your risk of getting type 2 diabetes. Having just two sugar-sweetened drinks per day can increase your risk of type 2 diabetes by as much as 26 percent, according to a 2010 study by the American Diabetes Association. Water is the best substitute and has many health benefits for your body.

Saturated and trans fats

Saturated fats are found in dairy products such as butter, whole milk, cream, and cheese as well as fatty meats. Trans fats are tied to fried foods (fast food restaurants, “bar” food) and packaged baked goods. Some healthy alternatives include:

  • Snacking on nuts, not sweets
  • Eating lean meats and/or poultry, and removing the skin
  • Avoiding salad dressings such as blue cheese, ranch and thousand island and using olive oil and balsamic vinegar instead
  • Cooking and baking with olive or canola oils

Red meats and processed meats

Processed meats such as hot dogs, bacon, and deli meats have higher levels of sodium and nitrites, which put you at not only higher risk of type 2 diabetes but heart disease. A study shared in the American Journal of Clinical Nutrition found that a three ounce serving of red meat daily increased the risk of type 2 diabetes by 19 percent, and a serving of less than three ounces of processed meats increased the risk by more than 50 percent. Protein is essential to your health so switch to wild caught fish, like salmon, or organic poultry like chicken or eggs combined with vegetables to optimize your meal plan.

Prediabetes is alarmingly prevalent. Did you know one of three Americans is prediabetic? Your best defense is getting information on your risk factors and how to optimize your lifestyle to decrease your risks. We primary care providers (PCP) are here to help. If you have not had your annual wellness exam, schedule it, and talk with your PCP about your health goals.

Resources

More from Misty Cox, FNP-C

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What Immunizations Does Your Family Need?

August is Immunization Awareness Month, so let’s review vaccines recommended throughout our lifetimes.
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Did you know November is American Diabetes Month?  According to the American Diabetes Association, more than 34 million people in the United States have diabetes, and more than seven million of those people are undiagnosed.

 

 

What You Need to Know about Ovarian Cancer

By Dana Putman, FNP-C, family nurse practitioner

Group of happy women

Contents:

September is Ovarian Cancer Awareness Month.  According to the American Cancer Society, more than 20,000 women will receive an ovarian cancer diagnosis in 2021, and nearly 14,000 women will die from this form of female reproductive system cancer.

Fortunately, the rate at which women have been diagnosed with ovarian cancers has been decreasing slowly in the past 20 years. Driving awareness and empowering women with the knowledge of how to decrease their risks and identify ovarian cancer symptoms early has helped significantly.

Did you know there are more than 30 types of ovarian cancer?

According to the American Cancer Society, 85 to 90 percent of ovarian cancers originate from epithelial cells, which cover the outer surface of the ovary. About 52 percent of all epithelial ovarian cancers are serous carcinomas.

What are the risk factors for epithelial ovarian cancers?

Because epithelial ovarian cancers are the most common, let’s take a closer look at risk factors for these types of ovarian cancers.

Getting older – The risk of getting ovarian cancer increases with age, unless a woman has had her ovaries removed.  Most women diagnosed with ovarian cancer have completed menopause and are age 63 or older.

Being overweight or obese – Women with a Body Mass Index (BMI) of 30 or higher have a higher risk of developing many cancers, not just ovarian cancer. In addition, obesity can negatively impact a woman’s chance of surviving ovarian cancer.

Having children later or not having a full-term pregnancy – Women who have their first full-term pregnancy after age 35 or who never carried a pregnancy to term have a higher risk of ovarian cancer.

Having a family history of breast, colorectal or ovarian cancer – If one’s mother, sister or daughter has had ovarian cancer, the risk is higher. Increased of risk of ovarian cancer can also come from the father’s side of the family.  In addition, breast and colorectal cancers can be caused by an inherited mutation (change) in certain genes that cause a family cancer syndrome that increases the risk of ovarian cancer. To learn more about family cancer syndromes and gene mutations, visit the American Cancer Society website.

Using fertility treatment – In vitro fertilization (IVF) has been linked to increased risk of ovarian cancer, while some types of fertility drugs have not. If you are considering or have had fertility treatments, speak with your women’s health physician about your risk factors.

Having had breast cancer – A family history of breast cancer may be linked to inherited mutation in the BRCA1 or BRCA2 genes, which are also linked to ovarian cancer.

Smoking – While smoking is not directly linked to ovarian cancer, it has been linked to an increased overall risk of developing some form of cancer.

What decreases the risk of ovarian cancer?

While some of the risk factors are not within our control, decreasing the risk of ovarian cancer is to some extent.  However, a woman must make the right personal and life choices for her and her family, so some or all these options may or may not be chosen.

Pregnancy – Women who have carried a baby to full-term by the age of 26 have a lower risk of ovarian cancer. The risk goes down with each full-term pregnancy.

Breast feeding – Breast feeding may reduce the risk of ovarian cancer even further.

Birth control – Using oral contraceptives (birth control pills) decreases the risk of ovarian cancer; the longer oral contraceptives are used, the more the risk decreases. According to the American Cancer Society, tubal ligation (having fallopian tubes tied) and short use of intrauterine devices (IUDs) have also been associated with a lower risk of ovarian cancer.

Hysterectomy – Removing the uterus without removing the ovaries reduces the risk of ovarian cancer by more than 30 percent.

Your first step in reducing your risk of ovarian cancer is getting an annual well-woman exam.  During this exam, you will share your medical history as well as that of your family, discuss your methods of birth control, receive a physical examination, and discuss your health goals.  We are here to help you understand your risks and create a care and lifestyle plan to support you in living the life you choose.

What Immunizations Does Your Family Need?

by Misty Cox, FNP-C, WHNP-BC, Family Nurse Practitioner

Arizona family

Contents:

Do you know anyone who has recently had Haemophilus influenzae type b (Hib)? Do you know what Hib is?  Probably not in both cases.  Affecting mostly children under five years-old, Hib is a disease that can seriously damage a child’s immune system and cause brain damage, hearing loss, or even death.  According for the Centers for Disease Control and Prevention (CDC), before the four dose vaccine was available, approximately 20,000 children were affected by Hibs annually.

Hib is just one of many diseases we rarely encounter any longer thanks to vaccines.  More than 16 diseases can be prevented or decreased in severity if vaccines are proactively administered.  The most current example is COVID-19 and associated variants, including delta.

August is Immunization Awareness Month, so let’s review vaccines recommended throughout our lifetimes.

Please consult your primary care provider (PCP) for more information on recommended vaccines, timing, number of doses and when to receive based on medical history, risks, and other factors.

Childhood Vaccinations

The CDC has easy to review children’s vaccines schedules by age group on their website.

Early Childhood: Birth to Age 6

  • Chickenpox/varicella
  • Hepatitis A
  • Hepatitis B
  • Diphtheria, tetanus, and whooping cough/pertussis (DTaP)
  • Hib
  • Influenza (flu): recommended annually from age six months and on
  • Measles, mumps, and rubella (MMR)
  • Pneumococcal conjugate disease (PCV13)
  • Polio (IPV)
  • Rotavirus (RV)

Children: Ages 7-18

In addition to any vaccines missed that were recommended during early childhood, the CDC recommends the following vaccines for kids ages 7-18:

  • Flu (annually)
  • Human papillomavirus (HPV)
  • Meningococcal conjugate (MenACWY)
  • Tdap (the DTaP booster)

If your child has certain health conditions that put them at an increased risk for serious diseases, your PCP may also recommend the following vaccinations be administered:

  • Pneumococcal
  • Serogroup B meningococcal (MenB)

 

Adult Vaccinations

The CDC also provides information to adults to help adults understand what vaccinations are recommended based on age, lifestyle, medical conditions, and more.

Young Adults: Ages 19-26

  • Flu: recommended annually
  • HPV, if not previously received
  • Tdap, if not previously received

Adults: Age 50+

  • Flu: recommended annually
  • PCV13: recommended for all adults with a condition that weakens the immune system, cerebrospinal fluid leak, or cochlear implant
  • Pneumococcal polysaccharide vaccine (PPSV23): protects against serious pneumococcal disease, including meningitis and bloodstream infections and is recommended for all adults age 65 and older

If you have one of the following medical conditions, talk with your PCP about additional vaccinations that may be recommended to decrease your risk of serious illness and complications.

  • Asplenia
  • Asthma
  • Diabetes Type 1 and/or Type 2
  • Heart disease, stroke, or other cardiovascular disease
  • HIV
  • Kidney/renal disease
  • Liver disease
  • Lung disease
  • Weakened immune system

Adults: Special Groups

If you fall into one of the following categories, additional vaccinations may be recommended.  Consult the CDC website for more information or speak with your PCP.

COVID-19 Vaccination

The COVID-19 vaccine is highly recommended to fight against the coronavirus and variants, like delta.  This vaccine is now available for everyone age 12 and older.  For the most current information on the COVID-19 vaccine, please visit the CDC website.

If you have questions about what vaccinations you and your family need, DMG primary care providers (PCP) are here for you. To find a DMG PCP at a location near you, click here. We’re here to support the health of you, your family, and the entire community.

UV Safety for You and Your Dog

By Misty Cox, FNP-C, WHNP, family nurse practitioner

couple outdoors with their dog

Contents:

July is UV Safety Month, and in Arizona, protecting ourselves and those we love against the harmful rays of the sun is even more important.  Did you know Arizona has more sunny days per year than California and Florida?

If you’re like me, you enjoy the outdoors, especially when you can enjoy it with someone you love. In my case, that “someone” is often my dog, Alfred.   Alfred and I can regularly be seen taking long, brisk walks together.

As a primary care provider and a “pet parent,” I’d like to share tips to protect you and your four-legged friend from the harmful rays of the sun.  First, let’s check out some facts about skin cancer for humans and canines.

Facts about Skin Cancer

According to the American Cancer Society:

  • Skin cancer is the most common form of cancer in the United States.
  • Melanoma is among the top five cancer types diagnosed in Arizona.
  • Incidence of melanoma are increasing in Arizona at a slightly higher rate than that of the United States as a whole.

According to the American Kennel Club (AKC):

  • Skin tumors are the most commonly diagnosed tumors in dogs.
  • Too much exposure to the sun is one of the top causes of skin cancer in dogs.
  • Malignant melanoma is one of the most common skin cancers in dogs.
  • Malignant melanoma in dogs grow quickly and have a high risk of spreading to other organs.

UV Safety Tips for You and Your Dog

Surprisingly, how we protect ourselves from harmful UV rays also apply to our dogs, with some minor adjustments.

Stay in the shade

Heading to the lake, beach or park this summer and taking your dog along?  Be certain to bring a large umbrella to provide shade for you, your family and dog.  Some parks have covered areas for picnics and gatherings; be certain to check the park’s website ahead of time to see if these spaces need to be reserved.

Wear protective clothing and accessories

If you are going to be out in the sun, wear certified UV protective clothing (and a wide brim hat), which can be purchased online or at most sporting goods stores.  Believe it or not, UV protective shirts are available for dogs, too.  In addition, remember if the pavement or ground is too hot for your bare feet, it’s too hot for your dog’s paws; if your dog will not tolerate paw protectors, do not walk him if you cannot put your hand or foot on the pavement or ground comfortably for 30 seconds.

Wear sunglasses

Sunglasses protect the eyes from UV rays and reduce the risk of cataracts and skin cancer in or on the tender skin around the eye for both humans and canines.  If your dog likes to have his head out the window when in the car, sunglasses can also protect his eyes from wind and debris. Just like with humans, companies that are dedicated to making eyewear for dogs are plentiful; just do a Web search to find the dog goggles (“doggles”) that work for your dog.

Apply and reapply sunscreen

The American Academy of Dermatology recommends that we use a sunscreen with an SPF of 30 or higher and be certain your sunscreen is not expired; most sunscreens have a shelf life of three years.

Similarly, the AKC recommends a sunscreen with an SPF of 30 or higher for dogs.  As dogs will often lick their skin, a sunscreen specifically made for canines should be used as some ingredients in human formulas are toxic for dogs.

For both you and your dog, sunscreen should be applied about 20 minutes before going outdoors and reapplied if you get wet or every two to three hours.

 

  • misty cox and her dog

    Here’s Misty Cox and her dog

Why Men Need to Get Annual Wellness Exams and Why They Don’t

By Misty Cox, FNP-C, WHNP, family nurse practitioner

Mature Male Friends Socializing In Backyard Together

Contents:

According to a study by the Cleveland Clinic, nearly 60 percent of men do not regularly see a doctor for preventive care; instead, these men only seek a medical specialist when they are seriously ill. Of those surveyed, three in five men get annual physicals.  When asked what they regularly talk about, only seven percent said their health.  

Did you know men die an average of five years sooner than women?  Perhaps the fact that, according to the Centers for Disease Control and Prevention (CDC), women are 33 percent more likely than men to see a medical provider is one reason why. 

June is Men’s Health Month so let’s get to the bottom of why men are less likely to seek preventive care, how you can help the men in your life, and what men’s health screenings are recommended.

Why are men less likely to seek medical care?

An online survey commissioned by Orlando Health revealed the following reasons men do not seek medical care, with the first two being the most reported:

  • Too busy
  • Afraid of what medical condition might be discovered 
  • Not “sick enough”
  • Discomfort of the exam (i.e., prostate checks, testicular exams, colon cancer screenings, etc.)

A survey by Cleveland Clinic revealed that 19 percent of men will seek medical care to get their significant other or a loved one to “stop nagging them” about it.  

What screenings should men get and when?

Depending on age, family medical history, lifestyle, and more, a primary care provider (PCP) will recommend the following screenings and potentially other tests to support the health of a male patient. 

Blood pressure screening

Regular blood pressure screening enables early detection of pre-hypertension and/or high blood pressure, a leading cause of heart issues and stroke. 

Cholesterol level test

Men need regular cholesterol testing at age 35; those with a higher risk factor should begin testing as early as age 20. Like blood pressure issues, high cholesterol can lead to heart attacks and/or stroke if not detected early and managed through diet, exercise, and/or medication.

Colorectal exam

Both men and women should begin colorectal screenings at age 50.  Based on family history and other risks, a PCP may recommend these screenings begin earlier.

Diabetes screening

Starting at age 45, healthy men should begin diabetes screenings every three years. Testing may begin earlier for those with higher risk factors, including high cholesterol or blood pressure.

Glaucoma test

Eye tests for glaucoma are based on age and personal risk.  Generally, men should be tested as follows:

  • Under the age of 40: Every two to four years
  • Age 40-64: Every one to three years
  • Age 65+ Every six to 12 months

Prostate exam

Prostate cancer is second only to skin cancer as the most common form of cancer in American men.  The American Cancer Society recommends men discuss prostate cancer screening with their PCP to make an informed decision.  Prostate cancer screening may be recommended as follows:

  • Age 50 for men at average risk with a life expectancy of >10 years
  • Age 45 for men at high risk, including African Americans and men who have a father or brother diagnosed with prostate cancer under the age of 65
  • Age 40 for men at higher risk due to having more than one first degree relative (i.e., father, brothers) who had prostate cancer at an early age

Skin cancer screening

Skin cancer is one of the top cancers found in men.  Annual screenings are recommended and may be increased in frequency if skin cancer or pre-cancerous cells are found.

Testicular cancer exam

Most testicular cancers can be detected early, so a testicular exam should be part of a man’s annual health screening.

Stroke Awareness and Prevention

By Richard Fowler, MD, internal medicine physician

stroke awareness

Contents:

According to the Centers for Disease Control and Prevention (CDC), nearly 800,000 people in the United States annually have a stroke, and the majority of these are first-time occurrences.  Additional striking statistics from the CDC include:

  • Every 40 seconds someone has a stroke.
  • Every four minutes a person dies of a stroke.
  • One in every six deaths from cardiovascular disease is due to a stroke.
  • One in every four people who experience a stroke have had a stroke in the past.
  • Stroke is the leading cause of disability.
  • Stroke reduces mobility in >50 percent of stroke survivors ages 65 and older.

Did you know May is National Stroke Month?

Strokes can occur at any age; in fact, according to the CDC, 34% of people hospitalized in one year due to stroke were under the age of 65.  So, it’s important for all of us to be aware of how to prevent strokes.

Causes of Stroke

Leading causes of stroke include:

  • Advancing age
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Obesity
  • Prior stroke/transient ischemic attack (TIA)
  • Smoking

According to the American Heart Association, one in three Americans has one of these conditions or habits.

Signs and Symptoms of Stroke

Early action is important to surviving a stroke and decreasing the long-term impacts. According to the CDC, patients who arrive at the emergency room within three hours of their first symptoms often have less disability three months after a stroke than those who received delayed care.

Unfortunately, many people do not recognize all the signs and symptoms of a stroke.  In fact, the CDC reports that in one survey, only 38 percent of respondents were aware of all major symptoms and knew to call 9-1-1 when someone was having a stroke.

While most people recognize sudden numbness on one side as a sign of a stroke, below are other signs and symptoms of a stroke.  Note that all these signs or symptoms occur suddenly.

  • Confusion, trouble speaking, or difficulty understanding speech
  • Dizziness, lack of coordination, loss of balance or trouble walking
  • Severe headache with no known cause
  • Trouble seeing in one or both eyes

F.A.S.T. to Save Lives

If you recognize signs or symptoms of a stroke in someone, follow these steps:

f.a.s.t diagram