The Virginia Beach Premier Medical Newsletter

May, 2013

VBPM Connection is a newsletter published by Virginia Beach Premier Medical, an internal medicine practice dedicated to personalized, highly attentive, high quality care for our patients. The newsletter provides information of a general nature about our office, current health news and various common illnesses and ailments. None of the information provided is meant to be specific for any particular individual. Always seek the advice of your personal physician for any specific information about your health.

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Broken Heart Syndrome

What is Broken Heart Syndrome: It’s a temporary condition that occurs following a very stressful event or perhaps a car accident. It occurs in women more often than men and is also referred to as takotsubo cardiomyopathy or stress cardiomyopathy or apical ballooning syndrome. The symptoms are sudden onset of chest pain and shortness of breath, although there is no evidence of any coronary artery blockage. Instead, the problem is with the left ventricle, the main pumping chamber of the heart, which becomes weak temporarily, sometimes even ballooning out on imaging studies. It can be associated with arrhythmias. There is no specific treatment for this but it usually goes away by itself. Recovery is usually less than a week. The cause of it is unknown but it is suspected that a surge in stress hormones may be responsible for a change in the heart’s condition temporarily.

COPD

What is COPD? COPD, or chronic obstructive pulmonary disease, refers to a group of lung conditions that reduce air flow when you try to exhale. There is a certain amount of air-trapping which occurs as a result. Your lungs actually have more air than they should have which decreases the ability to take in good air. Two of the illnesses that make up chronic obstructive pulmonary disease include chronic emphysema and chronic bronchitis.

Smoking is one of the main causes of COPD and will continue to aggravate the condition as long as the person continues to smoke. Quitting smoking is absolutely essential to prevent further progression of the disease. Sometimes even then, with aging, etc., COPD can progress, although it’s not as rapid as if the smoking continues.

Treatment usually requires one or more types of medications including bronchodilators like Albuterol, Atrovent and Spiriva and inhaled corticosteroids. Antibiotics are sometimes required to fight infection such as acute bronchitis or pneumonia.

Sometimes exacerbations of COPD occur, particularly in the presence of infection, which can lead to severe bronchospasm, wheezing, shortness of breath and excessive coughing with yellow or green sputum production. This is often associated with a decrease in oxygen levels or an increase in carbon dioxide levels caused by inadequate ventilation. This will sometimes require prompt treatment and hospitalization. Oxygen is usually required during these exacerbations. After the exacerbation is over, COPD patients may or may not require continued oxygen therapy depending on the situation and the severity of their COPD.

Too much oxygen can actually worsen problems with carbon dioxide retention which can, in turn, cause excessive somnolence. If patients with COPD suddenly become very sleepy and lethargic, it may be an indication that their carbon dioxide level is too high.

Prognosis usually depends on the severity of the disease. Often the illness can be maintained in a stable condition for many years with the appropriate treatment.

Step It Up to Improve Your Health

The average adult in the United States takes a little over 5,000 steps a day, whereas Australians and the Swiss take almost 10,000 steps each. The Japanese take about 7,000 steps a day. One of the main risk factors for heart disease and other diseases including cancers is a sedentary lifestyle. Many people say that we should take 10,000 steps a day as the optimum amount of exercise. A pedometer may be a helpful tool in determining how many steps you actually take each day. If you add 2,000 steps to your usual daily activity, this may significantly reduce your risk for coronary disease and other illnesses in the future.

Knee Pain

A torn meniscus could often be the cause of significant pain in the knee. Researchers found in a recent randomized trial that many meniscal tears are not symptomatic. Those that are symptomatic often get better without surgery. Symptoms usually include pain, catching, popping, giving way or pain associated with pivoting. If patients underwent physical therapy alone vs. arthroscopic surgery, of the ones who underwent physical therapy, only 70% of them required surgery at the end of 6 months. Between 6 and 12 months, only an additional 5% required surgery. Thus, most symptomatic patients with torn menisci do not necessarily require surgery.

Caring for Family Members with Dementia

This can be an exhausting and frustrating task for many caregivers. Sometimes these frustrations that occur naturally in these situations can arouse feelings of guilt which only heighten the stress. Sometimes the caregiver can feel quite lonely because their loved one is really not available for them to discuss their innermost feelings with any longer since they have dementia. You may want to seek another outlet such as talking with an understanding friend or meeting with a support group. Sometimes writing in a journal and meditation, just going for a walk or those kinds of activities may be helpful.

You may need to set certain limits. You may need to go out and go shopping or get away from the house or from the demented person for a while. It’s good to have someone that you can rely on for respite care. Remember, you can’t do everything yourself. It’s good to take breaks throughout the day or for a weekend. Do something that you enjoy that is unrelated to caregiving. Visiting with friends can help as well. Get help when you need it. When you are feeling very frustrated, lonely, angry and resentful, try to investigate other resources in your community that may be able to help you. A website called www.communityresourcefinder.org may be helpful, or the Alzheimer’s Association at 1-800-272-3900 can help you find resources in your own community.

Seeing Things?

Did you know that visual hallucinations can occur as a result of poor vision? Approximately 11-15% of older adults with significant visual loss such as macular degeneration, glaucoma, diabetes, etc., can experience vivid images of people, animals or scenes in the form of hallucinations which sometimes can last for very short periods of time up to rather long periods of time and may even be continuous. Sometimes they can involve just simple lines or geometric shapes. If you have seen these types of things and you have experienced significant visual loss, there is no need for any great concern. The visual acuity loss can be presumed to be the cause. They sometimes go away over time. Sometimes they get better just by improving lighting or by turning the head in different positions or even by just blinking your eyes.

What's New in the Journals?

A recent study in Belgium showed that joggers who run in urban areas tested lower on IQ and cognitive skills than those who jogged in rural areas.

A previously-known cancer drug called Bexarotene has been shown to significantly improve dementia in mice.

A recent study in the British medical journal confirmed that caffeine consumption decreases the likelihood for crashes for commercial drivers by over 60%.

Surgical masks only protect from influenza virus about 50% of the time.

Patients often worry about gaining weight as a reason to continue smoking. A study reported in JAMA, March 2013, showed that the benefits of quitting smoking far outweigh any risk of associated weight gain. The amount of risk reduction from coronary artery disease prevails over the risk for weight gain, even over a very short time frame.

There is a 66% higher risk for hip fracture when elderly patients (mean age 81) use hypnotics for a sleep aid. This includes medicines like Ambien (zolpidem), Lunesta, Sonata and their associated generics. There is similar evidence for benzodiazepines causing hip fractures in those patients who are elderly or nursing home residents. Benzodiazepines include drugs like Ativan, Xanax and Valium.

Perfume, Pets and Allergies

If you've ever known someone who has allergies, you know that sometimes exposure to certain things like pet dander and perfume can be quite distressing and can even precipitate a severe asthma attack.

So, when coming into the office, in order to protect our patients and office staff, please refrain from wearing perfumes and bringing in pets. We will be forever grateful.

About Our Office

Virginia Beach Premier Medical is a membership internal medicine practice specializing in comprehensive and compassionate, individualized and personalized patient-centered care. We pride ourselves on full continuity of care – in the office, in the hospital, or even at home.

If you would like more information about our practice please call us at 757-416-6750 or visit our website at www.vbpm1.com. Ask to speak with Brittany, our office manager, or Dr. Parks or Dr. Warth. We’d be happy to talk with you anytime.

Happy Spring!

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