Category Archives: 24 Hour Urgent Care

Abdominal Pain- Causes and Treatments

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If you are suffering from abdominal pain, contact us immediately. We have the tools and knowledge on hand to diagnose and treat the cause of your pain right now.
Abdominal Pain

Abdominal Pain

Treatment Procedures

Common Causes of Abdominal Pain

Many injuries and conditions can cause abdominal pain.

  • Abdominal Organ-Related Conditions:
    • Appendicitis – A potentially deadly condition caused by the inflammation, infection and build up of pus in the appendix
    • Gall Stones – Hardened fluid deposits in the gall bladder that cause intense pain and fever
    • Bowel Blockage – Caused by scar tissue, tumors, or narrowing of intestine, resulting in build- up of food, gas and fluid in the bowels
    • Peptic Ulcer – A painful sore in the stomach lining and upper small intestine that can sometimes be accompanied by bleeding or vomiting
  • Gender-Related Conditions:
    • Menstrual Cramps – Caused by the approach or start of a woman’s menstrual cycle
    • Mittelschmerz – Minor pain on one side of the abdomen that occurs during ovulation
    • Ectopic Pregnancy – A life-threatening condition caused when an ovum attaching itself to and growing inside the fallopian tube
    • Endometriosis – Caused by the lining of the uterus growing in other areas of the pelvis and abdomen
  • Food and Digestive Conditions:
    • Food Allergies – Caused by an allergic reaction to dairy, red meat, gluten and other foods
    • Heartburn – The result of acid reflux and indigestion after eating
    • Food Poisoning – Vomiting or diarrhea caused by eating or drinking contaminated food or beverages
    • Lactose Intolerance – A condition caused by the inability to absorb and digest lactose found in dairy
  • Conditions Caused by Other Organs:
    • Heart Attack – A life-threatening emergency caused when blood flow to the heart is restricted and causes part of the heart muscle to die.
    • Abdominal Aneurysm – A deadly enlargening or ballooning of the aorta that supplies blood f low to the abdomen, legs, and pelvis.
    • Pneumonia – A serious viral or bacterial infection in one or both lungs that causes coughing, shortness of breath, lethargy, high fevers, and pain in the stomach and ribs.
  • Other Causes:
    • Injury – A blow to the stomach, pelvis or lower chest can cause pain and swelling in the abdomen
    • Flatulence – Excess flatulence can cause pressure and pain throughout the abdomen
    • Anxiety – Worry, stress, anxiety and panic attacks can cause stomach aches and nausea

In order for us to alleviate your abdominal pain, we may need to perform some scans or tests. These include:

  • Abdominal x-ray – This procedure uses an x-ray machine to provide doctors with images of the intestines, spleen, stomach and other organs in the abdominal cavity. It may identify intestinal blockage, kidney stones or other causes of your pain or nausea. You may be asked to lie on a table or to stand as the x-ray machine captures images of the abdominal area.
  • Abdominal CT scan – This scan is similar to an x-ray, but it uses multiple rays in order to create cross-sectional images of organs and tissues in the abdomen. These images will allow us to identify any swelling, masses, infections or other issues that could be contributing to your pain. In order to receive these images, you will lie on a table that slides into the CT machine.
  • Magnetic resonance cholangiopancreatography– MRCP helps us identify gall stones through the use of magnetic resonance imaging. The scan can also provide us with information about the liver, pancreas and bile ducts. You will be asked to lie on a table that will be moved into an MRI tunnel, which is where the equipment will gather images.
  • Abdominal ultrasound – We may order ultrasounds to help us check for liver disease, abdominal aortic aneurysms and issues with other abdominal organs. These ultrasounds are often performed quickly and can give us immediate images that may help us make a diagnosis. We will place a small amount of gel on your abdomen, and then we will rub the area with a transducer that sends the images to a screen for us to view.

Abdominal pain is defined as any pain that you feel anywhere in your stomach or groin area. It can be accompanied by nausea, bloating, excess gas, sweating, cramps or fever. Abdominal pain can appear gradually and become worse or it can appear suddenly with no prior warning. If your abdominal pain is not relieved with home remedies or over-the-counter medication or you experience other symptoms like bloody stools or vomit, you should immediately go to the nearest emergency room.

If you are experiencing abdominal pain, please visit one of our convenient locations. We are always open with no wait.

Woah, Baby! Element of Surprise Helps Infants Learn

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A newborn baby brings all sorts of awe and wonder to a parent. Infants’ curious nature is precious to watch as they learn and grow.  But did you know the element of surprise is what helps infants to learn?

A new study published in Science shows that infants learn by being stunned by the objects surrounding them.

It is commonly known babies explore using their strongest senses of taste and feel. This is very evident when an energetic infant bashes, say a very full cup of juice, against a table.  Though they may not distinguish between play-objects and more unfavorable objects, parents can take comfort in knowing their child is exploring and learning.

Babies learn the most, however, when they experience the unpredictable!  Researchers from Johns Hopkins University took on a group of 11-month-olds to see what how they would behave towards the expected versus the unexpected.  The researchers, cognitive psychologists Aimee E. Stahl and Lisa Feigenson, experimented with two scenarios.  First, they rolled a ball down a ramp and the ball was promptly stopped by a wall.  Then, they rolled the same ball down a similar ramp but the ball was allowed through the barrier.

When their expectations were defied, the babies were curious to play with the ball that passed through the barrier using touch, taste, and, of course, bash.  However, when the ball reacted as predicted, the babies showed less interest.[i]

Their research suggests babies have more innate knowledge about how things work than what we might think.  They form predictions, have expectations, and utilize their own system for learning.

“For young learners, the world is an incredibly complex place filled with dynamic stimuli. How do learners know what to focus on and learn more about, and what to ignore? Our research suggests that infants use what they already know about the world to form predictions. When these predictions are shown to be wrong, infants use this as a special opportunity for learning,” said Feigenson. [ii]

As Stahl points out, “”These results are important because it shows that infants can use their very sophisticate knowledge about the world, about how objects behave, to then harness or guide their future learning.” [iii]

When science is this cute, you can’t help but watch:

[i] Khazann, Olga. The Atlantic.  Baby Geniuses: How Surprises Help Infants Learn.  2 Apr. 2015.  Accessed 26 Nov. 2015.  <Read More>

[ii] Science Daily. Element of surprise helps babies learn.  2 Apr 2015.  Accessed 26 Nov. 2015.  <Read More>

[iii] Bologna, Caroline.  The Huffington Post.  Adorable Experiments Show That Babies Learn from Surprises.  3 Apr. 2015.  Accessed 26 Nov. 2015. <Read More>

Can Dietary Supplements Send You to the Emergency Room?

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A new study reveals dietary supplements lead to over 20,000 emergency room visits a year.  Consumers trust manufacturers to create products that supplement their health. However, the $35 billion-a-year industry has created issues for consumers instead, particularly at the expense of children, young adults, and senior citizens. [4]

Shortcomings in Regulation of Supplements

The Centers for Disease Control and Prevention estimate that more than half of U.S. adults use dietary supplements. [1] From multivitamins, to energy boosters, to sleep aids, there are multitudes of products readily available for all ailments.  When considering the time restraints of many Americans lives, supplements seem like an effective solution to many problems.  But in an effort to save time and money, many have subjected themselves to costly and potentially life-threatening issues.

According to a study published in The New England Journal of Medicine, of the nearly 23,000 visits, 20% were unsupervised children.  After the exclusion of children, senior citizens made up 38% of trips after experiencing issues swallowing pills.  A quarter of trips were related to weight-loss supplements that produced symptoms like chest pains and heart palpitations.  Also creating cardiovascular problems, energy supplements were responsible for 10% of patients. [2]

According to a 1994 federal law, supplements are considered safe until proven otherwise.  The Food and Drug Administration regulates dietary supplements, but not as strictly as it does prescription drugs where extensive trials and tests are conducted.  Dietary supplement firms do not need FDA approval to put a product on a shelf. [3]

Instead, companies merely state they have done the research needed to vouch for the safety of their products.  Their information is rarely shared with the FDA and therefore it is never established what, if any, research has truly been done on the product. [3]

“Unlike companies that make prescription or over-the-counter drugs, those that manufacture supplements aren’t required to list possible side effects on their products,” according to the study. [2]

At this time, supplement manufacturers are not required to use child-resistant packaging.  This leads to small hands getting a hold of potentially potent substances.  The labels typically do not remind parents to store out of reach of children, but it is a crucial practice to mitigate unnecessary issues. [4]

The FDA also fails to regulate the physical size of supplements.  Pills are frequently made too large for people to swallow easily, particularly affecting the elderly population. [4]

With so many shortcomings in regulation of supplements, healthcare advocates are urging for better practices and launching more investigations into the products on shelves.

Mainstream Retailers and Fraudulent Products

Just this month, GNC, the massive health and nutrition retailer, was sued for selling dietary supplements containing amphetamine-like substances.  Oregon’s attorney general, Ellen Rosenblum, filed the lawsuit following an investigation in conjunction with the FDA. [5]

“It is scary to know that certain products sold by GNC contain an ingredient that is not even labeled — let alone approved in the United States,” Rosenblum said. [5]

One supplement contained an unapproved synthetic chemical called picamilon that is a prescription drug used to treat neurological disorders in countries like Russia.  [6]

The other supplement in question contained BMPEA, an abbreviated form of a powerful amphetamine-like stimulant that is banned by the World Anti-Doping Agency for use by athletes. [6]

Rosenblum estimates that thousands of these questionable products were sold over the past couple of years. [6]

GNC has denied the claims. This is not the first time the company has come under fire for selling supplements that have controversial ingredients or lack of accurate labels.  [6]

Earlier this year, the New York State attorney general’s office accused GNC, Walgreens, Walmart, and Target of selling unsafe herbal supplements.  [7]

An investigation was launched and authorities tested the top-selling store brands of herbal supplements at each of the retailers.  Investigators found that four out of five of the products were falsely labeled and did not contain any of the herbs listed.  [7]

In lieu of the herbs, the pills were filled with powdered rice, vegetables and houseplants, becoming a danger to those with allergies and a total farce to the consumer. [7]

Specifically from the investigation, Walgreens’ brand of ginseng pills was found to contain nothing more than rice and powdered garlic. [7]

Walmart sold a product labeled as ginkgo biloba but in reality only contained powdered radish and wheat – a hidden threat to those with Celiac Disease.

Similarly at Target, herbs were left out of some supplements and replaced with powdered fillers. [7]

GNC was again found to have unlisted ingredients in some of its supplements. [7]

As healthcare advocates take action against the supplement industry, the nation awaits stricter regulations on the products so readily available on the shelves of major retailers.

What Consumers Can Do to Make Smart Supplement Choices

Americans make daily choices for their safety and health from wearing seat belts to applying sunscreen.  While taking a vitamin or sleep aid may seem just as routine, do not let supplements go unresearched.

The FDA’s website provides some important information regarding supplements.  Specifically, the FDA warns against the following: products masquerading as alternatives to anabolic steroids, sexual enhancement supplements promising immediate effects, products claiming to be alternatives to prescription drugs, and products marketed in mass e-mails. [8]

Utilize resources.  The Mayo Clinic provides a comprehensive database of prescription and over-the-counter drug information on their website.  When researching melatonin supplements for example, Mayo Clinic provides background on the drug, related terms or brand names, dosing, safety information, potential interactions, and the methodology behind it.  [9]

Knowing your pre-existing conditions can be critical to avoiding complications from supplements.  For example, for those with high blood pressure or cardiovascular disease are at risk for adverse side effects from weight-loss drugs.  The stimulants in weight-loss products like Hydroxycut and Dexatrim are especially problematic for those prone to atrial fibrillation (an irregular heartbeat).  [10]

Patients often forget to list supplements currently in-use at the time of appointments or feel it is not of importance.  Always let your doctor know what supplements you are taking to prevent an interaction with any prescriptions you may be prescribed.  Additionally, pharmacists can provide insight to products on their shelves and their efficacy.

Practicing diligence and being knowledgeable of what you ingest are crucial to avoid a trip to the emergency room due to an unsafe supplement.

SOURCES:

1.^ Park, Madison (April 13, 2011). “Half of Americans use supplements.” CNN.com, Retrieved October 25, 2015.

2.^  Geller, A.I., Shehab N., Weidle N.J., Lovegrove M.C., Wolpert B.J., Timbo B.B…Budnitz, D.S. (2015).  Emergency Department Visits for Adverse Events Related to Dietary Supplements.  New England Journal of Medicine 2015; 373:1531-1540 doi: 10.1056/NEJMsa1504267.  Retrieved from:  http://www.nejm.org/doi/full/10.1056/NEJMsa1504267

3.^  O’Connor, Anahad (October 14, 2015). “Dietary Supplements Lead to 20,000 E.R. Visits Yearly.” NYTimes Well Blogs. Retrieved October 25, 2015.

4.^ Szabo, Liz (October 15, 2015).  “Side effects from dietary supplements send 23,000 people a year to ER.”  USATODAY.com.  Retrieved October 25, 2015.

5.^ Wattles, Jackie (October 22, 2015) “GNC accused of selling supplements laced with ‘amphetamine-like’ substance.”  Money.CNN.com.  Retrieved October 26, 2015.

6.^ Grover, Natalie (October 26, 2015).  “Oregon  Attorney General says GNC sold spiked products.” Reuters.com.  Retrieved October 26, 2015.

7.^  O’Connor, Anahad (February 3, 2015).  “New York Attorney General Targets Supplements at Major Retailers.” NYTimes Well Blogs. Retrieved October 25, 2015.

8.^ “Beware of Fraudulent Dietary Supplements” FDA.fgov.  Retrieved October 26, 2015.

9.^ “Melatonin Background” MayoClinic.org. Retrieved October 26, 2015.

10.^ Theobald, Mikel. “The Risky Side of Weight Loss Drugs: Disrupting Heart Rhythm.”  EverydayHealth.com.  Retrieved October 26, 2015.

What You Should Know About Psoriasis and Heart Disease

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Psoriasis Skin Disease May Lead to Heart Disease – Study Shows

[fair warning, this article contains some images that may not be for the faint of heart]

People with a rash and skin patch usually believe they have a simple allergy case on their hands. These breakouts which they call “allergies” begin to pile up in crusts and disrupt daily activities, worse, affect how you see yourself. This is typical of Psoriasis – a skin disease that you won’t notice until it actually grows on you. Worst case scenario you get a heart attack out of it. Can you imagine? How can a simple skin disease stop the beating of your heart?

Stop itching. Get to Thinking. Be Aware!

The HealthDay News reported a developing study which focuses on how the skin disorder of psoriasis is linked to generating heart disease in a person, particularly, erupting artery inflammation.

An investigatory study, headed by Dr. Nehal Mehta, senior clinical investigator of U.S. National Heart, Lung, and Blood Institute found that even the mildest form of psoriasis may increase a persons’ risk of stroke or heart attack [1].

“As the amount of psoriasis plaque increases, the amount of blood vessel inflammation increases,” reported by Mehta.

He also added that even just a single patch or plaque of psoriasis could be biologically active. This leads to the development of a low-form inflammation. With such inflammation, the blood vessel disease speeds up[1].

With that being said, he emphasized that people should really get to know what psoriasis is and get rid of the mentality that it is just a simple cosmetic disease [1].

Before reviewing the study, let us take you on a quick tour on the nature of Psoriasis.

The Skin Disease – PSORIASIS

The National Psoriasis Foundation defines Psoriasis as an autoimmune disease which result in red, raised, scaly patches appearing on your skin. This kind of rash doesn’t easily go away with simple over-the-counter medications [2].

How do you get it?

Psoriasis is associated with some serious health conditions, including: heart disease, diabetes and depression. But with its autoimmune nature, scientists have linked it to a person’s genes and immune system [3].

The flaring of such psoriatic patches are triggered by stress, infection, injury to the skin, medications (Lithium, Quinidine, Antimalarials, Inderal, Indomethacin), allergies, diet and even the weather[3].  These triggers result in the rapid turnover of skin cells resulting in the classical silver plaque like psoriasis lesion.

How popular is Psoriasis?

The National Psoriasis Foundation reports that Psoriasis usually develops between the ages of 15 to 35,  however, can develop at any age. Children are not immune either, there is a 10% to 15% that a child will manifest before the age of 10 [3].

There is a 1.3% incidence of Psoriasis in the African-American population and a 2.5% incidence in the Caucasian population. Men and women develop psoriasis at an equal rates [3].

Worldwide view, psoriasis is known to affect 2% of the population [4].

Despite its small scope worldwide, you may be amazed to know that it has affected 250,000 people in the United States alone [5],  accounting for 2.2% of the American population [6].  Psoriasis accounts 2.25 million annual ambulatory clinic visits [7].

Psoriasis in Pop Culture

Cara Delevingne by Walterlan Papetti“Cara Delevingne kate moss mario testino (cropped)” by Walterlan Papetti – Own work. Licensed under CC BY-SA 4.0 via Commons.

The stunning model and actress Cara Delevingne struggles with the management of her psoriasis and the high-pressure world of fashion.  Delevingne told the Times of London, “People would put on gloves and not want to touch me because they thought it was, like, leprosy or something.” She once had to wake up at 3 a.m. before modeling in the Louis Vuitton show to have her patches covered with body paint. “It wasn’t a good time… it is a mental thing as well because if you hate yourself and your body and the way you look, it just gets worse and worse.” She is currently taking a break from modeling to help manage her flares.

Where does it grow?

Psoriasis manifests on knees, elbows or scalp areas,  however can develop pretty much anywhere. Apart from the patches, other symptoms include stinging, burning and itching [1]. A more specific perspective on each body part is given below.

  • Scalp Psoriasis

Causes fine, mild and slight scaling. However, a severe case can bring forth thick, crusted plaques which covers the entire scalp. Lesions can even extend beyond the hairline to the back of the neck, ears, and forehead.

  • Facial Psoriasis

Usually seen on eyebrows, skin between upper lip and nose, hairline and upper forehead. This type of psoriasis is treated carefully as skin on the face is considered to be the most sensitive.

  • Psoriasis on the Hands, Nails and Feet

Causes swelling, blistering and cracking flares of skin in this area.  Roughly half of the population of those with psoriasis in this area develop nail lesions and up to 80% develop psoriatic arthritis [1].

  • Skin Folds Psoriasis

These lesions cause the most discomfort and irritation (e.g. under the breasts, armpits) [1].

  • Psoriasis of the Genitalia

Inverse psoriasis are the most common type of lesions to develop in this area,  however, other types of lesions can also cause symptoms, mostly in male genitalia. [1].

What Psoriasis do you have?

The National Psoriasis Foundation lists five types of psoriasis [1], described below:.

  • Plaque

plaque

What?

This is most common form of Psoriasis. It is usually red in color & raised with patches of silvery white covering the skin. This buildup is the result of dead skin cells.

Where?

Such patches are commonly seen in the following areas: lower back, elbows, knees and scalp.

Feeling?

They are painful, itchy and usually crack up and bleed.

  • Guttate

guttate

What?

Appears as small, dot-like, red lesions. Mostly seen in childhood to young adulthood and is the second most common type of psoriasis.  Can be triggered by an upper respiratory infection or strep throat

Where?

All over the body.

Feeling?

Itchy.

 

  • Inverse

inverse

What?

Smooth,red and shiny . Usually manifests along with other types of psoriasis

Where?

This affects the skin folds –behind the knees, armpits, groin.

Feeling?

Itchy, sweaty and irritating.

 

 

  • Pustular

pustular

What?

White blisters with non-infectious pus.often surrounded by red skin. The white pus consist of white blood cells.

Where?

Most often seen on the hands or feet but can occur in any part on the body.

Feeling?

Itchy, rough

 

 

  • Erythrodermic

erythrodermic

What?

Considered to be the most severe form of psoriasis.  Occurs most commonly after episodes of plaque psoriasis.  Quite rare, but occurs in at least 3% of people with psoriasis during their lifetime.

Where?

Widespread, distributing fiery redness

Feeling?

Severe itching and pain.  Skin usually comes off in sheets.

 

How is it treated?

The National Psoriasis Foundation lists the approaches to management of Psoriasis, however each case of Psoriasis is managed differently depending on severity, location, age and type [8]. It’s best to work closely with your healthcare provider to develop an individualized treatment plan..

Systemics

Used in moderate to severe cases of psoriasis and psoriatic arthritis.  Available in injectable and oral formulations.

Biologics

Used in cases of moderate to severe psoriasis and psoriatic arthritis unresponsive to other treatments. Only available in intravenous infusion or intramuscular injection. This treatment is usually derived from living sources.

New Oral Treatments

Oral medications such as Otezla have shown the greatest promise in managing moderate to severe psoriatic arthritis and Psoriasis by regulating inflammation within the cell. It inhibits an enzyme known as phosphodiesterase 4, or PDE4. PDE4 controls much of the inflammatory action within cells, which can affect the level of inflammation associated with psoriatic disease. Improves joint tenderness and swelling in people with active psoriatic arthritis, and can improve symptoms of redness and scaliness in people with psoriasis.

Topicals

Available in cream, ointment and lotion form.  Used in mild and localized cases of psoriasis

Phototherapy

Involves exposing the skin to certain wavelengths of ultraviolet light under the supervision of a medical practitioner. Usually done in a psoriasis clinic, doctor’s office or even at home with a phototherapy unit.

The Complementary and Alternative

Involves techniques such as acupuncture, yoga, tai chi and herbal remedies to supplement traditional western medicine.

Is Psoriasis Contagious?

Psoriasis is never contagious. Plaques like lesions are considered non-infectious.

Whew! What a mouthful of information and surely, you would agree, that psoriasis is anything but a simple skin disease.

Psoriasis goes beyond skin deep and can result in inflammation of blood vessels (vasculitis)

Vasculitis – Inflammation of the blood vessels

Vasculitis, described, by the National Heart, Lung and Blood Institute, to be the condition of the inflammation in the blood vessels. Usually, this occurs because the immune system mistakenly attacks blood vessels, mistaking them for a “foreign invader”. As inflammation develops, swelling, warmth, redness, pain, and occlusion of blood vessels can manifest.

What it commonly affects?

By blood vessels that vasculitis affects include almost all. From arteries, veins, down to capillaries, the inflammation hinders their function. Your arteries carry oxygen-rich blood from the heart. The veins, on the other hand, carry oxygen-poor blood back to your beating heart. Capillaries bridge the two and allow for diffusion of oxygen.

What happens when they are inflamed?

The inflamed, narrowed blood vessel results in decreased blood flow to the affected organ – heart, brain, skin and can bring about a heart attack or stroke.

The Study

Several studies in the past have suggested an association between psoriasis and cardiovascular risk. Dr. Mehta and his team sought out to prove this association.

Dr. Mehta emphasizes the discovery between psoriasis and blood vessel inflammation is an association and never to be expected as a direct cause and effect to a person’s health condition. So, in order to give the association a deeper proof, Dr. Mehta and his team are conducting a study that would discover if treating psoriasis would aid in lowering the inflammation of a person’s blood vessels.

“Blood vessel, or vascular, inflammation is most likely the direct result of psoriasis, not treatment. Treating psoriasis may lower the risk of heart attack and stroke,” Mehta said.

A study was published in the journal of Arteriosclerosis, Thrombosis and Vascular Biology, supported the claim of Dr. Mehta, showing those with psoriasis have increased blood vessel inflammation as compared to those without.

The study grouped 80 people in their 40s with an average to low risk of heart disease. 60 of which were adults with psoriasis while 20 were without.. Those with psoriasis, the mild forms were described to have few patches covering 3% or less of their skin while those severe cases had patches which covered their skin by about 10% [10].

The researchers revealed that the participants with psoriasis were found to have increased levels of blood vessel inflammation – A 41% increased in blood vessel inflammation was seen in participants with psoriasis as compared to those without.

Such evidences suggests proper treatment of psoriasis may lower the risk of heart conditions. Even the research program director of the National Psoriasis Foundation, Michael Siegel believes so with this statement,

“Even mild psoriasis carries a risk for heart problem. Although it is not yet proven that treating psoriasis reduces the risk of heart attack and stroke, there is enough evidence to suggest that patients should have their disease treated.”

Hence, it is advisable that people with psoriasis should focus on changing few of their lifestyles. Mehta recommends that psoriasis patients should avoid smoking and try to incorporate a healthy lifestyle through moderate exercise and a healthy well-balanced diet.  Comorbidities such as hypertension, diabetes, and elevated cholesterol should be controlled as well.

Now you have a clear preview on how managing such a “simple” disease condition can potentially protect you from having a graver disease condition.  So, if you get a little itch or rash be sure to get checked out!  You might  actually save your life in the long run.

SOURCES:

  1. Nehal Mehta, M.D., clinical investigator, U.S. National Heart, Lung, and Blood Institute;
  1. National Psoriasis Foundation, About Psoriasis, online
  1. National Psoriasis Foundation, Causes and Triggers, online.
  1. Raychaudhuri SP, Farber EM. The prevalence of psoriasis in the world. J Eur Acad Dermatol Venereol. 2001;15:16–17. doi: 10.1046/j.1468-3083.2001.00192.x.
  1. Lebwohl M. Psoriasis. Lancet. 2003;361:1197–1204. doi: 10.1016/S0140-6736(03)12954-6.
  1. Stern RS, Nijsten T, Feldman SR, Margolis DJ, Rolstad T. Psoriasis is common, carries a substantial burden even when not extensive, and is associated with widespread treatment dissatisfaction. J Investig Dermatol Symp Proc. 2004;9:136–9. doi: 10.1046/j.1087-0024.2003.09102.x.
  1. Linden KG, Weinstein GD. Psoriasis: current perspectives with an emphasis on treatment. Am J Med.1999;107:595–605. doi: 10.1016/S0002-9343(99)00284-3.
  1. National Psoriasis Foundation, Treatments,
  1. National Heart, Lung and Blood Institute, Explore Vasculitis; Sept. 23, 2014, What is Vasculitis,
  1. Michael Siegel, Ph.D., director, research programs, National Psoriasis Foundation; Oct. 8, 2015,Arteriosclerosis, Thrombosis and Vascular Biology, online;

What You Should Know About Kidney Stones

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Human kidney magnification from a body as a medical diagram with a cross section of the inner organ with red and blue arteries and adrenal gland as a health care illustration of the anatomy of the urinary system.

Human kidney magnification from a body as a medical diagram with a cross section of the inner organ with red and blue arteries and adrenal gland as a health care illustration of the anatomy of the urinary system.

What is a kidney stone?

A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract. Kidney stones are a common cause of blood in the urine (hematuria) and often severe pain in the abdomen, flank, or groin. Kidney stones are sometimes called renal calculi.

The condition of having kidney stones is termed nephrolithiasis. Having stones at any location in the urinary tract is referred to as urolithiasis, and the term ureterolithiasis is used to refer to stones located in the ureters.

What are the signs and symptoms of kidney stones?

While some kidney stones may not produce symptoms (known as “silent” stones), people who have kidney stones often report the sudden onset of excruciating, cramping pain in their low back and/or side, groin, or abdomen. Changes in body position do not relieve this pain. The abdominal, groin, and/or back pain typically waxes and wanes in severity, characteristic of colicky pain (the pain is sometimes referred to as renal colic). It may be so severe that it is often accompanied by nausea and vomiting. The pain has been described by many as the worst pain of their lives, even worse than the pain of childbirth or broken bones. Kidney stones also characteristically cause bloody urine. If infection is present in the urinary tract along with the stones, there may be fever and chills. Sometimes, symptoms such as difficulty urinating, urinary urgency, penile pain, or testicular pain may occur due to kidney stones.

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If you see or experience emergency symptoms, head to:

Highland Park Emergency Room

5150 Lemmon Ave. Suite #108

call us at 972-268-6346

or

Preston Hollow Emergency Room

8007 Walnut Hill Lane

call us at 214-217-0911

A free-standing emergency room right in your neighborhood. We are open 24-hours a day — the only no-wait emergency rooms around. An emergency room physician can see you quickly, evaluate your condition, and take steps to alleviate your symptoms immediately. If appropriate, they will admit you to the hospital if needed.

Phases of Migraine Headaches

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Migraine

About 1 out of 8 Americans has migraines. They usually begin during the teenage years. After puberty, migraines are more likely to affect girls and women. Experts still aren’t sure what causes these headaches. But they seem to involve a wave of unusual activity in brain nerve cells, along with changes in blood flow in the brain. Though migraines can trigger severe pain in the head, they aren’t simply headaches. They often also cause other uncomfortable symptoms, such as: Nausea, Vomiting and unusual sensitivity to light, noises, and smells.

A migraine episode can be a complicated event, with symptoms that change over hours or even days. Migraines tend to progress through several stages:

  • Prodromal phase before the migraine
  • Aura phase
  • Attack phase
  • Postdromal phase after the migraine

Prodromal Phase: Early Warning Signs

Several hours before the migraine begins — and sometimes even the day before — many people with migraines notice unusual sensations. They may feel: Either unusually energetic and excitable or depressed, Irritable, Thirsty, craving for certain foods, sleepy with frequent yawning, Need to urinate more.

In some cases, these symptoms before the headache can help health care providers diagnose the problem as migraines.

Aura Phase: Strange Sensations Arise

About 1 in 5 people with migraine develop an “aura” that begins before the headache or starts along with it. An aura may not occur with every headache. An aura can include:

Changes in vision. Often visual symptoms begin first during the aura phase. During a migraine you may experience these vision changes:

  • A flickering, jagged arc of light. This may take a complicated shape. It usually appears on the left or right side of your vision. Over a few minutes, it may spread in size.
  • An area of vision loss. This problem — combined with the flickering lights — can make driving or focusing your eyes on small objects difficult.
  • “See” images from the past or hallucinations.

These symptoms may continue to grow more severe over the next several minutes.

Skin sensations. This part of the aura may cause tingling or “pins and needles” sensations in the body. It may also cause numbness. These feelings often affect the face and hands but can spread out across the body. The sensations may continue to expand over the next several minutes.

Language problems. During the aura phase of a migraine, you may have trouble communicating with others. Symptoms may include:

  • Difficulty expressing thoughts while speaking or writing
  • Trouble understanding spoken or written words
  • Confusion
  • Trouble concentrating

Attack Phase: The Headache Begins

The attack portion of a migraine episode can last for a few hours to several days. During this phase of the migraine, the person usually wants to rest quietly and finds normal activities difficult.

A defining quality of migraines is their pain. The pain of a migraine:

Usually begins above the eyes

Typically affects one side of the head, but it may strike the entire head or      move from one side to the other. It may also affect the lower face and the neck.

  • Tends to have a throbbing intensity
  • May throb worse during physical activity or when you lean forward
  • May get worse if you become physically active
  • Other symptoms that may arise during this phase include:Continue reading below…
  • Unusual sensitivity to light, sounds, and smells
  • Light-headedness and fainting
  • Nausea and vomiting

Postdromal Phase: After the Storm

Following the most severe phase of the migraine, you may not feel well for up to a day. Symptoms of this post-migraine phase may include:

  • Extreme tiredness
  • Sluggishness
  • Confusion
  • Head pain that flares up when you lean over, move quickly, or experience a rush of blood to the head

Your overall experience with migraines may change over time. They can change in frequency or severity, and attacks may not always include all of these stages. Also, you may eventually develop the migraine aura without actually having a headache.

WebMD Medical Reference 01/06/2015

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If you see or experience emergency symptoms, head to:

Highland Park Emergency Room

5150 Lemmon Ave. Suite #108

call us at 972-268-6346

or

Preston Hollow Emergency Room

8007 Walnut Hill Lane

call us at 214-217-0911

A free-standing emergency room right in your neighborhood. We are open 24-hours a day — the only no-wait emergency rooms around. An emergency room physician can see you quickly, evaluate your condition, and take steps to alleviate your symptoms immediately. If appropriate, they will admit you to the hospital if needed.

What is Epigastric Pain and When should I be Concerned?

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Epigastric PainEpigastric pain is pain that is localized to the region of the upper abdomen immediately below the ribs. Often, those who experience this type of pain feel it during or right after eating or if they lie down too soon after eating. It is a common symptom of gastroesophageal reflux disease (GERD) or heartburn.

Some people have mild epigastric pain that occurs after eating and subsides quickly, while others may have a severe burning feeling in the abdomen, chest and neck that prevents sleep. Other symptoms that may accompany epigastric pain include abdominal bloating, constipation, diarrhea, and vomiting, depending on the underlying cause. In rare cases, epigastric pain is due to heart conditions such as heart attack and angina (chest pain due to the heart not getting enough oxygen).

Epigastric pain is not a serious symptom on its own. However, if it occurs with other life-threatening symptoms, it may be a sign of a condition that should receive immediate medical treatment, such as a heart attack. Seek immediate medical care (call 911) if you, or someone you are with, experience epigastric pain along with life-threatening symptoms such as severe breathing problems; chest pain, pressure or tightness; or vomiting blood or black material.

Seek prompt medical care if you are being treated for epigastric pain but mild symptoms recur or are persistent.

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If you see or experience emergency symptoms, head to:

Highland Park Emergency Room

5150 Lemmon Ave. Suite #108

call us at 972-268-6346

or

Preston Hollow Emergency Room

8007 Walnut Hill Lane

call us at 214-217-0911

A free-standing emergency room right in your neighborhood. We are open 24-hours a day — the only no-wait emergency rooms around. An emergency room physician can see you quickly, evaluate your condition, and take steps to alleviate your symptoms immediately. If appropriate, they will admit you to the hospital if needed.

How to Prevent Pneumonia

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Depositphotos_12823191_l-2015-300x199Pneumonia is an infection of the lungs that can cause mild to severe illness in people of all ages. It is the leading cause of death in children younger than 5 years of age worldwide. However, these infections can often be prevented with vaccines and can usually be treated with antibiotics, antiviral drugs (such as Tamiflu), or specific drug therapies. Common signs of pneumonia include cough, fever, and difficulty breathing. You are more likely to become ill with pneumonia if you smoke or have underlying medical conditions, such as diabetes or heart disease. However, you can lower your chances by taking good care of your medical problems, and quitting smoking . You can also help prevent pneumonia and other respiratory infections by following good hygiene practices, such and washing your hands regularly and disinfecting frequently touched surfaces.

 

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If you see or experience emergency symptoms, head to:

Highland Park Emergency Room

5150 Lemmon Ave. Suite #108

call us at 972-268-6346

or

Preston Hollow Emergency Room

8007 Walnut Hill Lane

call us at 214-217-0911

A free-standing emergency room right in your neighborhood. We are open 24-hours a day — the only no-wait emergency rooms around. An emergency room physician can see you quickly, evaluate your condition, and take steps to alleviate your symptoms immediately. If appropriate, they will admit you to the hospital if needed.

How to Ease Your Stomach After Eating Too Much

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Human kidney magnification from a body as a medical diagram with a cross section of the inner organ with red and blue arteries and adrenal gland as a health care illustration of the anatomy of the urinary system. Human kidney magnification from a body as a medical diagram with a cross section of the inner organ with red and blue arteries and adrenal gland as a health care illustration of the anatomy of the urinary system.[/caption]

Six in 10 Americans state they eat more than they should, which can mean you consume more calories than you need and feel painfully full. This often occurs at large gatherings, such as Thanksgiving, when you are surrounded by loads of delicious food, and you and your family and friends eat plates stacked high with food. Whatever the occasion, an overstuffed stomach is downright uncomfortable. You don’t have to wait hours until you digest but can try simple home remedies to quell your bloated belly.

Remedies:

Tea: While you may not want to put anything in your stomach after overeating, try to sip on certain teas. Integrative and Sports Nutritionist Beth McDonald recommends caffeine-free, chicory-root tea, which can settle down your mood and your stomach. This roasted coffee-flavored tea promotes movement of food through your digestive tract. If you don’t like coffee flavors, opt for chamomile tea, which has a similar therapeutic effect.

Peppermint: Peppermint naturally relieves gas, indigestion and nausea. Avoid it if you suffer from acid reflux, Avoid it if you suffer from acid reflux, though. Peppermint relaxes the opening between your stomach and esophagus, enabling stomach acid to flow back upward. Otherwise, feel free to enjoy a cup of peppermint tea or stick of peppermint gum.

Exercise: You may be tempted to crash on the couch with a belly food of food, but motivate yourself to go for a short walk. A walk after eating, even a slow stroll, promotes healthy digestion. By standing and moving around, you also prevent acid reflux because gravity stops stomach juices from coming back up and causing heartburn. Dr. Matthew Edlund, in “Psychology Today,” states walking helps to balance blood sugar levels, thereby preventing type 2 diabetes. If you walk after dinner, you also can cut down on belly fat.

 

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If you see or experience emergency symptoms, head to:

Highland Park Emergency Room

5150 Lemmon Ave. Suite #108

call us at 972-268-6346

or

Preston Hollow Emergency Room

8007 Walnut Hill Lane

call us at 214-217-0911

A free-standing emergency room right in your neighborhood. We are open 24-hours a day — the only no-wait emergency rooms around. An emergency room physician can see you quickly, evaluate your condition, and take steps to alleviate your symptoms immediately. If appropriate, they will admit you to the hospital if needed.