Pisgah Family Health News

November 2011

Office News

Medical News

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www.PisgahFamilyHealth.com/

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Office News

New Medical Staff

Melissa AlishaMoore (36K)

Melissa Martinez, PA-C is now practicing at Pisgah Family Health. Melissa practiced Internal Medicine and Geriatrics in Florida before moving to Asheville in 2006.

Melissa will be seeing patients will all types of problems, from urgent care to physical exams. She is bilingual, and looks forward to getting to know our Spanish speaking patients. We encourage our female patients to consider Melissa for their gynecologic care.

Alisha Moore is a Certified Medical Assistant who began working at Pisgah Family Health in September. She is greeting patients, taking medical histories, drawing labs, and doing procedures.

Happy Thanksgiving!

PFH Staff at Halloween

Happy Thanksgiving (and a late Halloween) from the staff of Pisgah Family Health.

Kyle Harris

Congratulations to Kyle Harris, who correctly guessed our pumpkin's weight at 69 pounds. Kyle will enjoy a free pumpkin pie this Thanksgiving.

New Website

Thanks to Christina Papandrea, who created our new website design. Be sure to check it out at www.PisgahFamilyHealth.com.

Christina is a recent UNCA grad with a degree in web design, and is eager to expand her business. She does excellent work at very reasonable rates. If you need web design work, please contact her at christinap@kinacreates.com. View her other work at http://www.kinacreates.com.

Office Hours

We are proud to announce our expanded office hours!

Our office hours are now 8:30-5pm Monday through Friday.   When the office is closed, emergency care is available at the Urgent Care Centers and Mission Hospital ER.  Our answering service can be reached after hours at 251-4873.   Telephone calls are handled by Dr. Curran’s call partners.

  • We will be closed November 24-25 for Thanksgiving.
  • We will be closed December 23-26 for Christmas.
  • We will be closed December 30 for the New Year's Holiday.

Office Reminders

We have only 30 flu shots left. Come to the office immediately if you want to get a flu vaccine this year.

Please notify our office if you have a new mailing address or phone number.

Please bring your medications to each visit. Dr Curran will review your medication bottles to keep our list up to date.

Health Privacy Law states that we can not release any of your information without your written consent. Please let us know if you would like to authorize us to release information to your spouse or a family member.

We now have a new billing company: Current Medical Services, 596 W Main St, Sylva, NC. The phone number is 855-226-5772. You will notice a new billing statement as well as local contact information for billing questions.


Medical News

Flu Shots

Pisgah Family Health has fewer than 30 flu shots left. Now is the time to get your influenza vaccine! If you want to prevent influenza this winter, come get your shot immediately.

The flu vaccine is recommended for everyone over 6 months of age. Infants and the elderly are at highest risk of influenza complications. Also at high risk are adults with asthma, COPD, heart conditions, or pregnancy.

Flu shots are most useful when given in October or November, to prevent the seasonal flu which occurs each winter. This year's flu shot is similar to last year's, containing both H1N1 and seasonal influenza vaccinations.

What is seasonal influenza?

Influenza, commonly called "The Flu," is caused by influenza viruses which infect the respiratory tract (i.e., the nose, throat, lungs). Unlike many other viral respiratory infections, such as the common cold, influenza can cause severe illness or life-threatening complications in many people. The best way to prevent seasonal flu is by getting a flu vaccination each year.

In the United States, on average 5% to 20% of the population gets the flu each year. More than 200,000 people are hospitalized annually from seasonal flu-related complications, and about 36,000 people die from seasonal flu-related causes.

What are the symptoms of the flu?

Influenza is a respiratory illness. People who have the flu often feel these symptoms:

  • Fever and chills
  • Muscle or body aches
  • Headaches
  • Fatigue
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Some people may have vomiting and diarrhea. This is more common in children.

http://www.cdc.gov/flu/

COPD and Emphysema

Emphysema (119K)

Chronic Obstructive Pulmonary Disease (COPD) is one of the most common lung diseases. It makes it difficult to breathe. There are two main forms of COPD - Chronic Bronchitis, which involves a long-term cough with mucus, and Emphysema, which involves destruction of the lungs over time. Most people with COPD have a combination of both conditions.

Causes, incidence, and risk factors

Smoking is the leading cause of COPD. The more a person smokes, the more likely that person will develop COPD. In rare cases, nonsmokers who lack a protein called alpha-1 antitrypsin can develop emphysema. Other risk factors for COPD are:

  • Exposure to certain gases or fumes in the workplace
  • Exposure to heavy amounts of secondhand smoke and pollution
  • Frequent use of cooking fire without proper ventilation

Symptoms

Because the symptoms of COPD develop slowly, some people may not know that they are sick.

  • Cough, with or without mucus
  • Fatigue
  • Many respiratory infections
  • Shortness of breath that gets worse with mild activity
  • Trouble catching one's breath
  • Wheezing

Signs and tests

Spirometry (91K)

The best test for COPD is a lung function test called spirometry. This involves blowing out as hard as possible into a small machine that tests lung capacity. The results can be checked right away, and the test does not involve exercising, drawing blood, or exposure to radiation.

Listening to the lungs with a stethoscope can also be helpful. However, sometimes the lungs sound normal even when COPD is present.

Imaging the lungs (such as x-rays and CT scans) can be helpful, but sometimes look normal even when a person has COPD (especially chest x-ray).

Sometimes patients need to have a blood test (called arterial blood gas) to measure the amounts of oxygen and carbon dioxide in the blood.

Treatment

There is no cure for COPD. However, there are many things you can do to relieve symptoms and keep the disease from getting worse.

Persons with COPD MUST stop smoking. This is the best way to slow down the lung damage.

Medications used to treat COPD include:

  • Inhaled Bronchodilators open the airways, such as albuterol, ipratropium (Atrovent), tiotropium (Spiriva), salmeterol (Serevent), formoterol.
  • Inhaled steroids to reduce lung inflammation
  • Anti-inflammatory medications such as montelukast (Singulair) and roflimulast are sometimes used

In severe cases or during flare-ups, you may need to receive:

  • Steroids by mouth or through a vein (intravenously)
  • Bronchodilators through a nebulizer
  • Oxygen therapy
  • Assistance during breathing from a machine (through a mask, BiPAP, or endotracheal tube)
  • Antibiotics are prescribed during symptom flare-ups, because infections can make COPD worse.

You may need oxygen therapy at home if you have a low level of oxygen in your blood.

Pulmonary rehabilitation does not cure the lung disease, but it can teach you to breathe in a different way so you can stay active. Exercise can help maintain muscle strength in the legs.

Walk to build up strength.

  • Ask the doctor or therapist how far to walk.
  • Slowly increase how far you walk.
  • Try not to talk when you walk if you get short of breath.
  • Use pursed lip breathing when breathing out

Things you can do to make it easier for yourself around the home include:

  • Avoid very cold air
  • Make sure no one smokes in your home
  • Reduce air pollution by getting rid of fireplace smoke and other irritants
  • Eat a healthy diet with fish, poultry, or lean meat, as well as fruits and vegetables.
  • If it is hard to keep your weight up, talk to a doctor or dietitian about eating foods with more calories.

Expectations

COPD is a long-term (chronic) illness. The disease will get worse more quickly if you do not stop smoking.

Patients with severe COPD will be short of breath with most activities and will be admitted to the hospital more often. These patients should talk with their doctor about breathing machines and end-of-life care.

Complications

  • Irregular heartbeat (arrhythmia)
  • Need for breathing machine and oxygen therapy
  • Right-sided heart failure or cor pulmonale
  • Pneumonia
  • Pneumothorax
  • Severe weight loss and malnutrition
  • Thinning of the bones (osteoporosis)

Prevention

Not smoking prevents most COPD. Ask your doctor or health care provider about quit-smoking programs. Medicines are also available to help kick the smoking habit. The medicines are most effective if you are motivated to quit.

Learn more at these sites:

Health Links

For local health events, check out these links:

A few of the most-trusted health information links:

  • WebMD.com A web service with health advice on hundreds of topics.
  • FamilyDoctor.org Patient-oriented information from the American Academy of Family Physicians.
  • CDC.gov The Center for Disease Control features credible information on almost every health topic.

About our Newsletter

Dr. Curran and the staff at Pisgah Family Health are proud to publish the Pisgah Family Health News to our patients.  Our goal is to provide regularly updated information about the office and current medical topics.  We plan to publish a new issue each quarter with breaking news.  The newsletters will also be archived on our website, http://www.pisgahfamilyhealth.com/

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