Pisgah Family Health News

February 2012

Office News

Medical News

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Office News

Heartstrings for Project Access

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The staff of Pisgah Family Health has signed up to participate in the Heartstrings 2012 fundraiser for Project Access. We will be exercising at the Asheville Mall on February 12, with other supporters. Please help us raise money for Project Access, by stopping by the office and making a donation.

Western Caroina Medical Society Project Access™ is a coordinated system of charity medical care provided to low-income uninsured people of Buncombe County. Services are donated by local physicians and Mission Hospital. Supplies are donated through Advanced Home Care. In addition, area pharmacies waive part of their charges and professionals such as interpreters and chiropractors donate their services.

Learn more at http://www.mywcms.org/HeartStrings2012

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.

  • Dr Curran will be out of the office April 2-6.
  • Melissa Martinez, PA-C will be here April 2-5 for patient care.
  • Pisgah Family Health will be closed April 6th for Good Friday.

Office Reminders

Please bring your medications to each visit. This helps us treat you safely, and make your refills in a timely fashion.

To protect your privacy, we will not release any of your medical 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.

Effective 10/1/11, we have a new billing company: Current Medical Services, 596 W Main St, Sylva, NC, phone # 855 226-5772.

If you have been seen both before and after October 1, 2011, you will receive a statement from both our new billing company as well as our previous billing company; Raleigh Durham Medical Group.


Medical News

February is Healthy Heart Month

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Cardiovascular disease remains the biggest killer of Americans. More men and women die of heart disease than of all cancers combined. February is the month to evaluate your own cardiovascular risk factors, and begin to reduce your personal risk. Not all heart disease can be prevented, and not all risk factors can be changed. However, by knowing your personal risks, you can begin to take control of your own health.

Cardiovascular Risk Factors include:

  • Age over 40 for men
  • Age over 50 for women
  • Smoking
  • High Cholesterol
  • Sedentary lifestyle
  • Hypertension
  • Diabetes
  • Family history of cardiovascular disease

Friday, February 3rd is National Wear Red Day

National Wear Red Day is a day to raise awareness of heart disease in women. Many people mistakenly think heart disease is only a man's disease. However, heart disease kills more women than all cancers combined, Heart disease and stroke are highly preventable diseases that can affect ANYONE.

Learn your cardiac risks today, and begin the process of reducing your risk of heart disease.

Most women don't think about heart disease until it is too late. Remember that women often have more subtle signs of heart attack. Heart attack symptoms can include:

  • Chest pain
  • Pain in the neck, arm, or back
  • Sudden weakness
  • Dizziness or Fainting
  • Arm numbness
  • Sudden sweating
  • Anxiety

Learn more at www.goredforwomen.org/

Know the signs of a heart attack

Some heart attacks are sudden and intense, with an obvious chest pain. But most heart attacks start slowly, with mild pain or discomfort. Often people aren't sure what's wrong and wait too long before getting help.

If you think you might be having a heart attack, immediately call 9-1-1 so an ambulance can be sent for you. The most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Learn the signs, but remember this: Even if you're not sure it's a heart attack, have it checked out. Minutes matter! Fast action can save lives — maybe your own. Don’t wait more than five minutes to call 9-1-1.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. EMS staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too. It is best to call EMS for rapid transport to the emergency room.

Learn more at http://video.about.com/heartdisease/Heart-Attack.htm
and http://www.medicinenet.com/heart_disease_pictures_slideshow_visual_guide/article.htm

Know how to respond to Cardiac Arrest

Cardiac arrest is reversible in most victims if it's treated within a few minutes. Before the development of cardiac defribrillators, heart attack victims had a 30 percent chance of dying if they got to the hospital alive; 50 percent of these deaths were due to cardiac arrest. In-hospital survival after cardiac arrest in heart attack patients improved dramatically when the DC defibrillator and bedside monitoring were developed. Later, it also became clear that cardiac arrest could be reversed outside a hospital by properly staffed emergency rescue teams trained to give CPR and defibrillate.

Signs of cardiac arrest: It strikes suddenly and without warning.

  • Sudden loss of responsiveness
    No response to tapping on shoulders
    Does nothing when you ask if he is okay
  • No normal breathing
    The victim does not take a normal breath when you tilt the head up
    Check for at least five seconds

If these signs of cardiac arrest are present:

  • Call 9-1-1 for emergency medical services.
  • Get an automated external defibrillator (AED). Use the AED as soon as it arrives.
  • Begin CPR immediately. Continue until professional emergency medical services arrive
  • If two people are available to help, one should begin CPR immediately while the other calls 9-1-1 and finds an AED.

Immediate treatment is essential to survival of cardiac arrest. The problem isn't whether cardiac arrest can be reversed but reaching the victim in time to do so. The American Heart Association supports implementing a "chain of survival" to rescue people who suffer cardiac arrest. The chain consists of:

  • Early recognition of the emergency and activation of the emergency medical services (EMS).
  • Early defibrillation when indicated.
  • Early bystander CPR (cardiopulmonary resuscitation).
  • Early advanced life support followed by postresuscitation care delivered by healthcare providers

Sources: www.heart.org newsroom and www.heart.org

Cervical Cancer Prevention

Cervical cancer used to be the leading cause of cancer death for women in the United States. However, in the past 40 years, the number of cases of cervical cancer and the number of deaths from cervical cancer have decreased significantly. Because of the Pap smear test, the number of deaths from cervical cancer has dropped by 90%.

Cervical cancer is one of the most preventable types of cancer. However, many women still develop cervical cancer. In fact, over 12,000 women in the U.S. develop cervical cancer every year.

While some cases of cervical cancer cannot be prevented, there are many things a woman can do to reduce her risk of developing cervical cancer.

How to Reduce Your Risk of Cervical Cancer

  1. Get a regular Pap smear.
    The Pap smear can be the greatest defenses for cervical cancer. The Pap smear can detect cervical changes early before they turn into cancer. Check cervical cancer screening guidelines to find out how often you should have a Pap smear, or check with your doctor.
  2. Limit the amount of sexual partners you have.
    Studies have shown women who have many sexual partners increase their risk for cervical cancer. They also are increasing their risk of developing HPV, a known cause for cervical cancer.
  3. Quit smoking or avoid secondhand smoke.
    Smoking cigarettes increases your risk of developing many cancers, including cervical cancer. Smoking combined with an HPV infection can actually accelerate cervical dysplasia. Your best bet is to kick the habit.
  4. If you are sexually active, use a condom.
    Having unprotected sex puts you at risk for HIV and other STD's which can increase your risk factor for developing cervical cancer.
  5. Follow up on abnormal Pap smears.
    If you have had an abnormal Pap smear, it is important to follow up with regular Pap smears or colposcopies, whatever your doctor has decided for you. If you have been treated for cervical dysplasia, you still need to follow up with Pap smears or colposcopies. Dysplasia can return and when undetected, can turn into cervical cancer.
  6. Get the HPV vaccine.
    If you are under 27, you may be eligible to receive the HPV vaccine, which prevents high risk strains of HPV in women. The HPV vaccine, Gardasil, was approved by the FDA to give to young girls as young as 9. The vaccine is most effective when given to young women before they become sexually active.

Source: http://cancer.about.com/
For more information, visit: http://www.cdc.gov/cancer/cervical/index.htm
For information on pap smears visit: http://www.cancer.gov/cancertopics/understandingcervicalchanges

Statins

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Recently the statin drugs (simvastatin and Lipitor) have come under much scrutiny. These drugs are extremently useful for lowering cholesterol and reducing cardiac events. However, in some patients they can cause muscle pains, fatigue, and liver irritation. New data also show they may slightly increase the risk of developing diabetes. For this reason, lab monitoring is needed for all patients taking these drugs.

Here are some more details about the statins.

The strongest doses of cholesterol-lowering statin medications prevent heart attacks and strokes in patients with cardiovascular disease, but they may also modestly increase the risk of developing type 2 diabetes, a new study shows. The study, a re-analysis of five clinical trials representing nearly 33,000 patients, found that the risk of developing type 2 diabetes increased slightly in patients who were on the most aggressive statin regimens compared to those on less powerful statin doses.

For every 498 patients who took high-dose statins for one year, there was one extra case of diabetes.

At the same time, however, the medications prevented one cardiovascular event such as a heart attack or stroke for every 155 people who took them.

“We found that for every one extra case of diabetes associated with this intensive statin use, you’d prevent approximately three people from having a major cardiovascular event,” says study researcher David Preiss, MRCP, a clinical research fellow at the British Heart Foundation Glasgow Cardiovascular Research Center at the University of Glasgow, in Scotland.

“We’re certainly not saying that people shouldn’t be taking a high-dose statin,” Preiss says. “If you’re somebody who’s at high risk of an event, it’s definitely favorable for you, but what you should be doing is every once in a while getting checked for diabetes.”

The new paper, which is published in the Journal of the American Medical Association, echoes two previous studies that noted an increased risk of type 2 diabetes in patients taking statins compared to those on a placebo.

“The evidence is strong that high doses of statins do slightly increase the risk of diagnosis of diabetes,” says Steven Nissen, MD, a cardiologist who is chair of the department of cardiovascular medicine at Cleveland Clinic, in Ohio. “However, the evidence is equally strong that patients on high doses have a reduction in cardiovascular events.”

Source: http://www.theheart.org/article/1047959.do
and http://diabetes.webmd.com/news/20110621/high-dose-statins-may-increase-diabetes-risk

Actos

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If you've watched television lately, chances are you've seen ads by lawyers targeting Actos. If you take this drug for diabetes, please don't be alarmed, but consult your physician for more details. Actos remains a viable option for treatment of diabetes, as long as you understand the risks and benefits of treatment.

June 16, 2011 -- The FDA has issued a new warning of increased bladder cancer risk associated with use of the diabetes drug Actos (pioglitazone).

The warning comes after a review of data from a five-year analysis of an ongoing study of Actos by the manufacturer, Takeda Pharmaceuticals.

The results show that although there was no increased risk of bladder cancer among Actos users overall, there was an increased risk of bladder cancer among those who had used the drug the longest. There was also a greater risk of bladder cancer among Actos users who had been exposed to the highest cumulative dose of the drug.

The baseline risk for bladder cancer is 7/10,000. In this study, long term Actos users had a bladder cancer risk of 10/10,000. This represents a roughly 40% increase from baseline.

Officials say information about this risk will be added to the label of the drug as well as the patient medication guide.

FDA officials say in light of this new information, Actos should not be prescribed to people with bladder cancer or people with a history of bladder cancer.

The FDA says people currently taking Actos should continue taking it until advised otherwise by their health professional. Those who are concerned about the possible risk of bladder cancer should talk to their health care provider.

Source: http://www.webmd.com/
and http://www.fda.gov/Drugs/DrugSafety/ucm259150.htm

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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