Pisgah Family Health News

August 2013

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Office News

Lindsey Bradley

Lindsey Bradley, who was working as our Medical Assistant, has been unable to work for the last 3 months, due to a medical condition. We expect Lindsey to be out indefinitely, and are hoping for her recovery.

Welcome Jessica Cole


In August, Pisgah Family Health welcomed Jessica Cole to our office. Jessica will be working full time as our medical assistant.

Jessica has been in the medical field for 7 years, with experience in both ophthalmology and family medicine. She has a wonderful husband and 3 beautiful daughters. She loves traveling, yoga, camping and most importantly spending time with her family.

PFH celebrates 9 years of practice.

Our 9th Anniversary

Pisgah Family Health recently celebrated the 9th anniversary of opening our doors. To celebrate our anniversary, Dr. Curran and the staff enjoyed a morning at the Asheville Treetops Adventure Park. This park offers a high ropes course with a variety of swinging, balancing, and zip-lining through the trees.

We look forward to many more years of providing comprehensive and caring medical care for your entire family.

Office Reminders

Are you overdue for your annual physical? Does your child need a well child check or physical to start Kindergarten or to play sports? Please call our office to schedule!

We anticipate receiving our flu vaccines in September. Call our office to schedule your flu shot for this upcoming flu season!

Please notify our office if you have a new mailing address or phone number and please present your insurance card at check in.

Bring your medication bottles to each visit. This helps us keep your medications up to date.

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.

Office Hours

Our office hours are now 8:30-5pm Monday through Friday.  If there is low demand, we will close on Friday afternoon. 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 and his call partners.

  • Pisgah Family Health will be closed Friday August 23rd for our 9th anniversary.
  • Pisgah Family Health will be closed Monday September 2nd for Labor Day.
  • Dr. Curran will be on out of the office Friday September 6th. Melissa Martinez will be here for patient care 8:30-12noon.

Medical News - Physical Exams

Child Physical Exams and Preventive Care

Happy Baby

Physical Exams

As children grow, they undergo great changes every year. That's why it is important for them to have a physical exam and preventive visit each year by a qualified professional. At this visit, we assess many aspects of a child's health, including:


We will chart a child's height, weight, and (in infants) head circumference. We will review growth curves to make sure the child is growing appropriately. We will also calculate the body mass index (BMI) to identify obesity or other weight problems.


We will assess age-appropriate developmental skills. This includes fine-motor, gross motor, language, and social skills. Through age 5, we use a scoring tool called the Ages and Stages Questionaire, which must be completed by a parent. After age 5, the evaluation is less formal.


Vaccinations are one of the most successful preventive health tools of modern medicine. Polio and Smallpox, which once ravaged young children, have been eradicated in America because of our vaccine program. Other once common illnesses, such as Measles and Mumps have been made rare by vaccines. Be sure your child gets all his/her age-appropriate vaccinations. In the first year of life, visits with vaccinations may be scheduled every 2 months. After 18 months, the primary vaccine series should be complete. Boosters are usually necessary at age 5, 12, and 18 years. For more details, visit http://www.cdc.gov/vaccines/recs/schedules/default.htm


One of the key predictors of a child's success in life is his/her academic success. We encourage children to stay in school, and achieve their highest potential. This should also include extracurricular interests such as sports, clubs, and religion.


As children age, their health and wellbeing may be affected by their lifestyle. Peer pressure and their own and choices may sometimes have a negative impact on their health. Older children face risks of violence, tobacco abuse, alcohol and drug abuse, pregnancy, and sexually transmitted illness. These risks should also be addressed at their annual physical.

Adult Physical Exams and Preventive Care

Physical Exam Supplies

Physical Exams

Adults should have a physical exam on a regular basis. The purpose of a physical exam and preventive visit is to identify medical problems before they cause illness. Your health risks will be assessed based on your age, medical history, family history, demographics, and lifestyle. Everyone should have a physical and preventive evaluation at least every 3 years. Plan an exam every year if you are:

  • over 50 or
  • taking daily medication


Your physical exam may begin at home. We will ask you to complete forms detailing your personal and family medical history. You may need to review your personal records or consult family members for this information. This will allow us to begin to assess your personal risks.


Lifestyle choices represent the greatest modifiable risks to most people's health. Smoking, drinking, lack of exercise, and poor diet account for millions of unnecessary deaths each year. At your physical you will be asked about these and other lifestyle risks. We will try to give you honest advice on how to improve your personal health risks.


Your weight and height will be recorded, and we will calculate your Body Mass Index (BMI). This helps us identify weight problems, including obesity. Obesity is the most rapidly worsening health statistic in America. It contributes to heart disease, diabetes, arthritis, cancers, and disability. We will try to give you a goal weight, and advice on how to achieve it.

The Exam

Examining the body is the basis for getting a physical. We will usually start by measuring your vitals, vision, and hearing. Be sure to bring any glasses, hearing aids, dentures, or other devices you use. The exam will include a head-to-toe exam of all parts and most organs. Family members will be asked to step out to allow for privacy. Breast exam and pelvic are included unless a woman has a separate gynecologist.

Cardiovascular Screening

This category of illness includes heart attacks, strokes, peripheral vascular disease, and aneurysms. Cardiovascular disease is the most common killer of men and women over 50. However, prevention of these diseases should begin in the 20's. Screening tools include a cardiac exam, cholesterol testing, EKG, Stress tests, and others. Cardiovascular disease can also be prevented by lifestyle measures, such as regular exercise, no smoking, and healthy diet.

Diabetes Screening

Diabetes is increasing rapidly in our country, largely due to poor diet and obesity. Screening tests can include a urinalysis or a blood sugar. These are routine parts of a physical exam.

Cancer Screening

Cancers are easiest to treat or cure if they are detected early. Most cancers increase in frequency with age. However testicular and cervical cancers are more common in young people. There is no universal test for all cancers. A variety of different screening tools for cancers are used, based on an individual's age and risks.

See the Cancer Screening Guidelines listed below.


Labs are usually done as part of a physical exam, or ordered to be done later. This may include cholesterol, blood count, kidney, liver, sugar, and thyroid tests. Certain populations may need a PSA, HIV, or other specific tests. Cholesterol testing requires fasting for 8 hours.


Vaccinations are needed less frequently by adults than children, however, there are a few vaccines to prevent illness in adults. Flu vaccine should be considered annually by people of all ages. Tetanus (TDaP) should be repeated every 5-10 years. Pneumonia and Shingles vaccines should be considered by older adults.

If your last physical was more than a year ago, you should call your doctor to make an appointment. This annual visit can improve the quality and length of your life by preventing illness.

Cancer Screening Guidelines

Cancer DNA

Cervical cancer

Women should begin cervical cancer screening at age 21, and 3 years after the first sexual intercourse. If a woman has never had intercourse, she does not need cervical cancer screening. If a woman has had her uterus removed, she does not need cervical cancer screening. Women who have had abnormal pap spears, or positive HPV tests, will require more frequent testing.

Women between ages 21 and 29 should have a Pap test every 2-3 years.

Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) every 3-5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.

Women over age 65 who have had regular cervical cancer testing with normal results should stop being tested for cervical cancer. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past age 65.

A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.

Some women – because of their health history – may need to have a different screening schedule for cervical cancer.

Breast Cancer

Breast Cancer is the second leading cause of cancer death in women, after lung cancer. The goal of screening is to detect breast cancer at its earliest stage, before it can spread or cause more harm.

Breast self-exam: Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.

Clinical breast exam: about every 3 years for women in their 20s and 30s and every year for women 40 and over.

Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.

Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRI in addition to mammograms. (The number of women who fall into this category is small: less than 2% of all the women in the US.) Talk with your doctor about your history and whether you should have additional tests at an earlier age.

Colorectal cancer

Beginning at age 50, both men and women should follow one of these testing schedules:

  • Colonoscopy every 10 years, or
  • Flexible sigmoidoscopy every 5 years, or
  • Double-contrast barium enema every 5 years, or
  • CT colonography every 5 years (often not covered by insurance), or
  • Fecal occult blood testing annually.

If you have certain risk factors, your doctor may recommend earlier or more frequent screening. Risk factors include:

  • A family history of colon cancer or colon polyps
  • A personal history of colon polyps

For more information on colorectal cancer screening, please call the American Cancer Society and ask for our document called Colorectal Cancer: Early Detection.

Lung cancer

Lung cancer is now the top cause of cancer death in America. While lung cancer is not the most common, it is the most deadly. Unfortunately, even early detection of lung cancer may not improve one's chances of survival. The best way to avoid lung cancer is to never smoke.

The American Cancer Society does not recommend screening for lung cancer in people who are at average risk of this disease. However, the ACS does have screening guidelines for individuals who are at high risk of lung cancer due to cigarette smoking. If you meet all of the following criteria then you should consider a chest Xray or chest CT scan:

  • 55 to 74 years of age
  • In fairly good health
  • Have at least a 30 pack-year smoking history AND are either still smoking or have quit smoking within the last 15 years

Prostate cancer

The American Cancer Society recommends that men make an informed decision with their doctor about whether to be tested for prostate cancer. Research has not yet proven that the benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes that men should not be tested without learning about what we know and don’t know about the risks and possible benefits of testing and treatment.

Starting at age 50, men should consider a digital rectal exam, and a PSA blood test. Frequency of testing will depend on their PSA level. Risk Factors for prostate cancer include

  • African American heritage
  • First degree relatives with prostate cancer before age 65.

Skin Cancer

Skin cancer is the most common and most easily treatable of all cancers. Skin cancer can be detected by a simple skin exam, and by a skin biopsy. All adults should have a skin-cancer screening as part of their routine physical.

Skin cancer risk is directly related to ultraviolet light exposure, and includes:

  • Caucasian (white) skin type
  • Sunburns and prolonged sun exposure
  • Use of tanning beds
  • A personal history of skin cancer.

Endometrial (uterine) cancer

The American Cancer Society recommends that at the time of menopause, all women should be told about the risks and symptoms of endometrial cancer. Women should report any unexpected bleeding or spotting to their doctors.

Some women – because of their history – may need to consider having a yearly endometrial biopsy. Please talk with your doctor about your history.

Cancer-related check-ups

For people aged 20 or older having periodic health exams, a cancer-related check-up should include health counseling and, depending on a person’s age and gender, exams for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries, as well as for some non-malignant (non-cancerous) diseases.

Take control of your health, and reduce your cancer risk.

  • Do not use tobacco.
  • Stay at a healthy weight.
  • Get moving with regular physical activity.
  • Eat plenty of fruits, vegetables, and whole grains.
  • Limit how much alcohol you drink.
  • Protect your skin from the sun.
  • Know yourself, your family history, and your risks.
  • Have regular check-ups and cancer screening tests.

For information on how to reduce your cancer risk and other questions about cancer, please call The American Cancer Society at 1-800-227-2345.

For additional information, visit www.cancer.gov/

Source: American Cancer Society

Flu Shots

FluShotBug (16K)

We will soon have our 2013 supply of influenza vaccine! Pisgah Family Health will NOT hold a flu shot clinic this year. Instead, we will give flu shots to our patients on a walk-in basis, during our regular business hours (8:30 am to 4:30pm) Please visit any time during the month of October to get your shot. Vaccinations can also be given at your regularly scheduled visit, but not when you have a fever.

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.


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, www.PisgahFamilyHealth.com/

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