Pisgah Family Health



September 2007







About this Newsletter



It is almost time for your flu shot! The flu vaccine is most effective if given in the months of October or November, to protect against winter illness. Our Flu Shot Clinic is scheduled for Friday October 19th, from 8amnoon. Please call ahead to schedule a time for your shot. We can also give flu shots at any routinely scheduled visit after October 1.  There does not appear to be a shortage of flu vaccine in 2007.

The flu vaccine is recommended and safe for all people over 6 months of age. It is particularly important for people over 65, and those with a history of heart or lung disease. Children under two-years old require two half-doses given 30 days apart.

If you have symptoms of the flu (fever, muscle aches, fatigue) it is too late for the flu vaccine. Make an appointment to be evaluated. Antibiotics do not cure the flu, but an antiviral such as Tamiflu® can shorten the course of illness.

The Pneumonia vaccine is often given at this time as well, though it can be given at any time of year. This vaccine prevents infection with strep pneumoniae, which is a common cause of pneumonia. This is recommended for people with chronic lung or heart disease, and all people over age 65. The pneumonia vaccine should be repeated every 5-10 years.

Office Hours

  • Our normal office hours are 9-5 Monday through Thursday, and 9-12 on Friday.
  • We will be closed for vacation from Wednesday, October 31 through Wednesday, November 7, 2007 . During this time staff will be answering the phones, but no office visits will be available.
  • We will be closed for Thanksgiving on Wednesday-Friday, November 21-23.
  • We will be closed for a medical conference Thursday and Friday, November 29 and 30th.
  • We will be closed for Christmas on Monday-Wednesday, December 24-26.
  • When the office is closed, emergency care is available at the Urgent Care Centers, and at Mission/Saint Joseph hospitals ER.  Telephone calls are handled by Dr. Curran’s call partners. Our answering service can be reached after hours at 251-4873.

Office Reminders

  • Please call 24 hours in advance if you are unable to keep your scheduled appointment.
  • Please notify our office if you have a new mailing address and/or phone number.
  • Bring all your medication bottles to each visit.  This is the only way we can guarantee an accurate record of your medications.
  • If you have any forms to complete, please read through the form entirely and complete your section prior to your visit.
  • Please bring your child’s vaccination record for a school or sports physical.


Medical News

Thursday, November 15, 2007 is the American Cancer Society's Great American Smokeout. Why not give up cigarettes for just one day?  Why not consider quitting for good? What have you got to lose? Your health? Your vitality? Your income?

Why Is It So Hard to Quit Smoking?

Mark Twain said, "Quitting smoking is easy. I've done it a thousand times." Maybe you've tried to quit too. Why is quitting and staying quit so hard? The answer is nicotine.


Nicotine is a drug found naturally in tobacco. It is highly addictive - as addictive as heroin or cocaine. Over time, the body becomes both physically and psychologically dependent on nicotine. Smokers must overcome both of these addictions to be successful at quitting and staying quit.

When smoke is inhaled, nicotine is carried deep into the lungs, where it is absorbed quickly into the bloodstream and carried throughout the body. Nicotine affects many parts of the body, including your heart and blood vessels, your hormonal system, your metabolism, and your brain. Nicotine can be found in breast milk. During pregnancy, nicotine freely crosses the placenta to affect the fetus.

A smoker will have nicotine by-products present in the body for about 3 to 4 days after stopping.  After smoking regularly, the smoker develops a tolerance to the drug, which leads to an increase in smoking over time. With tolerance, one has the urge to smoke just to maintain a steady level of nicotine in the blood. In fact, nicotine, when inhaled in cigarette smoke, reaches the brain faster than drugs that enter the body intravenously.

Nicotine Withdrawal

Nicotine is every bit as addictive as cocaine or heroin.  When smokers try to cut back or quit, the lack of nicotine leads to withdrawal symptoms. These symptoms can lead the smoker to crave cigarettes again to boost blood levels of nicotine back to a level where there are no symptoms.  Symptoms usually start within a few hours of the last cigarette and peak about 2 to 3 days later. Withdrawal symptoms may last up to several weeks.  Withdrawal symptoms can include any of the following:

  • frustration, anger, and irritability
  • sleep disturbances, including insomnia, and having bad dreams or even nightmares
  • dizziness (which may only last 1-2 days in the beginning)
  • depression
  • trouble concentrating
  • headache
  • tiredness
  • increased appetite

Most smokers interpret the nicotine withdrawal symptoms as "stress".  Because smoking relieves the "stress" of nicotine withdrawal, most smokers have the false belief that smoking is good for stress relief.  Of course, this fix is only temporary, and no life stress is actually solved by smoking.  In fact, smokers tend to be much more anxious people than non-smokers.

How to Quit?

Quitting smoking is not easy. Nobody quits smoking without some degree of discomfort.  Most smokers try to quit several times and relapse before they finally quit for good. However, there are a variety of methods and products that can make quitting easier and more successful.


The most important factor in quitting smoking is your own determination. Nobody ever quits without significant effort and determination. Unfortunately, a nagging wife or husband are not very helpful. The only reason people ever quit is because they make up their mind that it is important for them. Make a list of the pros and cons of smoking for you. Why you smoke? Why do you want to quit? When you realize that this is an important health problem for you, then you will be ready to quit.


The most effective product on the market today to help people quit smoking is called Chantix. Chantix is a prescription pill that binds to nicotine receptors in the brain, tricking the brain into thinking that it is getting nicotine when it is not. Therefore the pleasure of smoking is reduced. The withdrawal symptoms of nicotine are also minimized by using Chantix. Chantix is taken twice-daily, usually for two to three months. It should be started before quitting cigarettes, not after. It is now covered by many insurance plans.


Wellbutrin (also called Zyban) is a prescription pill most commonly used as an antidepressant. However, it also reduces the craving for nicotine and other addictive chemicals. It is not as effective as Chantix, but it is a particularly useful agent for smokers with depression. Like Chantix, this should be started two weeks before quitting.

Nicotine Replacement

Several non-prescription products are available which serve to replace nicotine when you give up cigarettes or chewing tobacco. These include the nicotine gum, nicotine lozenges, and nicotine patches. The gum and lozenges are most useful for people who have cut down dramatically, and want to minimize their use of nicotine. They can be used occasionally, just when you get the urge to smoke. The nicotine patch is used continuously, for people who have more constant cravings. All of these products contain nicotine, but are much safer than using tobacco products. They are typically used for two to three months after quitting smoking.


Hypnotism has also proven useful to help people gain the motivation to quit smoking. This is a very safe non-pharmacologic intervention. More than one session may be required to achieve maximum benefit. This is not covered by health insurance.

Why Quit?

Your Health

Health concerns usually top the list of reasons people give for quitting smoking. About half of all smokers who continue to smoke will end up dying from a smoking-related illness. Nearly everyone knows that smoking can cause lung cancer, but few people realize it is also a risk factor for many other kinds of cancer as well, including cancer of the mouth, voice box (larynx), throat (pharynx), esophagus, bladder, kidney, pancreas, cervix, stomach, and some leukemias.

Smoking increases the risk of lung diseases such as emphysema and chronic bronchitis. These progressive lung diseases - grouped under the term COPD (chronic obstructive pulmonary disease) - are usually diagnosed in smokers in their 60s and 70s. COPD causes chronic illness and disability and is eventually fatal.

Smokers are twice as likely to die from heart attacks as are nonsmokers. And smoking is a major risk factor for peripheral vascular disease, a narrowing of the blood vessels that carry blood to the leg and arm muscles, as well as cerebrovascular disease that can cause strokes.

Smoking also causes premature wrinkling of the skin, bad breath, bad smelling clothes and hair, and yellow fingernails and hair, yellow fingernails and an increased risk of macular degeneration, one of the most common causes of blindness in the elderly.

For women, there are unique risks. Women over 35 who smoke and use birth control pills are in a high-risk group for heart attack, stroke, and blood clots of the legs. Women who smoke are more likely to have a miscarriage or a lower birth-weight baby. Low birth-weight babies are more likely to die or to be impaired.

Based on data collected in the late 1990s, the US Centers for Disease Control (CDC) estimated that adult male smokers lost an average of 13.2 years of life and female smokers lost 14.5 years of life because of smoking. No matter what your age or how long you've smoked, quitting will help you live longer.

Ex-smokers also enjoy a higher quality of life with fewer illnesses from cold and flu viruses, better self-reported health status, and reduced rates of bronchitis and pneumonia.

When Smokers Quit - What Are the Benefits Over Time?

  • 20 minutes after quitting: Your heart rate and blood pressure drops.
  • 12 hours after quitting: The carbon monoxide level in your blood drops to normal.
  • 2 weeks to 3 months after quitting: Your circulation improves and your lung function increases.
  • 1 to 9 months after quitting: Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.
  • 1 year after quitting: The excess risk of coronary heart disease is half that of a smoker's.
  • 5 years after quitting: Your stroke risk is reduced to that of a nonsmoker 5 to 15 years after quitting.
  • 10 years after quitting: The lung cancer death rate is about half that of a continuing smoker's. The risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decrease.
  • 15 years after quitting: The risk of coronary heart disease is that of a nonsmoker's.

Meningococcal meningitis is a rare but potentially fatal illness caused by bacterial infection of the spinal canal. Symptoms may resemble the flu but progress rapidly and can cause death within two days. For those that survive, long term effects can include brain damage, seizures, hearing loss or limb amputations.

Meningitis is contagious and is spread through air droplets and direct contact with infected persons. It can be spread through coughing, sneezing, kissing or sharing items like drinking glasses, lip balm, eating utensils or cigarettes.

Adolescents and young adults are at increased risk of contracting this disease. The reason for this risk may be due to lifestyle factors, such as living in crowded situations (dormitories), going to bars, smoking, and irregular sleep habits.

However, the majority of cases among adolescents are preventable by vaccination. Meningitis vaccination is recommended for the following age groups:

  • Adolescents aged 11-12 year old,
  • Adolescents at high school entry (15 years old), or
  • College freshman, through 18 years of age, who live in dormitories, or
  • Children 11 > years of age who are at increased risk for meningococcal disease.

In addition to being vaccinated, young adults can reduce their risk for contracting the disease by not sharing eating utensils, beverages, cigarettes, etc. For medical advice about meningococcal immunization, consult your physician, college health service or local public health department


School Bus Safety

Help your child get to school safely by reviewing the following safety tips:

Getting Ready for School

  • Have your children put everything they carry in a backpack or school bag so that they won't drop things along the way.
  • Have them wear bright, contrasting colors so they will be more easily seen by drivers
  • Make sure they leave home on time so they can walk to the bus stop and arrive before the bus is due. Running can be dangerous.

Walking to the Bus Stop

  • Walk your young child to the bus stop and have older children walk in groups. There is safety in numbers; groups are easier for drivers to see
  • Practice good pedestrian behavior. Your children should walk on the sidewalk; if there is no sidewalk, they should stay out of the street.
  • If they must walk in the street, they should walk single file, face traffic and stay as close to the edge of the road as they can.
  • Tell you child to stop and look left, right and then left again if they must cross the street. They should do the same thing at driveways and alleys. Exaggerate your head turns and narrate your actions so your child knows you are looking left, right and left.

Waiting at the Bus Stop

  • Don't let your child play running games or push and shove at the bus stop. It is dangerous near traffic.
  • Make sure your child stands at least 10 feet (5 giant steps) from the road while waiting for the bus. The child will then be out of the way of traffic. Have younger children practice taking 5 giant steps to become familiar with 10 feet.

Getting On and Off the Bus

  • Warn children that if they drop something, they should never pick it up. Instead, they should tell the driver and follow the driver's instructions. If they bend over to pick up a dropped object, they might not be seen by the driver and could be hurt if the driver pulls away from the stop.
  • Remind children to look to the right before they step off the bus. Drivers in a hurry sometimes try to sneak by busses on the right.
  • Teach your children to secure loose drawstrings and other objects that may get caught in the handrail or door of the bus as they are exiting.
  • Give your child a note or follow the school's procedures if you would like for the child to get off at a stop other than the one they are assigned. The driver isn't allowed to let a child off at another stop without written permission.
  • If you meet your child at the bus stop after school, wait on the side where the child will be dropped off, not across the street. Children can be so excited at seeing you after school that they dash across the street and forget the safety rules.

Riding the Bus

  • Children should talk quietly, be courteous to the driver and follow the driver's instructions.
  • Children should stay seated during the entire bus ride and keep the aisles clear.


For more health information, check out these links:

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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