Pisgah Family Health News

Summer 2010

Office News

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Office News

New Billing Services

Pisgah Family Health has contracted with a new company to handle our billing and collections. All bills dated after February 1, 2010 will have a new appearance and new name. Along with this change, we will be updating our fees.

For billing questions, patients can call toll free (866)557-2612 or Email nccustomerservice@med-edge.com In the office, Julie will still be handling billing questions.

New billing statements will reflect:
Pisgah Family Health, Gary Curran, MD
C/O Raleigh Durham Medical Group PA
PO Box 650249
Dallas, TX 75265-0249

Office Hours

Our normal office hours are 9-5 Monday through Thursday, and 9-12 on Friday.   When the office is closed, emergency care is available at the Urgent Care Centers, and at Mission/Saint Joseph hospitals 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 May 31st for Memorial Day.
  • We will be closed July 19 - 23 for a vacation
  • We will be closed August 13th for a staff outing

Office Reminders

Now is the time to schedule your annual physical. During the summer months we are less busy, and more able to make time for routine care and physical exams. Please remember to schedule these extensive visits well in advance. You will avoid waiting, and avoid contact with sick patients by having your physical during these months.

If you are scheduling a DOT, sport, camp, school or work physical, there is always paperwork to complete. Prior to your exam, be sure your paperwork is entirely completed, leaving only the physician portion blank.

Vaccinations are generally required to begin Kindergarten and College. If vaccinations are required, be sure to bring your vaccination records with you.

HIPAA law states 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 family member(s).

Please turn off your cell phone while in our office. If you must use your phone, please step outside.

We have a demand for same day appointments. If you are not able to keep your scheduled appointment, please contact our office at least 24 hours in advance so we can accommodate patients who need to be seen urgently.


Medical News - Summer Spectacular

Summer Fun in AshevilleSplash!

Summer is the time to get outdoors and enjoy our beautiful environment. We are very fortunate to live in a town that offers great weather, beautiful natural resources, and a vibrant social life. Here are a potpourri of inexpensive and healthy ways to enjoy your summer.

Free Music

Downtown After 5

The city of Asheville host FREE music and dancing on the third Friday of the month, May through September. The high-powered rock and blues lineup includes StephaniesId, Dryvin N Cryin, Soulgrass Rebellion, Spam Allstars, and Larry Keel and Natural Bridge. The stage is located on Lexington Avenue at I-240. Free live music starts at 5 pm with food and drinks available for purchase. For more information, visit: http://www.ashevilledowntown.org/

Concerts on the Quad

UNC Asheville offers free Concerts on the Quad, every Monday from June 14 through July 12. They start at 7pm and last about 2 hours. Concerts are completely FREE and open to the public. In a large grassy quad, these concerts are very family-friendly! Sorry, no pets allowed. Rain location: Lipinsky Auditorium.
For details, visit http://www. unca.edu/summerquad/

Shindig On the Green

This mountain tradition features an always-enjoyable variety of mountain dancers, clogging, bluegrass and old time string bands, ballad singers, and storytellers. Saturday evenings from 7-10 p.m. July 3, 10, 17, 31, August 14, 21, 28, and September 4. Located at the newly renovated Roger McGuire Green at Pack Square Park in downtown Asheville .
More details at http://www.folkheritage.org/

Bele Chere

Asheville's biggest street festival offers hours of shopping and snacking, but the best part is the free music. With 4 stages playing music for 3 days, there is guaranteed to be something for everyone. I can't even begin to list all the bands here.
Find the music lineup at http://www.belecherefestival.com/pages/entertainment_home.htm

Go Swimming

Buncombe County Parks and Recreation will open its pools starting Memorial Day weekend. The pools will be open weekdays starting June 15. Pool hours are Monday-Friday 12-6, Saturday 11-7, and Sunday 1-7. Swim lessons start in two sessions, on June 21, and July 19, and cost $25. Find the pool nearest you and ore details at www.bumcombecounty.org/

  • Cane Creek - 590 Lower Brush Creek Rd, Fletcher. 828-628-4494
  • Erwin - 58 Lees Creek Road, Asheville. 828-251-4992
  • Hominy Valley - 25 Twin lakes Road, Candler. 828-667-9937
  • North Buncombe - 892 Clarks Chapel Road, Weaverville. 828-645-1080
  • Owen - 117 Stone Drive, Swannanoa. 828-686-1629

Asheville City Parks also offers three pools. Recreation Park, the largest, opens on Memorial Day. The other city pools are open June 12 through August 15th. Pool hours are Monday-Friday 12-6, Saturday 11-6, and Sunday 1-6. FREE Swim lessons start in two sessions, on June 21, and July 19. Learn more at www.ashevillenc.gov/

  • Recreation Park - 55 Gashes Creek Rd. 28806. 828-298-0880
  • Malvern Hills - 75 Rumbough Place, 28805. 828-253-1164
  • Walton Street - 2 Walton Street, 28802. 828-253-1143

Hendersonville also offers an excellent outdoor pool at Patton Park. This may be the last remaining pool with a diving board in the area. Learn more about Henderson County's park system at http://www.hendersoncountync.org/travelhvl/activities_family.htm and http://www.hendersoncountyrecreation.org/

  • Patton Park - 198 Park Place, Hendersonville, NC 28792 828-697-3084

Shakespeare in the Park

The Montford Park Players FREE summer season will begin June 4. Shows are performed at the outdoor theater on weekend nights, starting at 7:30. This season will include "A Midsummer Night's Dream", "King Lear", ""Troilus and Cressida", and "Twelfth Night".
Details at www.montfordparkplayers.org

Take a Hike

It's not summer in WNC without hiking in the woods. Asheville is surrounded by Pisgah National Forest, and the closest access - Bent Creek - is just south of our office. Smokey Mountain National Park is less than 1 hour away, as are Dupont State Park, Gorges State Park, and several others. Hiking is a free and healthy way to enjoy summer in our region. Hikes can be chosen for all ages and capabilities - be sure to consult a park ranger or a map before setting out. If you're new to hiking, consider joining a group or organized hike Always know your trails, and hike with a partner, plenty of water, and a map.

For an on-line guidebook, visit http://www.hikewnc.info/besthikes/index.html or http://www.mountaintravelguide.com/North%20Carolina/NorthCarolinaHikingTrails.htm

Visit a Waterfall

WNC is the the land of waterfalls, and our wet summer has made them better than ever. Experiencing our waterfalls is perhaps the most refreshing way to enjoy your summer. You can choose from road-side attractions, to remote and difficult hikes. No matter which you choose, be safe - never climb on waterfalls or walk in the water above them.

Here's a list of some of the best waterfall hikes in the area: http://www.romanticasheville.com/waterfalls.htm

More ...

These suggestion and many more are available on the website http://www.romanticasheville.com/outings.html

Play It Safe in the Sun: A Parents' Guide

Sun Warning

Too Much Sun Hurts

Did you know that just a few serious sunburns can increase your child's risk of skin cancer later in life? Kids don't have to be at the pool, beach, or on vacation to get too much sun. Their skin needs protection from the sun's harmful ultraviolet (UV) rays whenever they're outdoors.

Turning pink? Unprotected skin can be damaged by the sun's UV rays in as little as 15 minutes. Yet it can take up to 12 hours for skin to show the full effect of sun exposure. So, if your child's skin looks "a little pink" today, it may be burned tomorrow morning. To prevent further burning, get your child out of the sun.

Tan? There's no other way to say it-tanned skin is damaged skin. Any change in the color of your child's skin after time outside-whether sunburn or suntan-indicates damage from UV rays.

Cool and cloudy? Children still need protection. UV rays, not the temperature, do the damage. Clouds do not block UV rays, they filter them-and sometimes only slightly.

Oops! Kids often get sunburned when they are outdoors unprotected for longer than expected. Remember to plan ahead, and keep sun protection handy-in your car, bag, or child's backpack. Parents, help your children play it safe in the sun and protect your own skin as well. You're an important role model.


Hey Moms and Dads! Not all sun protection comes in a bottle. Here are five ways to protect your child's skin all year long.
Umbrella 1. Hide and Seek. UV rays are strongest and most harmful during midday, so it's best to plan indoor activities then. If this is not possible, seek shade under a tree, an umbrella or a pop-up tent. Use these options to prevent sunburn, not to seek relief once it's happened.
Shirt 2. Cover 'em Up. Clothing that covers your child's skin helps protect against UV rays. Although a long-sleeved shirt and long pants with a tight weave are best, they aren't always practical. A T-shirt, long shorts or a beach cover-up are good choices, too-but it's wise to double up on protection by applying sunscreen or keeping your child in the shade when possible.
Hat 3. Get a Hat. Hats that shade the face, scalp, ears, and neck are easy to use and give great protection. Baseball caps are popular among kids but they don't protect their ears and neck. If your child chooses a cap, be sure to protect exposed areas with sunscreen.
Sunglasses 4. Shades Are Cool. And they protect your child's eyes from UV rays, which can lead to cataracts later in life. Look for sunglasses that wrap around and block as close to 100% of both UVA and UVB rays as possible.
Sunscreen 5. Rub on Sunscreen. Use sunscreen with at least SPF 15 and UVA/UVB protection every time your child goes outside. Choose waterproof sunscreen that is made for kids. Avoid alcohol-based sunscreens (Bullfrog) which may burn the skin. Reapply sunscreen every 2-3 hours (or better yet, go inside!) Don't forget to protect ears, noses, lips, and the tops of feet.

Prevent Drowning

Floater

Drowning is the second leading cause of accidental death among children ages 1 to 14. Did you know that children can drown in as little as one inch of water?

Children can drown in a variety of circumstances - during water recreation (such as swimming and boating) or when a young child is left unsupervised for even seconds in the bathtub or around the home with access to pools and hot tubs.

A child can drown in as little as one inch of water, and drowning is usually quick and silent. A child will lose consciousness two minutes after submersion, with irreversible brain damage occurring within four to six minutes.

Parents and caregivers should understand the risks of drowning and know the proper steps to protect children.

  • Adults should never leave children unattended near water.
  • Wading pools should be emptied when not in use.
  • If a child cannot swim, he or she must use a certified flotation device in the water.
  • Rafts are not safe for children, as they can easily fall off into deep water.
  • Do not trust older children to watch infants around water. The risks are too great.

More Information: www.usa.safekids.org

Poison Ivy

Summertime is when most plant-related illnesses occur. Camping, hiking, picnicking, and yard work - all types of outdoor activities give us exposure to a wide variety of plants, some of which can be harmful. By far the most common among these is Contact Dermatitis (also called Rhus Dermatitis), or the rash to Poison Ivy.

What Causes the Poison Ivy rash?

Urushiol Oil is the toxin on the leaves of Poison Ivy, Poison Oak, and Poison Sumac. The oil is very hardy, and difficult to wash off. It must contact the skin directly to cause the rash.
  • Only 1 nanogram (billionth of a gram) is needed to cause a rash.
  • 500 people could itch from the amount covering the head of a pin
  • 1/4 ounce of urushiol could cause a rash in every person on earth
  • Specimens of urushiol several centuries old have been found to cause a rash.
  • Urushiol oil can stay active on dead plants for 1 to 5 years.

How can I prevent the rash?

  • Learn to identify the plants. Poison Ivy is by far the most common, and is easy to identify. Poison Oak and Sumac are less common.
  • Avoid plant exposure. Watch where you walk. Stay on the trail.
  • If you are handling plants, wear long clothing and gloves. Remove and wash the clothing immediately after any exposure. Wear heavy gloves if you must handle plants, and do not touch yourself with the gloves.
  • If you have contact with the plants, avoid touching yourself. When the oil is fresh, you can spread the oil by skin to skin contact. As soon as possible wash from head to toe (twice is better) with a detergent soap, such as Dial or Safeguard.
  • Prevent your pets from contacting the plants. Pets can spread the oil on their fur. Identify poison ivy in your yard and remove it. If your pet runs loose, wash it with a detergent soap.
  • Never burn Poison Ivy leaves or vines. Smoke exposure can cause a rash or respiratory distress.

Poison Ivy Myths vs. Facts

RedIvyIcon (1K) MYTH IvyIcon (1K) FACT
Poison Ivy rash is contagious Rubbing the rashes won't spread poison ivy to other parts of your body (or to another person). You spread the rash only if urushiol oil -- the sticky, resinlike substance that causes the rash -- has been left on your hands.
You can catch poison ivy simply by being near the plants Direct skin contact is needed to transmit urusiol oil. However it can become airborne by burning, lawnmowers, trimmers, etc.
Leaves of three, let them be Poison ivy and oak have 3 leaves per cluster, but poison sumac has 7 to 13 leaves on a branch.
Do not worry about dead or dormant plants Urushiol oil stays active on any surface, including dead plants, for up to 5 years.
Breaking the blisters can spread the rash Not true. Blisters are full of serum, not urushiol oil. But breaking the blisters may make your wounds become infected or make the scarring worse.
I've been in poison ivy many times and never broken out. I'm immune. Not necessarily. Upwards of 90% of people are allergic to urushiol oil, it's a matter of time and exposure. The more times you are exposed to urushiol, the more likely it is that you will break out with an allergic rash. For the first time sufferer, it generally takes longer for the rash to show up - generally in 7 to 10 days.

Poison Ivy Identification

  • Grows along trails and roadsides, most common in the borders between fields and woods.
  • Grows as a woody, ropelike vine that can grow along fences or up trees, or a free-standing shrub
  • "Leaves of three, let it be." Groups of three leaflets on the each stem come off the larger main vine. Rarely, the leaves may vary from groups of three to nine
  • Leaves are green in the summer and reddish in the fall. Individual leaves have a lateral notch, giving them the shape of a mitten.
  • White berries and yellow or green flowers are sometimes present.

Poison Ivy

Poison Oak Identification

  • Grows in the eastern United States as a low shrub.
  • Oak-like leaves, usually in clusters of three
  • Can have clusters of yellow berries

Poison Oak

Poison Sumac Identification

  • Grows in boggy areas, especially in the Southeastern United States
  • Grows as a rangy shrub up to 15 feet tall
  • Has seven to 13 smooth-edged leaflets
  • Can have glossy pale yellow or cream-colored berries

Poison Sumac

Virginia Creeper - a common fooler

  • Native and common in the Eastern US.
  • Not poisonous. Contains no Urushiol oil.
  • Rapidly growing vine, with clusters of 5 leaves.
  • Leaves are serrated and not notched.
  • Green in summer, morph to red or burgundy in Autumn

Virginia Creeper

Treatment of Contact Dermatitis

  • Don't catch it. Avoid contacting the plant and vines. If you are working with plants, wear gloves and long clothing. Remove and wash this clothing immediately after the project.
  • Wash your skin thoroughly within 1 hour of exposure. Use a strong detergent soap, such as Dial or Safeguard. First wash your hands and arms twice, as they are most likely to carry the oil. Then wash the rest of your body, rinse, and repeat.
  • Avoid scratching. If you have been exposed, the rash will develop within 1-3 days, and will worsen for 7-10 days. Once you see the rash, there is no quick fix. The rash is likely to stay for 2-4 weeks. Scratching may cause further skin irritation or infection. Scratching may spread the rash in the first day after exposure, but not after the oil has been washed off.
  • Antihistamines can minimize itching. Benadryl (diphenhydramine) is very effective, and causes sedation. This is a good choice at bedtime. Claritin (loratadine) and Zyrtec (citerizine) are 24-hour pills which cause less sedation. These are best for daytime use. Benadryl cream can also be helpful, and does not cause sedation.
  • Steroid Creams minimize itching and reduce inflammation. Hydrocortisone 1% cream or ointment can be used several times per day, and is safe for use on the face and with children. More potent steroid creams are available by prescription, but should not be used on the face.
  • Steroid Pills and Shots such as prednisone are the most effective treatment to suppress this immune reaction. These treatments can significanly shorten the duration and reduce the intensity of the reaction. Steroids have some side effects, such as hyperactivity, elevated sugar, and increased appetite. Therefore, systemic steroids are reserved for the most severe cases of poison ivy.
  • Calamine lotion and Oatmeal Baths and other topical treatments are minimally effective and generally not useful.

Sources of photos and information:

Outdoor Food Safety

Summertime is a great time to enjoy the outdoors with a cookout or picnic. Unfortunately, not all foods remain safe at outdoor temperatures. Outdoor water supplies may also pose a hazzard. To avoid contaminated foods and water, here are a few safety tips.

General Rules for Outdoor Food Safety

  • Pack safely: use a cooler, or pack foods in the frozen state with a cold source when hiking or backpacking.
    • Keep raw foods separate from other foods.
    • Never bring meat or poultry products without a cold source to keep them safe.
  • Protect yourself and your family by washing your hands before and after handling food.
  • Bring liquid hand sanitizer, disposable wipes or biodegradable soap for hand and dishwashing.
  • Bring bottled or tap water for drinking. Otherwise, boil water or use water purification tablets.
  • Leftover food is only safe if the cooler still has ice in it. Otherwise, discard leftovers.
  • Do not leave trash in the wild or throw it off your boat.

Keep Everything Clean

  • Always wash your hands before and after handling food, and don't use the same platter and utensils for raw and cooked meat and poultry.
  • If you are going somewhere where running water is not available, bring water with you. Or pack liquid hand sanitizer.
  • Bacteria present on raw meat and poultry products can be easily spread to other foods by juices dripping from packages, hands, or utensils.
  • When transporting raw meat or poultry, double wrap or place the packages in plastic bags to prevent juices from the raw product from dripping on other foods.

Cook Thoroughly

  • Fresh and frozen raw meat, poultry and fish should be cooked hot enough to kill the bacteria, parasites and viruses that may be in the product.
  • Always use a meat thermometer to check temperatures.
  • Color is not a reliable indicator of doneness.

Safe internal temperatures for meats:

  • Whole poultry 180°F
  • Chicken breasts 170°F
  • Ground turkey and poultry 165°F
  • Ground beef hamburgers 160°F
  • All cuts of pork 160°F
  • Beef, veal, lamb steaks, roasts and chops 160°F **
  • All other meat and fish 160°F

Safe Drinking Water

  • It is not a good idea to drink water from a lake or stream, no matter how clean it appears.
  • Bring bottled or tap water for drinking.
    • Start out with a full water bottle.
    • Replenish your supply from tested public systems when possible.
  • The surest way to make water safe is to boil it. Boiling will kill microorganisms.
    • Before heating, muddy water should stand for a while to allow the silt to settle to the bottom.
    • Dip the clear water off the top and boil.
    • Bring water to a rolling boil, and then continue boiling for 1 minute.
  • As an alternative to boiling water, you can also use water purification tablets and water filters.
    • The purification tablets kill most waterborne bacteria, viruses, and some parasites.
    • Because some parasites - such as Cryptosporidium parvum, Giardia lamblia, and larger bacteria - are not killed by purification tablets, you must also use a water filter.
    • These water-filtering devices must be 1 micron absolute or smaller.
    • Over time purification tablets lose their potency, so keep your supply fresh.

Safe Fish-handling

  • Scale, gut, and clean fish as soon as they're caught.
  • Live fish can be kept on stringers or in live wells, as long as they have enough water and enough room to move and breathe.
  • Wrap fish, both whole and cleaned, in water-tight plastic and store on ice.
  • Keep 3 to 4 inches of ice on the bottom of the cooler. Alternate layers of ice and fish.
  • Store cooler out of the sun and cover with a blanket.
  • Once home, eat fresh fish within 1 to 2 days or freeze them.
  • For top quality, use frozen fish within 3 to 6 months.

http://www.health.state.mn.us/foodsafety/away/boatcamp.html

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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