"What do you mean my blood pressure is high? I feel just fine.” In primary care, the above sentence is all too familiar, and it is the classic tell that this patient’s hypertension will be more difficult to treat. Patients are motivated to treat their illnesses if such illness causes discomfort or impairment. While our patients willingly seek care when something hurts, it ... Continue Reading
Are Supplemental Medication Effective in Preventative Medicine?
“I see that you’re taking a multivitamin. What are you taking it for?” I asked my 80-year-old patient. “Oh, I’m taking it for my memory, joint pain and to improve my hearing,” she responded. “OK. I see that you missed all the words on the memory test. We may need to find you a different vitamin,” I yelled back at my patient as she cupped her hand around her ... Continue Reading
Recovering from a Concussion
By Cheryl L. Appleberry, ATC, LAT, ITAT; Amy Kolarova, DO; and Yevgeniya Sergeyenko, MD, MPH
A concussion, also known as a mild traumatic brain injury (mTBI), is a very common injury that is experienced by hundreds of thousands of people each year. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recognize concussions as a national and international health crisis and have made recommendations for increased concussion ... Continue Reading
Resource Limitations in the Chronic Care Neurology Practice
According to the Centers for Disease Control and Prevention (CDC), there are 61 million people in the United States living with a disability. This equates to approximately 20% of the U.S. population. The primary functional disability factors include mobility, cognition, independent living, hearing, vision and self-care. Caring for patients with chronic neurological diseases ... Continue Reading
Contemporary Management of Acute Ischemic Stroke
A stroke is the acute neurologic injury that occurs as a result of impaired blood flow to the brain. It is a devastating disease that effects all people of all ages. It negatively impacts the patient as well as their families and the community in which they live. Stroke is ubiquitous throughout the world. It is the second leading cause of death worldwide and is the fourth ... Continue Reading
Evaluation of New Onset Seizures
New onset seizures are common, with epilepsy being the fourth most common neurological disorder. An epileptic seizure is defined as a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. The location of this neuronal activity in the brain helps to define the clinical manifestations that can be quite ... Continue Reading
A Window into the Future of Health
Pregnancy complications may predict cardiovascular risk By Adrienne D. Zertuche, MD, MPH, FACOG After surviving the nearly year-long prenatal plight with morning sickness, back pain, heartburn and swelling – and then successfully navigating the early postpartum weeks of vaginal bleeding, raw nipples, urinary incontinence and sleeplessness – most women cannot wait to mark ... Continue Reading
Compassion and Communication in Caring for Patients
Excerpts from the book Manners, Morals and Medical Care: How To Be an Effective Physician By: Barry Silverman and Saul Adler When patients first encounter their physician, hospital or medical insurance company, their initial impressions of the care they will receive are shaped by the physical surroundings and the healthcare workers they encounter. Consider the 25,000 ... Continue Reading
Contraception for the Medically Complex Patient
It is estimated that 84.6% of women between the ages of 18 and 49 years old are at risk for unintended pregnancy in the state of Georgia12. As the obesity epidemic continues to drive an increase in chronic disease, the percentage of women at risk for pregnancy-related adverse events is on the rise9. Now more than ever, there is a call to action to promote and optimize health ... Continue Reading
Addressing Menopause Symptoms
It is time to take another look at hormone replacement therapy. It is time to reconsider hormone therapy use. With the publication of the Women’s Health Initiative (WHI) in 2001, many women were taken off hormone replacement therapy abruptly. These women then came in with complaints of hot flashes, mood changes and vaginal dryness. These symptoms interfered with their ... Continue Reading
Depression: Throughout the Female Lifespan
Detection, prevention and treatment of depression. Depression in women is more prevalent than in men, and there are specific times in a patient’s life that make them more vulnerable: during adolescence, pregnancy, postpartum and menopausal transition. Screening for depression during these sensitive times in our patients’ lives is the key to the prevention of morbidity and ... Continue Reading
Colorectal Cancer in Women: Challenges and Opportunities
Colorectal cancer (CRC) remains a major health challenge in the United States and throughout the developed world. Eminently preventable and treatable in most situations, the successful management of CRC as a public health problem requires a comprehensive strategy of risk assessment, prevention, early detection, effective treatment, awareness and, most importantly, access to ... Continue Reading
Psychiatric Presentations in Primary Care
In the primary care setting, mental health has become a prominent and emerging concern. At times, depression has often been overlooked and not been a focus of the office visit, especially when patients come in with other organic medical complaints. Multiple studies have shown that more than 50% of depression cases have been overlooked or missed in the primary care ... Continue Reading
Treatment-Resistant Depression in Outpatient Setting
By John Tumeh, MD and Hatcher, PA-S and Stephen Davis, LMHC
Major Depressive Disorder (MDD) is the leading cause of disability worldwide.[1] According to the 2019 National Survey on Drug Use and Health (NSDUH), 7.8% of all U.S. adults above age 18 have experienced at least one major depressive episode.[2] The prevalence of major depressive episodes was higher among adult females (9.6%) compared to males (6.0%), and the prevalence of ... Continue Reading
Functional Neuro-Psychiatric Disorders in General Medicine
By Jorge L. Juncos, MD and Jennifer J. Hawkins, APC, NCC, CCTP
Functional disorders were previously known as psychogenic and conversion disorders.1 These entities consist of a series of neuropsychiatric and medical conditions in which individuals present with sensorimotor or somatic symptoms not explained by current or other know conditions. The change to the phrase functional and somatoform disorders was based on a new and more robust ... Continue Reading
