Parkway Medical Blog

This fall, for the first time, Arizona children 11 years and older entering 6th grade will be required to be vaccinated against meningococcal disease and pertussis (whooping cough) prior to school entry. The recommendation is for all persons aged 11-18 years to receive one dose of meningococcal vaccine at the earliest opportunity, and children 11-12 years to be vaccinated with the pertussis vaccine providing it has been at least five years since their last tetanus/diphtheria vaccine dose.

The meningococcal vaccine protects against infections caused by meningococcal bacteria. It is a leading cause of bacterial meningitis in children two to eighteen years of age, and it can cause serious blood infections. College freshman are also at increased risk.

Pertussis (whooping cough) is a highly contagious bacterial infection of the upper respiratory system that is making a big comeback especially among teens and pre-teens.

These immunizations are available at Parkway Medical. Our providers would be happy to discuss them further with you.

MRSA or Methcillin Resistant Staph Aureus is a bacteria resistant to the penicillin family of antibiotics. The presentation is usually skin lesions, boils, abscesses that may have started as a cut or scratch. Frequently these are treated with broad spectrum antibiotics without success. Once cultured, the bacteria can be identified and treated with appropriate antibiotics. Frequently in debilitated patients the bacteria can cause a form of pneumonia. The bacteria has the ability to alter its structure to make it resistant to the usual antibiotics. This occurs due to multiple reasons. Food and water supply containing antibiotics, overuse or inappropriate use of antibiotics, and treated hospital infections have led to the development of these bacteria. Certain other antibiotics also have led to the proliferation of resistant bacteria.

The best way to prevent MRSA is good hygiene, especially frequent hand washing. This is extremely important in healthcare workers as the bacteria is transferred from one to another through skin to skin contact. Ask health care workers to wash their hands before seeing you, especially in the hospital setting. It is important to note that the bacteria is NOT transferred through the air, but can be transferred through sharing towels, poor hygiene, living in unsanitary conditions, and contact sports. Learn to recognize the lesions and seek medical attention soon in order to get early treatment.

Additional information about MRSA can be found at the Centers for Disease Control & Prevention, www.cdc.gov or through the Arizona Department of Health Services, www.azdhs.gov.

Osteoporosis is a condition characterized by a reduction in bone density and quality that causes bone to be more fragile and increases risk of fractures (broken bones).  Did you know?

• The maximum bone density of our hips is built by the time we are in our late teens; spines by our early 20’s.
• Osteoporosis has no symptoms, until there is a broken bone.
• 30% of women over the age of fifty are at risk for osteoporosis.
• 6 out of 100 men by the age of 65 have osteoporosis.
• 50% of individuals who sustain a hip fracture do not return to their previous level of independence.

In 1900, life expectancy in the U.S. was approximately 45 years. As that has increased over the past century, we are confronted with the task of improving the quality of life well into our 80’s and 90’s.

Parkway Medical offers bone density testing. This safe, easy test allows us to successfully prevent and treat osteoporosis. The bone density test, called DXA (dexa) is safe, painless, simple and quick. The amount of X-ray exposure is less than 10% of a routine chest X-ray, and the test takes less than 5 minutes. You will be positioned on a table; then an X-ray beam will be passed through areas to be measured: usually the hip, spine and perhaps forearm. You may remain fully clothed if you avoid wearing zippers, snaps, underwires, etc.

Using DXA scanning to diagnose those at risk for fractures, we can markedly decrease fracture incidences, as well as the associated pain and disability.

Ask your healthcare practitioner if DXA scanning would be appropriate for you.

So you want to live to be one hundred yet look like you’re thirty. You envision your skin to be soft, your eyes to sparkle, your muscles to be strong and your libido to match. Many healthcare providers believe that keeping our hormone levels regulated is part of the key.

The safety issues of hormone replacement and supplementation have become more controversial with the availability of bio-identical hormones. For women, synthetic hormones meant to replace estrogen and progesterone are not equivalent to those produced by the human body, nor do they perform the same as what the body makes. In fact, in some cases they are harmful. By replacing the estrogen and progesterone with bio-identical preparations in variable amounts, women can get closer than ever before to the image they desire.

There is great news for men as well. There are many causes of low testosterone. A common reason is stress or burnout. Psychological trauma, depression, and prescription medications can also cause low testosterone levels. Physical signs may include muscle loss, weight gain, fatigue and low sex drive.

A diagnosis can be quickly confirmed by careful history and laboratory testing. Relief may be as easy as a visit to your healthcare provider.

Nurse Practitioner Kathleen Rickard along with Dr. Stuart Medoff can assist patients who wish to proceed in this direction. Call 480-348-3200 if you are interested in an evaluation.

Three new vaccines have become available, two of which will soon be required for school-age children.

The meningococcal vaccine protects against infections caused by meningococcal bacteria. It is a leading cause of bacterial meningitis in children two to eighteen years of age, and it can cause serious blood infections. The disease is most common in infants less than one year old and people with certain medical conditions. College freshman are also at increased risk. The vaccine is recommended for all children at their routine pre-adolescent visits (ages eleven and twelve). For those who have not been vaccinated, a dose is recommended at high school entry.

Gardasil is a vaccine against Human Papilloma Virus (HPV). There are over forty types of HPV, and while most infections do not cause any symptoms and resolve on their own, some types cause cervical cancer. Gardasil does not protect against all types of HPV, but it protects against the four major types which cause 70% of cervical cancers and 90% of genital warts. It is recommended for girls eleven and twelve years old and is approved for females ages nine to twenty-six.

Zostavax is a vaccine that reduces the risk of developing Shingles, also known as Herpes Zoster. Shingles is a very painful rash that usually occurs on one side of the face or body and lasts seven to ten days. One in five people have severe pain that persists even after the rash clears up. Shingles is caused by the same virus that causes chickenpox. Once a person has chickenpox, the virus can live in an inactivated state for years. If it becomes active again, it causes Shingles. It is more common in people over sixty years of age and in patients who have a weakened immune system. Zostavax is recommended for people over the age of sixty.

These vaccines are available at Parkway Medical. Our providers would be happy to discuss them further with you.

Acupuncture is known to be effective in the treatment of many conditions, including acute and chronic pain, allergies, gastrointestinal reflux, urinary problems and anxiety, to name a few. It also is effective in treating smoking cessation and obesity. However, these conditions in particular have a strong emotional and behavioral component to them. Treatment with just one modality is usually not enough.

This is where hypnotherapy comes into play. When a patient has a strong motivation to stop smoking or to lose weight, there is often an acknowledgement that long-term behaviors and habits need to be altered. Hypnotherapy can aide in developing new patterns of thoughts and behaviors that result in life changes. It can also help someone approach a problem with newfound self-confidence. Acupuncture complements hypnotherapy in the process of quitting smoking or losing weight. It tends to have an effect on curbing one’s physical craving for nicotine or food. When treatments are repeated on a regular basis, this reduction in cravings can translate to success in altering one’s behavior.

Of course, patient motivation is a necessity in this process. Acupuncture can also aide in the inevitable emotional and physical agitation that may accompany changes in addictive behavior, especially in the case of smoking cessation.

Parkway Medical offers combination packages in acupuncture and hypnotherapy. Dr. Grant Phillips, who practices acupuncture, and Julie Jones, our hypnotherapist, offer this combination therapy for both smoking cessation and weight loss.

What does off-label mean to you? Many medications and devices used in medicine are used “Off Label”. What it means is that the medication or device is FDA (Food and Drug Administration) approved for one purpose, and we use it for another purpose. It is legal and appropriate for physicians to use medication in this fashion, although not approved for other uses by the FDA. If something has no FDA approval, it is NOT legal to use anywhere!

Many years ago a heart medication was found to be useful in treating migraine headaches. The medication was used to treat hypertension, but those who took it found a decrease in headaches. So, doctors began using this medication and shortly thereafter, it was FDA approved for migraine treatments. Similarly, the product minoxidil (Rogaine) was used to treat hypertension and men noticed that their hair was growing. Some dermatologists began emptying the capsules to make a product that men could apply directly to the scalp, and hair grew. Thereafter, the company applied for and received FDA approval for hair growth, and the rest is history. It is now sold over the counter to treat male pattern baldness.

Many of the injections we perform at Parkway Medical Laser and Skin Centre are off label. Botox is FDA approved for use in the glabella (frown lines), yet it is used for forehead, eye’s, mouth, etc. Juvederm and Restylane are FDA approved for nasolabial folds, yet we use it for lips, chins, ears, and other areas. This does not mean we just said one day “I think I will use this somewhere else other than where it is approved.” There are conferences, studies, research, and other avenues where these things have been tried and have been successful. There is some science surrounding the use of injections.

Parkway wants you to know and understand that we and many others use these products in an off label fashion, but still within the legal limits and perfectly appropriate. Please ask about this if you have any questions.

Yearly checkups are a necessary part of maintaining good health. Many people feel that visiting a specialist, such as a cardiologist or gynecologist, each year is sufficient. Yet, you still need to visit with your family doctor.

Why you may ask? Family Practitioners are trained in preventative medicine, providing continuing and comprehensive health care. They take care of the physical, mental and emotional health of patients and their families. They know your family’s health history and how it can affect you, and are trained to care for you through all the stages of your life. Family physicians know when to treat you, and when to bring in a specialist you can trust.

What can you look forward to in a yearly exam? This is an excellent time to review all those problems that have bothered you throughout the year but were never discussed or you were afraid to talk about. Are there certain medical issues that deserve more attention than others?

The physical should cover everything from your head to your toes with a few stops in between. This includes blood tests to look for diabetes, kidney problems, liver function, anemia, cholesterol and triglycerides, thyroid function and prostate screening. If necessary, an EKG, mammogram, bone density, or a holter monitor for those feeling a flutter in their chest, may be ordered.

Most importantly, you will have the attention of a trained, familiar pair of ears that are focused on you. We look forward to seeing you for your annual exam.