Internal Medicine

Does Allergy Season Arrive Earlier in Florida?

Residents and snowbirds relish living in Florida for the same reason: the warm weather is the draw, especially during the temperate climate of winter months, when most of the country is freezing. Yet living in the Sunshine State has its pitfalls, such as allergies that can affect Floridians throughout the year.

Seasons in Florida

Florida has seasons just like the rest of the country – they just aren’t quite as obvious. Neither is the allergy season. There’s not a specific time when it arrives, it just always is. It’s totally possible to suffer from an allergy during a chilly Florida winter or when the trees don’t turn in the fall.

Allergy Season

Different allergens appear at different times of the year – however, in Florida, the allergy season begins early. Allergy sufferers up north find a bit of relief as a result of hard freezes. When allergy season awakens in the northern states, due to hay fever and tree pollens, Floridians have already been submersed for many months.

Allergy season in Florida is brought in with the New Year: beginning in January and lasting through the year until it subsides in November. That’s a long season.

Florida trees don’t lie dormant during winter months, which explains the length of the allergy season. The allergy season basically sticks around for most of the year, unlike up north when trees pollinate in the early spring. Florida trees can begin pollinating as early as December and rarely later than the end of January. Additionally, Florida has many trees that pollinate 12 months out of the year.

Allergen-Producing Trees

Pollen is perennial in the state of Florida. Pollinating trees are an issue prior to traditional spring, but so are Florida grasses that pollinate. Wind is pollen’s carrier and of course Florida is no stranger to the winds that deliver massive volumes of the substance, hundreds of miles at a time.

Pine pollen is common in Florida due to moist, humid air. Fine yellow dust appears on outside surfaces. Florida is full of pine trees and while allergies to pine are fairly rare, pollen produced by trees causes discomfort in the sensitive. The pollen spreads through the air as it’s released in very large quantities, but it’s also visible on surfaces.

Dealing With Pollen Allergies

It is impossible to avoid pollen altogether, but keeping doors and windows closed on days with a high pollen count will help. You may notice pollen on the surface of your car each morning. Pollen is highest between 5 a.m. and 10 a.m., but you may feel it before seeing it, as it is highly allergenic.

If you know your triggers, you can help prevent allergy symptoms with medications or by limiting time spent outdoors. If you can’t get control over your body’s immune system, consulting with an allergist will help.

Professional Allergy Help in Wellington

The family medicine provider’s at Advanced Medical Clinic can address your allergy symptoms and determine what your triggers are to help you find relief. Same-day appointments are available. Call us at (561) 434-1935, or you can request an appointment using our online form.

Should I Be Concerned If I Have Herpes?

For the more than one in six Americans aged 14 to 49 who have genital herpes, life for the most part is lived without complication or pain. However, the psychological and social implications of the disease can be much more complicated. That said, should those who have or live with someone has herpes be concerned? Learning about what herpes is and when it is contagious can help.

What is Herpes?

There are two viruses that cause herpes, herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Most cases of genital herpes are caused by HSV-2, while most cases of oral herpes (which can cause cold sores around the mouth) are caused by HSV-1. Herpes most often is diagnosed by appearance alone, when there are one or more sores present. Herpes can also be confirmed with a swab test or blood test.

Recognizing Herpes Symptoms

Most people who have herpes do not have symptoms. For others, the virus lays dormant for years before presenting any recognizable symptoms. Up to 90% of those who have herpes are not aware that they have it until they experience an outbreak, which most often presents with sores and blisters.

HSV-1 is recognized usually by cold sores or canker sores located around the mouth. Cold sores can be painful and certainly an inconvenience; you can expect an outbreak within two to twenty days after exposure. The initial outbreak of HSV-1 most often is the most severe; expect fever, muscle pain, sore throat and headache, swollen glands and being tired.

Regarding HSV-2, an initial outbreak of herpes is usually the most severe and most painful. Along with sores around the genitals or anus, you may experience flu-like symptoms of fever, aches, and/or swollen glands. Many never have any symptoms at all after the first outbreak, or symptoms may occur several times in a year. Outbreaks usually last no more than two weeks total from the first tingling and irritation (called prodrome) to development of sores, concluded by healing.

How Contagious is Genital Herpes?

Oral herpes is very contagious and can be contracted through contact with an infected razor, glass, toothbrush, or by kissing.

Genital herpes is classified as a sexually transmitted disease (STD), and anyone who participates in oral, anal, or vaginal sex is susceptible if exposed. However, it is not as contagious as you may think. Avoiding sex when you have symptoms, either prodrome or an outbreak, can greatly reduce the possibility of transmitting herpes to your partner. Using condoms further reduces the risk by about half. These are the numbers:

  • For a woman with HSV in a monogamous sexual relationship, there is a 4% chance that her partner will become infected in one year of unprotected sex, if they abstain from sex when she has symptoms.
  • If a man is infected, there is an 11% chance of transmitting HSV to his partner in the course of one year of unprotected sex, if they abstain when symptoms are present.

Treatment for Herpes

With HSV-1, the good news is that most cold sores last only a few days and can be treated with a variety of home remedies (vitamin E, aloe vera or echinacea, as examples); or over-the-counter medications such as Abreva, zinc oxide rub or Orajel. A healthy diet will keep your immune system healthy, further preventing any outbreaks or lessening your risk of exposure.

As for HSV-2, it is possible to pass herpes to a sexual partner when there are no symptoms present. Antiviral drugs such as Valtrex® (generic valacyclovir) can shorten the length of an outbreak and decrease the severity of symptoms. Some choose to take these medications at the first sign of an outbreak. If outbreaks happen frequently or if you are sexually active, your family medicine provider may recommend taking antiviral medication every day. This suppresses the virus and further decreases risk of transmission.

Finding Help

Finding out you have herpes can be a very upsetting; you may feel angry, frightened, embarrassed or ashamed. Your family medicine provider can help you realize that herpes is not the end of the world. And while there is no cure for herpes, abstaining from sex when there are symptoms, practicing safe sex, and/or daily use of antiviral medication can greatly reduce the risk of giving it to your partner.

The compassionate providers at Advanced Medical Clinic in Wellington and Royal Palm Beach care for acute and chronic conditions throughout their patients’ lives. Husband and wife team, internal medicine specialist Dr. Ishan Gunawardene and nurse practitioner Shariffa Gunawardene provide continuity of care from minor illness to managing life-threatening conditions and look forward to welcome you into their healthcare family. Call (561) 434-1935 for an appointment at Advanced Medical Clinic today. We offer same day appointments for your convenience.

For the more than one in six Americans aged 14 to 49 who have genital herpes, life for the most part is lived without complication or pain

Heart Disease and Heart Attacks: What’s the Connection?

The connection between heart disease and heart attacks is clear.

Heart disease, or cardiovascular disease, encompasses many different conditions that can lead to a heart attack. Most types of heart disease involve atherosclerosis.

Atherosclerosis: Most Common Cause of Heart Attacks

Atherosclerosis is characterized by plaque buildup in the arteries that carry oxygen-rich blood to the heart and the rest of the body. When plaque builds up on artery walls, it narrows the passageway and restricts blood flow.

Plaque deposits – made up of cholesterol, fat, calcium, and other substances in the blood – build up over time and harden, damaging the smooth, thin layer of tissue within arteries that allows for the easy flow of blood. And that’s not all. If some of the plaque breaks off, blood clots can form and stop blood flow.

Atherosclerosis can affect any of the arteries that carry oxygenated blood throughout the body. For example, when blood flow is blocked within the coronary arteries (the arteries taking oxygenated blood to the heart), it can result in a heart attack. When it occurs in arteries taking blood to the brain, it can result in stroke.

Heart Diseases That Also Can Lead to Heart Attacks

While atherosclerosis is common among the heart diseases that can lead to heart attacks – there are other types of heart diseases that can result in heart attacks, too. These include:

  • Arrhythmia is a condition when the heart beats abnormally, either too fast or too slow, depending on the type of arrhythmia. When the heart beats too fast (more than 100 beats per minute), it’s called tachycardia. Bradycardia is when the heart beats too slow (less than 60 beats per minute). Either is dangerous for the heart and may cause discomfort because your heart isn’t circulating enough blood or is moving it through the body too quickly.
  • Damaged heart valves are another form of heart disease. Heart valves open and close for allowing for blood flow. There are four valves in the human heart: tricuspid, pulmonary, mitral, and aortic; each has a vital function and must open and close properly without leaking. When they don’t open wide enough, blood leaks can occur. A damaged heart valve may be incurred due to poor choices like smoking, or it might be a genetic defect. Whatever the cause, damaged valves are bad news for the heart, such as in these cases:
  •  Aortic stenosis is characterized by a narrowing of the valve, which prevents proper opening, reducing blood flow from the heart.
  •  Aortic regurgitation is characterized by leaking that’s caused when the aortic valve doesn’t close tightly enough.

Many types of heart disease can be prevented – sometimes with just a lifestyle change if the heart or blood vessels are not too far damaged. Eating foods that are low in cholesterol and eliminating bad habits like smoking will help. Your family medicine provider can help determine the current condition of your cardiovascular system and may recommend particular treatments with a specialist if needed.

In addition, a regular checkup can guard against heart disease and help prevent heart attacks. Advanced Medical Clinic will monitor your heart to ensure it’s healthy. And if it’s not, we will help you to get and stay on track to good heart health. Call (561) 434-1935 today to make your appointment or use our convenient online appointment request form.

How Hypertension Affects Women

Hypertension Define

If there is one cardiovascular risk every woman needs to be aware of it is hypertension, also known as high blood pressure. Up until age 65, men and women are equally likely to have high blood pressure—but as we age the risk of high blood pressure in women increases dramatically. High blood pressure occurs when a high rate of blood is forced against the artery walls. Over time the high force of blood within the artery walls will result in health problems associated with high blood pressure. Blood pressure grows higher when the heart pumps excessive amounts of blood at a quick rate into narrow blood vessels.

Hypertension affects people differently. Symptoms vary, but by the time symptoms appear, it may be too late to avoid additional health problem; such as heart disease, stroke, dementia, blindness, heart failure and kidney disease.

Understanding your blood pressure reading is the first step in controlling high blood pressure. Two numbers measure blood pressure; the systolic is the upper number, and diastolic is the lower. Systolic measures the amount of blood in your arteries when the heart contracts. Diastolic measures the amount of blood in the arteries when the heart is between beats.

The American Heart Association places a normal blood pressure as less than 120 over 80.

Stages of Hypertension

If either the systolic or diastolic numbers are above the normal range, it is an indication that blood pressure is too high.

Hypertension Stage 1

  • 130-139 over 80-89.

Hypertension Stage 2

  • 140 or higher over 90 or higher

Hypertension Stage 3

  • More than 180 over higher than 120

Hypertension is bad news for anyone, but the negative effects on women are cause for concern. The American Heart Association claims that women account for nearly half of adults with high blood pressure. The fact that high blood pressure isn’t gender related doesn’t change the fact that women 65 years of age and older contract high blood pressure at a higher rate than men.

From pregnancy, right through menopause, women should take special care to know their blood pressure numbers so they can eliminate problems related to hypertension.

Family Planning

Women who take birth control pills are at risk of high blood pressure, especially if there’s a family history or if she had high blood pressure during a previous pregnancy. Weight is also a factor. This is true at any stage. There is a link between obesity and high blood pressure. High blood pressure doesn’t occur for all women taking birth control pills, but women who take birth control should definitely monitor their blood pressure. Before prescribing oral contraceptives, your family medicine provider should take your blood pressure. He or she should then apprise their patient of the risk.

Pregnancy

During pregnancy, women are susceptible to gestational hypertension, which occurs for some women after 20-weeks. Hypertension may have never been an issue prior to pregnancy, but this secondary condition of hypertension is actually caused by the pregnancy. Even though the condition will disappear after delivery, it is imperative that the mom is treated so that the danger is eliminated for her and her child. Gestational hypertension can trigger another dangerous illness related to pregnancy, pre-eclampsia or toxemia. Like hypertension, it begins about 20 weeks post baby delivery. The only cure for preeclampsia is for the baby to be born.

By the way, ACE inhibitors, drugs that fight high blood pressure, don’t mix well with pregnancy. Women should not take ACE inhibitors during pregnancy. Speak to your health professional about maintaining normal blood pressure during pregnancy.

Menopause

The chances of increasing normal blood pressure are likely with age, even if your blood pressure has always been normal. Menopausal women should monitor their blood pressure. Get your family medicine provider involved. Make regular visits, once every six months to have your pressure checked.

Monitoring blood pressure is crucial. Women who wish to stay healthy throughout their lives will do everything within their power to get and keep their blood pressure under control.

At Advanced Medical, PA, we pride ourselves in providing quality healthcare in both internal medicine and primary care. To learn more about us and the services we offer, or to schedule a visit, call us at (561) 434-1935 to request an appointment.

What is Internal Medicine?

There is often confusion in understanding the difference between internal medicine, family medicine and primary care. On the face of it, they seem to be one and the same. People are not all one-size-fits-all, and neither are their needs. Nor are providers. People have unique needs and should choose a family medicine provider that best fits those needs.

Primary care is a role and not a specialty. Providers trained in different specialties can offer primary care services: pediatrics, women’s health, or geriatrics, for example.

Internists or internal medicine providers too are qualified primary care providers. But they only focus on the diagnosis, treatment, and care of adults, 18 years or older across the spectrum of health and illness. Some focus their practice on hospital medicine, medical education and/or research. Family medicine providers, on the other hand, treat adults and children.

The goal of the internal medicine family medicine provider is health promotion, disease prevention, diagnosis and treatment of both acute and chronic illness.

Patient-centric Care

The central person in internal medicine is the adult patient as a whole individual. They work to establish and maintain a trusting relationship to create the best plan for your health. This includes age-appropriate health maintenance through routine monitoring, immunizations, and screenings.

They provide counseling, patient education, and treatment of acute and chronic illnesses. They promote healthy lifestyle choices. The internist is the focal point of a patient’s health care needs. They offer continuity of care that extends from their office to specialists, to hospitalizations, and anywhere the patient requires medical attention.

Internists are skilled diagnosticians, adept at figuring out complex symptoms to identify both common and rare illnesses. They are often known as the “family medicine provider’s provider” or “medical detectives.”

General Internal Medicine

Many internists begin practicing upon completing basic internal medicine training.  They practice “general internal medicine” and are referred to as “general internists.” They handle the broad and comprehensive spectrum of illnesses that affect adults. They provide primary care to patients over the duration of their adult lives.

General internists practice in different locations. Some, known as “hospitalists,” may focus on caring for patients in the hospital setting. Others combine both outpatient and inpatient care. General internists may practice in settings such as rehabilitation centers and long-term care facilities as well.

Internal Medicine Subspecialties

Internists may take additional training to “subspecialize” in a more focused area of internal medicine. This training, known as a “fellowship” usually requires several additional years beyond the basic three-year internal medicine residency.

Providers with additional training in a particular area of internal medicine are frequently referred to by their area of subspecialty –cardiologists, pulmonologists etc. They have all undergone the same basic internal medicine training and are also considered as “internists.”

The subspecialty training in a particular medical area is comprehensive and qualifies them to manage complex medical issues and perform advanced procedures.

Conditions Treated by Internal Medicine Providers

Internal medicine practitioners focus on the whole body. They treat both internal and external conditions. They diagnose and treat a wide range of medical conditions. A family medicine provider of internal medicine may be employed by a hospital or work out of his own clinic or office.

Subspecialties of internal medicine include: 

Arthritis and joint conditions

Hepatitis

Allergy and immunology

Cardiology (heart diseases)

Endocrinology (hormone disorders)

Hematology (blood disorders)

Infectious diseases

Gastroenterology (diseases of the digestive system)

Nephrology (kidney diseases)

Oncology (cancer)

Pulmonology (lung disorders)

Rheumatology (arthritis and musculoskeletal disorders)

Hypertension

Diabetes

ENT – ear, nose and throat

Neurological conditions

Sexual dysfunction, including erectile dysfunction (ED)

Weight loss and management

This exhaustive area of medicine basically includes any illness that affects adults.

The role of the internist is to manage your overall health, promote a healthy lifestyle and recommend steps to prevent illness, and treat illnesses. Your internist is your “go-to” when you have health concerns because he knows you best. He can provide most of your medical needs.

At Advanced Medical, PA, we pride ourselves in providing quality healthcare in both internal medicine and primary care. To learn more about us and the services we offer, or to schedule a visit, call us at (561) 434-1935 to request an appointment.

Is it arthritis, or something else?

Is it Arthritis, or Something Else?

Getting to the bottom of the reason you may be experiencing swollen, stiff or sore joints is not always easy. If you have noticed that your joints are inflamed and painful or that your range of motion is diminished, you may have a form of arthritis.

Although there are two major forms of arthritis, known as rheumatoid (RA) and osteoarthritis (OA), there are actually over a hundred different forms of arthritis related disorders. The main difference between them is that OA is caused by wear and tear on your body, whereas RA is a form of disease known as an autoimmune disorder, in which the internal mechanisms that normally protect your body from attacks by bacteria and viruses become confused and attack your own joints and tissues instead.

Different Disorders: Overlapping Symptoms

Autoimmune disorders include fibromyalgia, lupus, psoriatic arthritis, gout and many others. Several of these disorders are known to mimic rheumatoid arthritis and can be a bit more difficult to pin down because the symptoms may overlap. Lupus, for instance, also known as SLE or Systemic Lupus Erythematosus, can affect internal organs, connective tissues, blood vessels and joints. So much so that it can be fatal.

Unlike Rheumatoid arthritis however, lupus does not typically deform or erode away the joints. The joint symptoms also tend to be less severe and the disease can seem to “hop around,” hitting different joints at different times. Some patients can have both rheumatoid arthritis and Lupus.

Lyme disease is an infection caused by a strain of bacteria called borrelia burgdorferi or Bb, which is carried by ticks and can be passed to humans through a bite. Lyme disease often causes flu-like symptoms such as fever, headache and neck stiffness, shooting pains or facial palsy. It is often accompanied by a noticeable “bull’s eye” ring around the bite. Lyme disease symptoms also usually occur in stages, which means it can be easily misdiagnosed.

Gout is another disorder that sometimes presents like rheumatoid arthritis. It is caused by high levels of uric acid that form tiny crystals within the affected joint(s). Gout is also extremely painful, even excruciating and often appears in a single joint with pain, swelling, warmth and redness. It can spread to others areas, and when left untreated can cause joint deformation that appears very similar to rheumatoid arthritis.

Get Your Symptoms Checked

If you have aching, fatigue, redness or swelling in or around your joints, or notice an unusual rash or redness on your face or other areas of your body, you should consult a family medicine provider. While most people think of arthritis as an older person’s disease, the truth is that it and other autoimmune diseases can strike young and old alike. Your family medicine provider can run the appropriate tests and to help determine the underlying cause and develop a treatment plan that works for you.

If you are concerned about how arthritis, or other autoimmune disorders are affecting your body, board-certified internal medicine specialist Dr. Ishan Gunawardene can help. He will take the time to talk to you, answer your questions and prescribe the necessary medications to help ease the symptoms of arthritis and other disorders. To make an appointment in Wellington or Royal Palm Beach, request an appointment online or call (561) 434-1935 today.