RMUC Blog

Signs and symptoms of Roseola?

Fri, 31 Aug 2012 22:00:00 GMT

Roseola (also known as sixth disease) is a viral illness in young kids, most commonly affecting those between 6 months and 2 years old. It is usually marked by several days of high fever, followed by a distinctive rash just as the fever breaks. http://kidshealth.org/parent/infections/skin/roseola.html#

Signs and Symptoms:

A child with roseola typically develops a mild upper respiratory illness, followed by a high fever (often over 103° F or 39.5° C) for up to a week. During this time, the child may appear fussy or irritable and may have a decreased appetite and swollen lymph nodes (glands) in the neck. www.SeeADoctorTODAY.com should these symptoms arise.

The high fever often ends abruptly, and at about the same time a pinkish-red flat or raised rash appears on the trunk and spreads over the body. The rash's spots blanch (turn white) when you touch them, and individual spots may have a lighter "halo" around them. The rash usually spreads to the neck, face, arms, and legs.

The fast-rising fever that comes with roseola triggers febrile seizureshttp://kidshealth.org/parent/general/sick/febrile.html (convulsions caused by high fevers) in about 10% to 15% of young children. Signs of a febrile seizure include:

Unconsciousness

2 to 3 minutes of jerking or twitching in the arms, legs, or face
Loss of control of the bladder or bowels

The fever of roseola lasts from 3 to 7 days, followed by a rash lasting from hours to a few days.

Professional Treatment:

To make a diagnosis, your doctor first will take a history and do a thorough physical examination. A diagnosis of roseola is often uncertain until the fever drops and the rash appears, so the doctor may order tests to make sure that the fever is not caused by another type of infection. www.SeeADoctorTODAY.com

West Nile Virus

Fri, 24 Aug 2012 14:15:00 GMT

The current West Nile outbreak is one of the largest in the U.S., with four times the usual number of cases for this time of year, federal health officials said Wednesday. It's still too early to say how bad the year will end up because most infections are reported in August and September. But never before have so many illnesses been reported this early, said Dr. Lyle Petersen, of the Centers for Disease Control and Prevention.

"We're in the midst of one of the largest West Nile outbreaks ever seen in the United States," said Petersen, who oversees the CDC's mosquito-borne illness programs. http://www.nj.com/news/index.ssf/2012/08/west_nile_virus_outbreak_is_on.html

West Nile virus is an infection transmitted by mosquitoes. If you become infected with West Nile virus, you may not experience any signs or symptoms or you may experience only minor ones, such as fever and mild headache. However, some people who become infected with West Nile virus develop a life-threatening illness that includes inflammation of the brain. http://www.mayoclinic.com/health/west-nile-virus/DS00438

Mild signs and symptoms of a West Nile virus infection generally go away on their own. But severe signs and symptoms such as a severe headache, disorientation or sudden weakness require immediate attention. If you think you may have symptoms of West Nile virus infection or think you may have been exposed, make an appointment at one of our clinics. You can make an appointment on our website at www.SeeADoctorTODAY.com.

Exposure to mosquitoes where West Nile virus exists increases your risk of getting West Nile virus. Protect yourself from mosquitoes by using mosquito repellent and wearing clothing that covers your skin to reduce your risk. Avoid spending much time outside at dawn and dusk when mosquitoes are more active.

More Whooping Cough (Pertussis) News

Wed, 22 Aug 2012 03:51:00 GMT

Here is the latest on pertussis from the Colorado Department of Public Health and Environment on Pertussis. Bottom line: Get a pertussis shot!

Pertussis Outbreak

Fri, 27 Jul 2012 17:42:00 GMT

Please read this important article about the recent pertussis outbreak.

By Laura L. Myers

SEATTLE (Reuters) Jul 20 - The number of U.S. whooping cough cases has risen to around 18,000 in an outbreak that is on track to become the most severe in over a half century and could in part stem from possible waning vaccine protection, health officials said on Thursday.

Washington state, which declared an epidemic in April, and Wisconsin were particularly hard hit, with each reporting more than 3,000 cases, according to the U.S. Centers for Disease Control and Prevention.

Nine people have died overall and the number of cases was already more than double than at the same time last year.

All adults, including pregnant women, should get a booster shot because the contagious illness is especially dangerous for children under a year old who have yet to complete a cycle of vaccinations, Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases, told a media briefing.

"It's most dangerous for babies," Dr. Schuchat said, adding that the current outbreak at its existing pace could become the most severe since 1959, when 40,000 cases were reported. "Preventing infant deaths from the disease is our primary national goal," she said.

A spike in pertussis cases among 10-, 13- and 14-year-olds was a concern, perhaps an indicator that the pertussis vaccine may be wearing off earlier than anticipated, Washington Health Secretary Mary Selecky said.

The U.S. groups of 10-, 13- and 14-year-olds who are experiencing a high illness rate had DTaP vaccinations, which were introduced in 1997 at the same time that the prior DTP vaccine was discontinued.

The earlier vaccine used whole cell parts made of killed pertussis bacteria, while DTaP uses only small acellular bacteria pieces, not the whole bacteria cell, said Donn Moyer, Washington state Health Department spokesman

CDC officials will begin an investigation in Washington state later this month "to analyze our data for cases among 13- to 14-year-olds to see what can be learned about disease rates and vaccination status," Moyer told Reuters.

The number of cases in Washington, with no deaths, has tripled since April, with 1,132 cases reported by the end of that month.

Moyer said the CDC also plans a similar study in California, where a 2010 epidemic counted more than 9,000 cases, including 10 infant deaths.

Earlier this week, New York state released preliminary figures showing 970 cases so far in 2012. In all of 2011, there were 931 cases reported in New York. (See Reuters Health report of July 18, 2012.)

This year, Australia is also experiencing a high rate of whooping cough, Schuchat said.

Rocky Mountain Familiy Medicine Coming To Lowry!

Fri, 29 Jun 2012 22:50:00 GMT

Rocky Mountain Family Medicine is excited to announce its newest location in Lowry. The Lowry office will open on August 1, 2012 at 130 Rampart Way, Suite 150, Denver, CO. Dr.'s Amy Cook and Celeste Dean will be our initial physician providers at this site, and will be supported by Dr. Moore and our team of mid-level providers. Appointments can be made at this time by calling our family medicine clinic at Aurora at 303-695-8684. The new phone number for Lowry will be available soon!

Check out our new monthly dietician newsletter!

Wed, 27 Jun 2012 18:57:00 GMT

http://seeadoctortoday.businesscatalyst.com/LiteratureRetrieve.aspx?ID=140710

Sunscreen Spray and Kids

Wed, 20 Jun 2012 13:17:00 GMT

Wow is it hot in Denver right now. Great days for being out in the sun at the pool or at Elitches or the water park.

I just came across this article from Consumer Reports 2011 which I think is still relevant regarding the use of sunscreen sprays in kids. Aerosols from these sprays can easily be inhaled. We recommend spraying the sunscreen spray into your hand first and then applying to your child. If you are going to spray the sunscreen on your child, avoid the face and head areas.

Cosumer Reports Article:

http://news.consumerreports.org/health/2011/07/spray-sunscreens-should-not-be-sprayed-on-kids-at-least-for-now.html#.T96mnkJ0yz0.facebook

The American Academy of Pediatrics offers these summer sun safety tips:

http://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Spring-Break-Safety-Tips.aspx

Have fun this summer!

Should you get your cholesterol checked?

Sun, 03 Jun 2012 15:18:00 GMT

We see many patients every day who come in for a physical exam, a general check-up to make sure everything is okay. Frequently patients want to have routine blood work done to check for a variety of problems including liver, kidney, electrolytes, cell counts, and of course, cholesterol. Who really needs to be screened for these things? Should we screen everyone at every age? Every year? Below are the basic recommendations for cholesterol screening.

Based on recommendations from the United States Preventative Services Task Force (USPSTF) increased risk of coronary heart disease (CHD) is defined as the presence of any one of the following risk factors: diabetes; a personal history of CHD or non-coronary atherosclerosis; a family history of cardiovascular disease before 50 years of age in male relatives or before 60 years of age in female relatives; tobacco use; hypertension; and obesity (BMI greater than or equal to 30 kg per m2).

Decisions to screen for lipid disorders should be based on the patient's age and sex, and the presence of CHD risk factors. Women older than 20 years who are at risk of CHD are likely to benefit from screening. The optimal interval for lipid screening is uncertain. The USPSTF recommends that all men 35 years and older receive screening for lipid disorders. However, in men 20 to 35 years of age and women 20 years and older who are not at risk of CHD, the benefits and harms of screening are closely balanced. Consequently, the USPSTF makes no recommendation for or against routine lipid screening in these groups.

According to the USPSTF recommendation, the preferred screening tests for dyslipidemia are total cholesterol and HDL cholesterol levels from fasting or nonfasting samples. There is insufficient evidence of the benefit of including triglycerides. Abnormal screening test results should be confirmed by a repeat sample on a separate occasion, and the average of the two results should be used for risk assessment. Treatment decisions should take into account a person's overall risk of heart disease rather than lipid levels alone.

$20 Sports Physicals

Sun, 03 Jun 2012 14:56:00 GMT

Athletic Competition Form

For many teenagers playing sports at school or in summer leagues is a great way to maintain a healthy lifestyle. As most parents know, getting a sports physical is required by schools as well as by most athletic leagues. Physicals are also required for camps and other programs that kids and young adults attend during the summer or any time of year.

Why are these physicals required? It is important to make sure children and young adults are healthy before they engage in strenuous physical activity. This involves taking a complete family history to make sure there are no genetic problems that could be passed on to the young athlete. It involves taking the athlete's medical history to determine if medical conditions such as asthma, diabetes or previous concussions exist that may pose a problem for participation. It involves asking questions about many symptoms such as chest pain, dizziness, and shortness of breath, especially with strenuous activity such as running.

As part of the physical exam, the doctor will:
•measure height and weight
•take a blood pressure
•check the vision
•listen to your heart and lungs
•feel your abdomen
•look in your ears, nose, and throat
•test how strong and flexible you are

At the end of

the sports physical the doctor gives the athlete and parents time to ask questions and reviews other important aspects of playing sports, such as staying hydrated and using sunscreen.

Rocky Mountain Urgent Care & Family Medicine offer sports and athletic physicals for only $20.00. Just mention this newsletter or bring in a copy. We believe in offering these exams for this low price because many kids could not afford them otherwise. We encourage parents and athletes to bring in the attached athletic competition form, with the history information completed. Many people will also have required forms from their schools or other programs and we are happy to fill these out as well.

Booking Appointments Online

Fri, 01 Jun 2012 03:02:00 GMT

We are very excited to now offer patients the ability to book appointments online. What a great new feature. When we learned about ZocDoc and the service they provide, we couldn't wait to sign up. I think we have great front office staff and we work very hard to make sure they provide excellent customer service. But many patients want the flexibility to go online and make their appointments. Patients can see which of our family medicine doctors are available on each day and can see all of the available appointment slots. The patient selects the provider and the time slot and books the appointment. Our front desk staff gets a pop up indicating the appointment has been made and confirms the appointment. The patient then gets an email or text confirmation of the appointment. How easy is that? We welcome any comments you may have about this new feature. Dr. Moore

Book Your Appointment Online!

Tue, 29 May 2012 06:00:00 GMT

Please Read: Important Message from Rocky Mountain Family Medicine

I’m writing with great news. You can now book appointments with Rocky Mountain Family Medicine online! This change will make it easier than ever for you to get great family medical care, and I encourage you to schedule all of your appointments this way.

To make an appointment, simply visit www.SeeADoctorToday.com and click ‘Book an Appointment’ or visit www.ZocDoc.com. You’ll see a list of all of our available times. Choose the time that works best for you, and schedule it on the spot. It’s that easy, and it’s completely free.

At Rocky Mountain Family Medicine we believe that getting healthcare should be as fast, simple, and convenient as everything else you do online. That’s why we have chosen to partner with ZocDoc, the top provider of online appointment-booking.

As your family doctor, I am proud to offer you this special service. I hope that it shows my commitment to serving you. Please let me know if you have any questions.

Best regards,

Nathaniel Moore, MD and the Rocky Mountain Family Medicine team

Malaria Update

Sun, 27 May 2012 18:16:00 GMT

The American Academy of Family Physicians recently published an article about malaria prophylaxis for travelers (http://www.aafp.org/afp/2012/0515/p973.html), which is also accompanied by a patient handout on preventing malaria during travel (http://www.aafp.org/afp/2012/0515/p980.html). It is important that travelers to sub-Saharan Africa, the Indian sub-continent and Southeast Asia, between the months of May to December, consider taking anti-malaria medication. In many instances these medications need to be started prior to travel. Given that there are approximatley 1 millions deaths worldwide every year from malaria, this is a big deal.

Travelers to endemic areas should be aware of their potential exposure to malaria. How is malaria tranmitted? Mosquitos! Mosquitos carry around those nasty little parasites that are the cause of malaria. Five main species of parasites are responsible for transmission of malaria in humans: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium knowlesi, and Plasmodium malariae. These protozoa are concentrated in different areas of the world, and each produces a different manifestation of infection. P. falciparum is the most life-threatening form of malaria.
These parasites are transmitted to humans by the bite of an infective female Anopheles mosquito. To produce eggs, the mosquito usually consumes a blood meal, thus needing humans and animals as hosts.

What can you do to prevent acquiring malaria? Insect repellant. Some studies suggest that there is an 80% decrease in the incidence of acquring malaria just by using insect repellant. If you plan to travel to endemic areas, don't forget your DEET.

Concerned about the toxicity of DEET? Consider using PMD instead. Available since 2007, PMD is an extract from the eucalyptus plant. The formula is less toxic, cheaper, and more effective against malaria than a 20 percent solution of DEET. In the United States, PMD is available as 65 percent and 10 percent concentrations.

What else can you do? Take medication. But you must start taking medication before travel, and then continue the medication during travel, and for a period of time after leaving the area where malaria is prevalent. Atovaquone/proguanil (Malarone), doxycycline, and mefloquine are the drugs of choice for malaria prevention in most malaria-endemic regions. These medications are easily obtained with a prescription from Rocky Mountain Urgent Care & Family Medicine.

Measles Update

Tue, 22 May 2012 06:00:00 GMT

During 2011, the number of reported measles cases in the United States was the highest in 15-years, due primarily to unvaccinated U.S. residents returning from overseas travel with the infection and spreading it to other unvaccinated individuals. With the summer vacation season approaching and a large number of people expected to travel to Europe for the 2012 Olympics in London, there is concern that Americans returning from travel in Europe and travelers visiting the U.S. may import measles from countries where transmission is ongoing.

Measles can be acquired through international travel to many countries, including developed countries, and even in the United States, if measles outbreaks related to travel occur this spring/summer.

Measles is an ongoing risk to those who choose not be vaccinated and a risk to infants and children who have not received vaccine.

Measles is a highly contagious disease that is transmitted by respiratory droplets and airborne spread. The measles virus may remain in the air of enclosed spaces for up to two hours.

Measles can be a severe, life-threatening illness; however, the measles vaccine is highly effective in preventing infection.
The incubation period (exposure to rash onset) for measles ranges from 7 to 21 days.

Diagnosis

The diagnosis of measles should be considered in any person with a generalized maculopapular rash and a fever, especially if accompanied by cough, coryza, or conjunctivitis (immunocompromised patients may exhibit an atypical rash or no rash).

MEASLES SYMPTOMS:

Rash: Usually begins on face 2-4 days after prodrome onset, typically spreads downward/outward to hands and feet
Fever (usually 101 degrees F)
Cough
Coryza (runny nose)
Conjunctivitis

Healthcare providers should assess all persons traveling abroad to determine their need for measles vaccination. The following recommendations apply to international travelers and differ from routine recommendations:

Infants 6 – 11 months of age should receive 1 dose of measles vaccine (or MMR) prior to traveling abroad.

All persons ≥ 12 months of age without evidence of measles immunity (birth before 1957, or physician-diagnosed measles, or serologic evidence of immunity) should have 2 doses (at least 1 month apart) of MMR or measles vaccine prior to traveling abroad.

Travel Consultations - Just in time for Summer!

Mon, 07 May 2012 06:00:00 GMT

Rocky Mountain Urgent Care and Family Medicine is pleased to offer expert travel medicine consultations. Visits will include detailed medical information about the patient's travel destination, all required travel vaccinations and anti-malarial medications if indicated. Rocky Mountain Urgent Care and Family Medicine has many providers who are able to offer the International Certificate of Vaccination (yellow card) for yellow fever vaccination validation.

We strongly suggest you make a travel consultation EARLY because many vaccines are part of a series, and the series should be completed before travel begins.

Please see our Travel Medicine Page for more information or visit the Centers for Disease Control website.

Immigration Physicals Offered at Centennial

Fri, 02 Mar 2012 07:00:00 GMT

Rocky Mountain Family Medicine is pleased to announce that it is now offering immigration physicals at its Centennial, CO office. The cost of an immigration physical is $150.00. Blood/laboratory testing and vaccinations will be at an additional charge. Please call 303-693-2000 for an appointment. Please download a copy of Form I-693 and complete the patient portion. Bring this form with you to the appointment. Please also bring a copy of your vaccination records with you to your appointment. You may obtain a list of the required vaccinations from the CDC's web site at http://www.cdc.gov/immigrantrefugeehealth/exams/diseases-vaccines-included.html