Monday, December 1, 2014

Helping Your Patients Understand and Treat the Common Cold

English: Original description: "This full...
English: Original description: "This full color 17"x22" poster is planned for use in doctor's offices, clinics, other healthcare facilities, and media outlets. It is intended to raise awareness about appropriate antibiotic use for upper respiratory infections in adults. It explains that antibiotics are not the best answer for a cold or flu." (Photo credit: Wikipedia)
Common cold
Common cold (Photo credit: Wikipedia)
A British poster from World War II describing ...
A British poster from World War II describing the cost of the common cold "The Cost of the Common Cold and Influenza". Imperial War Museum: Posters of Conflict . vads . . (Photo credit: Wikipedia)
Chicken soup is a common classic comfort food ...
Chicken soup is a common classic comfort food that might be found across cultures. (Photo credit: Wikipedia) It is a common food to eat when you have a cold
Many time patients present at the family practitioners office with stuffy noses and a general feeling of malaise. These are symptoms that can be so many things, yet most patients even if they are diagnosed with the common cold will not understand why they are not leaving the doctor’s office without an antibiotic. Once the doctor has determined it is a common cold you can help the patient understand time will take care of the sneezing and there are things at home they can do to feel better.

]It is also important to remember that overuse of antibiotics is a real risk to our patients and health care system.
Remind patients of the importance of not getting antibiotics when they do not need them. The common cold is not improved or cured by having antibiotics. Patients who develop secondary sinus infections might be back to the office in week or so for antibiotics, but most will recover without being issued any prescription.

It is cold season again and before you grab the Kleenex and anti-histamine bone up on other things you can do to lessen your cold symptoms. Many of these things are common sense things that our grandparents did that we thought were silly when we were younger.
Drink lots of fluids. Don't drink a lot of caffeinated soda as caffeine acts as a diuretic and the goal is to keep yourself well hydrated ;while you have a cold. Drink water, decaffeinated tea, or juice. You need the proper amount of fluids to help your body get rid of toxins while you are fighting the cold virus.
Open up your house. While it may seem contrary to common sense, or grandmothers knew the value of fresh air in the house. If you have a chill you can curl up in a blanket, but open a window to let in fresh air. It helps to rid your sick room of dry germ filled air and let some fresh brisk air in.
Eat your chicken soup. It is better if it is homemade chicken soup, but all chicken soup works. Chicken soup has substances that actually helps reduce inflammation in your nasal tissues. If you can tolerate it add some fresh garlic to your chicken soup as it is known to have properties that help boost your immune system.
Don't over blow your nose. This is something grandma probably did not know about. If you over blow your nose there is a good chance you will be sending bacteria back into your nasal cavity. Use saline solution and a tissue to clear out your nose. There is less chance that you will irritate your sinuses with the saline solution then by blowing it hard anyway. To clear away post nasal drip gargle with warm salt water.
Don't skip breakfast. A Dutch study showed that eating breakfast boosted the bodies best anti viral compound gamma interferon by 450 % .Skipping breakfast lowered the level of gamma interferon by 17%. You will want to avoid dairy if you are really stuffed up because it encourages the formation of mucus. Eat an egg if you can, because your body needs protein to produce antibodies.
Drink your orange juice. While vitamin C is not a cure for the common cold it does help boost your overall immune system. People with the flu who took at least 500mg of vitamin C; studies showed had less risk of complications than those who did not take vitamin C.

It is fine to take over the counter cold medicine. If you do not have to work don't avoid the regular drowsy cold medicine. If you can get some extra rest; you will feel better faster. A good night's sleep has been shown to boost your immune system and in general improve how you feel. If you have to work with a bad cold; be sure to drink lots of fluids and keep some disinfectant wipes in your cubicle. Be considerate of your co workers and wipe off things that you have touched like the phone or shared keyboard

Thursday, November 20, 2014

Helping Our Patients Follow Up With the Right Eye Care Professionals.

English: Dilated pupils after an optometrist a...
English: Dilated pupils after an optometrist appointment. (Photo credit: Wikipedia)
Conventional surgery to treat glaucoma makes a...
Conventional surgery to treat glaucoma makes a new opening in the meshwork. This new opening helps fluid to leave the eye and lowers intraocular pressure. Description: Conventional surgery to treat glaucoma makes a new opening in the meshwork. This new opening helps fluid to leave the eye and lowers intraocular pressure. Credit: National Eye Institute, National Institutes of Health Ref#: EDA11 (Photo credit: Wikipedia)
That's the name for this thing that you look t...
That's the name for this thing that you look through so the optometrist can tune the settings for your eyeglass prescription. (Photo credit: Wikipedia)
"Slit lamp examination of Eyes in an Opht...
"Slit lamp examination of Eyes in an Ophthalmology Clinic" (Photo credit: Wikipedia)
The Optometrist
The Optometrist (Photo credit: Wikipedia)
When it comes to eye health it is important to know which eye care practitioners can provide you the best care. Many of our patients may be referred to an optometrist or ophthalmologist for follow up care after they have been in our office for minor eye injuries, unexplained eye inflammation, or have been newly diagnosed with diabetes. In the case diabetes the patient will be referred to have their eyes screened for signs of glaucoma. Glaucoma is a common eye condition in patients with uncontrolled or poorly controlled blood sugar. Some patients may be referred to an eye specialist to determine if the headaches they experience are a result of pressure from various eye conditions.
Many times eye doctors both optometrist and ophthalmologist will refer patients to our practice to be screened for high blood pressure, diabetes, or even neurological conditions. This is because eye exams can be the place that Symtoms of many conditions first appear.
An eye specialist many times will consult family physicians about a patient’s eye problem if they suspect a medication is responsible for a decline in vision. Blurred vision is a very common side effect of many of the drugs people take for heart conditions, arthritis pain, or even erectile dysfunction drugs. It is good as a allied health professional to help our patients understand the difference between optometrist and ophthalmologist.


Optometrist is the primary care givers for our eyes. If we have ever needed glasses or contacts we have been evaluated by an optometrist at least once. Optometrist diagnoses complex eye conditions such as glaucoma, cataracts, and retinal issues. In some states they even treat they these conditions. Optometrist also follow the eye health of people with underlie health conditions that may effect their eye health such as diabetes and hypertension.
They can prescribe certain medications for eye conditions and provide low vision rehabilitation. They also can remove foreign objects from the eye.
An ophthalmologist is a medical doctor. Many are eye surgeons. They provide comprehensive service that covers the services provided by optometrist. The difference is that those seeking regular exams for glasses or contacts from an ophthalmologist many times have been diagnosed with a significant eye condition not traditionally treated by the optometrist.
Ophthalmologist treat disease related to the cornea and conditions that effect the exterior of the eye such as sclera, conjunctiva, and tumors. They tend to deal with any disorder that affects the optic nerve in any way. This includes optic nerve damage related to brain tumors, MS, or any condition causing intraocular pressure.
Ophthalmologists are frequently surgeons today. They do surgery ranging from common Lasik procedures to complex retinal reattachments. They provide a range of cosmetic as well as vision restoring procedures. Many ophthalmologists may specialize in areas related to neurology or pediatric eye care.  Some devote their careers to the research of serious eye conditions.
Sometimes care is based on insurance coverage and not necessarily the seriousness of the eye condition. If you have vision insurance your first choice for any eye problems will be an optometrist. If you have no eye coverage you may opt to see an ophthalmologist because they are medical doctors and many times their services will be covered, but their testing may not be. If you can afford to pay out of pocket it is best to see an optometrist first. This is for several reasons. Costs are greatly reduces and optometrist can treat a great deal of conditions such like glaucoma and retinal diseases
When optometrist fined your condition out of the scope of expertise then they will referral you to an ophthalmologist. Eye injuries and conditions creating a sudden loss of vision should be evaluated in the emergency room. Any follow up care will probably be referred to an appropriate provider.


Sunday, November 16, 2014

The Role of the Medical Assistant in Risk Management In the Medical Office

Dr. Schreiber of San Augustine giving a typhoi...

Thursday, November 6, 2014

Looking at Prescription Drug Addiction in Our Patients

Prescription
Prescription (Photo credit: Wikipedia)
Drug companies use direct-to-prescriber advert...
Drug companies use direct-to-prescriber advertising in an effort to convince prescribers to dispense as written with brand-name products rather than generic drugs. (Photo credit: Wikipedia)

Anyone who pays any attention to the news knows that in general populace addiction to prescription drugs is seen by some experts as being at a record high. Many folks feel like they can hide their addiction because no one really questions you're going to the pharmacy to get just what the doctor order. Prescription drug use and abuse does not have the same stigma for the abusers as 'street drugs."


Many people feel sorry for the prescription drug addict, because the doctor gave them the drugs and the addiction is viewed as some unfortunate medical accident. We seem to overlook the fact' like all addicts, prescription drug addicts lie, steal, and cheat to keep themselves in the prescription drugs they are addicted to.
English: A graphic map showing the rates of ac...
English: A graphic map showing the rates of accidental prescription drug overdose deaths for the state of Ohio by counties for the years 2004 to 2008. Information obtained from here and here. (Photo credit: Wikipedia)





All medical assistants should has a basic understanding of how prescription pain drugs pose a threat to the patient’s health. Yes, physicals and nurse practitioners prescribe drugs, but medical assistant take medical histories and obtain medical records. You may be the first person to notice that a new patient has be doctor hopping or has gotten multiple prescriptions for different kinds of pain drugs. T
These are red flags in a patient’s medical record. Many times addicted patients return again and again to their primary care physicians with complaints of headaches or back pain that no apparent cause can be found. Many times if these patients are referred to specialists or for further testing, they put up a great deal of resistance. They will balk at the suggestion of physical therapy for pain related to an injury. They want pills and many times will even suggest to the doctor the kind of narcotic that works best for them. You as a medical assistant may be the first to notice this type of behavior.
A busy doctor may be just too busy to notice these types of behavior. It might be helpful to tell the doctor you think a patient might be engaging in drug seeking behavior,  Be sure to back you suspicions with information from the patient’s chart. 

When retrieving records for new patients , be sure the prescriptions the patient’s says they are on, match the patient’s record. Many times the patients forget to tell you about the prescription for pain killers from the dentist. They are bold enough to complain of back pain and get another prescription from you. Many times pain killer addicts use multiple pharmacies;so it may take a little extra work for you to get an accurate picture of what drugs your patient is really taking.
.Those who are addicted to Vicodin, Zanax, or Oxycontin tend to miss a lot of time at work. Many sit at home in a stupor  making up ailments to gain more access to the prescriptions they are addicted to. I am not sure we will actually know how much property damage or death is caused by drivers addicted to prescription drugs. Only those who appear seriously impaired would probably be tested by authorities at an accident scene . Someone impaired on Vicoden does not reek of alcohol.

There is a public awareness of the problem of teens getting high out of their parent's medicine cabinet. Those five  pain pills that are a couple of years old patient’s  have left over in their  medicine cabinet; are not the real problem. The 20 pills  a teen takes regularly out of the  mom’s hundred Vicoden is the source of serious teen addiction..  Patients may deceive health care providers with complaints that they have a chronic pain condition. Over use of painkillers leads to the painkillers not being effective anyway. The dose must be upped on many drugs for them to work for patient pain.
States are now using computers to track the distribution of  controlled substances from pharmacies. Still an addict will not hesitate to cross state lines to bypass these types of obstacles. Even older patients are at risk for pain killer abuse. That sweet Mrs. Jones may have several active prescriptions at pharmacies in Florida as well at the corner drug store.  

Ask about any prescriptions that might have been obtained by the patient on vacation or when wintering outside of your own state.

There are alternative methods of treating people with chronic pain. Acupuncture, bio feedback and just losing a few extra pounds have brought pain relief to thousands of patients. Still there is no magic cure for chronic pain and certainly no magic pills.. We must make sure our  patients understand that just because it came from doctor does not mean prescriptions are a real cure all for chronic pain.

We need to discuss prescription drug addition with teens because once they are addicted from raiding mom’s medicine,t the next level of addiction will have them forging prescriptions or ordering mail order prescriptions off the internet. The cost of most of the addictive drugs is not as draining on our teen wallets as the street drugs. Most teens will not get caught popping a pill at the water fountain in the hall at school. We need to examine our own attitude to the popping a pill for every small ailment. It is better to show your patients healthy ways to deal with pain, Doctors and supporting staff need to show patients  the ultimate solution to pain management does not come in the form of a pill.

Friday, October 31, 2014

Undertanding The Patient With Anxiety Issues

Panic attack
Panic attack (Photo credit: Wikipedia)
English: This chart shows the lifetime prevale...
English: This chart shows the lifetime prevalence of anxiety disorders found in the Epidemiological Catchment Area Study. Data from: L. N. Robins and D. A. Regier, Eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York, NY: The Free Press. (Photo credit: Wikipedia)
English: Signs & Symptoms of Anxiety
English: Signs & Symptoms of Anxiety (Photo credit: Wikipedia)
English: An anxious person
English: An anxious person (Photo credit: Wikipedia)
Millions of Americans need help to deal with anxiety related health problems. If your patient reports anxiety to you when you take a medical history then you should report it to the doctor. Screenings for anxiety and depression are now part of routine check ups. What really is anxiety? Many people are anxious when they come to see the doctor for any reason. If a patient’s blood pressure is high and it is not part of their medical history to have hypertension there is a good chance anxiety is the cause. Taking the blood pressure again after the patient has settled in the exam room sometimes solves this issue.  Having a base understanding of anxiety is good for any Medical Assistant to help them understand this common patient issue.






Anxiety is a natural emotion that all humans experience. It is both a physiological state and a psychological state. It is a state of reaction to a perceived threat real or imaginary  causes people stress on all levels of experiences: cognitive, physical, and emotional. It determines that way we act in situations that generally trigger fear. Many people suffer from a generalized state of anxiety unable to understand what triggered it. It can manifest itself in panic attacks or just a state of constant worry and depression.
Anxiety is not always a non rational response to one's environment. It can be a normal reaction to everyday stress and the uneasiness can push us to complete tasks that it would be our natural inclination to avoid. A student feeling mild anxiety over an upcoming test might be inclined to study.
A student feeling severe anxiety about a test may be so paralyzed by fear that they cannot take a test at all. The measure or good motivational anxiety and pathological anxiety are a very personal thing. No one suffering panic attacks is experiencing motivational anxiety , but a child anxious to pass a test may be motivated to put up the videogame and study by a little anxiety.
There are different types of anxiety disorders. One type is a spiritual anxiety called existential anxiety. This tends to be the type of disorder freshman in college experience when they learn to think critically and realize that life is more complicated than it appears. They are no longer sure of the safe guards’ of meaning and purpose in life that they grew up with. This can be seen as a positive anxiety as it motivates people to define their own purpose in life and pick their own spiritual path.
Older people may again question the meaning of their lives in middle age. Again, a little anxiety is a good motivation to reevaluate the purpose of your life. This type of anxiety is best addressed by spiritual advisors and life coaches. It is part of the growth of spiritual and emotional maturity to realize that the decision you make in life determine your purpose and meaning
There are situational events that will trigger anxiety to some degree in almost all people. Most people will experience anxiety before a test. Still, for most people this is motivation that causes them to adopt positive actions to pass the test. It becomes pathological anxiety when it causes a person to be so consumed by fear they cannot take the test. This is also true; when it comes  to stranger anxiety and social anxiety. If a person is wary of strangers and avoids walking in dark streets for fear of getting mugged, then most would agree that is rational anxiety. If a person refuses to leave their house for fear of meeting any stranger on the street, it becomes a mental health issue
Most people do not suffer from an anxiety disorder to the point they will not leave the house. More likely people seek treatment for anxiety disorders when they suffer from panic attacks. They become flushed, sweat, and shake. Some people experience chest pain and think they are having some sort of coronary attack. Many people report feeling they are 'dying" during a panic attack. Many people will head to the emergency room when they have their first panic attack.
Many people do not know what triggers a panic attack. They will generally develop a fear of the environment that triggered the first panic attack. If you had a panic attack driving to the mall you would then probably not want to drive to the mall. Still the underlying cause of the panic attack; most likely had nothing to do with driving to the mall. Behavioral therapy helps people find the true triggers for their anxiety and helps them see their fears in a rational light. The goal of behavioral therapy is to give practical ways to behaving that stave off a panic attack.
There are other mental health disorders associated with anxiety. Post traumatic stress syndrome is one where the experience of a traumatic event keeps promoting a reaction of depression, anger, and anxiety long after the traumatic event has passed. It is usually a combination of medication and therapy that help people with this type of anxiety.
Obsessive compulsive disorder can also be seen as an anxiety disorder. People channel their anxiety into obsessive behaviors in order to feel in control of their environment. Unfortunately ,the obsessive and compulsive behaviors of these individuals become as source of increased anxiety of which the individual has no control. Again, medication with therapy is the approach most medical professional use to deal with OCD.
In the general category of anxiety there are a number of disorders that can affect the individual. The following are all considered anxiety disorders; Generalized Anxiety Disorder, Panic Disorder, Agoraphobia, Social Phobia, Obsessive Compulsive Disorder, Specific Phobia, Post-Traumatic Stress Disorder, and Acute Stress Disorder.
Many anxiety disorders are more common in women than men. Conditions like Post Traumatic stress however, will affect a significant amount of males who have served in the military, as opposed to a male just in the general population.
There appears to be biochemical and genetic factors that lead to anxiety disorders. Most people can find some relief from symptoms in cognitive / behavioral therapy and medication. Some people suffering from a generalized state of anxiety unable to identify a true trigger will opt to control symptoms with just medication.
The fast paced nature of life in the world today probably means we will be seeing an increase in individuals with some sort of anxiety disorder. Relaxation techniques and stress relieving exercises and family time can help most people deal with the anxiety of everyday life. People should avoid using recreational drugs and alcohol to self treat anxiety symptoms as an issue with substance abuse could develop.

If your patient is anxious to the point it affects their every day work and family relations they seek out professional help. 

Thursday, October 23, 2014

Understanding Steriods in Patient Treatments






Various anabolic steroids. Author: Wikidudeman...
 (Photo credit: Wikipedia)
Generic structure of the steroids, numbered
Generic structure of the steroids, numbered (Photo credit: Wikipedia)
Steroids are prescribed for numerous conditions including in high does to treat conditions like cancers(in conjunction with chemotherapy and for most autoimmune disorders Steroids are used in small does and most people will find themselves starting at a higher dose and , “stepping down” to a lower dose. Depending on the condition you are being treated for you will find yourself stopping them completely or staying on a maintained dose.
It is amazing how many conditions are treated with steroids. Lupus, rheumatic fever, severe asthma, and even organ transplant patients will find themselves using steroids. It also is administered in many different forms. There are steroid creams for skin conditions, sprays, shots, and pills.
Steroids act on the body by decreasing inflammation. Dexmethsone is a common steroid prescribed for pain. However predisolone may also be used to treat pain. The use of steroids in palliative care in the elderly has become wide spread. Steroid can interact with mineral absorption and cause elderly patients to be more inclined to weakening in bones and joints. The benefits of treatment for chronic pain of steroids as a whole is something doctors will consider if you are prescribe steroids for strictly pain control.
The degree of side effects you can expect from steroid usage is really dependent on dose. These are the most common side effects and some solutions to them
Heartburn – Steroids like aspirin can upset your stomach. It helps to take steroid with a meal and possibly with milk.
Mood Swinging-Most people fell anxious and more emotional on steroids. Try not to take yourself too seriously if you find yourself feeling this way. Avoid emotionally stressful situations if you can during your steroid therapy
Insomnia- Steroids can give you an adrenal rush so avoid taking you medicine right before bed. It is ideal to take you doses as early as possible to avoid this side effect
Weight gain- Steroids tend to make you retain water and have a huge appetite. Your weight will eventually return to normal after therapy has stopped. If you eat more doing treatment tries to stick with fruits, nuts, and other healthy snacks.
Increase in Acne: Many people find the acne they had outgrown in adolescence returning with steroid use. Home remedies and over the counter acne treatments should minimize this side effect.

Some of the more serious side effects are only likely to occur with long term treatment. Vision problems like glaucoma or cataracts can occur during treatment. Any changes in your vision when receiving steroid treatment should be reported to your doctor. Blood pressure and blood sugar increase in people being treated with steroid therapy. The doctor may need to adjust the dosage of any high blood pressure medicine you now take to keep you hypertension under control. The same is true if you are a diabetic, the doctor may adjust your insulin.
Steroids lowers your immune system .To be on the safe side avoid contact with people you know are ill. It is also good to avoid people who have recently been vaccinated and to no be vaccinated you during steroid treatment.

People on long term steroids can develop some odd problems that the doctor will be looking for. Call your doctor if you develop a swollen face. This is known as,”Cushing syndrome “and your doctor will want to know about it. Your doctor also will monitor you for weaker bones and muscles that can occur as a result of long term steroid use.



Buttock injections are a common way for patients to recieve steriods.