Call a doctor if you have skin rashes:
- accompanied by a fever. In this case, call the Generations' office immediately. Rashes with a fever may indicate scarlet fever, measles, mononucleosis, or shingles.
- accompanied by other general illness, which may indicate more serious illnesses or infections.
- all over your body. This may be a more serious allergic reaction or sign of infection.
- including blisters. Blisters and open sores in your rash may indicate an internal cause or a reaction to a medication.
- that are painful or infected. Signs of infection are a yellow or green fluid, swelling, crusting, pain and warmth in the area of the rash, or a red streak coming from the rash.
Seizures are a scary thing to witness, especially if it happens to your child. More than 3 million Americans have epilepsy, and many pediatric epilepsy diagnoses begin in childhood.
Epilepsy is a problem in the central nervous system in which electrical signals of the brain misfire. A seizure occurs when these misfires cause communication problems between nerve cells. This “electrical storm” can cause a person to behave in odd ways. There is a lot of false information surrounding epilepsy.
What You Need to Know About Pediatric Epilepsy:
- One or even several seizures does not mean your child has epilepsy.
- Epilepsy isn’t the only cause for childhood seizures, so the diagnosis needs to be made by a doctor.
- The good news is that epilepsy does not usually worsen over time.
- It is not a mental illness and does not affect intelligence.
- Epilepsy is not contagious.
If your child has seizures or spells of confusion, shaking, or staring, visit his or her doctor. He or she will refer you to a pediatric neurologist, who can conduct tests to determine problems with the brain or neurological system. Blood tests may help find the cause of the seizures, but in more than half of epilepsy cases, doctors cannot find a cause.
March 26 is Purple Day for Epilepsy Awareness. Purple Day was started in 2008 by Cassidy Megan, a child with epilepsy. Her goal is to raise awareness through events. Visit her website to learn more about how you can help.
An estimated 1.6 million people -- 80,000 of those being children -- are living with Crohn’s Disease or Colitis in the United States today. That’s 1 in every 200 Americans! Inflammatory bowel disease (IBD)are debilitating, medically incurable diseases that attack the digestive system. Many patients experience numerous hospitalizations. About 23-45% of people with ulcerative colitis and up to 75% of people with Crohn’s disease will eventually require surgical intervention for their disease. Although considerable progress has been made in IBD research, the cause is not yet known, nor is there a cure.
Carinne Woodworth, PA-C is asking for your support as she “Takes Steps” to fight Crohn’s and Colitis!
Triangle Take Steps is a walk being held April 29 to raise awareness and money for research in the hopes of finding a cure. Your support can be achieved through well wishes and prayer, as well as financial support. Donations can be made directly to the The Crohn's & Colitis Foundation via Carinne’s Walk page. Or you can chose to join Carinne and her walking group, Carinne’s CUREageous CROHNies, for a fundraiser dinner at Diced Gourmet Salads & Wraps. Carinne has set a fundraising goal of $5000 and would love your support in reaching that milestone!
I knew at a very young age, 5 years old in fact, that I was going to go into the medical field. Twenty years later I completed my school to do just that. In 2009, I received my license to practice medicine as a Physician Assistant. I met my best friend, and now husband, five years prior, in 2004. We had our lives planned out. I was going to finish my schooling. We would move to North Carolina, get married and continue on our path to live our dreams with a few kids added to the mix later on. However everything changed the fall of 2011.
I can remember to this day laying on the gurney looking at the television screen of my colon during my colonoscopy. Unfortunately, the medication they had given me did not put me to sleep. I heard the doctor say, "yep, that is definitely Crohn’s." I began to cry.
I was officially diagnosed with Crohn’s Disease in Fall of 2011. I met with a few different doctors in the area to get additional opinions since nothing was working to make me feel better. I was put on many different medications, none of which were helping. I became increasingly ill. I was having difficulty functioning on a day-to-day basis. I remember getting IV fluids in between seeing patients while I was working in the ER just to function. My mom insisted I get another opinion and pushed me to go to Mayo Clinic. We were not sure how I could even get to Mayo from NC in my condition; a two hour flight was concerning. Once at Mayo, I was immediately seen by a doctor. Due to being so sick, I was admitted to the hospital. Shortly after, I was diagnosed with severe Crohn’s disease when just a few months earlier I had been diagnosed with mild to moderate Crohn’s disease. They immediately started me on an infusion that I would get every 8 weeks and a weekly injection. This allowed me to feel better for a very important event in my life - my marriage to my best friend, Chad in June of 2012.
After our wedding I began to get sicker. The doctors began a regimen of medications including pills, injections, and infusions trying to find just one that would put this awful disease into remission. No such, luck. I was prescribed all of the traditional medications and still no relief. The doctors discussed trying clinical trial medications, however this meant I would not be able to get pregnant for years. This was really was not an option in my mind. After many discussions with doctors and family I had my first surgery in 2014 to remove the most diseased part of my intestines. Although this helped my symptoms for a few months, my symptoms came back with a vengeance. I was once again put on high doses of steroids with other medication. We still could not get my Crohn’s under control. In Early 2015, my doctor recommended getting a temporary ileostomy and a colon resection to give my body time to heal. Reluctantly, I agreed to the surgery. But I had so many questions: How was I going to function with an ileostomy? Would I be able to do the same things? Would my husband still want to hug me? Would I ever feel pretty again? Unfortunately, I was so sick I did not have any other option…so surgery it was.
Surgery did not go as planned. My intestines were much more diseased than what the surgeons thought. One month later I went back into surgery to revise my ileostomy. This began the scariest time of my life. The next three months were spent in the hospital. I was in so much pain and was physically unable to eat. I remember the doctors, my mother, and husband just begging me to eat but I physically could not - it was not a matter of choice. I lost 80 pounds in 3 months. It is such a scary feeling knowing that you are literally wasting away and you have absolutely no control over it. The surgeons, doctors, and residents did not know what was happening either. Since they had no medical reason why this was happening they began to doubt me wondering if I was intentionally not eating. It was a very hopeless feeling knowing that the nurses and doctors were judging me, not believing my symptoms. During this time my mother was flying from Chicago to North Carolina multiple times to stay with me. I remember sobbing when she had to leave -- this meant I would be in the hospital all by myself, as my husband had to work and take care of our furry family at home.
After 3 months of wasting away, I was finally consulted by another surgeon at a different hospital. He initiated TPN (food through an IV) right away. This allowed me to get some key nutrients, which in turn allowed me to gain some strength and heal a little. Finally, I was able to leave the hospital and go home – even though I was still unable to eat and in a lot of pain. I remember how hard it was to just take a shower. It took over an hour due to sitting down multiple times because I was so tired and weak. I was still unable to work and sat at home 24 hours a day just waiting to get better. I struggled watching my husband work nine hours a day only to come home and take care of me and the dogs day in and day out. I couldn't help but think how much stress I was putting on him and that he would be better off with someone else, someone who was healthy, could enjoy life and could be a 50/50 partner. I was incredibly depressed.In October 2015, I was still unable to do much on my own. When my husband had to go out of town for work I flew to Chicago so my mother could take care of me. The night before my flight home to NC, I developed a 102 degree temperature and became very ill. My mother called the ambulance and I was admitted into the hospital for sepsis (infection in my blood stream) from my port. This turned out to be a blessing in disguise. After treating my infection they transferred me to Northwestern Hospital to be further evaluated for my Crohn's disease.
While at Northwestern I was consulted by Dr. Strong, one of the best Crohn’s surgeons in the nation. He was able to take me to the operating room in November 2015 to fix my ileostomy and take some more diseased intestine out. This was a huge success. After the surgery my mother and husband felt that it was best to stay in Chicago for 4 weeks while I healed. My mother was able to help me since I was still getting my food and fluids from an IV as well as giving myself IV antibiotics at home. I remember calling Chad daily the first week just sobbing, begging him to allow me to come home. I was so homesick.
Life with Crohn's Disease
2015 was a rough year for my family and I, to say the least, but I fought through it with the help of my extended family and friends. After numerous wound infections, port placements, PICC placements, an 80-pound weight loss, sepsis, bacteremia, septic emboli, TPN (nutrition from an IV), and over 100 days in the hospital, I can officially say I am on the road to recovery. I will always have Crohn's disease, but I am finding ways to manage it. This includes getting a 45-minute IV infusion monthly and taking injections weekly. My recent colonoscopy in January 2017 showed no disease in my intestine and mild disease in my esophagus and stomach. This was an improvement!
I am not a believer in the phrase "things happen for a reason." I do not believe that God gave me Crohn's disease and allowed me to suffer. I do believe though that He has given me the choice on how I handle the situation I was dealt. I chose to fight this head-on and to make the best of it. I have learned so many valuable lessons over the past few years but I think the biggest one is pretty easy - life is short and can change in a moment. So live it to the fullest. Chad and I have done just that in 2016. We were able to travel, deep sea fish, watch the Cubs play in Atlanta, see my sister play flute for the Thanksgiving Day Parade in Orlando, FL, and be with family and friends. We truly do not take life for granted anymore. We are once again living out our dreams and hope in the near future we can start a family.
I still do have an ileostomy and if given the choice in the future to reverse it I would decline. I am very proud of my stoma, whom I have named ‘Stella’. She has given me my life back. ‘Stella’ does not define who I am as a person; she is just a part of me.
I thank you for reading my story and would greatly appreciate any donation you are able to give. 100% will go directly to Crohn's and Ulcerative Colitis research. I hope one day we are able to eradicate this painful disease. My hope in the future is to work with young adults who are faced with the same life-changing event as I was - living with an ileostomy. While going through this experience I found that there is not enough support and education for new ileostomy patients. It is a very traumatic experience and something that is not spoken about openly. I want to educate others that there is life on the other side - you are able to do everything you did pre-ileostomy, you will feel pretty again, and your husband will definitely still hug you.
I would like to thank all my family and friends for their love and support on my journey. I personally want to thank my husband, Chad, and mother, Pam, who have been my biggest supports and have truly been my angels. I thank God for them every day. Thank you to my Dad and friends for the visits and support as well. I sincerely thank Generations Family Practice for being so supportive and holding my job while I was out most of 2015. I can honestly say I have the BEST work family! Thank you to Bob Sweet and Streamline Plumbing for supporting my husband while we were on this difficult journey. Lastly to all my friends and family for their prayers, good wishes, cards, and visits. I am truly blessed!
Autism is treatable. People often have ideas about autism and what it means, but autism spectrum disorder can mean a wide variety of things.
More importantly, while children do not outgrow autism, early diagnosis and intervention lead to significantly improved outcomes. Knowing that it’s treatable means helping more people at a younger age.
What is Autism?
Autism spectrum disorder (ASD) is a developmental disability that affects people’s ability to communicate and interact with other people. Some people experience these on a mild level while others are severely disabled, which is why it is referred to as a spectrum. The signs of ASD usually appear during early childhood. There is no known cause of autism. Signs of autism include:
- Lack of or delay in spoken language
- Repetitive use of language and/or motor mannerisms (e.g., hand-flapping, twirling objects)
- Little or no eye contact
- Lack of interest in peer relationships
- Lack of spontaneous or make-believe play
- Persistent fixation on parts of objects
These are just a few signs. Read more at the National Institute for Mental Health.
Autism Spectrum Disorder
While people previously labeled autism separately from similar disorders, in 2013, the American Psychiatric Association merged four previously distinct diagnoses into one umbrella diagnosis of autism spectrum disorder (ASD). These are autistic disorder, childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS) and Asperger syndrome.
Your pediatrician will check your child for signs of autism during regular well visits in his or her early life. Autism cannot be diagnosed in a single meeting. Parents may raise concerns about autism, but later learn their child has Sensory Integration Disorder or even ADHD.
The Centers for Disease Control estimates autism is present in about 1 in 68 births, a large increase from the 2004 estimate of 1 in 125 births. This increase means more people are aware of autism and its costs. While there is no cure, “treatment and education can address some of the challenges associated with the condition. Intervention can help to lessen disruptive behaviors, and education can teach self-help skills for greater independence,” according to the Autism Society. There are many treatment and education options, but because the autism spectrum varies widely, it’s best to select an approach based on the best interests of your family.
This new interest in autism is important as those in the spectrum begin to age. There are high demands and pressures on families living with someone who has autism. Included in that is planning for the future.
If you have concerns about your child, don’t hesitate to ask your Generations Family Practice physician. The sooner autism is diagnosed, the sooner treatments can begin to help you, and your family, figure out a path forward.
There is a very real need for caregiver resources as the challenges that caregivers face are broad and can be overwhelming.
"Aging Matters" is a joint project among Transitions GuidingLights, Transitions LifeCare, and local Raleigh news station WPTF. This wonderful radio show helps you navigate the many choices and issues we face as we age or as we care for an aging loved one.
Show Notes & Caregiver Resources
- According to a recent Pew Research Center study, 4 out of 10 Americans are caring for an older adult with a chronic condition and 50% of Americans anticipate doing so at some point.
- Key Takeaway: Consider beginning the conversation about end of life care with loved ones before they are critically ill or in crisis.
- If you or your loved one has been diagnosed with a chronic condition, regardless of age, consider end of life planning,
- Guiding Lights Caregiver Support Center has been designed solely with caregivers in mind. It is their goal to have the very best resources and means of support for all local family and professional caregivers, that they might maximally diminish the fear, doubt, and overwhelming stress that accompany this very important aspect of family life.
- Transitions LIfeCare cares for individuals and families with compassion, support, and expertise as they navigate the end of life or life-changing illness. Wherever you or a loved one may be on a path of a serious illness or grief, Transitions LifeCare surrounds you with a comprehensive circle of expert care and support. It’s your life. It’s your choice.
Have you recently heard the term "Osteopathic Medicine?" Patients at our Generations Family Practice office may have noticed the initials behind our doctor’s names and wondered why they are different. Doctor Justin Glodowski is a DO. Doctors Melanie Mintzer, Chad Cox and Christine Macomber are MDs.
Right now, most doctors in the U.S. are MDs, but the number of DOs is growing, which means you may start to see those initials more often. So what’s the difference and does it matter to you?
MD stands for Medical Doctor. DO stands for Doctor of Osteopathic Medicine. Both are licensed to practice medicine in the United States. Both take the MCAT and follow the same undergraduate path.
Both also attend four years of medical school, complete a residency, and must meet the same requirements to practice medicine.
The difference is in the philosophy of care. MDs are an allopathic doctor, which is focused on the diagnosis and treatment of specific human diseases and illnesses.
DOs are an osteopathic doctor, which means they approach care holistically. According to the American Osteopathic Association (AOA), DOs consider a patient’s environment, nutrition, and body system as a whole when diagnosing and treating medical conditions. DOs receive additional musculoskeletal training (OMT) often used to treat muscle pain that can help patients with conditions such as asthma, sinus disorders, and migraines, according to the AOA.
Should I Choose a Doctor of Osteopathic Medicine (DO) or a Medical Doctor (MD)?
For patients, there isn’t much difference in the treatment you receive from a DO versus an MD. You can be comfortable with both. Both are physicians and will use the same modern treatments. Both will prescribe medications when needed and consider your history and health when selecting treatments and making a diagnosis. Both physicians base recommendations on scientifically-proven conclusions.
However, medical care is a personal choice, and you may prefer one philosophy over another. If you suffer from chronic pain or a musculoskeletal condition such as fibromyalgia, you might consider a DO, whose musculoskeletal training may be helpful.
The initials don’t matter as much as choosing a doctor with whom you feel comfortable discussing all aspects of your health, body, and wellness. After all, communication is the most important part of the doctor-patient relationship.
Contact us if you’re looking for a doctor’s practice that can take care of you and your family’s needs.
Bell's Palsy Symptoms May Include:
- Symptoms might show up at once or take a few days to appear, one or a few at a time. Here is what to watch for:
- twitching, weakness, or stiffness on one side of the face
- half of the face drooping (especially one corner of the mouth)
- trouble closing one eye
- dryness in one eye
- difficulty speaking, eating, or drinking
- pain behind or in front of one ear
- loss of taste at affected parts of the tongue
- changes in the amount of saliva in the mouth
- hearing sounds louder in one ear
- If these symptoms appear, go to the doctor immediately. He or she will perform tests to confirm its Bell’s Palsy.
Is It Bell's Palsy or a Stroke?
January is Cervical Health Awareness Month, which means it’s a good time to talk about the HPV vaccine. The vaccine was released for use in June 2006. While it has already been available for over 10 years and has been given to over 80 million people, the HPV vaccine is one of the newer vaccines and thus raises a lot of questions, including concerns about its safety.
All About the HPV Vaccine
Is it safe?
Yes, the vaccine itself is very safe and quite effective. Clinical trials have shown that HPV vaccines provide close to 100 percent protection against cervical pre-cancers and genital warts. And all vaccines go through years of rigorous testing before they are released for use.
Here are some other common questions answered:
What is HPV?
HPV, or human papillomavirus, is a very common sexually transmitted virus. It’s so common that nearly all men and women will get at least one type of HPV at some point in their lives. Most get it and pass it on without knowing they have it. About 80 million people, or one in four, are currently infected in the United States.
Why is it a problem?
The HPV infection can cause many types of health problems in both men and women. In women, the virus causes cervical, vaginal, and vulvar cancers. Men with HPV can get penile cancer. Both genders can also get anal cancer, cancer of the back of the throat, and genital warts. These health problems may later lead to fertility issues.
My child is young and nowhere near being sexually active. Why do we need the vaccine now?
The preteen years at ages 11 or 12 are best for the vaccine. For the vaccine to work most effectively, all doses must be given before any exposure to HPV. Plus, the vaccine produces a more robust immune system response if the doses are given at this time.
Christine Macomber, MD, Generations' pediatrician on staff explains her reasoning for administering the vaccine to her own children. "With the gardasil vaccine, I have been given the opportunity to reduce my children’s risk of getting a cancer with low risk intervention. Two of my children have already received the vaccine series; the other two will when they are eligible.”
My teen hasn’t had the vaccine yet. Is it too late?
Teen boys and girls who did not start or finish the HPV vaccine series when they were younger should get it now. In general, young women can get the HPV vaccine through age 26, while young men can get vaccinated through age 21.
How is it administered?
The vaccine is given in a series of two or three shots, spaced out during a period of several months - depending on the age at which the series is started.
What are the side effects of vaccination?
Some people have no side effects. Those who experience them usually report mild side effects, such as a sore arm where the shot was given. Brief fainting spells may occur after any medical procedure, including vaccinations. Other side effects include a fever, headache, nausea, muscle, or joint pain. HPV vaccine does not cause HPV infection or cancer.
Why is this vaccine not mandated for school entry?
Each state determines which vaccines are required for school entry. In North Carolina, this vaccine is not required, but it is recommended.
If you have more questions about the vaccine, contact us to schedule an appointment. We’ll be happy to address any of your concerns.
For the THIRD year in a row, our very own Dr. Melanie Mintzer was recognized as a Maggy Award Winner! Just as exciting is the fact that Dr. Justin Glodowski earned Honorable Mention in the class of Best Doctor. This is his second year to be honored with this recognition. The Maggy Awards are presented each year by Cary Magazine. More than 11,000 area residents vote for their favorite service heroes, and we’re proud that our doctors were chosen. We would like to say ‘Thank you’ to our patients for recognizing Dr. Mintzer and Dr Glodowski! Learn more about the awards or see the full list of winners.
Most people have heard of menopause and know that women experience it as they age. But did you know that men also go through a process during which they lose hormones? Let's take a look at testosterone replacement therapy.
Sometimes called andropause, the process in men isn’t as swift; these changes take place gradually. This hormone loss can cause some side effects, which is why many more men are asking about testosterone replacement therapy. But TRT is not for everyone.
The Effects of Testosterone Changes
Men begin to lose testosterone at a rate of about 1 percent a year starting at age 40. The changes in their reproductive system occur mainly in the testes. The mass of testicular tissue decreases; the levels of testosterone may remain the same or decrease gradually. The testes continue to produce sperm, but at a slower rate, and the tubes that that carry sperm may become more elastic. While some men experience problems with erectile function, men are often still able to father children even into old age.
These changes also affect urinary function. About 50 percent of men experience an enlarged prostate as some of that tissue is replaced with scar-like tissue. This can cause problems with slowed urination and ejaculation.
Reduced testosterone can also cause:
- changes in sleep patterns
- emotional changes, such as low self-confidence or lack of motivation
- physical changes, like increased body fat, reduced muscle bulk and strength, and decreased bone density
- reduced sexual desire, or low libido
- fewer spontaneous erections
- impotence (erectile dysfunction)
Testosterone Replacement Therapy
TRT is also known as Androgen replacement therapy (ART) and involves the prescription of testosterone either by injections, patches, or skin creams. (There is a pill form, but it poses hazards to the liver.) This therapy is often prescribed to those with hypogonadism, a condition in which the body doesn't produce enough testosterone. Many men who try TRT report improvements in energy levels, sex drive, quality of erections, and have been shown to have higher bone density and muscle mass.
The Problems with TRT
Some men are asking for testosterone to counteract some of the unpleasant side effects of normal hormone loss. On their own, low testosterone levels caused by aging do not need treatment and TRT is not recommended for this use. TRT can have side effects, and the long-term risks aren’t fully known yet because there have not been any large extended studies on its use. Experts studying this approach have concerns that such therapy might stimulate the growth of prostate cancer cells. TRT can worsen sleep apnea, cause blood clots, and congestive heart failure. Some men experience increased breast size, decreased testicular size, mood swings, or acne. However, others argue more research is needed before dismissing TRT as an aid.
Cost is another factor when considering TRT. Testosterone injections are the least expensive option, but they still cost between $150 and $400 per month and must be administered by your doctor every few weeks. Patches, gels, creams, and similar methods often cost between $200 and $500 per month.
If you are experiencing the side effects of decreased testosterone, speak to your Generations Family Practice doctor. He or she can perform tests to confirm whether your testosterone changes are due to aging or another cause and determine the best approach, whether it’s TRT or other hormone therapies.