Here Comes the Sun!
We wait for it all winter long and then there it is – that glorious sunshine! It literally and emotionally brightens our day. But we also need to be careful of its effects when we stay outside as the days get longer. Sunburn can be a bad side effect of soaking up those warm rays.
The first signs of a sunburn may not appear for a few hours. By the time the skin starts to become painful and red, the damage has already been done. The pain is worst between 6 and 48 hours after your exposure to the sun. In severe sunburns, your skin may blister.
If you have a sunburn you can try a few things at home to relieve the pain. Take a cool bath or shower or apply a cool, clean damp towel to your injured skin. Apply aloe vera or moisturizing lotion several times a day. Take over-the-counter pain reliever like aspirin, ibuprofen, naproxen or acetaminophen.
The flip side is what not to put on your skin if you have sunburn. Don’t use petroleum jelly, butter, egg whites or other home remedies on your sunburned skin. They can actually prevent or delay healing.
If you or a loved one experience the following symptoms after sun exposure, call a healthcare provider immediately or go to your nearest emergency room:
- fever or chills
- nausea or vomiting
- the sunburned person is a child under a year old
- the burn has blisters or the skin appears white or is numb
Soaking up the sun for extended periods of time can put you at risk for possible complications. If your skin blisters and the blisters rupture, you are at risk for bacterial infection. Also, you could be accelerating the aging process of your skin, a condition called Photoaging that can leave you with deep wrinkles, freckles, large brown lesions, fine red veins on your cheeks, nose and ears or even thinner, more translucent skin.
Other even more intense issues could include Actinic Keratoses, considered a precancerous condition that appears as rough scaly patches in sun-exposed areas, skin cancer and/or eye damage.
Prevention is the best way to be “sun safe”
We all want to enjoy the sunshine and have fun outside, so be sure to take preventative measures so that you can continue to enjoy it every day and not have any sun side effects.
Wear a wide-brim hat and sunglasses to help protect your eyes from harmful UVA and UVB rays. Loose, lightweight shirts will also provide an appropriate amount of protection, but the most important item to wear is sunscreen.
The American Cancer Society encourages the “Slip! Slop! Slap! and Wrap” method to protecting you and your loved ones from the sun’s harmful rays:
- Slip on a shirt – wear clothes to protect your skin
- Slop on sunscreen – a palmful every two hours and more often if you are swimming or sweating
- Slap on a hat – a wide brim hat is best to protect your ears, eyes, forehead, nose and scalp
- Wrap on sunglasses – choose glasses that block 99% to 100% of UVA and UVB radiation
With so many products on the shelf, how do you choose what’s best for you? While no sunscreen will block all UV rays, a broad-spectrum sunscreen which contains active chemical and physical sunscreen ingredients is a good choice. Broad spectrum sunscreens contain ingredients to protect against exposure to both UVB and UVA lights.
Read the Label
Look for three active ingredients when you’re selecting your sunscreen:
- Padimate O (Octyldimethyl PABA), Homosalate, Octisalate (Octyl salicylate), or Octinoxate (Octyl methoxycinnamate or OCM) for blocking UVB rays.
- Avobenzone (Parsol 1789) or Ecamsule (Mexoryl) for blocking UVA rays.
- Octocrylene, Titanium Dioxide, or Zinc Oxide for blocking both UVA and UVB rays.
The American Academy of Dermatology recommends everyone use sunscreen that offers the following:
- Broad-spectrum protection (protects against UVA and UVB rays)
- Sun Protection Factor (SPF) 30 or greater
- Water resistance (up to 40 or 80 minutes)
When using sunscreen, one key thing to remember is that regardless of the SPF or whether its waterproof, it’s important to re-apply sunscreen every two hours to make sure the ingredients are still active. For more information, go to SkinCancer.org and search “sunscreen” and talk with your dermatologist about skin and sun safety.
Did you know?
Sunscreen is considered an over-the-counter drug by the U.S. Food and Drug Administration (FDA) who regulates sunscreen safety and effectiveness and governs the manufacture and marketing of all sunscreen products including safety data.
Healing Waters: Osteoarthritis and Aquatics
Joint pain. Stiffness. Less movement. An estimated 27 million Americans live with osteoarthritis (OA), a painful, degenerative joint disease primarily affecting your cartilage. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, it’s the most common type of arthritis and predominantly occurs in the knees, hips, hands, and spine.
Cartilage is the slippery tissue that covers the ends of bones in a joint. Healthy cartilage allows bones to glide over each other and helps absorb the shock of movement. With osteoarthritis, the top layer of cartilage breaks down and wears away, allowing bones under the cartilage to rub together, and often making the joint swell.
Many different factors are believed to play a role in whether or not you get osteoarthritis: genetics, age, obesity, injury or overuse.
While there is no cure for osteoarthritis, several treatment options are available including exercise, weight control, physical therapy, non-drug pain relief techniques, bracing and medical equipment, prescription medicines, complementary and alternative therapies, and finally surgery.
Exercise is probably the most important thing each of us can do to maintain our health throughout our lifetime. But for people who have this disease, just moving a joint can be painful.
Telling a patient in pain to exercise doesn’t really put a smile on their face. That’s when aquatic therapy can help. Whether a patient requires surgery or not, this exercise can help a patient with limited mobility regain his or her strength without the added stress of weight or gravity. Harnett Health offers both aquatic therapy and aquatic exercise classes at Betsy Johnson Hospital in Dunn.
For patients who have had surgery or have significant limitations in range of motion, strength, or endurance, aquatic therapy may be an option. With aquatic therapy, a physical therapist works individually with the patient in the pool providing them with one-on-one instruction as part of their physical therapy program.
Aquatic exercise is a class environment without the direct supervision of a physical therapist but led by an aquatic exercise instructor. Bobbie Barbour who has been an aquatic exercise instructor with the hospital since 2005 says, “We have several different exercise routines for people who use this program. We customize the program to each person’s ability and the speed at which they are comfortable doing the routines. If they can only do three leg lifts with correct form, that’s three they didn’t do yesterday.”
Not only are range-of-motion exercises important but equally important is the cardiac workout. “We have a variety of water toys such as noodles, weights, dumbbells, and scoops to get your heart pumping,” says Bobbie. “When someone comes in here with a bad knee, they need to work on those muscles but they need to work on the most important one, too… their heart muscle.”
Aquatic exercise can help a person regain enough strength and mobility to eventually be successful with an exercise program out of the pool. Aquatic exercise classes are not usually covered by insurance, but the prices are very reasonable. A two-day per week program is less than forty dollars a month, and a three-day per week program is under fifty dollars a month. To participate, a physician’s clearance is required.
If you would like more information on Aquatic Exercise or Aquatic Therapy, please call Harnett Health’s Outpatient Rehabilitation Services Department at 910-892-1000 x4610.
What’s The Deal With Gluten?
Gluten-free products are getting lots of attention lately, and more and more gluten-free products are popping up on store shelves. Is gluten-free eating a fad diet or is there more to this gluten-free trend?
Gluten is a protein found in wheat, rye, barley and triticale (a cross between wheat and rye). It is found mainly in foods but may be in other products like medicines, vitamins and supplements, lip balm, and even the glue on stamps and envelopes.
Is gluten bad for you? For most people, not necessarily. But for people with Celiac Disease, gluten can be dangerous. Celiac Disease is an immune disease in which people can’t eat gluten because it triggers a serious autoimmune response in the digestive system, can damage the small intestine and keep it from absorbing nutrients. The disease affects each person in different ways. Symptoms may occur in the digestive system, or in other parts of the body. One person might have diarrhea and abdominal pain, while another person may be irritable or depressed. Irritability is one of the most common symptoms in children. Some people have no symptoms.
According to the National Digestive Diseases Information Clearinghouse (NDDIC), more than 2 million people in the U.S. have the disease. That equates to about 1 in 133 people. Celiac disease is genetic and is more common among people with other genetic disorders, including Down syndrome or Turner syndrome. Blood tests can help your doctor diagnose the disease. Your doctor may also need to examine a small piece of tissue from your small intestine. Treatment is a diet free of gluten.
People may think that gluten-free automatically means the food is good for you. That is not always the case. To make gluten-free food taste good, the ingredients used may not be healthy alternatives. Be sure to carefully read gluten-free product labels.
If you are gluten intolerant or just want to give gluten-free eating a try, check out these gluten-free tips and foods.
Eating From Home
1. When starting a gluten-free diet don’t automatically run to the store in search of gluten-free products. Take a look at the food in your home. Many items may already be gluten-free.
2. Plan your meals and snacks in advance.
3. Make a shopping list to help you stay focused on gluten-free foods.
4. Think about how to prepare the food ahead of time to avoid contaminating your food with gluten, especially if other members of your household eat foods that contain gluten.
1. Visit a restaurant’s website to review the menu; you may find a gluten-free section.
2. Call the restaurant manager or chef to ask about preparing gluten-free options.
3. Identify yourself to the waitstaff as a person who cannot eat gluten.
4. Ask about ingredients and how the food is prepared.
More and more brands are hitting the shelves with gluten-free products, but remember that there are lots of naturally gluten-free foods too.
- Dark leafy greens and crunchy vegetables: artichokes, peas, sweet corn, potatoes, cabbage, Brussels sprouts, carrots, broccoli, turnip greens, green beans
- Gluten-free grains and flours: amaranth, brown rice, or buckwheat
- Legumes: lentils, beans, pinto, garbanzo/chick peas, kidney, navy, white, or soy
- Seeds and nuts: flax seeds, sunflower seeds, almonds with skins, pecans, pumpkin, walnuts, pistachio, hazelnut
- Oranges, grapefruit, apples, bananas
- Fresh berries with skins and seeds: blackberries, blueberries, raspberries, strawberries
- Fresh beef, pork, poultry, fish and eggs
Having the support of friends and family members may help as you adjust to your new eating habits. And, as always, consult your doctor before making major changes to your diet.
Jumoke Ladapo, MD
Board Certified Family Medicine
Lillington Medical Services
Whoa! One out of three children and adolescents are overweight or obese according to data from the Centers for Disease Control and Prevention. No doubt this is a huge and serious problem in our society, and we must do something to change the tide.
Jumoke Ladapo, MD, family medicine physician at Lillington Medical Services, is working to turn around that startling statistic by helping parents to get their kids moving.
Make It Fun
“The key to getting kids moving is to make it fun and to offer support,” said Dr. Ladapo. “Make small changes in your family’s routine that allow the children in your life to move around.”
She suggests turning household chores into games such as counting how many steps it takes to put away clothes or clean your room. The person who counted the most steps wins. Another idea is to turn TV/video time into movement time. Each time a commercial airs or a song is played on a video the kids must march in place, jump in place or dance.
You join in too! Have a few moments of fun with your children dancing around the room during a song – you’ll all feel energized and your children will see and feel your support.
“It is very important for adults to be role models of positive healthy activities,” continues Dr. Ladapo. “Let your kids see you making efforts to include more movement in your day. Small things like taking the stairs or parking farther away from a store to get in a few more steps can make a big impact on the way children view activity.”
Outside and Inside Play
Dr. Ladapo encourages play time outside as much as possible. Playing outside brings together many aspects of exercise at one time; cardiovascular fitness, building muscle strength, increasing endurance, strengthening bones, getting natural sunlight for vitamin D. Plus, children tend to play together, which teaches them social skills. “And it gets them out of your hair for a while,” she comments.
If playing outside is not feasible, do what you can to keep kids moving inside. Check out the list of inside play tips that accompanies this article.
Also, take advantage of local parks and recreation departments, which typically offer many types of sporting activities through the year for children, youth, adults and senior adults at low costs.
Encourage More Movement Activities
Another way to get kids moving is through classes at school and during before and after school programs. Talk with your kids’ teachers and before and after school program leaders about incorporating movement in the learning process and providing ample play time.
“We must get moving!” Dr. Ladapo exclaims. “Literally, moving our bodies for exercise and moving in the right direction to build a healthy generation of kids.”
To learn more about Dr. Ladapo and other Harnett Health medical staff, please visit our Find A Physician tool online at HarnettHealth.org.
Inside Play Tips
1. Help kids create a walking path through the house using construction paper. They can use arts and craft skills to design their own path blocks and use their imagination to create a game based on the path. You can also set a timer to see who can walk the path the most times.
2. Invest in an indoor trampoline.
3. Play dress up and have a Ball where everyone dances.
4. Put a treadmill or exercise bike in front of the TV. Anyone watching TV must be walking or riding.
5. Play video games that encourage movement.
Christopher Stewart, MD
Board Certified Internal Medicine
Hospitalist Program Director
Central Harnett Hospital
For so many years your parents have been independent and self-reliant. They cared for you, so the role reversal where you now need to care for your parents can be hard on you and on them. Use these helpful ideas to make this transition of roles as smooth as possible.
Christopher Stewart, MD, board certified in internal medicine and hospitalist program director at Central Harnett Hospital in Lillington, has worked with patients who are going through both sides of this family issue, “The first step is to have a loving conversation with your parents to let them know you want to be there to support them. Let them know you have noticed some changes and, if needed, get a trusted family doctor, lawyer or religious leader to help in the conversation.”
If you have siblings, be sure to get them involved too. “You and your brothers and sisters can work together to share the load,” continues Stewart. “The sibling who lives the closest to your parents could take on finding in-home care while the sibling with the best financial sense can take on the financial aspect. Break down the work so it is not overwhelming and doesn’t create hard feelings and family rifts.”
If you are an only child or would like additional resources to help in the process, Dr. Stewart recommends talking with your county’s department on aging or call or visit online the Eldercare Locator (800-677-1116).
One of the first things to do is compile a list of your parents’ doctors, medications, pharmacies, lawyers, financial advisers and financial information, including all contact information. This list could also include their friends, neighbors and fellow church members who would be willing to help when needed.
“A document that may be needed is a durable power of attorney for healthcare, which will allow an appointed person to make healthcare decisions on your parents’ behalf if your parent cannot,” commented Stewart. “Also, have your parents complete appropriate release forms so doctors have permission to release and share medical information. Another thing is to agree on one family member to communicate with doctors and medical staff so information flow is seamless and easy for the doctors and for the family.”
In-home help can be good to establish with small things at first and increased as needed. Be sure the in-home help is a good fit for both your parents and the caregiver. There are several levels of in-home care from help with running errands and light house work to caring for bed-ridden individuals.
If the load of coordinating care for your parents becomes too much, consider hiring a geriatric care manager. These professionals will assess your parent’s needs, help identify services and, if necessary, provide ongoing care management.
“Use this time to get to know more about your parents and family,” suggests Dr. Stewart. “Keeping a positive outlook will help you all, and you may discover some amazing things about your parents that you didn’t know.”
Asif Zia, MD
Board Certified Internal Medicine and Infectious Disease
Lillington Medical Services
Arthritis is a disease that destroys joints, bones, muscles, cartilage and other connective tissues in the body. Osteoarthritis (OA) is one of the most common forms of arthritis and is a joint disorder where the joint’s cartilage breaks down causing bones to rub against each other leading to pain, stiffness and loss of movement in the joint.
Close to 27 million adults have OA according to the National Arthritis Foundation. The disease can hinder a person’s quality of life and limit daily activities while also complicating other diseases such as diabetes and heart disease.
OA is generally considered a normal result of aging and is common in people of all races and backgrounds. It usually appears after age 45, and overall more women have OA than men.
There are many factors that are possible causes of OA:
- OA tends to run in families.
- Being overweight increases the risk of OA in the hip, knee, ankle, and foot joints because extra weight causes more wear and tear.
- Fractures or other joint injuries can lead to OA later in life. This includes injuries to the cartilage and ligaments in your joints.
- Jobs that involve kneeling or squatting for more than an hour a day put you at the highest risk. Jobs that involve lifting, climbing stairs, or walking also put you at risk.
- Playing sports that involve direct impact on the joint (such as football), twisting (such as basketball or soccer), or throwing also increase the risk of arthritis.
Medical conditions that can lead to OA include:
- Bleeding disorders that cause bleeding in the joint, such as hemophilia.
- Disorders that block the blood supply near a joint and lead to avascular necrosis.
- Other types of arthritis, such as chronic gout, pseudogout, or rheumatoid arthritis.
Pain and stiffness in the joints are the most common symptoms of OA. The pain is often worse after exercise and when you put weight or pressure on the joint.
If you have osteoarthritis, your joints probably become stiffer and harder to move over time. You may notice a rubbing, grating, or crackling sound when you move the joint.
The phrase “morning stiffness” refers to the pain and stiffness you may feel when you first wake up in the morning. Stiffness usually lasts for 30 minutes or less. It is improved by mild activity that “warms up” the joint.
During the day, the pain may get worse when you’re active and feel better when you are resting. After a while, the pain may be present when you are resting. It may even wake you up at night.
Some people have no symptoms of OA even though they have the disease. In such cases, X-rays are used to check for joint space and signs of wearing on the ends of bones to determine if a patient has OA.
Tests for OA
No blood tests are helpful in diagnosing OA. Physicians will look for the following factors during a physical exam to help determine if a patient has OA:
- Joint movement that may cause a cracking (grating) sound, called crepitation
- Joint swelling (bones around the joints may feel larger than normal)
- Limited range of motion
- Tenderness when the joint is pressed
- Normal movement is often painful
The physician may order an x-ray of affected joints to check for a loss of joint space. In advanced cases, the x-ray will show a wearing down of the ends of the affected bone and bone spurs.
There is no cure for OA, but its symptoms can be controlled through a variety of options:
- Medications – Over-the-counter pain relievers and/or prescription medication.
- Lifestyle Changes – Staying active and getting exercise helps maintain joint and overall movement. If your work is causing stress in certain joints, you may need to adjust your work area or change work tasks.
- Physical Therapy – Improve muscle strength and the motion of stiff joints, as well as your sense of balance.
- Massage Therapy – Provides short-term pain relief.
- Braces – Support weakened joints.
- Alternative Treatments – Acupuncture and S-adenosylmethionine (SAMe, pronounced “Sammy”), a man-made form of a natural byproduct of the amino acid methionine, are options.
- Surgery – To replace or repair damaged joints.
To learn more about Dr. Zia and other Harnett Health medical staff, including orthopedic specialists, please visit our Find A Physician tool online at HarnettHealth.org.
Also known as viral rhinitis, the ordinary cold is among the most common infections among humans. It is primarily an upper respiratory track infection that can be caused by several virus families. The virus family that is responsible for up to 40 percent of colds is called rhino-virus and it has over 100 distinct virus types.
Since common cold symptoms can be caused by so many viruses, it has not been possible to develop a simple cure for the infection. The common cold should not be mistaken for influenza, which can make you ill for much longer, has more severe symptoms, and can result in hospitalization or lead to serious health problems including pneumonia.
Common Cold Symptoms
Typical symptoms associated with common cold are well known to both doctors and patients. Over half of patients start by developing a sore throat followed by congestion in the sinuses and the nose, sneezing and a runny nose. These symptoms are usually accompanied by fever, cough, and hoarseness which may outlast them sometimes by a few weeks. High fevers, are however, rare from common cold alone.
Other less common symptoms of common cold include:
- Decreased appetite
- Muscle aches
- Sore throat
- Post-nasal drip
The symptoms will however, last longer if you have developed a viral bronchitis concomitantly. This happens when the same virus infects both your upper airways and the inner airways. Apart from bronchitis the congestion caused by the common cold can create conditions for other illness, with bacterial sinus infections (sinusitis) being the most common. Patients with respiratory track complications such as asthma may experience more severe symptoms lasting for a month or even longer.
Common Cold Prognosis
Patients are at their most infectious during the first 24 hours but they continue to remain infectious for the duration of the symptoms. As the cold progresses, the discharge from your nose will initially be runnier but will thicken and may even turn yellow. However, this is quite normal and there is rarely any need for antibiotics.
In most cases, the common cold goes away within five to ten days although a few symptoms can last for as long as three weeks among certain individuals. There are over one billion cases of colds in America every year but complications are rarely reported.
Common Cold Prevention
Transmission of the common cold commonly occurs when viruses that cause the disease from the mouth, nose or sneezed or coughed as droplets by an infected individual come into direct contact with a healthy individual. Viruses passed from the hand of one individual to another’s hand can also result in transmission if the second person proceed to rub or touch his/her nose or eyes, where a new infection takes root. One can also get infected by coming into contact with surfaces recently touched by a infected individual.
Due to the ease with which the common cold gets transmitted, nearly half the family members, flatmates or roommates also end up getting infected. There is also a high rate of transmission of colds in day care facilities and schools.
To lower your chances of getting infected:
- Hand washing: Adults and children should wash their hands after nose wiping, using the bathroom, preparing food, eating, etc.
- Keep your environment sterile – your priority should be to disinfect commonly touched surfaces such as door knobs, sink handles, sleeping matters, etc with an EPA approved disinfectant.
- Stop the spread of germs by using instant had sanitizers.
- Replace cloth towels with paper towels when using public facilities.
- Drink plenty of fluid to keep your immune system working at the optimal level.
- Consume a healthy diet with plenty of vitamins and minerals to optimize your immune health.
- Avoid using antibiotics unless they are really needed.
- Eat yogurts containing “active cultures” as they may help prevent the common cold.
Common Cold Treatment
Although it is possible for you to improve the symptoms of common cold using a variety of medical therapies, they do not cure, shorten of prevent the illness. It is advised to try and keep yourself comfortable by get as mush rest as possibly, drink lots of fluids and treat the symptoms. Some of the common ways to treat the symptoms of cold are:-
- Gargle warm salt water to soothe sore throat
- Inhaling steam with or without essential oils and herbal aromas can temporarily relieve nasal congestion
- OTC remedies containing decongestants help relive congestion and stop secretions. They can also be used to stop cough if I is triggered by mucus in the throat.
- Antihistamines are used to relive symptoms of watery eyes and runny nose.
- According to some studies, zinc lozenges can shorten the duration of common cold symptoms.
Antibiotics should not be used to treat common cold and its symptoms.
When to call your physician
Some cases of common cold can result in the development of complications such as bacterial infections of the lungs, sinuses or middle ear. If you develop ear pain, tooth ache, high fevers, breathing difficulties, severe pain over the sinuses, then it is advised to consult your physician to ascertain that you have not contracted a more serious illness such as bacterial sinusitis, a middle ear infection, pneumonia or bronchitis.
Harnett Health is proud to announce that our four primary care practices have earned a Level III Designation as a Patient Centered Medical Home and are currently the only facilities in our county with this designation. Being a Patient Centered Medical Home means we are committed to your total well-being by providing comprehensive, continuous medical care. It means building a lasting partnership with you so that together, we can care for your health today and help prevent illnesses tomorrow.