We are pleased to welcome Dr. Heather Rivera Gutekunst to the practice. She is double board certified in Internal Medicine and Pediatrics and board eligible in Allergy and Clinical Immunology. She has expertise in the treatment of allergies, asthma, sinus disease and immunodeficiency.

A native of Raleigh, Dr. Gutekunst attended UNC-Chapel Hill for her undergraduate studies. She went to medical school at the Brody School of Medicine at East Carolina University and interned at the Maine Medical Center in Portland, Maine. She completed her residency at Georgetown University Hospital where she was Chief Resident in Internal Medicine and Pediatrics. She received her fellowship in Allergy and Immunology at the University of Virginia Hospital.

Dr. Gutekunst is practicing at the Durant Medical Center office location. She is accepting new pediatric and adult patients and those in need of specialized allergy care.

Wake Internal Medicine Consultants, Inc. is pleased to welcome Wake Women’s Health to our family of medical practices. Wake Women’s Health is a gynecology practice committed to providing women’s health care that is up-to-date, compassionate and patient friendly.

The doctors of Wake Women’s Health are Richard Kurzmann, MD, Rildia Pritchett, MD, and Wanda Radford, MD. The doctors previously practiced at Capital Area OB/GYN. Each brings extensive experience to the new practice.

The doctors are welcoming previous patients back and looking forward to serving new patients. Wake Women’s Health offices are located at 3100 Blue Ridge Road in Raleigh. Appointments may be made by calling (919) 719-2600. The practice website www.WakeWomensHealth.com will be available shortly after publication of this newsletter.

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Lyme disease is a bacterial infection that is spread by deer tick bites. It can affect the skin, joints, heart and nervous system. It is NOT contagious. Not every tick carries lyme disease, so don’t panic if you find one on yourself. There are three phases of lyme disease; early and localized with skin inflammation, early and disseminated with heart and nervous system involvement and late-stage disease with motor and nerve damage. Take heed of the following symptoms to “nip it in the bud” in the first stage:

EARLY SYMPTOMS OF LYME DISEASE
In the first few days after a tick bite, the skin around the bite develops an expanding ring of redness. It is flush with the skin and will resemble a “bull’s-eye” in appearance. The redness of the skin can be accompanied by fatigue, muscle and joint stiffness, swollen lymph nodes (swollen glands) and headache. The redness will resolve itself without treatment in about a month but the bacteria can spread throughout the body during this time and affect the joints, heart and nervous system. Some but not all people will develop a rash.

LATER STAGES OF LYME DISEASE
If Lyme disease is not controlled in the early stages, it can cause inflammation of the heart, nervous system issues such as Bell’s Palsy (facial muscle paralysis), meningitis, or arthritis of the joints (most commonly the knee). A blood test can determine the stage of the disease and proper treatment may then be administered. Some symptoms of late stage Lyme disease can include headaches, unexplained hair loss, twitching of the facial muscles, tingling of the nose, or pain or stiffness in the neck or jaw. You may have only one of these symptoms or several, but it is very important to get to the doctor as soon as any of them occur for a proper diagnosis.

HOW IS LYME DISEASE TREATED?
Most cases of Lyme disease are usually treated with a 2- to 4-week course of antibiotics. Cases that are diagnosed quickly and treated with antibiotics almost always have a good outcome. A person should be feeling back to normal within several weeks after beginning treatment. Antibiotic treatment will get rid of the rash within one to two weeks with no long-term consequences. Later stage illness will require intravenous drugs.

HOW CAN I PREVENT LYME DISEASE?
If you are going into an area where ticks are known to be plentiful, follow these tips:

• Spray exposed skin with an insect repellent containing 20% to 30% DEET.
• Wear long pants tucked into boots and a long-sleeve shirt.
• Wear light-colored clothing foreasier detection of ticks.
• Keep long hair pulled back or wear a cap for protection.
• Examine clothing, skin and hair after leaving the area.
• Wash your skin, scalp and clothing upon immediate return from a tick-infested area.
• Remove the tick as soon as you discover it. Use tweezers to grasp the tick firmly, next to your skin. Pull upward and steadily until the tick lets go of the skin. DO NOT twist or jerk the tick. You could risk leaving part of its body in the skin. DO NOT squeeze or puncture the tick because it could release bacteria. Wash your hands and infected area immediately with soap and warm water. Swab the bite site with alcohol.
• Put the tick in a jar of alcohol to kill it and take it to the doctor or vet to determine if it is carrying any harmful bacteria.
• Check your animals thoroughly for ticks.

If you find a tick, the best course of action is to remove it, treat the area and watch for symptoms. Starting antibiotics quickly will lessen the risk of having more serious and prolonged problems.

The hottest months of the year are upon us, and along with the heat comes an increase in outdoor activities. While it’s important to be outside and active, it’s vital to make sure you follow some basic rules to keep your body safe from the dangers of too much sun and heat. Skin cancer is the most common form of cancer in the U.S. The two most common forms of skin cancer – basal cell and squamous cell carcinomas – are highly curable. The third most common form, melanoma, is much more dangerous and is caused by exposure to ultraviolet (UV) light from the sun or tanning beds. To block against UVA and UVB light from the sun, follow these tips:

• Use a water resistant sunscreen or sun block that has a sun protection factor (SPF) of 30 or higher and says on the packaging that it provides broad-spectrum coverage against BOTH UVA and UVB light. Reapply every 1 1/2 to 2 hours.

• Wear a hat outside.

• Wear sunglasses that protect against both UVA and UVB light.

• Wear a shirt if you will have prolonged exposure to the sun.

• Wear lightweight and light colored clothing.

• Avoid drinks with caffeine and alcohol. They can dehydrate the body.

• Seek shade between the hours of 10 a.m. and 4 p.m.

• NEVER leave a child or pet in a car for any length of time in extreme heat.

• Drink plenty of fluids. When you sweat you lose water, and it’s important to replace lost fluid to prevent heat exhaustion. Drink before you become thirsty. By the time you feel thirsty, dehydration is already setting in.

• Get out of the sun if you feel overheated, tired, weak or dizzy. Take frequent breaks and head to the shade for rest and fluid replacement.

• If a person stops sweating and has very red, hot skin, a very high temperature, becomes uncoordinated, confused or even loses consciousness, seek medical attention immediately. Heat stroke is occurring and can be extremely dangerous and even fatal if not treated quickly.

There is no reason you can’t enjoy the summer outdoors...just be careful to follow some basic rules and pay attention to your body for signs that it is receiving too much sun or heat.

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Food Safety in Hot Weather

It’s summertime and that means pool fun, barbeques and picnics. What you don’t want invited to the party is bacteria. Each year over 70 million cases of food borne illnesses occur in the United States. These illnesses may cause nausea, vomiting, diarrhea and fever. Symptoms can be mild or quite severe. Follow these tips to keep your food and your picnic safe and healthy!

• Pay attention to how long your dishes sit out. Most of your food will be safe for only up to two hours before the temperature reaches the bacteria breeding stage. If the air is over 90 degrees, cut that time down to one hour maximum. Once the food reaches that time limit, throw it out.
• Keep cold foods cold until the very last minute. Use coolers and ice packs if you are away from home.
• Keep uncooked meats in a separate cooler from your drinks and ready-to-serve dishes. Be careful of foods that contain mayonnaise, eggs and potatoes (favorites such as pasta salad and potato salads). Bacteria grow quickly within these ingredients, so keep the salads cold for as long as possible and only put out enough to be eaten within 45-60 minutes.
• Fresh fruits need to be eaten within one to two hours of cutting. If they are not yet cut, they can stay at room temperature for days.
• Casseroles should be cooked to an internal temperature of 165 degrees and held at 140 degrees using insulated containers.
• Ground beef and chicken should be cooked to an internal temperature of at least 165 degrees.
• Keep all raw meat and poultry cold until the time you cook it. Don’t grill frozen meats because they can be tricky to cook safely and to the right temperature.
• Condiments are not a problem as they are acidic. Just keep the tops on to maintain freshness.
• Cookies, breads and crackers can be kept at any temperature but keep the packages closed for freshness.
• Pack clean utensils for serving. Once you have used a utensil for raw meat, place it in a separate box or plastic bag until taken home for cleaning.
• Clean the grill before cooking.
• Bring spray cleaners, wipes and napkins to clean the table before eating.
• Make sure your guests use separate utensils for serving. Do not let people serve themselves with spoons and forks they have eaten with.
• Make sure everyone uses wipes or a hand sanitizer to reduce the spread of bacteria.
• Pack your cooler in the reverse order of how the food will be eaten.

Following basic rules of food safety will ensure your event is healthy and fun by keeping party-busting bacteria away.

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