Smart Tip:
Chew sugarless gum after you eat or drink. Chewing gum keeps the saliva flowing after you eat. Keeping that flow going after eating helps reduce the formation of cavities.

Smart Tip:
Fruits and vegetables are packed with beneficial fibers, vitamins and antioxidants. They fill up your stomach fast so you feel full earlier. They are also low in calories and helps to keep your calorie count low.

Smart Tip:
Colonoscopy prevents colon cancer by detecting polyps before they can become cancer. People over age 50 should have a colonoscopy screening which makes earlier diagnosis and treatment possible.

Smart Tip:
W
alking for as little as an hour a week can lower the risk of heart disease.

Fun Fact:
Banging your head against a wall burns 150 calories an hour.

Welcome to the Winter 2010 Edition of Wake Internal Medicine Consultants’ Smart and Healthy News!

Our first newsletter for 2010 focuses on prevention and healthy living practices. The primary topics discussed are related to national awareness months taking place early in the New Year. January is Thyroid Awareness Month; February is American Heart Month; and March is National Colorectal Cancer Awareness Month.

We are pleased to welcome a new physician to our practice, Dr. Bhavna Bhat. Learn about Dr. Bhat right below this introduction. I hope you find this information helpful, and thank you for reading our newsletter.

Sincerely,

Arvind Jariwala, M.D.

Wake Internal Medicine Consultants
Welcomes New Physician

We are pleased to welcome Bhavna Bhat, M.D., to the Wake Internal Medicine Consultants family. Dr. Bhat is board certified in Internal Medicine and will practice at our West Raleigh office.

Dr. Bhat earned her medical degree at the Government Medical College in Jammu, India, in 1999. She served her residency in the Internal Medicine program at Harbor Hospital, Baltimore, Maryland, from 2002 through 2005, then earned her Internal Medicine board certification in October 2005. She practiced as a primary care physician at Haymarket Medical Practice in Haymarket, Virginia. After moving to North Carolina in 2007, she joined Generations Family Practice in Cary, and now brings her expertise to Wake Internal Medicine Consultants.Dr. Bhat is seeing new patients as of March 1. You may contact the practice for an appointment at 781-7500. Same-day appointments are available for most specialties.

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Your Colon Health

Symptoms of colon cancer are not always obvious, and that’s why it is so important for every person to know when their body is giving them signals that can mean all is not “normal.”

What Is the Colon?
Before understanding symptoms, it is important to understand the organ involved. The colon is part of the digestive system and has a major role in helping the body absorb nutrients, water and minerals. It also helps (in the form of stool) to rid the body of waste. It is approximately six feet in length and makes up the major part of the large intestine. As you may imagine, the colon is an important organ of the human body.

What Is Colorectal Cancer?
Colorectal cancer is a disease in which cells in the colon or rectum become abnormal and divide without control, forming a mass, or tumor. It can spread and affect the tissues surrounding the colon.

What Are the Symptoms of Colon Cancer?
The scary part of colon cancer is that in the early stages people may suffer no symptoms at all. That is why regular screenings (colonoscopy) beginning at age 50 are very important to your future health.

There are two general varieties of colon cancer – local and systemic.
Let’s examine both:

Local Colon Cancer Symptoms
(bathroom habits)

  • Changes in your bowel habits. If you are going more often or less frequently, this a sign to heed and discuss with your doctor.
  • Constipation (difficulty having a bowel movement)
  • Diarrhea (loose or watery stools)
  • Alternating diarrhea and constipation
  • Bright red or dark red blood in your stool
  • Feeling like you cannot empty your bowels completely
  • Abdominal discomfort, bleeding, frequent gas, cramps or bloating

Systemic Colon Cancer Symptoms
(symptoms that affect your whole body)

  • Unintentional weight loss
  • Loss of appetite
  • Jaundice (yellowish color to your skin and whites of eyes)
  • Nausea or vomiting
  • Extreme fatigue
  • Anemia (low red blood count)

If you experience any of the above symptoms for even a couple of days at a time, you should notify your physician so he or she can determine the nature and extent of the problem.

Who Is at Risk for Colon Cancer?
While many questions remain as to the causes of colon cancer, some risk factors have been found that may be linked to an increase in development of the disease:

People over 50 are more likely to develop colon cancer.

The occurrence of polyps (abnormal growths that protrude from the inner wall of the colon or rectum). Most polyps are benign (noncancerous) but the cancer can develop in some of these polyps.

Personal history – If you have already had colorectal cancer, your chances of developing it again are higher.

Existence of ulcerative colitis – A condition that causes inflammation and sores in the lining of the colon.

Existence of Crohn’s disease – Chronic inflammation in the gastrointestinal tract.

Diet – some studies suggest colorectal cancer may be linked to a high ingestion level of red and processed meats. It can also be linked to low intake of whole grains, fruits and vegetables.

Exercise – A sedentary lifestyle may increase the risk of colorectal cancer.

Smoking – more evidence is coming to light that smoking, particularly long-term smoking, is linked to colorectal cancer.

Colon Cancer Screening: Many people are fearful and/or embarrassed about having a colon cancer screening. Relax... chances are better than average that all your caretakers have to go through it too. There are several different tests that may be given to screen for the disease.

Here is what to expect and how to prepare for a colon cancer screening:

Test Advantages Disadvantages
Fecal Occult Blood Test (FOBT)- checks for hidden blood in stool.
  • No cleansing of colon
  • Low cost
  • No bleeding in colon lining
  • Samples taken at home
  • May not detect all cancers
  • May not detect polyps
  • False positives are possible
  • Further tests may be needed
Sigmoidoscopy test -rectum and lower colon are examined
  • Test is quick with minimal discomfort
  • Doctor may be able to remove polyps
  • Less cleansing of colon needed
  • Doctor only can view rectum and lower colon
  • Small risk of bleeding/tearing of the lining of colon
  • Additional tests may be needed
Colonoscopy test- rectum and entire colon are examined
  • Doctor can view entire colon and rectum
  • Doctor can perform a biopsy and remove any polyps
  • May not detect all small polyps and cancers
  • Thorough cleansing of colon is required
  • Some form of sedation is required
  • Though uncommon, bleeding or tearing of colon can occur
Double Contrast Barium Enema (DCBE) test- after an enema containing barium, x-rays of the entire colon and rectum can be taken
  • Allows doctor to view rectum and entire colon
  • Complications are rare
  • No sedation needed
  • May not detect some cancers and polyps
  • Thorough cleansing of colon required
  • False positives are possible
  • No biopsies or polyps can be taken or removed
  • Additional tests may be needed

Your doctor will determine which test or tests would be best for you. Many things will be taken into consideration such as age, family history, potential harm of the test, and preparation needed for the test. However, screening is very important in catching and treating any abnormalities that may occur. The benefits of screenings far outweigh any discomfort of the tests. Early detection of colorectal cancer equals better chances of a long and healthy life.

March is National Colorectal Cancer Month. Follow these links for additional information about colorectal cancer and its prevention:

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Many people are fearful and/or embarrassed about having a colon cancer screening.

A sedentary lifestyle may increase the risk of colorectal cancer.

People over 50 are more likely to develop colon cancer.

Tips for a Healthy Heart

How’s this for some scary statistics?

Approximately one of every six deaths in the United States can be attributed to coronary heart disease (CHD).

  • There are more than one million new and recurrent heart attacks every year.
  • There are an estimated 10 million+ people in the United States who suffer from angina (chest pain due to CHD).
  • An estimated 500,000 news cases of angina occur every year.

These facts from the American Heart Association are pretty frightening, but there are easy and relatively painless ways to guard against coronary heart disease.

January is American Heart Health Month, so let’s review some tips on how to keep your ticker in top shape!

Stop smoking! This is the single best thing you can do for your heart. If you smoke, you are two times more likely to suffer a heart attack than a non-smoker. As soon as you cut out the cigarettes, your chances of a heart attack begin to drop. If you can’t quit cold turkey, talk to your doctor about methods of helping you quit. They may suggest Nicotine Replacement Therapy (nicotine patches, gums, nasal sprays, inhalers or lozenges) or they may suggest prescription medication, hypnosis or acupuncture. The road can be tough, but your heart AND your loved ones will thank you!

Ditch the salt. Too much salt = high blood pressure. High blood pressure is a heart attack waiting to happen. Avoid foods infused with salt such as chips, salted nuts, canned and packet soups and sauces, and ready-made meals. Check your breakfast cereal. It may be loaded with salt. Also check your bread. It can be packed with unwanted salt. If you are confused as to what a healthy diet should look like, go to the American Heart Association website www.americanheart.org. Your doctor can also offer guidelines on foods to eat and to avoid.

Monitor your diet. Everywhere you look, people are touting a balanced and healthy diet. There’s a reason. It really does make a huge difference. If your diet consists of fresh vegetables, fruits, whole grains and healthy proteins, your heart will stay in much better shape. Avoid foods like biscuits, sweets, and all products that are high in saturated fats and sugars. They may taste good, but they won’t do you any good.

Limit alcohol intake. Too much alcohol can damage heart muscles, increase blood pressure and cause weight gain. Those are three top contributors to heart attacks. Limit your alcohol intake to one or two drinks maximum per day.

Get moving. If you get your heart pumping, it will then pump blood efficiently through your body. Aim for 30 minutes of moderate exercise per day. This could be walking the dog, hitting the treadmill, or even raking leaves. If you are new to exercise, start off with a brisk 10-minute walk, pumping your arms as you walk. Then, add a minute per day to that walk. Before you know it you’ll be walking 30 minutes a day. You can sneak in exercise everywhere. Instead of parking close to the store or office, park farther away and walk that extra distance. Take the stairs instead of the elevator. Every little bit will help as you build a healthy heart.

Watch your weight. We are an overweight society and it is taking its toll on us. Carrying extra weight can and does cause a host of medical problems, but at the top of the list are heart issues. Too much weight means the heart has to work harder to pump blood through your body. If you need to drop a lot of weight, start small by making little health changes as you go. Reduce your portion sizes, cut out fats, salts and sugars. Exercise more. Develop a plan to reach a weight that is healthy and right for you. Your doctor can provide direction and recommend resources that will help you reach your goals.

Check your vital signs. Have your doctor check your blood pressure and cholesterol at every visit. The higher the blood pressure, the shorter the life span. If you have high blood pressure, talk to your doctor about how to reduce it. It may be a few simple tweaks to your diet, or it may require medication to help lower it. Cholesterol levels are also a key indicator of future heart problems. Changes to diet and/or exercise will often reduce cholesterol levels. Your doctor will guide you in bringing blood pressure and cholesterol levels to acceptable levels.

Watch the stress. It’s easier said than done in the fast-paced world we live in, but stress can take a serious toll on your heart. When things start to overwhelm you, it’s easy to overeat, overdrink or forget your exercise routine. Keep an eye on the stress and don’t let it undermine your good efforts. When stress becomes an issue, seek options to reduce its effects. Some recommended techniques: reduce caffeine intake; join a support group; try meditation; get out and sweat... exercise is a great reliever of stress; establish a bedtime routine and get seven to eight hours of sleep a night; make it a point to relax doing something you enjoy at least three times a week.

Know your family history. This is one of the top factors in avoiding heart and general health problems. If you have a family history of heart disease, it is imperative your doctor knows that. This allows him or her to keep a closer eye on some of the signs that may pop up along the way that point to heart problems in the future. With knowledge of family history, they can address potential problems before they occur.

Know the early signs of heart disease. If you feel tightness or discomfort in the chest, neck, arm or stomach and it comes on when you exert yourself but goes away with rest, you may be experiencing angina. This is the first step towards a heart attack. Tell your doctor about the symptoms immediately and schedule an appointment for a comprehensive analysis. Early detection saves lives.

With care and attention to living a safe and heart-healthy lifestyle, you and your heart will live to be a ripe old age. Start with small steps and you’ll find yourself feeling healthier and more vibrant almost immediately.

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Reduce your portion sizes, cut out fats, salts and sugars.

Develop a plan to reach a weight that is healthy and right for you.

Is It Your Thyroid?

Do you ever feel overly tired... suffer from body aches... gain weight without reason?
If so, you may be suffering from a sluggish thyroid and that can result in a whole lot of things going awry in your body. Conversely, if you are suffering from insomnia, heat intolerance and weight loss, an overactive thyroid may be your problem. Thyroid issues affect roughly 50 million people in the United States alone... the majority of those being women. It’s a startling statistic but one in five women have a chance of developing thyroid problems during their lifetime. It’s a common yet somewhat hidden chronic issue that can be dealt with as long as you have the knowledge to steer you in the right direction.

What Is the Thyroid?
The thyroid is a butterfly-shaped gland on the front part of the neck. The thyroid gland’s function is to regulate the speed of the body’s metabolism. In simpler terms, the gland converts the food we eat into energy for the body.

If it does not operate as it should, a whole domino effect of problems can occur in the body. More technically, hormone synthesis begins in the part of the brain called the hypothalamus. A hormone is sent to the pituitary gland that, in turn, releases a thyroid stimulating hormone (TSH) into the blood. The TSH travels to the thyroid to produce two thyroid hormones. If the pituitary gland senses too much or too little of these hormones, it regulates them. If there is a defect in this regulation, hypothyroidism or hyperthyroidism will occur.

What Are Hypothyroidism and Hyperthyroidism?

Hypothyroidism occurs when
the thyroid gland produces
LESS thyroid hormone than the body
needs. The most common symptoms
of hypothyroidism are:

Conversely, hyperthyroidism
occurs when there is
TOO MUCH thyroid hormone
produced. Symptoms of
hyperthyroidism can be:

  • Fatigue and weakness
  • Cold intolerance
  • Dry or coarse skin
  • Hair loss
  • Cold hands and feet
  • Weight gain
  • Insomnia
  • Constipation
  • Depression
  • Poor memory function, forgetfulness
  • Nervousness or tremors
  • Immune system problems
  • Heavy menstrual periods
  • Muscle and joint pains
  • Low blood pressure
  • Slow reflexes
  • Fluid retention
  • Infertility/miscarriage
  • Nervousness
  • Irritability
  • Increased perspiration
  • Thinning of the skin
  • Fine, brittle hair
  • Muscle weakness, generally in upper arms and thighs
  • Shaky hands
  • Panic disorder
  • Insomnia
  • Racing heart
  • Frequent bowel movements
  • Unexplained weight loss
  • Lighter menstrual periods

Who Is at Risk for Thyroid Disorders?

  • Women are four times more likely than men to be at risk.
  • Persons over the age of 50
  • People with personal or family history of thyroid or autoimmune disease
  • People who have had surgical removal of all or part of their thyroid
  • Pregnant women or women within the first year postpartum
  • Current or former smoker
  • Persons who have had recent exposure to iodine
  • People using iodine or herbal supplements containing iodine
  • People who overconsume certain raw foods... brussel sprouts, turnips, cauliflower, soy
  • Peolple who have had recent neck trauma, biopsy or surgery
  • Persons exposed to radiation, particularly to the neck area
  • People suffering from high-stress events

How Is Thyroid Disease Diagnosed?
The easiest way to initially diagnose thyroid disease is through a blood test that measures your Thyroid Stimulating Hormone (TSH). This test is the most effective and cost-efficient method. It can be done quickly and painlessly at a physician’s office.

How Is Thyroid Disease Treated?
The goal of any treatment is to restore normal blood levels to the thyroid hormone. Hypothyroidism is treated with a drug called levothyroxine. It is a synthetic hormone table that replaces the missing thyroid hormone. With careful monitoring and dosage adjustment, you will return to full health promptly.

Hyperthyroidism is more difficult to treat. Treatments may involve drug therapy to block the excessive hormone production, radioactive iodine treatments that will disable the thyroid or possibly even surgery to remove either part or all of the gland.

The not so good news is that thyroid conditions are lifelong. The good news is that with careful management, people with thyroid disease can live long, healthy lives. If your symptoms match any of the ones listed above, call your doctor and get a blood test. Restoring your body to its proper thyroid levels will make you feel immeasurably better!

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Thyroid issues affect roughly 50 million people in the
United States alone...

Health Tips for Women Over 40

For women, turning 40 is a milestone in many ways. It also can be a time of confusion as to how to take care of your body. Women over 40 have different needs when it comes to health maintenance compared to a 20- or 30-year-old. It may seem confusing but it doesn’t have to be. Here are some of the primary issues you should be aware of as a woman over 40.

Breast Health: Women over 40 need to pay special attention to their breasts. While self-exams are recommended for women of all ages, mammograms are recommended for those 40 and over. Early detection of breast cancer means more conservative treatment and higher success rates. Also important are yearly, regular exams with your physician and knowing the risk factors you may face when it comes to breast cancer. Talk to your physician…he or she can do a complete medical history and talk to you about what that means for your personal situation when it comes to breast health.

Osteoporosis: The disease osteoporosis is the loss of bone density that leads to thinner, more fragile bones. Although the disease shows no outward symptoms in its early stages, it can be very debilitating. Women are roughly four times more likely than men to develop osteoporosis. Bone loss can slowly begin after the age of 30. Talk to your doctor to determine when you should obtain a bone density test (DEXA scan). He or she will likely map out a plan that involves diet changes and weight bearing exercises to help keep osteoporosis under control.

Heart Disease:
Heart disease is the leading cause of death in women in the United States. Annual blood pressure and cholesterol tests are vital at this point to make sure heart disease is kept at bay. It’s also extremely important to talk to your physician about family history. If you have family members who have been affected by heart disease, you will need to take steps to ensure that you do not go down the same path. For more information on healthy heart tips, go to www.americanheart.org.

Perimenopause and Menopause:
Everyone has heard horror stories about menopause, but the truth is that most women have little or no symptoms when it comes to this major change in their life. Perimenopause is the period before actual menopause occurs. You still will have your menstrual period but your body may be experiencing a lot more hormonal ups and downs. These ups and downs can last a year or quite a few years. Each woman’s experience will be different.

There have been a lot of conflicting reports on the benefits of hormone treatments for perimenopausal and menopausal women. There is no one right answer. The most important thing to do is to talk to your doctor about what is right for YOU. Make sure you know when your mother may have gone through menopause and, if possible, try to find out what that experience was like for her. Chances are good that your experience will be much the same. Menopause will occur at many different times. Some women may experience it early in their 40s while the majority will experience it in their late 40s to early 50s.

General Health Tips for Women Over 40:
Maintain a healthy weight. Talk to your doctor about what that weight should be. Be extra mindful of keeping the weight off of your mid-section. You will most likely need to reassess your calorie intake and make adjustments to your diet. Metabolism slows down even more at this point, which means those extra calories are not being burned off at the same rate they used to. Eat lots of whole grains, vegetables and fruits. Stay away from processed foods and sweets.

Bone up on the calcium! Most women fall short of the recommended daily allowance, so a supplement may be beneficial.

Do weight-bearing activity. In addition to cardio, weight lifting activities are crucial at keeping bones strong and heart disease at bay. Do a weight bearing exercise three times per week for at least 20 minutes each session. Add cardio to your routine for at least 20 minutes five times per week.

Take time for yourself. Women tend to take care of everything and everyone around them but forget that taking time for themselves is one of the most important things you can do. Make yourself a priority.

Quit smoking. If you haven’t started, don’t. If you smoke…quit. It’s probably the best thing you will ever do for yourself and your family! More support than ever before is available to help free yourself of cigarettes.

See your doctor. Don’t skip visits to either your primary physician or your gynecologist. They will monitor you and tell you what screenings you should be having and when. They can also give you a road map for your own personal diet and exercise program. Don’t be shy. Talk to your doctors about anything you may be concerned about. There can be a lot of nervousness and confusion regarding perimenopause and menopause. Your physician is there to help.

Keep family records up to date. This may be one of the most important things you do. Find out what parents, siblings, aunts, and uncles have gone through in terms of disease. It can be a great guide in knowing what to watch out for and what to avoid.

Taking steps to guard your health will make for a beautiful and healthy lifestyle regardless of your age!

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