Summer 2013 News

Jessica Hedrick, Certified Physician Assistant, Joins Wake Internal Medicine and Pediatrics

Jessica-HendrickWake Internal Medicine and Pediatrics in North Raleigh is pleased to welcome Jessica Hedrick, PA-C. She has been in practice since 2006 and with the Wake Internal Medicine Consultants family of practices at Rx Urgent Care since 2009. Ms. Hedrick graduated from the University of North Carolina at Wilmington cum laude with a Bachelor of Arts degree in Chemistry. She completed her Masters Physician Assistant Studies program at South University in Savannah, Georgia. She has earned certification from the National Commission on Certification of Physician Assistants (NCCPA) and is licensed by the North Carolina Medical Board. You can schedule an appointment with Ms. Hedrick by calling 919-781-7500. The average person has about two million sweat glands on their skin.

IMPORTANCE OF HYDRATION IN THE HEAT

Water, or hydration, is important to the body all year long, but it becomes vital during warmer weather. Simply put, water keeps your body from overheating. As your body moves and exercises, muscles generate heat. To keep from overheating, your body needs to rid itself of the heat and it does that by sweating. As you sweat, the body’s water level is reduced and that loss of water can affect normal bodily functions. Not only that, but water helps flush toxins from the body and transports vital nutrients throughout the body. Because we sweat so much more in the heat, instances of dehydration tend to be higher in the summer months.

Signs of dehydration:

  • Dry mouth
  • Headache
  • Irritability
  • Fatigue
  • Decreased urination
  • Constipation
If you experience the following symptoms, get to your doctor or a hospital immediately:
  • Nausea and/or vomiting
  • Dizziness
  • Fever
  • Delirium
  • Increased heart rate
  • Chills
The best way to tell if you are indeed dehydrated is by your urine. You should be urinating three to four times minimum throughout the day and your urine should be pale yellow or clear. If it’s darker yellow or there is an odor, you need more water.

What to Drink When Dehydrated

Not all beverages are good for you when you are dehydrated. If you are out walking or doing moderate exercise on a hot day, water should be sufficient in hydrating you. If you are doing more strenuous exercise, you may need a sports drink that will replace not only the fluid, but also needed electrolytes like sodium and potassium. Alcohol and caffeine should be avoided if you might be dehydrated. Stay away from cocktails, coffee and sodas because they promote dehydration. The rule of thumb for the amount of liquid (preferably water) you need on a regular basis is about eight 8-ounce glasses per day for women and slightly more each day for men. If you are spending a lot of time outside in the heat because of work or vacation, increase that level accordingly. Two out of three adults in the United States have hemorrhoids.

TICK AND FIRE ANT CARE

With warm weather upon us, outdoor activity is increased, and along with that comes the threat of ticks and fire ants. Should you encounter these bugs, here are steps for handling their bites.

TICKS:

Tick bites are actually quite common and in the vast majority of cases, harmless. Many times the tick bite is so small that you may not even notice it. However, there are instances when a tick bite may potentially spell trouble. An illness due to a tick bite can present itself days or even weeks after the tick is gone, so be on the lookout for the following signs: Flu-like symptoms
  • Fever
  • Numbness
  • Rash
  • Confusion
  • Weakness
  • Pain and swelling in the joints
  • Paralysis
  • Shortness of breath
  • Nausea and vomiting
If you do find a tick on you, there is a proper way to remove it. Do NOT use the following methods: a hot match touched to the hind part of the tick or painting the tick with nail polish or any other substance. Not only could this harm you further, it also might prompt the tick to release harmful secretions into the skin. The entire head and mouth of the tick needs to be removed. Wear gloves to make sure you do not spread any of the secretions from the tick to your hands. Then use a small pair of tweezers to flip the tick onto its back and then gently pull until the tick comes off the skin. DO NOT TWIST OR TURN THE TICK. USE GENTLE FORCE. You can then apply an antibiotic cream to the area of the bite. If you experience any of the symptoms listed above after removing a tick, see your doctor and tell him or her about the bite.

FIRE ANTS:

If you have ever been the victim of the fire ant bite, you know that what the little ant lacks in size, it makes up for in a painful and itchy bite. What you may not know is that the bite of one fire ant spurs an entire colony of ants to go on the attack. If a fire ant does attack you, the only way to get rid of it is to brush it (or them) off. They cannot be rinsed off during an attack. Within a few seconds of the bite, you will notice a painful itching. An over-the-counter after-bite product can help reduce the pain, or apply a cold compress or ice pack to the site until the itching subsides. Fire ant bites can easily get infected. If you notice a tiny pustule forming several hours after the bite, that area has become infected. To avoid this infection, take the following steps as soon as possible:
  • Wash the site with antibacterial soap for at least several minutes.
  • Pour one of the following onto the bite to disinfect: Betadine®, rubbing alcohol or hydrogen peroxide.
  • Apply hydrocortisone cream to help with itching.
  • Dab on antibiotic cream.
  • Cover with a bandage and repeat this process several times a day until the area is healed.
  • Do not pick at the site.
Some people may have an allergic reaction to a fire ant bite. Look for the following and seek medical treatment immediately:
  • Shortness of breath
  • Difficulty breathing
  • A sudden pale skin color
  • Sweating
  • Anaphylactic shock
Diabetics should take extra precautions and seek help at the first sign of infection because it can lead to serious foot and leg issues. The vast majority of the population will move through these warm months without incident, but if you do become the victim of a tick or fire ant bite, don’t panic. Follow basic steps and you will rid your self of the pests and their bites with minimum discomfort. Towels and beach cosmeticsHOW TO PICK A SUNSCREEN There are many choices of sunscreen on the market and every manufacturer touts theirs as the best, but what is it you really need in a sunscreen? When you take into consideration that one in five Americans will be diagnosed with skin cancer in their lifetime, the choice is not an insignificant one. So let’s break it down and point out what is most important when selecting sunscreen for you and your family. BROAD SPECTRUM: This is the most important designation to look for because it protects against both Ultraviolet A (UVA) and Ultraviolet B (UVB) rays. These are the rays that cause skin cancers, premature aging, eye damage and even suppression of the immune system. A good broad-spectrum sunscreen will protect against both of these rays. Make sure the sunscreen contains at least one of the following: ecamsule, avobenzone, oxybenzone, titanium dioxide, zinc oxide or sulisovenzone. SPF LEVEL: The SPF (Sun Protection Factor) rates how effectively the sunscreen protects against the UVB rays. The American Academy of Dermatology recommends an SPF of 30 or higher. Anything over SPF 50 though has been proven to be no more effective than SPF 50. WATER RESISTANT: Sunscreen cannot actually claim to be waterproof or sweat proof. It can, however, be water resistant for 40 to 80 minutes so look for this on the bottle. KID-FRIENDLY CHOICES: Children’s skin tends to be quite sensitive and easily irritated. Look for sunscreen with titanium dioxide and zinc oxide for less irritation and more protection without absorbing into the skin. SENSITIVE SKIN: people with sensitive skin will fare well with the same sunscreens used for children. HOW MUCH SUNSCREEN DO I NEED? One ounce of sunscreen per person (enough to fill a shot glass) is recommended to cover the most exposed areas of the body. Most of us only use about one-fourth of this amount, so we aren’t being adequately protected. HOW OFTEN DO I NEED TO APPLY? Sunscreen should be applied 30 minutes before any sun exposure so that the sunscreen can bind adequately to the skin. It should then be reapplied every two hours and immediately after swimming, toweling off or sweating a great deal. If you are swimming for a long period, reapply at least every 80 minutes. Wear an SPF of 15 or higher daily to protect against rays you receive doing basic and routine activities and if you are going to be outdoors for more than 20 minutes.

Hemorrhoids

Hemorrhoids. Not many people want to talk about them, but it happens to be a very common problem. While it is a painful situation, hemorrhoids are rarely serious. There are two types of hemorrhoids: internal and external. Both are the result of swollen veins in the anal canal, caused by too much pressure. Constipation, diarrhea, pregnancy and obesity may all contribute to the condition. Internal and external hemorrhoids have similar symptoms. Common signs are bleeding during bowel movements, itching in the rectal area , swelling around your anus, a lump near your anus and rectal pain. Talk to your primary care doctor if you feel irritation in the rectal area. He or she can determine the severity of your hemorrhoids and prescribe treatment, or they may recommend you see a specialist.

Treatment of Hemorrhoids

Once you have determined that a) you have hemorrhoids and b) the type you have, you can proceed with treatment. Many times your doctor will suggest lifestyle changes (such as a revised diet and exercise plan) that will reduce and over time clear up the problem. There are topically applied creams on the market, but don’t use over-the-counter products for more than a week at a time to avoid possible skin rashes or irritation. Your doctor may suggest one of the following:

Minimally Invasive treatment

Your doctor may remove a clot from an external hemorrhoid with a simple incision. Rubber Band Ligation – A rubber band is placed around the base of an internal hemorrhoid, cutting off its circulation. The hemorrhoid will fall off in about a week. Sclerotherapy – A chemical solution is injected into the hemorrhoid to shrink it. Not as effective as the rubber band treatment. Infrared, laser or bipolar Coagulation – This infrared light or heat can cause the hemorrhoids to harden and shrivel but this technique also has a higher recurrence rate.

Surgical Procedures

Hemorrhoidectomy – excessive tissue that causes bleeding is removed. While this is the most effective method in removing hemorrhoids, it also has some complications. Post-surgical pain and difficulty emptying your bladder are two of the issues. Both are temporary complications. Hemorrhoid stapling – procedure that blocks blood flow to the tissue. This procedure has a higher recurrence rate that the hemorrhoidectomy. Preventing hemorrhoids Keeping your stool soft is the best way to prevent hemorrhoids from occurring. Eat a high fiber diet, drink plenty of fluid, don’t strain when relieving yourself, don’t stand or sit for long periods of time, exercise and maintain a healthy weight. Shrimp Scampi and Linguini

Ingredients

8 ounces linguine 2 tablespoons olive oil 4 cloves garlic, minced 1/2 onion, minced 2 teaspoons red pepper flakes, or to taste 1 pound shrimp, peeled and divided 2/3 cup white wine 3 tablespoons fresh parsley, minced Prepare linguine according to directions on package. Heat olive oil in a large skillet. Add garlic, onion and red pepper and saute until soft. Add shrimp and cook until firm, about 5 minutes. Remove shrimp. Add wine to skillet and bring to a simmer. Add parsley. Let simmer gently. Drain pasta, toss with sauce and serve.