Tucson Local Media: The Doctor Is In

The Doctor Is In

Wednesday 09/03/2014
Six steps to a shorter hospital stay 

We all know that education is a life-long experience – we can all learn something new every day.

In this spirit, the Spine Center at Carondelet Neurological Institute (CNI) developed a unique and valuable program for patients called Spine Camp. The program’s goal is to educate patients who are scheduled for spine surgery about their upcoming procedure in an engaging and informative way that is designed to maximize their recovery and minimize their hospital stay.

And it’s working. Since its inception nearly four years ago, more than 500 patients have attended Spine Camp. These patients experience a shorter hospital stay; reduced, on average, by about 20 percent. At the same time, outcomes have improved significantly and patient satisfaction with their surgical experience has increased.

 The CNI Spine Center equips surgery patients with information that enables them to return home more quickly and to get on with their normal routine, whether going back to work or play.

 It’s all done in six simple steps:

1.  Patients are connected to the patient navigator. Not unlike a concierge, the patient navigator guides the surgery patient through the process, providing personalized information on what to expect before, during and after surgery.

2. Patients are informed about what they should bring with them to the hospital to make their stay more comfortable and productive.

3. Patients receive information to help them appropriately prepare their homes once they return from surgery.  This ensures ample time to make necessary adjustments or modifications to their homes that will assist them in recovering more rapidly.

4. The Spine Center staff helps patients coordinate brace fittings and other necessary equipment before they go into surgery; versus the conventional, and often disruptive, model of waiting until after the procedure.

5. Patients are given information and precautions on what they can – and cannot – do after surgery, helping them better understand the physical limitations they will encounter.

6. Schedules for subsequent outpatient visits are actually made before the patient goes into surgery, removing one more potential worry for the recovering patient.

Spine Camp consists of a 90-minute class, facilitated by the patient navigator whose aim is to raise the comfort level of patients awaiting surgery. The program includes an interdisciplinary team of professionals directly involved in every aspect of the patient’s needs – surgeons, nurses, physical and occupational therapists and others.

In this scenario, every possible need of the patient is not only anticipated but formally addressed, long before he or she ever arrives in the operating room.

In medicine, there is an important need to provide not just the highest quality care but the highest level of compassionate care as well.

(Editor’s Note: Dr. Sipos is medical director at the Carondelet Neurological Institute at St. Joseph’s Hospital in Tucson.)

Posted in News, The doctor is in, Speak out on Wednesday, September 3, 2014 4:00 am. Updated: 10:07 am. Comments (0)

Wednesday 08/21/2013
The Doctor Is In: Give your baby a healthy start

Expecting a baby? Ensuring that your baby boy or girl has a healthy start to life begins with good prenatal care. Prenatal care refers to the care you receive for yourself and your baby during your entire pregnancy. Following a prenatal care plan can positively impact both you and your baby’s health by minimizing pregnancy complications, decreasing the likelihood of birth defects and easing postpartum recovery. It’s important to begin prenatal care early – and see your doctor regularly – to get the maximum benefit for you and your developing baby.

The first step in promoting your growing baby’s good health is to establish healthy habits for yourself, before you become pregnant: a nutritious diet, regular exercise, and avoiding harmful substances such as tobacco, alcohol, and certain medicines and foods. Women who are planning to become pregnant should talk with a doctor for advice on lifestyle changes and healthy practices that will contribute to a healthy pregnancy. 

Once you are pregnant, getting good nutrition, plenty of exercise, sleep and avoiding stress are good guidelines to follow. Babies born to mothers who do not receive prenatal care are three times more likely to have a low birthweight and five times more likely to die than those born to mothers who do get care, according to the March of Dimes. Babies that weigh less than 5 pounds, 8 ounces at birth are considered low birthweight and are at greater risk of serious health problems and disabilities such as mental retardation, learning problems, cerebral palsy, bleeding in the brain, digestive problems, and vision or hearing loss. These infants’ survival rate is also lower than babies of normal weight (ranging from about 5 1/2 to 9 pounds). Research suggests that babies with low birthweight may be at risk for health problems as adults, too, such as high blood pressure, diabetes, and heart disease. 

The main reasons that a baby may be born with a low birth weight is premature birth – born before the 37th week of pregnancy – or growth restriction (a baby that is full term, but underweight). This means that, during pregnancy, something happened to slow down or stop the baby’s growth. A variety of health and lifestyle factors can cause premature birth or slow the baby’s growth and development during pregnancy. Be sure to discuss these factors with your doctor.

Giving your baby an early foundation for good health is one of the greatest gifts. If you’re planning to start a family, begin with a pre-conception checkup. Your doctor can help screen for certain health problems, infections, make sure your immunizations are up to date, as well as discuss your nutrition and lifestyle habits, medications and certain foods and beverages to avoid during pregnancy.

Your doctor will establish a regular schedule of check-ups and various screenings. It’s important to follow this plan, and comply with your doctor’s instructions for your medical care and personal health habits. Specific lifestyle choices an expectant mother can make to reduce the chances of having a low birthweight baby include avoiding tobacco and alcohol, getting adequate rest and nutrition, managing stress, and taking a daily multivitamin with folic acid (0.4 mg). It’s also important to work with your doctor to manage any chronic conditions that can affect your pregnancy and your baby’s growth, such as high blood pressure, diabetes, or thyroid disease.


(Editor’s Note: Dr. Alicia Constantino is a board-certified OB/GYN practicing with the Marana Health Center.  She can be reached at 682-4111 or maranahealthcenter.org.)

Posted in The doctor is in on Wednesday, August 21, 2013 4:00 am. Comments (0)

Wednesday 07/17/2013
The Doctor Is In: Feeling Restless? It might not be “in your head”

Children are quite obviously always in motion.  As we grow up, most people outgrow that tendency to “squirm.” Some; however, continue to have difficulty “staying still.”  We all know someone who can’t seem to sit still through a meeting or rather than lying down, has to pace the room to fall asleep.  Those individuals may have a disorder called Restless Legs Syndrome (RLS).

RLS is a neurological condition characterized by the irresistible urge to move one’s limbs – usually the legs – when at rest.  This disorder affects up to 10 percent of the nation’s population. An additional 2 to 3 percent of American adults – approximately 5 million people – have severe RLS that affects their quality of life. 


Symptoms and Course

RLS is characterized by an uncomfortable pulling, creeping, itchy, or painful, sensation that is relieved by moving the affected limb(s).  The symptoms usually occur in the legs but can also affect other areas of the body.  Symptoms come and go, and vary in severity, but are usually more noticeable when sitting or lying down.  According to the National Institute of Neurological Disorders and Stroke (NINDS), symptoms are worsened by long periods of inactivity such as long car trips, sitting at a concert or theater, airline flights, or immobilization in a cast.

More than 80 percent of people with RLS also experience a more common condition known as periodic limb movement of sleep (PLMS), according NINDS. PLMS involves involuntary leg twitching or jerking movements during sleep, typically occurring every 15 to 40 seconds, sometimes throughout the entire night. 

RLS can begin at any age, but most commonly begins before age 40. It occurs more often in women than in men and runs in families. Symptoms typically become more frequent and obvious with age. In children, RLS is frequently attributed to “growing pains” or misdiagnosed as symptoms of attention deficit disorder (ADD). To complicate matters, there is a high tendency for the two disorders to occur together, making it challenging to distinguish between symptoms of ADD and RLS.  Adult RLS symptoms are often mistaken for nervousness, insomnia, stress, arthritis, muscle cramps or aging.

There is also a significant impact of RLS on sleep.  Patients with RLS frequently complain of insomnia.  The combination of the need to move the limbs when lying down as well as PLMS can cause difficulty falling asleep and staying asleep.  The patient’s movements can interrupt one’s partner’s sleep as well, impacting their family life.  


Causes and Triggers

The cause of RLS is multi-factorial, but there are several factors that are associated with RLS.  These disorders have never been shown to have a causal relationship, but do tend to occur more commonly together.  Parkinson’s disease, ADD, pregnancy, diabetes, peripheral neuropathy, and kidney problems have all been associated with increased likelihood of developing RLS.  

The symptoms of RLS can also be worsened by certain conditions and/or medications, including iron deficiency, alcohol, sleep deprivation and certain medications such as anti-nausea drugs, antidepressants, psychiatric medications and some cold and allergy medicines that contain antihistamines.


Diagnosis & Treatment

RLS is diagnosed through a physical exam, medical history (including individual and family), blood tests for iron and vitamin deficiencies as well as other chronic diseases typically associated with RLS, and in some cases, a sleep study.  The sleep study is an overnight study that measures several physiological indicators including: brain waves, heartbeat, how quickly the patient falls asleep, whether they stay asleep, rate of breathing, and limb movements can help identify the presence of RLS or other causes of sleep disruption.

While there is no cure for RLS, symptoms can be controlled through medication or lifestyle changes including:

• Reduced intake of caffeine, alcohol and tobacco.

• Vitamin supplements to correct iron, folate and magnesium deficiencies.

• Setting and maintaining good sleep habits.

• Hot baths, or a heating pad or ice pack.

• Management of any underlying medical conditions that may be worsening symptoms.

Posted in The doctor is in on Wednesday, July 17, 2013 4:00 am. Updated: 10:14 am. Comments (0)

Wednesday 06/05/2013
The Doctor Is In: Start early to prevent heart disease

This month, make your heart health a priority. Ask yourself – no matter what your age – is there a history of heart disease, high cholesterol or high blood pressure in your family? Have any relatives died from a stroke or a heart attack? 

Your family’s history of heart disease is a major indicator of your own risk, but history doesn’t have to repeat itself. The good news is, armed with this knowledge, you can take control of your own health, maintain a healthy heart, and prevent heart disease.

Your Family History

If you have a brother or father who was diagnosed with heart disease before age 55 or a sister or mother diagnosed with heart disease prior to the age of 65, you’re considered to have an increased risk of heart disease, according to the American Heart Association.  Having a relative die of heart complications before age 60 doubles your own risk of premature heart disease, according to a study in the Journal of American College of Cardiology. And if it’s a parent or sibling, your risk increases 72 percent. If there are two or more premature cardiovascular deaths, your risk increases two-fold further.

If a family member has or had high blood pressure, high cholesterol, diabetes or atherosclerosis (a build-up of fat in the arteries), you may also be at increased risk of heart disease.

Know your Numbers

For people with a family history of cardiovascular disease, it’s important to see your doctor before symptoms arise. It’s critical for you to be aware of your own risk. The numbers to be aware of are your cholesterol level, blood pressure and waist size. High cholesterol and high blood pressure put you at risk for heart disease and other cardiovascular problems. If you have a family history of heart disease, cholesterol testing and blood pressure checks should begin as early as your twenties, to help determine if your levels are in the normal range. Obesity is a major risk factor for heart disease, especially if you carry your weight in your belly. Your doctor will be able to measure and evaluate all of these health indicators for you. 

Knowing your heart-health numbers is the first step to preventing heart disease; having them checked regularly is equally important. If you have elevated numbers or other signs of heart disease, follow your doctor’s prevention and treatment recommendations to help lower your risk. This may include medications in addition to lifestyle changes, including a more heart-healthy diet, and increased aerobic exercise. According to the AHA, if test results show your cholesterol and blood pressure levels are normal, getting a check-up about every three to five years is sufficient, up to age 40. After age 40, the frequency with which your doctor recommends you be screened for disease will depend on your other risk factors.

Breaking the Family Pattern

Your heart disease risk is mostly in your hands – regardless of family history – and several lifestyle changes should be maintained for a healthy heart:

Don’t smoke, and limit alcohol to a moderate amount (no more than two drinks per day for men and one drink for women).

Eat lean proteins, whole grains, fruits, and vegetables, and limit trans and saturated fats, salt, and sugar.

Posted in The doctor is in on Wednesday, June 5, 2013 4:00 am. Comments (0)

Wednesday 05/01/2013
The Doctor Is In: It’s never too late to start taking care of your bones and joints

Those aches and creaks when you roll over in the morning can often become more common as the years go by. Age-related changes in your bones, muscles and joints are a fact of life, but they’re also preventable – don’t assume that those creaking noises and pain are an inevitable part of aging. There are many things you can do to prevent pain, as well as reduce your risk for diseases like osteoporosis and arthritis.

As we age, our muscle and joint tissue changes, becoming thinner and more brittle. Certain diseases and conditions can affect the structure of your bones and muscles as well, including osteoporosis, osteoarthritis, and rheumatoid arthritis. That can mean joint pain, inflammation, stiffness, and deformity – as well as a significant risk of falls and fractured bones.

You can stay active and help minimize bone and joint problems by following some simple nutrition and lifestyle guidelines – and by seeing your doctor regularly for screening tests to determine your risk for diseases that affect the bones and muscles. If diagnosed early, the effects of these diseases can be slowed, though lost bone and muscle matter cannot be regenerated.

Risk factors for osteoporosis can be minimized: by eating a diet rich in calcium (i.e., at least 1,000 mg/day for adults up to age 50, and 1,200-1,500 for those over age 65) and vitamin D, and avoiding smoking and excessive alcohol consumption.

In addition to good nutrition, weight-bearing exercise can lower your risk level for osteoporosis and related diseases: walking, hiking, jogging, climbing stairs, lifting weights or dancing. 

Healthy bones are just one part of the fitness equation. Your joints and soft tissues provide the support and cushioning you need to stay active, so it’s important to take good care of them, too. If you’re an athlete, you may have experienced more than your fair share of wear and tear. The good news is, the benefits of exercise outweigh the minuses of impact-bearing activities, and actually help keep your bones and joints healthy.

Exercises that are kind on our joints include swimming, yoga and bicycling. Activities that emphasize range of motion, strength development and endurance help preserve good joint function.  Stay away from high-impact and competitive sports such as step aerobics, soccer, running, skiing, basketball and softball. These types of exercise can often result in injuries and can be hard on your joints.

Joint pain and inflammation happens as the cartilage and other soft tissues in between our bones become less elastic as we age, or are injured. Arthritis – the leading cause of mobility problems among Americans age 15 and up – can develop at any age, but is most common among adults age 65 or older. The two most common forms are osteoarthritis, which primarily affects our weight-bearing joints such as knees and hips, or hands; and rheumatoid arthritis, which impacts other joints. By maintaining an appropriate body weight, you can limit unnecessary stress on your joints, particularly the hips and knees.

It is also important to follow your doctor’s recommendations for necessary screenings, such as a bone density test, which determines your bone mass and likelihood of developing osteoporosis. All women 65 years and older should have this test, as well as women or men age 50 or older who have a broken bone or one or more known risk factors.

Finally, over-the-counter medications may relieve symptoms of joint pain and decrease further degeneration of cartilage. Joint replacement surgery is an option, although it is generally discussed when other methods of pain control and mobility improvement have failed.

Caring for your bones and joints is a lifelong journey, and it’s imperative to be proactive: eating right, getting plenty of exercise, and safeguarding against injury. By doing the right things now, patients reap the benefits of staying pain-free and active, later in life.


(Editor’s Note: José Alicea, M.D. is a board-certified orthopedic surgeon practicing with Northwest Allied Physicians.  He is a member of the medical staff at Northwest Medical Center and Oro Valley Hospital. The office phone is 520-382-3050 or www.mytucsondoc.com.)

Posted in The doctor is in on Wednesday, May 1, 2013 4:00 am. Comments (0)

Wednesday 03/20/2013
The Doctor Is In: Colorectral cancer: Screening is the key

Men and women approaching age 50 often shudder when their doctor informs them it’s almost time for a screening colonoscopy. But regular screening, beginning at age 50, is the key to preventing colorectal cancer, according to the Centers for Disease Control and Prevention.

Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States, reports the American Cancer Society. And, when men and women are combined, it’s the second-leading cause of cancer-related deaths in the United States. 

The good news is that with early detection – through a colonoscopy – the survival rate dramatically increases. If colon cancer is detected before it spreads, the five-year survival rate is about 90 percent, according to the National Cancer Institute, but if not caught before the cancer spreads to other organs, the survival rate dips to about 10 percent.

What is a colonoscopy?

A colonoscopy is a procedure that allows a doctor, usually a gastroenterologist, to see inside the colon and rectum. Used as either a screening test or a diagnostic tool, it can help your doctor investigate early signs of cancer in the colon and rectum, as well as help diagnose the causes of unexplained changes in bowel habits such as abdominal pain, rectal bleeding and weight loss. While you’re sedated, the doctor will insert a long, thin, flexible lighted tube (a colonoscope) into your rectum and slowly guide it into your colon. The scope transmits an image of the inside of the colon onto a screen so the doctor can carefully examine the lining of the colon. 

If anything abnormal is observed, such as a polyp (growth), it is painlessly removed at that time and later tested in a laboratory for signs of cancer. Since most colorectal cancer begins as a polyp, removing polyps early is an effective prevention method. Your doctor can also take samples from abnormal-looking tissues (a biopsy) so that suspicious areas can be examined.

A colonoscopy takes 30 to 60 minutes, but you will need to remain at your doctor’s facility for one to two hours until the sedative wears off.

Most common risk factors?

Risk level for colon cancer varies according to age, gender, ethnic background, and overall health and lifestyle. Factors that increase your risk level include, being age 50 or older, being African-American, having certain digestive diseases, such as inflammatory bowel disease (Crohn’s disease and ulcerative colitis), having a family or personal history of polyps or colorectal cancer, eating a high-fat diet, or having type 2 (usually non-insulin dependent) diabetes 

In addition, if you are physically inactive, obese, or a smoker, you have a greater chance of developing colorectal cancer. Increasing your activity level may help reduce your risk. 

How Often?

The American Cancer Society recommends that screening for colon cancer should begin at age 50 for both men and women who are of average risk for developing colorectal cancer. Your doctor can advise you about the right time to begin, as well as testing frequency, but standard guidelines suggest that a repeat screening be conducted every 10 years for adults with normal risk. People at higher risk of developing colorectal cancer may need to be tested earlier than age 50 and more frequently, as determined by your doctor.  


(Editor’s Note: Paul R. Butler, M.D. is a board-certified gastroenterologist practicing with Northwest Allied Physicians.  He is a member

of the medical staff at Oro Valley Hospital. The office phone is 901-6336 or www.mytucsondoc.com.)

Posted in The doctor is in on Wednesday, March 20, 2013 4:00 am. Comments (0)

Wednesday 03/06/2013
The Doctor Is In: Diagnosing your heart health

Heart disease is the leading cause of death for men and women in the United States, claiming the lives of one in four people annually. 

Advanced diagnostic and intervention techniques now allow doctors to gather information about heart problems – whether you’re in the ER experiencing heart attack symptoms, or just concerned about your risk of a heart attack. These procedures help not only diagnose heart trouble, but relieve pain and resolve heart problems early to avoid a more serious heart episode and major surgery down the road. 

Diagnostic tests generally fall into two categories: non-invasive, and invasive. Non-invasive tests utilize imaging, such as X-rays or CT scans, which take a picture of the heart. Invasive tests might use a catheter inserted inside the body through an artery or vein to pinpoint the source of heart trouble. 


Non-invasive tests

Echocardiograms/electrocardiograms – An echocardiogram uses ultrasound to view the heart’s structure and function, while an electrocardiogram uses electrodes applied to the chest, arms and legs that are connected to a machine, which records the heart’s electrical activity. 

CT coronary angiogram – This newer heart imaging test provides information about the heart previously only available using more invasive testing methods. It can help detect blockages, such as deposits of fat or plaque that have narrowed the coronary arteries and cause coronary artery disease. Coronary CTA is a special type of x-ray exam. Patients undergoing a coronary CTA scan receive an IV injection of iodine-containing contrast material (dye) to help provide the best possible detail of the areas being examined. It provides imaging previously only available using more invasive testing methods. 


Invasive tests/Intervention

Cardiac catheterization – This widely used, minimally-invasive procedure provides a look at the inside of the heart and surrounding structures. A catheter (a long, thin and flexible plastic tube) is inserted into an artery or vein in the arm or groin, and threaded into the heart’s arteries or chambers. Your doctor is then able to measure blood pressure in the heart, the heart’s pumping capability and the amount of oxygen in the blood. Patients who are usually awake during the procedure, feel little or no pain. However, there may be some residual soreness in the blood vessel where the catheter was inserted, after the procedure.

Cardiac catheterization is not only a diagnostic method, but in many cases, a first step in surgical procedures that can help minimize or stop a heart attack. Once the catheter is in place, it can be used to perform interventional procedures such as angioplasty or stent implantation. 

Percutaneous Intervention – This catheter-based procedure is used to restore blood flow to the heart. A catheter with a balloon at its tip is threaded through a blood vessel to the narrowed artery. Once in place, the balloon is inflated to compress built-up plaque against the artery wall; this opens the area and restores blood flow. Angioplasty is frequently used to relieve symptoms of coronary artery disease, such as chest pain (angina), and it can reduce heart muscle damage when performed early during a heart attack. Sometimes the cardiologist will place a stent (a metal support structure) inside the artery that has been opened with a balloon to help the artery remain open.

If you’re experiencing symptoms of a heart attack, get to your closest ER immediately or dial 911. Also, talk with your doctor about your family history and individual risk level. Your doctor can recommend routine tests and preventive habits to help manage your heart health.

(Editor’s Note: Gundeep Singh, M.D., FACC is a board-certified cardiologist practicing with Desert Cardiology of Tucson. The office phone is 797-8550 www.desertcardiology.com.)


Heart Attack Symptoms

If you think you’re having a heart attack, don’t wait: go to the nearest ER, immediately. Be sure you know the warning signs and symptoms of a heart attack. 


Chest discomfort, such as uncomfortable pressure, squeezing, fullness or pain

Pain in one or both arms, the back, neck, jaw or stomach

Shortness of breath, with or without chest discomfort 

Cold sweat

Nausea or vomiting

Weakness, lightheadedness or dizziness


Recent research has shown that women may experience different heart attack symptoms – instead of, or in addition to the “classic,” better-known heart attack symptoms. These may include:


Unusual fatigue


Sleep disturbances

Anxiety or a feeling of impending doom

Back or jaw pain

Posted in The doctor is in on Wednesday, March 6, 2013 4:00 am. Comments (0)

Friday 02/22/2013
The Dentist is in: The work to make smiles brighter

Smile! Whiter, brighter teeth are all the craze. From toothpastes, to bleaches, to lasers, it seems like everyone has a new method to noticeably make smiles brighter.

When you look in the mirror, if your smile is not as white as you would like it to be, it is time to take a look at what could be staining your teeth and what you can do to improve your smile. Coffee, tea, cola, white and red wines, as well as smoking can all stain teeth. Luckily, there are a variety of ways to whiten your yellowing teeth.

Venus whitening. Venus White Max is a relatively new whitening product that does not utilize a light and contains potassium nitrate which helps decrease sensitivity associated with bleaching. The process starts with an in-office procedure that takes about one hour. It is dentist-supervised and is fast and effective. Combined with the Venus White Pro, which is delivered via customized bleaching trays - made by your dentist, which precisely fit and bleach your teeth evenly using mint flavored gels. The result is natural, even and fast whitening - without the hassle of wearing over-the-counter whitening strips.

ZOOM! whitening. This method of whitening that utilizes a light in-office is very popular and has been available for quite some time. Known for its effectiveness, ZOOM! takes about two hours in-office to complete. ZOOM! has been proven to be a simple, safe, effective and lasting way to enhance your smile. It does not harm the teeth or gums. It simply removes all the stains from your teeth so that they are as white as they naturally can be. Bleaching is available in a wide variety of methods and considerations and for various kinds of teeth.

Custom fit tray bleaching. With this treatment, a custom fitted tray made by your dentist, combined with bleaching gel is worn over the teeth for a specified amount of time everyday. This procedure can be done together with Venus or ZOOM! whitening for the most effective results. Some results may be noticed in a couple of days, but more complete whitening results may take two to four weeks.

If you are interested in achieving that bright white smile, talk to your dentist regarding the criteria for best results, how whitening could impact your particular situation, and which procedure will best suit your needs. Bleach will not whiten through plaque and tarter so its ideal to have your teeth cleaned and polished prior to whitening.

Studio Dental is currently offering a special on Venus White Max in-office whitening and Venus White Pro at-home custom fit trays and gel for $149 (normally $298). If you would like more information on whitening, contact Studio Dental or your dentist.

(Editor’s Note: Athena Storey is the owner/dentist at Studio Dental, PLLC. She can be reached at 575-5576.)

Posted in The doctor is in on Friday, February 22, 2013 8:49 am. Updated: 8:59 am. | Tags: Venus White Max , Teeth Whitening , Studio Dental , Oro Valley , Zoom Whitening Comments (0)

Wednesday 01/23/2013
The Doctor Is In: Understanding food allergies in an active lifestyle

With the recent outbreaks of tainted food – from produce to pantry staples like peanut butter – Americans are paying more attention than ever to what they eat. For the several million Americans living with food intolerances and allergies, meticulously reading food labels and monitoring reactions to certain foods is an everyday routine.


Food Intolerance

A food intolerance is different from a true food allergy because it does not involve the immune system. Food intolerance is an abnormal reaction – such as abdominal pain or gas after consuming milk – after eating a certain food. Common symptoms of food intolerance include:

• Gas

• Cramps

• Bloating and heartburn

• Possibly severe nausea, headaches or vomiting.


Food Allergy

Food allergies affect an estimated six to seven million Americans and are becoming increasingly common among both children and adults. The effects are often underestimated: a food allergy can cause serious health problems and even death. What’s more, a recent report from the Centers for Disease Control suggests that food allergies are becoming more prevalent. An October 2008 CDC study found that child food allergies alone are up 18 percent over the last decade. Some of these allergies can be outgrown in time, but others last into adulthood. 

A food allergy is much more serious than a food intolerance. In the case of a food allergy, the body’s immune system will perceive an ordinary food as a contaminant, and the immune system will release antibodies to fight the foreign agent. 

Eight types of foods are responsible for 90 percent of food allergies, according to the CDC: milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat. 

Symptoms can appear after exposure to only a trace amount of the allergen and can range from mild to severe. Symptoms may include:

• Hives – red, swollen, itchy bumps on the skin that appear suddenly.

• A red, itchy rash on the skin

A stuffy or itchy nose or eyes, congestion or sneezing.

• Gas, stomach or abdominal cramps, vomiting or diarrhea.


A severe allergic reaction, called anaphylaxis, can involve any of the above symptoms, as well as a feeling of lightheadedness, anxiety, throat tightness, coughing or breathing difficulties – and, if not treated promptly, can lead to death. Immediate medical attention is imperative for a severe allergic reaction – even if the symptoms subside. 

Your doctor can help you to distinguish between a food intolerance and a food allergy and determine the most appropriate treatment, including if an allergist or immunologist should be seen.

A food allergy is generally diagnosed through a medical exam and a review of symptoms and foods that trigger the symptoms. You may be asked to keep a food diary to help determine foods that are causing the allergic reaction, and foods may later be introduced by your doctor in a controlled environment to determine their effect.  Your doctor may conduct an allergy test, either a skin test or food allergy blood test (known as a RAST test) – a quick and painless test where the skin is pricked with a small amount of the food allergen to observe the body’s reaction. 

Food allergies are often inherited and are most often diagnosed by your family history, according to the American Academy of Allergy, Asthma and Immunology, rather than a skin or blood test alone. A food allergy can also raise your risk of other allergies, such as asthma, according to recent industry studies, so it’s important to see your doctor if an allergy is suspected.


(Editor’s Note:  Kent Diehl, M.D. is a family medicine physician practicing with Northwest Allied Physicians at Saddlebrooke.  His office may be reached at 818-0300. )

Posted in Active living, The doctor is in on Wednesday, January 23, 2013 1:02 am. Updated: 2:28 pm. Comments (0)

Wednesday 01/16/2013
The Dentist Is In: Why do I have bad breath?

Few conditions are more embarrassing than halitosis, or bad breath odor. Nearly every person suffers from bad breath from time to time, and some people are unaware that they have halitosis. 

The most common cause of bad breath is poor oral hygiene. Brushing and flossing daily can help eliminate many of the odors in the mouth. Foods, such as garlic and onions, can leave a residue, and particles in the mouth that chewing gum and mouthwash will only mask. Good brushing and flossing can eliminate any remnants of food that would otherwise remain between and on the teeth, causing odor.  An offensive odor may also be the result of periodontal disease (gum disease), or cavities in the mouth. 

Another cause of bad breath is decreased saliva. Saliva helps clean out all the bad bacteria in the mouth and thus reduces bad breath. In the mornings, the decreased saliva gives way for the bacteria to grow and hence causes bad breath. When we eat, we chew food that gives good saliva in the mouth, but if you are not eating or are dieting, the saliva also decreases in the mouth, which can cause bad breath. Certain medications can also decrease saliva flow, causing bad breath.  

If you suffer from dry mouth, your dentist may prescribe an artificial saliva, or suggest using sugarless candy and increasing your fluid intake.

In some cases, though, bad breath is a symptom of disease or infection. These medical disorders can be chronic sinusitis, local infection in the respiratory tract, postnasal drip, diabetes, chronic bronchitis, liver or kidney ailment, and gastrointestinal disturbance. If your dentist confirms that your mouth is healthy, he or she can refer you to a physician to determine the cause of your bad breath.

To avoid bad breath, there are certain things we need to remember to do the following - 

Gargle water after eating anything.

Brush teeth at least twice a day, in the morning and before sleeping.

Eat lots of fruits and vegetables, and foods that are also low in fat.

Eat at regular intervals and do not skip meals or diet irregularly.

Clean dentures or braces at least once a day or as directed by your dentist.

Maintain regular dental checkups.

Eating certain foods, smoking, decreased salivary flow, dental cavities, periodontal disease, and certain health problems all contribute to halitosis.  Good oral health is essential in eliminating bad breath. Regular cleanings and dental check-ups; brushing and flossing remove debris and plaque will help to eliminate bad breath. If you’re concerned about bad breath, see your dentist. He or she can help identify the cause and, if it’s due to an oral condition, develop a treatment plan to help eliminate it.

Posted in The doctor is in on Wednesday, January 16, 2013 4:00 am. Comments (1)

Wednesday 09/03/2014

Six steps to a shorter hospital stay 

Wednesday 08/21/2013

The Doctor Is In: Give your baby a healthy start

Wednesday 07/17/2013

The Doctor Is In: Feeling Restless? It might not be “in your head”

Wednesday 06/05/2013

The Doctor Is In: Start early to prevent heart disease

Wednesday 05/01/2013

The Doctor Is In: It’s never too late to start taking care of your bones and joints

Wednesday 03/20/2013

The Doctor Is In: Colorectral cancer: Screening is the key

Wednesday 03/06/2013

The Doctor Is In: Diagnosing your heart health

Friday 02/22/2013

The Dentist is in: The work to make smiles brighter

Wednesday 01/23/2013

The Doctor Is In: Understanding food allergies in an active lifestyle

Wednesday 01/16/2013

The Dentist Is In: Why do I have bad breath? The Doctor Is In: The connection between psoriasis and arthritis

Wednesday 12/26/2012

The Doctor is In - Steps to overcoming infertility

Wednesday 12/19/2012

The Dentist Is In: The connection between the health of your mouth and the health of your body

Wednesday 11/21/2012

The Dentist Is In: A broken tooth can ruin any good meal The Doctor Is In: ’Tis the Season - How to keep off the extra pounds

Wednesday 11/14/2012

The Doctor Is In: Endometriosis: The pain is treatable if the disease is correctly diagnosed

Tuesday 11/06/2012

The Doctor Is In: Play it smart - Sports physicals can save lives

Wednesday 10/31/2012

The Doctor Is In: Advice: Breast cancer screening saves lives

Wednesday 10/10/2012

The Doctor is in: Dementia: Alzheimer’s or something else?

Wednesday 09/19/2012

The Doctor Is In: The West Nile Virus, precautions advised

Wednesday 09/05/2012

The Doctor Is In: Arthritis can strike any age

Wednesday 08/29/2012

The Doctor is in: Controlling varicose veins

Tuesday 08/14/2012

The Doctor Is In - Chronic stress can lead to chronic health conditions

Wednesday 08/08/2012

The Doctor Is In: COPD - It is preventable

Wednesday 08/01/2012

The Doctor Is In: Weight-loss surgery sheds pounds, improves health

Wednesday 07/25/2012

The Doctor is In: What to do when the wounds just won’t heal

Wednesday 07/18/2012

The doctor is in: Sleep: Good health is related to quality and quantity of slumber

Wednesday 06/27/2012

The Doctor Is In: Women living with endometriosis

Wednesday 06/13/2012

The Doctor Is In: Arthritis: Common types and treatments

Wednesday 06/06/2012

The Doctor Is In: Summer safety is important

Wednesday 05/09/2012

The Doctor Is In - How to understand your food allergies

Wednesday 05/02/2012

The Doctor Is In - Preventing cancer starts with the annual Pap test

Wednesday 04/11/2012

The Doctor Is In - How to help your kids avoid Type 2 Diabetes

Wednesday 04/04/2012

The Doctor is in: Leg pain signals heart trouble

Wednesday 03/14/2012

The Doctor Is In - Hit the hay for heart health

Wednesday 03/07/2012

The Doctor Is In: Getting headaches regularly? Is it time to see a doctor?

Wednesday 02/29/2012

The Doctor Is In - ADHD - Can the disorder be treated without medication?

Wednesday 02/22/2012

The Doctor Is In - Vitamin C: What it does, why you need it, where to find it

Wednesday 02/08/2012

The Doctor Is In - Depression: Don’t dismiss the blues

Wednesday 01/04/2012

The Doctor is In - Prediabetes: Obesity and diabetes share common risks and solutions

Wednesday 12/28/2011

The Doctor is In: Cold or allergy? How to tell the difference

Wednesday 12/21/2011

The Doctor is In: Steering kids away from salt

Wednesday 12/14/2011

The Doctor is In - Information on Childhood obesity

Friday 12/02/2011

The Doctor Is In - Don’t Be Down for the Count this Year: Cold and Flu Facts


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