Friday, December 5, 2014

Flu Season

The Flu Season is here - according to the Centers for Disease Control and Prevention (CDC) this flu season could be worse than usual, due to an aggressive strain of influenza virus. 
Why is this Flu Season Worse? 
A strain of influenza called H3N2 appears to be circulating. This strain has appeared during the 2012-13, 2007-08, and 2003-04 flu season, the three seasons with the highest death rates in the past decade, according to the CDC. 
"We know that in seasons when H3 viruses predominate, we tend to have seasons that are worse flu years, with more hospitalizations from flu and more deaths from influenza," CDC Director Dr. Tom Frieden said during a news briefing.
To make matters more difficult, about half of the H3N2 viruses detected by CDC researchers so far appear to have mutated, and have genetically "drifted" away from the virus strain included in this year's flu vaccine.
"They're different enough that we're concerned that protection from vaccination against these 'drifted' H3N2 viruses may be lower than we usually see," Frieden said.
Three of the five children had the H3 flu virus, although doctors don't know if they had the mutated form of the virus, Bresee said.
What Should My Healthcare Provider Do? 
Because vaccine protection is likely to be shakier than usual this season, CDC officials are urging doctors to use antiviral drugs as soon as possible for any suspected flu cases.
Drugs like Tamiflu and Relenza can't prevent flu, but will reduce the amount of time people are sick, Frieden said.
"Antivirals aren't a substitute for vaccination," Frieden said. "Vaccination prevents flu. But antivirals are an important second line of defense to treat the flu. And this year treatment with antiviral drugs is especially important, particularly for people who are at high risk for serious flu complications or for people who are very sick with flu."
The CDC is recommending that doctors not wait for the results of a flu test before starting patients on antiviral drugs, he said. Antivirals are most effective when given within two days of the onset of symptoms.
A CDC health advisory issued Wednesday urges doctors to aggressively use antiviral drugs in suspected flu patients who are:
  • younger than 2 years old,
  • 65 or older,
  • suffering from chronic disease -- such as asthma, diabetes, heart or lung disease -- or have a suppressed immune system,
  • pregnant,
  • morbidly obese,
  • residents of nursing homes or chronic-care facilities.
Will this year's flu vaccine protect me? 
It takes about four months to make flu vaccine and ramp up production, Frieden said. This lag means that every year, immunologists have to take an educated guess as to which flu strains should be included in the vaccine.
Even though this year's vaccine does not directly protect against this particular H3N2 strain, Frieden still recommends that people get their annual flu shot.
The vaccine will protect against several active strains of flu, and could even provide some protection against mutated flu viruses, he said.
"If we have a severe season, getting a vaccine that provides even partial protection may be more important than ever," he added.
Consumer Health (2014) Flu Shot May Offer Less Protection This Winter.

Sunday, November 2, 2014

Good Morning Let The Stress Begin

Do you feel stressed? Do you know when you get up in the morning you are going to spend the majority of your day multitasking or feeling out of control?
Many things have an impact on our health - diet, exercise, sleep, social patterns, environmental exposure, work, and stress play a crucial role in our health.  Over the last two weeks I have seen several patients in my clinic who are physically ill from stress.  Stress can cause, headaches, stomachaches, memory loss, and obesity, just to name a few common symptoms associated with stress. Today I want to try explain how stress impacts your health.
What is stress?
Stress is something we cannot put our finger on, we cannot measure it, and often we dismiss stress as not being real. But, in reality our bodies are driven by the nervous system which tries to maintain a perfect balance.  The body is a miraculous creation, we have many built-in options to try to keep us healthy and safe.  But, just like an automobile if we do not take care of our bodies, the options wear out, switches get broken, and safety features fail.

For instance: Your central nervous system has two branches, the parasympathetic (think: peace) nervous system and the sympathetic (think: stress) nervous system. The two work like a switch — when one is turned on, the other is off.

The sympathetic nervous system is associated with the rapid release of stress hormones, slowed digestion, and faster breathing and heart rate. This is the state you are in when you are speeding through your day stressed out and multitasking like crazy to get everything on your to-do list done. I know this feeling, for many years this is how I l have functioned every day.
What happens when we are stressed?
1. Stress changes gene expression.

The chemicals your body produces when you are under stress turn on or off of genes that change everything from how much fat you store, to how well your immune system works, to how fast you age, to whether or not you will develop cancer.

2. Stress causes brain damage.

High levels of stress hormones damage critical parts of the brain, such as the hippocampus, the area responsible for memory. One reason people experience “adrenal burnout” after long term chronic stress, is because the brain, in order to save itself, turns off the adrenals.

3. Stress shuts down the immune system and increases inflammation.

From slowing wound healing, to diminishing the protective effects of vaccines, to increasing your susceptibility to infections, stress is the ultimate immune-modulator. Stress can also reactivate latent infections — people who get cold sores know this from experience.

4. Chronic stress damages the energy powerhouses of your body, your mitochondria.

These energy factories produce ATP, the currency through which all cells and organs in your body do their work. The good news is this damage is reversible over time, as stress goes away.

5. Stress reduces your ability to metabolize and detoxify.

Studies have shown that the activity of hundreds of genes responsible for enzymes that break down fats and detoxify prescription drugs, are negatively impacted by stress. Stress can also increase your toxin burden by increasing your desire for high fat, high sugar foods.

6. Your cardiovascular system responds to stress, increasing cardiac output if you have to run away from a tiger.

But chronic stress has been shown to increase the thickness of the artery walls, leading to high blood pressure and heart disease.
7. Stress messes with your sex hormones.

Stress increases the amount of something called sex hormone binding globulin, the school bus that ferries testosterone and estrogen around your body, meaning fewer of these hormones are available to your cells. Chronic stress also increases the production of cortisol, leading to something called “cortisol steal,” where fewer sex hormones are produced.

8. Stress is bad for your bones and muscles.

There is evidence that higher stress levels are associated with lower bone mineral density, and many studies show that people under chronic stress experience more physical pain.

9. The gut and stress are intimately intertwined.

You may have heard that 95% of your serotonin is in your gut, and you may remember a time when you were nervous or sad, and your belly was in knots.

But more research is showing how stress impacts the function of your gut every day. It slows transit, leading to constipation and the re-circulation of hormones like estrogen through your liver. It increases the overgrowth of bad bacteria. And it loosens the barriers between the cells that line the intestines, creating something called leaky gut, which then leads to inflammation, food sensitivities and even autoimmune disease.

Next week I will start a series on how to help minimize the effects of stress on your health.

~ Connie ~

Thursday, September 18, 2014


Dehydration can occur quickly - Jamie at Jamie's Thots does an excellent job of explaining how quickly dehydration can occur.  
 She also gives you a great outline of signs and symptoms of dehydration.   Please take a moment to visit her site so that you can be more productive and prevent health problems.

~ Connie ~

Wednesday, August 20, 2014

When Should I Get the Flu Vaccine?

When Should I Get the Flu Vaccine?

It is hard to believe television commercials are already advertising the flu vaccine.   This must mean that fall is right around the corner, followed by winter.   So, should you be pressured to get your flu vaccine now?  No, since the peak of flu season usually begins in December, it is optimal to receive the flu vaccine in October or November.

“Flu vaccination should begin soon after vaccine becomes available, ideally by October. However, as long as flu viruses are circulating, vaccination should continue to be offered throughout the flu season, even in January or later. While seasonal influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later. Since it takes about two weeks after vaccination for antibodies to develop in the body that protect against influenza virus infection, it is best that people get vaccinated so they are protected before influenza begins spreading in their community” (CDC, 2014).
Who should get a flu vaccine?
While everyone should get a flu vaccine this season, it’s especially important for some people to get vaccinated.

Those people include the following:
·         People who are at high risk of developing serious complications (like pneumonia) if they get sick with the flu.
o    People who have certain medical conditions including asthma, diabetes, and chronic lung disease.
o    Pregnant women.
o    People younger than 5 years (and especially those younger than 2), and people 65 years and older.
·         People who live with or care for others who are at high risk of developing serious complications (see list above).

o    Household contacts and caregivers of people with certain medical conditions including asthma, diabetes, and chronic lung disease.
o    Household contacts and caregivers of infants younger than 6 months old.
o    Health care personnel.

Where can I get the flu vaccine?
Our office, Family Medicine Associates will have flu vaccines available after September 1.  Please call 870-762-5360 or stop by. 
Tell them Connie sent you.

Centers for Disease Control (2014). Seasonal Influenza (Flu). Retrieved from:

Wednesday, May 28, 2014

Minimizing Your Risk of Skin Cancer

Summer is officially here!  I want each of you to be proactive about your health this summer.  Over the next few weeks I will be providing you with information on how to be healthy during the summer.  Today we are going to talk about minimizing your risk of skin cancer.
Can you minimize the risk of skin cancer?  Yes, most skin cancers are related to sun exposure.  Melanoma diagnoses have risen nearly 2 percent a year since 2000.   Minimizing your risk involves refraining from sun exposure during certain times of the day and using an appropriate sunscreen.
Some experts blame inappropriate use of sunscreen for the increase in skin cancers, saying the people do not apply enough lotion or do not reapply the sunscreen every two hours as instructed.  But, until this year sunscreens were misleading the consumer – sunscreens were designed primarily to protect people from ultraviolet B rays (UVB), the main cause of sunburn.  Sunscreens allowed us to stay outside longer without getting a sunburn, but did not protect against ultraviolet A rays (UVA).  Ultraviolet A rays are associated with aging and skin damage, the cause of skin cancers.

In 2013 the Food and Drug Administration increased the requirements for sunscreen labeling. The new rule requires sunscreens be labeled accurately to depict which Ultraviolet rays are blocked by the sunscreen.   You may see the term “broad spectrum protection” – this now means the sunscreen has been approved to protect against both UVA and UVB rays.   Sunscreens cannot claim to be waterproof, only water-resistant, and labels must note a time limit of either 40 or 80 minutes before the sunscreen is ineffective. 
What can you do to protect yourself against skin cancer?
  • Look for products with an SPF of 15 to 50, that are labeled “broad spectrum protection” meaning they protect against both UVA and UVB rays. 
  • Keep babies younger than 6 months out of the sun, as their skin is especially sensitive.  Sunscreens should not be used on infants. According the U.S. Food and Drug Administration, combination sunscreens containing insect repellants like DEET should be avoided with young children. Young children may lick their hands or put them in their mouths. 
  • Try to keep older children inside when the sun is harshest, from 10 a.m. to 2 p.m.  A bad sunburn in childhood or adolescence doubles the risk of melanoma later in life, according to the Skin Cancer Foundation.
  • Avoid sunscreen sprays.  The U.S. Food and Drug Administration has banned sunscreen powders (though some products may be available).  The spray may be inhaled into the lungs causing respiratory issues.
  • Products containing Vitamin A, retinol or its derivatives, such as retinyl palmitate and retinyl acetate.  The U.S. Food and Drug Administration has not banned these products, but they are concerned that the additives increase sun sensitivity. 
  • According to the New York Times, consumers should take endorsements and seals of approval with a grain of salt.  The Skin Cancer Foundation gives a “seal of recommendation” to sunscreens, but only if their manufacturer has donated $10,000 to become a member of the organization.
  • Use the ABCD rules for identifying skin lesions that need immediate attention.  
A - Asymmetry: Normal moles or freckles are completely symmetrical. If you were to draw a line through a normal spot, you would have two symmetrical halves. In cases of skin cancer, spots don't look the same on both sides.
B - Border: A mole or spot with blurry and/or jagged edges.
C - Color: A mole that is more than one hue is suspicious and needs to be evaluated by a doctor. Normal spots are usually one color. This can include lightening or darkening of the mole. Melanoma cells usually continue to produce melanin, which accounts for the cancers appearing in mixed shades of tan, brown and black.
D - Diameter: If it is larger than a pencil eraser (about 1/4 inch or 6mm), it needs to be examined by a doctor. This is includes areas that do not have any other abnormalities (color, border, asymmetry). But, don't be fooled by size alone - it can be smaller.
E - Elevation/Evolving: Elevation means the mole is raised above the surface and has an uneven surface. Looks different from the rest or changing in size, shape, color.

ABCD Mole Recognition
Remember - if you are not sure about a mole or lesion, see your healthcare provider.  Healthcare providers would rather tell you, all is good, instead of having to deliver bad news.

                                                    Happy Summer
                                                    ~  Connie ~

The New York Times (2013). The New Rules for Sunscreen. Retrieved from:
U.S. Food and Drug Administration (2013). Should You Put Sunscreen on Infants? Not Usually Not. Retrieved from:

Any information received on this site is not intended to diagnose, treat, or cure skin cancer. This site is for informational purposes only and is not intended to replace proper medical care. Always seek the advice of a trained health professional with any questions you may have regarding a medical condition and before seeking any treatment. Proper medical attention should always be sought for specific ailments. Never disregard professional medical advice or delay in seeking medical treatment due to information obtained on

Monday, May 19, 2014

Welcome to my Connie's Family Practice Blog

    Why blog about health? I'm a family nurse practitioner, and much like parents never stop being parents no matter the age of their children, being a nurse practitioner is a permanent part of my psyche.
    I'm always on the lookout for the newest health topic in the news. When I read about something that interests me, I want to know more about it. That's one of the joys of being a life-long student (it took me 4-1/2 degrees and 18 years of school to become a nurse practitioner).

    I see patients every day that want to be healthy, no one wants to bill.  With this blog I will share ways to lead a proactive healthy life.

    Some of you may want to know, what is a family nurse practitioner?  A family nurse practitioner (FNP) is a registered nurse (RN) who has completed advanced education (a minimum of a master's degree) and clinical coursework in the diagnosis and management of common medical conditions, including chronic illnesses. FNPs provide a broad range of health care services. They provide some of the same care provided by physicians and maintain close working relationships with physicians. An FNP can serve as a patient's regular health care provider.

    Family nurse practitioners (FNP) see patients of all ages. The core philosophy of the field is individualized care. Nurse practitioners focus on patients' conditions as well as the effects of illness on the lives of the patients and their families. FNPs make prevention, wellness, and patient education priorities. This can mean fewer prescriptions and less expensive treatments. Informing patients about their health care and encouraging them to participate in decisions are central to the care provided by FNPs. In addition to health care services, FNPs conduct research and are often active in patient advocacy activities

    My goal is help you identify ways to be healthy. My health blog will contain info from mainstream sources such as the CDC, the National Institutes of Health, the World Health Organization, American Academy of Pediatrics, and the American Association of Nurse Practitioners to name a few.

    ~ Connie, FNP ~