Medical Assistant

When in doubt, throw it out!


Half of parents of  parents  fail to discard leftover prescription opioids, granting teenagers easy access to these narcotic pain medications.

Researchers found some troubling numbers while examining opioid painkillers, such as oxycodone or Percocet prescribed to children for surgery or illness:

8% reported returning the leftover medications to a pharmacy or physician

30% disposed of medication in the trash or toilet

6% said other family members used the medication

9% couldn’t recall where the medication went

Only 1/3 of parents surveyed said their child’s physician had discussed what to do with leftover medicine; when parents were advised only 26% had leftover medications at home. When not given guidance, 56% of the parents had leftover medications in the home.

Improved communication needs to take place. Check out this link for appropriate disposal methods.

CMA Today Sep-Oct 2016




Feel better while eating better


Strangely, eating better can sometimes make you feel worse. Here are some tips on why eating well may make you feel ill and ways to stay on the right track.

Against the grain- quickly increasing intake of fiber can cause gas, bloating and belching because fiber is an indigestible carbohydrate. Increase fiber gradually, and drink water to aid in digestion.

A sour note- stomach discomfort from drinking almond milk may be caused by carrageenan, a thickening agent extracted from seaweed. Pick almond milk that doesn’t contain this thickening agent.

Feeling green- raw cruciferous vegetables (broccoli. brussel sprouts and collard greens) can cause gas tanks to the complex sugar raffinose. The soluble fiber in these greens can lead to bloating and an upset stomach. To avoid this, steam the vegetables to break down raffinose. The steaming also helps preserve the cancer-kicking compounds which can be lost when veggies are boiled or microwaved.

Aw, shucks- despite being a good source of folate, vitamin C, phosphorus and magnesium, corn can cause some gastrointestinal distress due to cellulose. When it isn’t chewed enough, it passes through undigested and can cause stomach upset. So chew well and eat corn plain or with a little spice.

CMA Today Sep-Oct 2016 

Checkup for your medicine cabinet


Take stock and stay safe!

Check expiration dates- prescriptions have dates on their original containers but it is up to the pharmacist to label the script. Discard dates are typically one year from the filled date. Certain medications should never be used beyond their expiration dates: nitroglycerin, insulin, inhalers and EpiPens.   If medication is in original packaging (including over the counter meds) check the container for the expiration date.

Know the dangers of common painkillers- some analgesics including Advil and Aleve can trigger a heart attack or stoke. Ibuprofen and naproxen can also increase bleeding risk and bump up blood pressure. Acetaminophen can cause liver damage especially when taken with alcohol. Narcotics like Oxycontin and Percocet should only be taken as prescribed and then disposed of.

Beware of risky herbals- which can interact with certain prescription medications. St. John’s wort can interfere with statins and high blood pressure medications. Ginkgo and ginseng can interact with blood-thinning meds and increase risk of bleeding and kava has been known to cause liver damage.

Don’t  overdose on everyday vitamins- Watch daily limits on vitamin B6: more than 100 mgs/day can cause temporary nerve damage. Vitamin A: more than 10,000 IUs  may bring on vomiting, headache, dizziness and blurry vision. Vitamin D: more than 10,000 IUs daily may cause poor appetite, frequent urination and kidney problems. Vitamin C may contribute to increase risk of developing kidney stones.

Cut back on allergy and sleeping pills: Those who take certain insomnia and some allergy meds long term (like Benadryl or Nytol) are more likely to have problems with memory and decision making plus have a higher risk of dementia.

by Robin Westen AARP The Magazine/Real Possibilities

Ensuring your wishes

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Every adult Minnesotan should have a written Health Care Directive. This communicates your intentions, making it easier for your loved ones and medical professionals to accomplish your intentions when you are not able to speak for yourself. Many work with an attorney to establish a document but it is not necessary. The most useful HCD will include the appointment of at least one agent and perhaps an alternate to make decisions for you, and important things as to whether you want to be an organ donor or how you would like your remains handled after your death.

Another option is a POLST (Provider Order for Life-Sustaining Treatment is a form often prepared at a hospital or care facility to specify the patient’s wishes for emergency interventions in the event of a medical crisis or during follow-up inpatient care. Emergency responders are required to follow POLST orders. Medical orders contained in a POLST are considered to supersede over a HCD. It is not as flexible as a HCD and has only a few options related to emergency medical decisions.

Minnesota law allows you to create a temporary (up to a year) Power of Attorney, to give someone else the authority to make decisions including medical for your minor child but is a document that should be drawn up with an attorney. Temporary or Standby Custodian is a legal process where a person is appointed b the court to be custodian of a minor child. In extreme cases a court ordered guardian can be appointed for a child or for an adult who has lost the capacity to make sound decisions; this sometimes becomes the only available option if no HCD exists.

Robeet McLeod, JD Minnesota Health Care News June 2016

Preventative health exams


Have you wondered  what topics  might be covered in a preventative health exam visit?

Immunizations: Children receive them. Adolescents should receive boosters of some of their childhood shots along with age specific vaccinations like HPV or meningitis. Adult immunizations depend on other health conditions, age and may include vaccines for tetanus, pneumonia, shingles, whooping cough and some forms of hepatitis.

Home Safety: from childproofing to decreasing risks of falls for elderly including drowning risks, gun safety, risks for lead exposure, fall risks and driving safety.

Eyes, teeth, ears: relates to health care done outside of the clinic, like vision exams screening for glaucoma and cataracts and dental exams.

Screenings focused on detecting diseases at an earlier state to decrease costs and disease burden and improve survive-ability and quality of life. Pap smears, breast, colon and prostate cancer. There may be recommendations for genetic testing.

Other medical conditions often screened for include depression, diabetes, obesity, vascular disease, osteoporosis and dementia. Lifestyle factors will be discussed that are important for preventing disease and conditions. A partial list of life style concerns include tobacco use and cessation, alcohol intake, drug use, caffeine intake, sexual activity, sun prevention, dietary choices, seat belt use, safety/violence in your home and relationships, stress reduction and self/spiritual care.

An area that is receiving more focus than in the past is advance care planning. This conversation is never easy but easier to have when you can participate and discuss them in a non-emergent situation.

Dania Kamp, MD, FAAFP Minnesota Health Care News June 2016

Travel-associated mosquito-borne risks


Mosquito-borne disease risks can vary considerably depending on geographic location, local mosquito ecology, time of year, and the traveler’s length of stay and previous exposure to mosquito-borne viruses.

Malaria: most commonly reported with vast majority occurring in foreign-born residents returning to their country of origin; Liberia and Nigeria. Minnesota has the largest Liberian population in the world outside of the country itself. Caused by several protozoan species, malaria is endemic in many tropical and subtropical regions of the world. Transmitted to humans through bites by one genus of infected mosquitoes; people develop symptoms within one month like serious febrile illness. Confirmed by blood tests.

Chikungunya: following a rapid spread in the Caribbean islands and Latin America, the virus was reported in 2014 in Florida; after this small outbreak no further cases have been reported in the US. Transmitted to humans from bites of two species of infected mosquitoes commonly referred to as the yellow fever and Asian tiger mosquitoes.  Symptoms develop 3-7 days of infection which include fever and joint pain primarily.  Diagnosed using serology.

Zika: Introduced to Latin America and Caribbean in spring of 2015. Transmitted primarily by tiger and yellow fever mosquitoes. Like Chikungunya, Zika is spread rapidly due to infected individuals traveling to areas with competent mosquito vectors. Minnesota due to lack of appropriate vector populations is a Zika free area.

Dengue: one of the most frequently occurring mosquito-borne diseases worldwide most of which are acquired in Latin America. Outbreaks have occurred in warmed states like Texas and Hawaii. Endemic regions include Africa, India, and Southeast Asia, Latin America and the Caribbean. Transmitted through bite of infected yellow fever or Asian tiger mosquitoes. There are four distinct but use of NSAIDs is not recommended due to increased risk of hemorrhage so needs to be ruled out.

MDH monitors other diseases not commonly seen in the US including Rift Valley Fever virus, Murray Valley encephalitis virus, yellow fever and Japaneses encephalitis.

Franny Dorr, MPH Minnesota Health Care News June 2016

Genetic Risks


Type 2 Diabetes

Who’s Got It: about 29 million Americans including 1 in 4 people 65 or older

Family Risk: If both parents have the disease, you have a 1 in 2 chance of developing it. I just one parent has it, your risk is 1 in 7.


Who’s Got It: nearly 14.8 million in the U.S.; some 43,000 commit suicide each year with men in midlife at highest risk.

Family Risk: Having one parent with major depression or another mood disorder makes people two to thee times more likely to develop depression. If both parents have a mood disorder, the risk rises to five times higher than average.

Colorectal Cancer

Who’s Got It: third most common cancer in the U.S and second most deadly, with approximately 137,000 people diagnosed each year.

Family Risk: People with a close relative who has had coon cancer are up to three times as likely to develop it themselves. African Americans have a 20 percent higher incidence rate and a 45 percent higher mortality rate.

How to Defy Your Genes by Sarah Mahoney; AARP The Magazine June/July 2016



Health fraud scams abound in nontraditional markets such as international stores, flea markets, and online warns the FDA.

Products may be marketed as dietary supplements that are ‘all natural‘ which is meant to target consumers who use herbal remedies,and shop at nontraditional places.

The FDA offers these tips to determine whether or not a non-prescription drug product is fraudulent;

One product can’t do it all. Be wary of products that claim to cure a wide range of disease.

Evaluate the evidence. Personal testimonials are not a sufficient substitution for scientific evidence.

True treatment takes time. Few diseases and conditions can be treated and cured quickly, even with legitimate products. Beware of quick-fix language.

Nature doesn’t equal nurture. Beware of ‘all-natural’ products; remember some plants can kill if ingested. Some products have hidden and dangerously high doses of prescription drug ingredients.

Check for FDA approval. Domestic or imported dietary supplements are not approved by the FDA.

CMA Today Mar-Apr 2016


Oil change


A little fat does a body good, and these oils are loaded with the healthy kind that keeps systems running smoothly.

Sesame- rich in flavor and packed with poly- and monosaturated fats. It has a low smoke point making it best for lower temperature cooking and dressings.

Olive- contains monosaturated fats and antioxidants. Has been shown to help reduce inflammation and to lower heart disease risk, Look for “col and “extra-virgin” which mean the oil has not been treated with chemicals or altered by temperature, so the nutrients are persevered. Loses antioxidants within six months of opening.

Walnut- one off the best nut sources of omega-3 fatty acids that are good for heart and brain. Has a low smoke point; try in vinaigrettes or drizzled on veggies.

Grapeseed- full of anti-inflammatory antioxidants along with heart-healthy polyunsaturated fats and vitamin E. Mixes well with herbs and spices.

Flaxseed- concentrated source of omega-3s and 6s that may help ease stomach issues. Only keeps for two to three months and should be refrigerated.

Avocado- nearly 70% heart healthy monosaturated fats. High some point and a smooth, nutty taste. Costs a bit more than most but has a long life- about a year.

Peanut- same health benefit as peanuts including monounsaturated fats and resveratrol, the antioxidant also found in red wine. High smoke point so good for stir-frying, sautéing and roasting.

February 2016 Better Homes and Gardens

Checking out chickenpox


Chickenpox cases in the US have dropped sharply since a vaccine against this disease became available in 1995. Before this, nationwide cases of chickenpox numbered about 4 million annually. Of these 4 million people, nearly 11,000 were hospitalized, and  up to 150 died according to the CDC. As of 2012 there have been 94% fewer hospitalizations and 84% fewer outpatient visits for chickenpox than before 1995.

The largest decrease in chickenpox occurred among the target group for vaccination: children and teenagers between the ages of 1 and 19. But there were also significant drops in outpatient visits and hospitalizations among children younger than 12 months- whom the vaccine is not recommended and among adults who tend to not get vaccination. These results illustrate the potential of herd immunity.

CMA Today Mar-Apr 2016