Medical Assistant

What’s your diabetes IQ?

Diabetes is not just a disorder of the pancreas. It can cause serious complications to other parts of the body. How much do you know about how diabetes can affect more than blood sugar?

True or False?

1. People with diabetes can develop blurry vision and even blindness.

2. High blood sugar can lead to tooth and gum disease.

3. People with diabetes catch the flu more than others.

4. Diabetes can hurt feet.

5. Diabetes causes acne.

All are true except for 3 and 5. Flu can make diabetes more difficult to manage. Diabetes can cause skin to become itchy, dry, cracked ad thin and more vulnerable to fungal infections.

June 2014

Well Cultured: Probiotics may be popular- but are they right for you?

Most of the bacteria cells hanging out in the digestive system are ‘friendly’; they extract nutrients from the diet and boost immunity by fighting off germs. Scientists suspect that each person can harbor more than 500 different kinds of bacteria species; no two people’s gut bacteria are the same. Most of these bacteria coexist harmoniously but can be affected by illness, stress and even antibiotic use. Some experts believe that consuming probiotics in either food or supplement form can help improve or maintain health.  Kicking out the digestive system’s unwanted guest. can alleviate depression, assist with weight loss and reduce the duration and some symptoms of illnesses. Be warned that much of the research on probiotic use is yet to be done.

Check out this article by Maria Masters in July 2014 to determine how to choose a probiotic supplement. One needs to seek out specific strains, pay attention to packaging and be your own judge by monitoring improvement of symptoms.

Exercise smart: advice for student athletes

  1. Hydrate, even days before a game.
  2. Rest from main activity by cross-training. This avoids overuse injury and ensures good overall conditioning.
  3. Fuel with a good, balanced diet with adequate  protein. Eat fruits and vegetables along with lean meats.
  4. Stretch before a workout and after.
  5. Use your body safely and get your form perfected to decrease the risk of injury.
  6. Have perspective and learn to be a good sport, participate on a team and build character Spring 2014


Eat to Beat Cancer

One of three cancers can be prevented by exercising, keeping a healthy weight and eating right. Here are some of the most potent superfoods and drinks:

Apples contain flavonoids and phenolic acids. Together they may protect against damage to cells that can trigger malignancies and may also prevent emerging cancer cells from dividing any further.

Nuts a serving a day helps ward off deaths from heart disease too.

Beans and lentils are loaded with fiber and antioxitants, phytochemicals and folate which protect colon cells while stimulating bowel function. Soybeans contain genistein that may be linked as a possible treatment for prostate, lung and colorectal cancer.

Tea and coffee: The antioxidants in coffee seem to be effective against endometrial cancer. Green tea seems protective against prostate cancer. Very hot beverages may increase the risk of esophageal cancer.

Curry contains curcumin which gives its yellow color and sizzle and can fight cancerous changes in healthy cells as well as slow the growth of malignant cells. There is some evidence that it may also offer protection against brain tumors.

Tomatoes teem with the antioxident lycopene and may block cancer by stopping malignant cells from multiplying and by causing them to destroy themselves. Lycopene is more easily available to the body in cooked tomato products like sauce.

Garlic and onions: compounds that give these strong flavor appear to stave off cancer by neutralizing carcinogenic substances and speeding the repair of damaged DNA.  Garlic seems especially effective against digestive tract cancers.

Milk contains calcium that may neutralize potential carcinogens, particularly those found in processed meats. Milk drinkers are less likely to become obese.

Broccoli and other cruciferous vegetables are packed with sulforaphane, another cancer fighting substance so potent that researchers are testing it as a drug.

Dark, leafy greens arugula, kale, spinach and romaine abound in antioxidants called carotenoids, which have been shown to inhibit the growth of cancer cells of the skin, lung, stomach and certain kinds of breast cancer. Spinach may even block carcinogens from cooked meat.

Red grapes and red wine are loaded with resveratrol which inhibits cancer cell growth and causes them to self-destruct. Resveratrol remains effective and even more powerful after it is metabolized by the body. The compound is found in peanuts, cranberries and blueberrie.

Whole grains are linked to a lower risk of colorectal cancer. Whole grains offer protection against other chronic conditions, including heart diseases and diabetes.

AARP The Magazine April – May 2014

Diabetes: Ways to Reduce the Risk

25.8 million is the number of Americans who have diabetes which is an increase from 8 million more than six years ago. Losing weight, exercising rigorously and following a low-fat diet can significantly reduce the odds of getting the disease.

26% is your chance of developing diabetes if your spouse already has it. Drinking just one or two sugar-sweetened beverages a day increases risk of diabetes by 26%.

45% is your likelihood of developing diabetes if you lead a successful life. Taking a 15-minute stroll a half hour after eating lowers post-meal blood sugar levels for at least three hours.

Adopting the Mediterranean diet with its abundance of fish and heart healthy olive oil can lower risk by 83%. Olive oil boosts insulin sensitivity. Vegetables, whole grains and nuts also lower blood sugar and cholesterol.

People who sit six to eight hour daily are 19% more likely to have diabetes. Move around for at least two minutes every half hours to up metabolism enough to lower glucose.

Muscles is where glucose is stored. Glucose from food is released into blood and blood sugar rises. Resistance training keeps blood sugar levels lower longer than aerobic exercise. Lift weights at least twice a week.

Eating slowly increases satiety and prompts eating smaller portions.

AARP The Magazine April – May 2014

Skin Cancer 411

You are at a higher risk for skin cancer if: you are age 50 years or older, have a fair complexion that burns easily in the sun, have had long hours of sun exposure early in life, or have a family history of skin cancer.

Regardless of your risk, you can take these steps:

  1. Watch the time of day- UV spectrum light is strongest between 10:30 am and 2:30 pm
  2. Wear sunscreen in any area you can not physically protect
  3. Use physical sun blockers- long pants and sleeves, a hat with a 4 inch brim or use an umbrella


Melanoma or cancer in the skin cells that produce melanin (skin pigment, is the most serious type of skin cancer. Early diagnosis and treatment is key for melanoma survival. About half the time melanoma develops from a mole, but not always! Keep an eye on irregularly shaped moles, as well as those that change color or shape, or get bigger. Spring 2014

Osteoarthritis: 4 Treatments to Try Now

Until fairly recently, providers have been limited in their treatment options: exercise, anti-inflammatory drugs, physical therapy and joint replacement.

Pain relief: Cymbalta which boosts levels of serotonin and norepinephrine in the brain, inhibiting pain perception doesn’t work for everyone but has existed since 2010. Tanezumab which seems to inhibit nerve growth factors is in clinical trial.

Injections: Within synovial fluid is hyaluronic acid which degenerates in those with osteoarthritis. An injection of it in joints will reduce pain. Platelet rich plasma, which involve withdrawing blood from the patient, spinning and separating the platelets and then injecting the concentrated platelets into a joint has shown great promise.  More recently, stem cell injections have been used to treat knee injuries.

Distraction: by creating a metal frame outside the skin around the joint and anchoring the frame surgically to the bones above and below. The frame absorbs the weight, but the real benefit comes from the bones separating. The ends of the bones soften enhancing blood flow and stimulating the growth of cartilage. This procedure is not widely available in the U.S. The frames stay on for months and rehabilitation is long. The cartilage produced may be less durable than natural cartilage.

Cartilage replacement: Autologous chondrocyte implantation involves providers taking a small amount of cartilage from the patient’s joint, cultivating the cells, sealing the affected area and injecting the cultivated cells under the seal however works only when the arthritis is contained in a small area. Recently scientists have been able to prod bone marrow stem cells to act like cartilage and someday may up up with something that regenerates cartilage.

885,000 knees and hips are replaced each year in the U.S.

$186 billion is the annual cost of osteoarthritis

AARP The Magazine April – May 2014


The Amazing Macula

Cameras have changed dramatically in the past 30 years and so has our understanding of the eye, especially the retina. Before the digital age, cameras were a great analogy for the eyeball function. The retina was described as
the ”film” of the eye. There is a specialized portion for focus vision known as the macula. Even though it is a very small area, it is arguably the most important part of our vision.

You cannot read without macular vision. Thirty years ago there wasn’t much to be done if damage occurred to the macula. Now there is an array of medical and surgical interventions to help preserve and repair damage to this important part of our vision. As part of routine preventative health care, people who are middle-aged and older should be seeing an eye specialist every 2 years to screen for age-related macular degeneration. If detected early, age-related (“dry”) macular degeneration may be helped by taking specialized vitamins. If more complicated (“wet”) forms of macular degeneration are present, other new treatments have had excellent results and usually stabilize the condition to prevent more severe stages of vision loss.

Another macular condition with sudden loss of focus vision called a “macular hole” generally has a great outcome thanks to new surgical techniques. In summary, our macular (focus) vision is probably the most amazing part of our sight. Thanks to new developments in ophthalmology, it is now another building block of preventive health care.

By Alden Tetlie, M.D. Entira Family Clinics Monitor April 2014

5 job-interview mistakes to avoid

People are often wrongly dressed for the interview. Usually they are overdressed, have on too much makeup and jewelry or impractical shoes.

When explaining decisions you have made, like why you are changing jobs, the interviewer is often interested in hearing about your motivations and attitude. Never complain about a former job or situation. Find a positive way to frame what you want to say.

Many people have negative speech habits, such as using hedges like just, actually, kinda and almost. Using them makes you seem less confident, less authoritative and therefore less employable. Don’t undermine your credibility.

At an interview talk only about the things that directly correlate with your ability to do the job: know your knowledge, skills and abilities. Talk about the job not your likes and dislikes.

Too many people walk into an interview with tons of extraneous items. Do not bring in your cell phone. Don’t bring in reading material. A water bottle may be acceptable but better off without a drink in hand. Companies hire people not just on a set of skills but take everything you do into account to determine if you fit in to their business.


April 10th is… National Alcohol Screening Day

The AUDIT C is a condensed, hence “C”, version of the full 10 question AUDIT tool. The AUDIT C contains 3 questions which quantifies the amount of alcohol a person drinks. Using a validated scoring system it helps to determine which people might be at higher risk for having a problem with alcohol.

As is true with many screening tools a positive score does not diagnose a person with alcoholism. Rather the tool is used  to assist in deciding which patients need a more elaborate tool, like the full AUDIT, to help determine if they indeed have a substance abuse problem.

Entira Family Clinics Monitor April 2014