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Deerwood Education

Multivitamins

8/7/2024

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Are you considering supplements to enhance your overall health but unsure where to start? At Deerwood Family Practice, we recommend multivitamins as an excellent place to begin.
​The Dietary Guidelines for Americans 2020-2025 highlight that many people may not get enough micronutrients from their diets alone. Factors like mass food production, food storage practices, poor dietary choices, and nutrient-depleting cooking methods can contribute to these deficiencies. While it's ideal to obtain your nutrients from a diverse diet rich in vegetables, fruits, whole grains, and dairy, sometimes this isn't enough. In such cases, high-quality multivitamin/mineral supplements can be a valuable addition to your health regimen. The products we offer at Deerwood are provided in bioactive forms so they are adequately absorbed and utilized efficiently 
ActivNutrients by Xymogen is a  multivitamin that features a well-balanced nutrient profile, including calcium, magnesium, zinc, copper, vitamins C and E, bioactive folate, vitamin B12, a B vitamin complex, beta-carotene, and trace elements. The formulation is expertly balanced to enhance nutrient synergy and prevent competitive absorption issues. Additionally, it provides broad-spectrum antioxidant activity, supporting intra- and extracellular functions, and offers significant levels of bioavailable riboflavin, niacin, folate, and B12 to aid cellular detoxification and tissue support. Another option is ActivNutrients® Phyto. This premium formula combines metabolically active B vitamins and a bioavailable mineral complex for superior nutrient utilization. Alongside foundational nutrition, it includes powerful phytochemical sources such as astaxanthin and extracts from green coffee beans, green tea, and rosemary. These components work together to support antioxidant defenses, and cell protection, and help mitigate oxidative stress.

Sources:
1. Block G, Jensen CD, Norkus EP, et al. Nutr J. 2007;6:30. doi:10.1186/1475-2891-6- 30  
 2. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th ed. December 2020. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_ Americans_2020-2025.pdf 
3.Blumberg JB, Bailey RL, Sesso HD, et al. Nutrients. 2018;10(2):248. doi:10.3390/ nu10020248 
4.Reider CA, Chung RY, Devarshi PP, et al. Nutrients. 2020;12(6):1735. doi:10.3390/ nu12061735  
5. Multivitamin/Mineral Supplements Fact Sheet. National Institutes of Health. Updated October 12, 2021. Accessed November 29, 2021. https://ods.od.nih.gov/factsheets/ MVMS-HealthProfessional/?print=1  
6.Blumberg JB, Frei BB, Fulgoni VL, et al. Nutrients. 2017;9(8):849. doi:10.3390/ nu9080849
7.Blumberg JB, Cena H, Barr SI, et al. Clin Ther. 2018;40(4):640-657. doi:10.1016/j. clinthera.2018.02.014
8. Marra MV, Bailey RL. Position of the Academy of Nutrition and Dietetics: micronutrient supplementation. J Acad Nutr Diet. 2018;118(11):2162-2173. doi:10.1016/j. jand.2018.07.022 
9. Jayedi A, Rashidy-Pour A, Parohan M, et al. Adv Nutr. 2018;1;9(6):701-716. doi:10.1093/advances/nmy040 
10.Doyle ME, Pariza MW. In: Kotsonis FN, Mackey MA, eds. Nutritional Toxicology. 2nd ed. Taylor & Francis; 2002:1 30. https://doi.org/10.1201/9781420025088
  








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Crp labs

6/25/2024

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At Deerwood Family Practice, we emphasize the importance of annual physicals and blood work. An important test within your lab results is called C-Reactive Protein or “CRP.” This value can be added to your labs and is an indicator of inflammation.
CRP is a protein produced by your liver, usually rising in periods of acute inflammation. However, it has both proinflammatory and anti-inflammatory effects. It clears foreign pathogens but can also exacerbate tissue damage by activating an inflammatory response in your body.
There are many reasons behind elevated CRP levels, but most elevated levels are associated with infections or trauma. Other known causes include sleep issues or periodontal disease. In healthy adults, a normal level is less than 3mg/dL. Certain medications like NSAIDs or statins can falsely decrease CRP levels. High levels above 50mg/dL are most often due to infections.
CRP has been recently used as a predictive factor in conditions like Hepatitis C, dengue and malaria, but these studies are still limited. Additionally, there is believed to be some correlation between elevated CRP and cardiovascular risk, but this research is still developing as well.
At your follow-up lab review visit, your provider will be sure to highlight and discuss your CRP level with you. We look forward to seeing you and educating you about your health!


Caitlin Vandermolen FNP student
University of Southern California Class of 2025
​

Reference:
Nehring SM, Goyal A, Patel BC. C Reactive Protein. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441843/

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WHAT’S A WELLNESS?

6/11/2024

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A wellness visit focuses on preventative care.
At this visit we discuss how to improve your overall health and watch for warning signs that something may change in your health. We don’t want to wait for you to develop a chronic disease, we want to stop it before it happens! Think of this visit as a “status update” with your provider to evaluate for any health changes in the past year. We collect your vital signs, check on your medications, ask about recent surgeries or specialist you may have seen, and assess what screenings are appropriate for your age and gender. Some screenings we may discuss include cholesterol and diabetes screenings, blood pressure evaluation, mammograms, Pap tests, PSAs, colonoscopies, osteoporosis or even STI/STD testing. Your family medical history is just as important as your own personal medical history. We want to look out for early warning signs to keep you at your best health! Vaccines and immunizations status is also important for all patients. A full body exam is also performed along with an EKG or Max Pulse depending on your age and personal medical history. Specific issues that you may have not related to the Wellness visit are considered part of the follow up. These additional concerns are considered a “sick visit” by insurance companies and may require a copay if they are addressed at the same time. Please let your provider know if you have additional concerns at your Wellness visit and depending on their complexity, they may have to be addressed at your lab review visit. 

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Skin cancer awareness

5/19/2024

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This May we’re shining the light on skin cancer. This is one of the most common cancers in America and it’s estimated that everyday over 9,000 Americans are diagnosed. Sun protections is one of the easiest ways to decrease your skin cancer risk. Look for products that are broad spectrum, water resistant, and SPF 30 or higher. Make sure you wear it throughout the entire year and not just during the sunny months. Reapply every two hours to maximize protection. If you have a mole or growth you’re worried about consider your ABCDEs! Asymmetrical, irregular Borders, Color, Diameter > 6mm, and Evolving. 
​Come see us at Deerwood Family Practice for latest skin care treatments, products, and prevention. 


Sources:

https://www.skincancer.org/get-involved/skin-cancer-awareness-month/

https://www.beaumont.org/conditions/melanoma/abcde's-of-melanoma#:~:text=ABCDE%20stands%20for%20asymmetry%2C%20border,the%20shape%20isn't%20uniform.
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Colorectal cancer

3/8/2024

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1 in 3 adults age 45-75 are not receiving adequate screening for colon cancer. In adults under 50, colorectal cancer is the top cause of cancer related death in men and the 2nd in women. Colonoscopies should start at age 45 and are still the gold standard for screenings; they are the only test that can visualize and remove colon polyps. These polyps can grow and progress  into cancer if left untreated within 10 years. If you are nervous or hesitant to get this done, come visit with us about your other options for screenings. 68% of colon cancer related deaths could have been prevented by early screenings. Don’t become a statistic! ​

One alternative option we have at Deerwood is Cologuard. This is a kit that analyzes your stool for colon cancer DNA and microscopic blood. With Cologuard there is a risk for having a false positive or a false negative result. In a clinical study, 13% of patients who did not have cancer received a false positive result. In that same study 8% of patients who actually did have cancer received a false negative result. 

An additional option is Shield. This is a blood test that can be done at any of your lab visits. This test works by looking for colorectal neoplasm DNA in the blood. With this test there is no prep required or elimination of food or meds from your diet. These results are back in about 2 weeks. Shield demonstrates a high sensitivity rate of 83% detection rate and 90% specificity as well. 

If these tests come back positive it could mean you have colorectal cancer or advanced adenomas. This would require a follow up colonoscopy. These tests are meant for adults 45 years old who are at typical risk for colon cancer.  It’s not meant to replace a colonoscopy in individuals who are at high risk. This would mean people with IBD, chronic ulcerative colitis, crohn’s, or a family medical history of colorectal cancer need to consider a colonoscopy. 

Source:

https://fightcolorectalcancer.org/wp-content/uploads/2024/02/2024_CRCFactSheet_Web_Compressed.pdf

https://www.cologuardhcp.com/crc-screening-unmet-need/impact-of-choice

https://guardanthealth.com/wp-content/uploads/Guardant_Shield_FactSheet-1.pdf
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Prevent cancer!

2/21/2024

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Don’t wait, prevent!
  • Lung cancer screening is recommended for adults who smoke now or have quit within the past 15 years, have a 20-pack-year or more smoking history, and are between 50 and 80 years old.
  • Women between the ages of 40-75 are encouraged to get a mammogram every one or two years to detect early signs of breast cancer. 
  • Adults between the ages of 45 to 75 are encouraged to get colorectal screening for colon cancer.
  • Women ages 21 to 65 years are encouraged to get screened for cervical cancer via a Pap smear every 2-3 years.
  • For men starting at age 40, a PSA should be offered to evaluate prostate health. This is done with blood work and is recommended annually. 
How to decrease your risk
  1. Don’t smoke
    1. Smoking and exposure to second hand smoke cause 90% of lung cancers deaths.
    2. Chronic exposure to tobacco can also cause larynx, mouth and throat, esophageal, bladder, and other cancers.
  2. Protect your skin
    1. Skin cancer is one of the most common and most preventable cancers.
    2. Sun screen even on cloudy days decreases UV ray exposure and lessens the chance for developing abnormal cell growth
  3. Maintain a healthy weight
    1. Overweight and obesity has been linked to an increased risk for certain cancers like endometrial, uterine, breast, and colorectal. 
    2. Physical activity, healthy eating habits, and lifestyle interventions can help mitigate this risk
  4. Limit alcohol intake
    1. Heavy and binge drinking has been linked to increase risk of liver, colon, rectal, mouth, pharyngeal, laryngeal, and esophagus cancer.
    2. The CDC recommends men have no more than 2 alcoholic drinks a day and women no more than 1.
  5. Practice safe sex, get tested, and get vaccinated.
    1. Unprotected sex can spread HPV and hepatitis B. If left untreated HPV can cause cervical cancer, throat and oral cancer, anus and penile cancer while hepatitis B can lead to liver cancer.
  6. Know your family medical history
    1. Knowing your family cancer history can help you and your provider decide which screening tests you need, when you need them, and how often.
    2. It’s better to find cancer early than to wait for symptoms. 
  7. Make sure you participate in basic screening tests like colonoscopies, PSA blood work, mammograms, and pap smears.

At Deerwood Family Practice we offer Invitae Testing that screens for 85 genetic cancer markers. We also offer Galleri testing which looks for active cancer tumor DNA in the blood.

https://www.dhd10.org/national-cancer-prevention-month-february-2023/

https://cancerprogressreport.aacr.org/progress/cpr22-contents/cpr22-preventing-cancer-identifying-risk-factors/

https://www.chcw.org/february-is-national-cancer-prevention-month/


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Cardiovascular health

2/9/2024

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February is the time when all people, especially women, are encouraged to focus on their cardiovascular health.
  • Heart disease is the #1 killer of American women and stoke is the #4 killer 
  • By the age of 40, most women have at least one risk factor for heart disease 
  • Risk factors for heart disease include but aren’t limited to high blood pressure, high cholesterol, extra weight, diabetes, sleep apnea
  • Risk factors for stroke include smoking, lack of physical activity, excessive alcohol use, poor eating habits, migraine headaches.
  • To help protect yourself from stroke and heart disease; exercise, eat a heart healthy diet, know your lab values, limit alcohol use, stop smoking, take care of your mental health! 
  • Signs of a heart attack in women are different than men. Look out for constant and unrelieved pain in the back, neck, jaw, or throat. Indigestion and heartburn unrelieved by medication, sudden extreme fatigue, or shortness of breath, and chest pain.
  • Strokes happen quickly, and the sooner you get medical attention the better. Look out for sudden onset of numbness or weakness on one side of the body,face, or arm, confusion, trouble speaking or understanding, difficulty walking, extreme dizziness or loss of balance of coordination, severe headache. 
https://www.womenshealth.gov/heart-disease-and-stroke#:~:text=Heart%20disease%20is%20the%20number,and%20stroke%20at%20any%20age.​

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Sleep apnea

1/26/2024

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Written by Alexis Sekula, BSN, RN, TAMUCC FNP-Student (Graduation May 2024)

Sleep apnea is one of the most common sleep-related breathing disorders (National Heart, Lung, and Blood Institute, 2022). This disorder causes repeated lapses in breathing as a result of a blockage in your airway (Cleveland Clinic, 2022). Sleep apnea affects about 3 % of people of normal body weight and over 20% of obese people (Johns Hopkins Medicine, 2022). 


Why does this matter? 
The blockage of the airway results in decreased oxygen levels and the build of carbon dioxide levels which triggers a survival reflex that wakes you up to correct the obstruction (Cleveland Clinic, 2022). Sleep apnea does not only impact sleep quality but, uncorrected sleep apnea can lead to serious health problems such as increased cardiovascular disease, hypertension, stroke, and metabolic disease (Cleveland Clinic, 2022).

What happens to the body? 
Blockage of the airways leads to carbon dioxide retention in the bloodstream. This causes a problem as this will decrease the body’s ability to exchange carbon dioxide for oxygen.

What are the symptoms of sleep apnea? 
#1 symptom is snoring or pauses in breathing while asleep. Other symptoms include daytime sleepiness, mood changes, disruption in brain function, insomnia, night sweats and feeling restless at night, sexual dysfunction, waking up feeling short of breath, headaches - especially when waking up (National Heart, Lung, and Blood Institute, 2022). 

How do I know if I have sleep apnea? 
Your PCP can perform a physical evaluation and order a sleep study. 
Treatment for sleep apnea should be coordinated with your primary care provider. The most common treatment is continuous positive airway pressure (CPAP). Studies have shown that regular use of CPAP reduces blood pressure, lowers the risk of stroke, heart attack, and blood glucose, and improves daytime sleepiness (Johns Hopkins Medicine, 2022). 


References
Cleveland Clinic. (2022). Sleep apnea: What it is, causes, symptoms & treatment. https://my.clevelandclinic.org/health/diseases/8718-sleep-apnea
Johns Hopkins Medicine. (2022, November 1). The dangers of uncontrolled sleep apnea. https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-dangers-of-uncontrolled-sleep-apnea 
National Heart, Lung, and Blood Institute. (2022, March). What is sleep apnea? NHLBI, NIH. https://www.nhlbi.nih.gov/health/sleep-apnea
National Heart, Lung, and Blood Institute. (2022, March). Sleep apnea-symptoms? NHLBI, NIH.
https://www.nhlbi.nih.gov/health/sleep-apnea/symptoms


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Cervical Cancer Awareness

1/15/2024

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More than 14,000 women in the U.S are diagnosed with invasive cervical cancer each year. 
Starting at age 21, every person with a cervix should have a Pap smear, and then at age 30 co-tested with a pap and HPV test.
HPV (human papillomavirus) is directly liked to cervical cancer and most sexually active people will be exposed to it at some point in their lives. 
This infection is usually harmless and the body is able to destroy it most of the time, but some types or strains of this virus can lead to cancer if untreated. 
The HPV vaccine can protect you from cervical cancer. Vaccines are recommended starting at age 11 all they way to 45. 

https://www.nccc-online.org//wp-content/uploads/2019/01/January_2019_printable.pdf

https://www.nccc-online.org/cervical-health-awareness-month/​

https://www.nccc-online.org/wp-content/uploads/2021/06/HPV-Vaccine.pdf
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Blood Donor Month

1/1/2024

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January is blood donor awareness month!  Did you know…
  • Red blood cells help carry oxygen to your tissues and take carbon dioxide back to the lungs. They make this journey through the circulatory system every 20-60 seconds depending on your heart rate.
  • Red blood cells live for 120 days before they are taken to the spleen to be recycled.
  • Blood type O negative is the universal donor. That means your blood can save anybody. Only about 7% of Americans have this blood type. 
  • When you donate blood, you give about 1 pint which can save up to three lives.
  • Only 3% of Americans donate blood each year. 

​Where you can donate:
 
South Texas Blood & Tissue - Shavano Donor Center
4079 N Loop 1604 W #102, San Antonio, TX 78257

South Texas Blood & Tissue - Northeast Donor Center
​8500 Village Dr #102, San Antonio, TX 78217



https://www.rrvbc.org/faq-items/30-fascinating-blood-facts/
https://www.redcrossblood.org/donate-blood/how-to-donate/how-blood-donations-help/blood-needs-blood-supply.html
https://americasblood.org/wp-content/uploads/2022/05/Whitepaper-National-Stats_5.22.pdf

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