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Polymyalgia Rheumatica and Giant Cell Arteritis

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Polymyalgia rheumatica
North Fulton Studio
Polymyalgia Rheumatica and Giant Cell Arteritis
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Polymyalgia rheumatica

Polymyalgia Rheumatica and Giant Cell Arteritis (Episode 82, To Your Health with Dr. Jim Morrow)

On this episode, host Dr. Jim Morrow describes two related little-known conditions called Polymyalgia rheumatica and Giant cell arteritis, also known as Temporal arteritis. These conditions involve inflammation of the arteries and usually occur in the elderly and affect mostly women. Dr. Morrow discussed symptoms, diagnosis and treatment, and stressed the need to not wait to get symptoms checked out because of the damage that can occur if left untreated.  He also included an update on the latest COVID-19 booster.

To Your Health is brought to you by Village Medical (formerly Morrow Family Medicine), which brings the care back to healthcare.

About Village Medical (formerly Morrow Family Medicine)

Village Medical, formerly Morrow Family Medicine, is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Village Medical one that will remind you of the way healthcare should be.  At Village Medical, we like to say we are “bringing the care back to healthcare!”  The practice has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Village Medical offers a comprehensive suite of primary care services including preventative care, treatment for illness and injury, and management of chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD) and kidney disease. Atlanta-area patients can learn more about the practice here.

Dr. Jim Morrow, Village Medical, and Host of To Your Health with Dr. Jim Morrow

Covid-19 misconceptionsDr. Jim Morrow is the founder of Morrow Family Medicine. He has been a trailblazer and evangelist in healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

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The complete show archive of To Your Health with Dr. Jim Morrow addresses a wide range of health and wellness topics.

Dr. Morrow’s Show Notes

What are giant cell arteritis (GCA) and polymyalgia rheumatic (PMR)?

  • This condition causes inflammation of the arteries in the arms, upper body, and neck.
    • Arteries are blood vessels that carry blood from the heart to the rest of the body.
    • Arteritis is a condition in which the arteries become inflamed (swollen). This reduces blood flow.
      • Giant cell arteritis (GCA) causes certain arteries to become inflamed, red, hot, or painful.
      • It usually affects the arteries above and in front of the ears on both sides of the head (the temples).
      • This type of GCA is also sometimes called temporal arteritis or cranial arteritis.
    • Polymyalgia rheumatica (PMR) is a condition involving inflammation of the muscles in your neck, shoulders, hips, and thighs.
      • This causes stiffness and aching in these areas.
      • It usually develops over time. But for some people, it can start as quickly as overnight.
      • With treatment, PMR usually goes away within a year.
      • It can last for several years in some cases.
      • Both disorders mainly affect people over 50,
        • particularly women.

How are GCA and PMR related?

  • About half of people who have GCA also have PMR. They can have these diseases at the same time, or GCA can develop after PMR.
  • Symptoms of GCA and PMR
    • The symptoms of GCA include:
      • Flu-like symptoms. These can include fatigue, fever, and loss of appetite.
      • Severe headaches.
      • Pain and tenderness in one or both temples.
      • Jaw pain, especially when chewing.
      • Double vision or vision loss.
      • Pain and stiffness in the neck and arms.
      • Unintended weight loss.
    • The symptoms of PMR include:
  • Aching pain and stiffness in the neck, shoulders, hips, and thighs.
  • General muscle weakness.
  • Unintended weight loss.

What causes GCA and PMR?

  • Doctors aren’t sure what causes the inflammation associated with GCA or PMR.
    • Aging and problems with the immune system are possible factors.
    • It also could be related to your genes,
      • or to an environmental trigger like an infection.

Who gets these conditions?

  • You are more likely to develop GCA and PMR if you are older than 50 years of age.
    • The conditions are most common in women between 70 and 80 years of age.
    • For unknown reasons, Caucasian people are more likely to develop GCA and PMR than people of other races.

How are GCA and PMR diagnosed?

  • To diagnose GCA, your doctor will ask about your symptoms and examine the arteries in your temple.
    • He or she will check if they are swollen or tender.
      • They may order blood tests to check for inflammation of the arteries and to rule out other conditions.
        • Often, a biopsy of the temporal artery is needed to confirm the diagnosis.
        • This is an outpatient procedure that involves removing a sample of your temporal artery from your scalp area.
        • To diagnose PMR, your doctor will likely perform a physical exam and ask about your symptoms.
        • He or she may order a blood test.
        • This can help detect inflammation of your arteries and check your blood count.
        • Your doctor could also order a muscle biopsy (removing a small sample of muscle) to check for PMR.
        • Your doctor also can order a c-reactive protein test.
        • This blood test measures the amount of inflammation in your bloodstream but doesn’t identify where the inflammation is located.

Can GCA and PMR be prevented or avoided?

  • There is no known way to prevent GCA or PMR because doctors aren’t sure what causes them.

GCA and PMR treatment

  • Your doctor may prescribe a corticosteroid medicine to treat inflammation and pain.
    • This can help with symptoms of GCA and PMR.
    • These medicines are taken by mouth (in pill form).
    • Once you start taking a corticosteroid, you should feel better quickly.
    • You may need to take this medicine for 6 months up to 2 years.

What else can I do to ease the symptoms of these conditions?

  • Eating a healthy diet and getting enough exercise can help relieve the symptoms of both GCA and PMR.

Living with GCA and PMR

  • Taking a corticosteroid for a long time can raise your blood pressure.
    • It can also increase your blood sugar levels or weaken your bones.
    • Your doctor will need to keep checking you for these side effects during your treatment.
    • Corticosteroids can cause other side effects.
      • These include jitteriness, poor sleep, and weight gain.
      • These symptoms usually get better as you take smaller doses of the medicine.
      • Getting early treatment for GCA is important. If inflamed arteries aren’t treated right away, they could be permanently damaged.
      • This increases your risk of blindness or stroke.
      • Even with proper treatment, GCA and PMR may come back.
        • About half of the time, though, a person who has PMR will experience at least 1 relapse.

 

Acid and Ulcers

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Ulcers
North Fulton Studio
Acid and Ulcers
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Ulcers

Acid and Ulcers (Episode 81, To Your Health with Dr. Jim Morrow)

On this episode of To Your Health, Dr. Jim Morrow of Village Medical offered information about indigestion, ulcers, and stomach issues. He detailed the symptoms of indigestion that sometimes can overlap with other serious conditions. Dr. Morrow also talked about what causes indigestion, what can be done to treat it, the causes and treatments of peptic ulcers, and more.

To Your Health is brought to you by Village Medical (formerly Morrow Family Medicine), which brings the care back to healthcare.

About Village Medical (formerly Morrow Family Medicine)

Village Medical, formerly Morrow Family Medicine, is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Village Medical one that will remind you of the way healthcare should be.  At Village Medical, we like to say we are “bringing the care back to healthcare!”  The practice has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Village Medical offers a comprehensive suite of primary care services including preventative care, treatment for illness and injury, and management of chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD) and kidney disease. Atlanta-area patients can learn more about the practice here.

Dr. Jim Morrow, Village Medical, and Host of To Your Health with Dr. Jim Morrow

Covid-19 misconceptionsDr. Jim Morrow is the founder of Morrow Family Medicine. He has been a trailblazer and evangelist in healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook | LinkedIn | Twitter

The complete show archive of To Your Health with Dr. Jim Morrow addresses a wide range of health and wellness topics.

Dr. Morrow’s Show Notes

What is indigestion (dyspepsia)?

  • Indigestion, also known as dyspepsia, is a common condition.
    • It can happen when your body has trouble digesting food.
    • It occurs in your gastrointestinal (GI) tract.
      • The GI tract is a group of organs that plays a part in digestion.
      • Anyone can get indigestion.
      • You can get it on occasion,
        • or it can be an ongoing problem.
      • The symptoms and causes vary by case.
      • If there is no known cause for indigestion, it is referred to as functional dyspepsia.

Symptoms of indigestion

  • Indigestion can feel like a stomachache. You can have a range of symptoms including:
    • Pain, discomfort, or a burning feeling in your chest or stomach
    • Burping
    • Bloating
    • Gurgling stomach and/or gas
    • Acid reflux
    • Heartburn
    • Nausea and/or vomiting
  • Talk to your doctor if symptoms continue for more than two weeks. Seek medical care right away if your symptoms are severe, such as:
  • Shortness of breath
  • Trouble swallowing
  • Ongoing vomiting
  • Throwing up blood
  • Sudden pain in the chest, arm, neck, or jaw
  • Cold sweats
  • Thick, black, or bloody stool

What causes indigestion?

  • A lot of factors can cause indigestion. These include:
    • Eating certain foods, such as those that are spicy and fatty, and those with lots of acid or fiber
    • Eating too late in the day
    • Drinking alcohol or too much caffeine
    • Taking certain medicines
    • Smoking
    • Not sleeping
  • Problems in your GI tract or other health issues also can cause indigestion. These include:
  • Acid reflux or gastroesophageal reflux disease (GERD):
    • This is when your food and drink come back up from your stomach after eating or drinking.
    • It’s in the form of acid and can come into your esophagus, the tube-like organ connecting your mouth and stomach.
    • Acid reflux also can produce vomiting.
      • This condition also may cause heartburn.
    • Irritable bowel syndrome:
      • This disorder affects your intestines.
      • Symptoms include stomach pain, bloating, gas, constipation, and diarrhea.
    • Infection:
      • A bacterial infection from Helicobacter pylori (H. pylori) can cause indigestion.
    • Gastroparesis:
      • This condition affects digestion. If muscles in your GI tract stop working, your body slows down or stops the movement of food. Symptoms include nausea, vomiting, stomach pain, bloating, and acid reflux.
    • Ulcer:
      • This is a sore on the lining of your stomach (peptic ulcer), small intestine, or esophagus.
    • Gastritis:
      • This is inflammation of your stomach lining.
    • Stomach cancer:
      • This is a rare condition, but indigestion can be one of its signs.

How is indigestion diagnosed?

  • Your doctor will review your symptoms and perform a physical exam.
    • They may order tests to determine the cause of indigestion.
    • Those tests can include blood work, urine/stool tests, or an X-ray or ultrasound.
    • Sometimes your doctor may perform an upper endoscopy to see inside your stomach.
    • Your doctor will insert a thin tube with a camera on the end into your esophagus.
    • This will be done after you’re given medicines to go to sleep.

Can indigestion be prevented or avoided?

  • There are ways to prevent indigestion.
    • To start, you need to know your body and how it reacts to different food and drinks.
    • Spicy and acidic foods and carbonated drinks can trigger indigestion.
    • Try to avoid those things when possible.
    • Eat smaller meals throughout the day, and don’t eat too late at night.
    • Don’t lie down too soon after eating.
    • Limit the use of alcohol.
    • If you use tobacco, try to quit.
    • Stress and lack of sleep also can worsen symptoms.

Indigestion treatment

  • Your treatment will depend on what is causing your indigestion.
    • Your doctor can help you decide which treatment is best for you.
    • Some over-the-counter medicines may help your symptoms.
    • Check with your doctor before starting something new.
  • Antacids (Tums) work against the acid in your system.
  • Proton pump inhibitors
    • omeprazole and
    • lansoprazole
      • help block the site of acid production in your stomach.
    • Histamine blockers
      • help reduce pain and symptoms, but should not be used long-term.
    • Do not take pain and anti-inflammatory medicines
      • for your symptoms.
      • They do not help and can worsen your condition, especially if used often.
    • If you have a stomach ulcer, you may need to take an acid-blocking medicine.
    • But your ulcer can be cured.
      • If you have an infection in your stomach, you also may need to take an antibiotic.
    • Prevention methods for indigestion also are forms of treatment.
      • These include changing your diet and the way you eat.
        • Also get more sleep and reduce your level of stress.

Living with indigestion

  • Most people who have indigestion lead a normal life.
    • You may need to make some lifestyle changes or take medicine to treat your symptoms.
    • Exercise regularly and maintain a healthy weight.
  • In rare cases, indigestion can be the sign of a serious problem.
    • Examples include a deep stomach ulcer or stomach cancer.
    • If you have any of the following symptoms, contact your doctor right away:
      • You recently lost weight without trying.
      • You have trouble swallowing.
      • You have severe vomiting.
      • You have black, tarry bowel movements.

What is peptic ulcer disease?

  • A peptic ulcer is a sore or raw area in the lining of the stomach.
    • It also can occur near the top of the small intestine.
      • This area of the small intestine is called the duodenum.
      • The lining is damaged by the acids your body uses to digest food.

Symptoms of peptic ulcer disease

  • The most common symptom is a burning pain in your stomach.
    • It usually lasts for a few minutes to a few hours.
    • It comes and goes for days or weeks at a time.
    • The burning typically occurs between meals and at night.
    • Small ulcers may cause no symptoms.
  • Other symptoms can include:
    • A feeling of fullness
    • Difficulty drinking as much liquid as usual
    • Hunger or an empty feeling in your stomach after you eat
    • Mild nausea
    • Stomach pain that wakes you up at night
    • Less common symptoms include:
    • Bloating
    • Burping
    • Poor appetite
    • Bloody or dark stools
    • Chest pain
    • Fatigue
    • Weight loss
    • Vomiting
    • Complications include:
    • Bleeding (this occurs from a broken blood vessel in the small intestine)
    • Perforation (tear)
    • A blockage
    • Peritonitis (infection)

What causes peptic ulcer disease?

  • The main cause is the bacterial infection, Helicobacter pylori (H. pylori).
    • Another common cause is long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
    • This includes aspirin, ibuprofen, and naproxen.
    • In rare cases, the disease can be caused by cancerous and noncancerous tumors.
    • A less common cause is a rare disorder called Zollinger-Ellison syndrome.

How is peptic ulcer disease diagnosed?

  • Your doctor will do a physical exam.
    • Your doctor may schedule a special procedure to look at your stomach.
    • This is called an endoscopy.
      • For this procedure, you’ll be given medicine to relax.
      • The medicine may make you fall asleep.
      • The doctor will insert a thin, flexible tube down your throat.
        • A tiny camera on the end of the tube displays the lining of your stomach and duodenum.
        • The doctor may take a sample of your stomach lining (a biopsy).
        • This is done to test for H. pylori.
        • Blood, breath, and stool sample testing can also be used to check for H. pylori.

Can peptic ulcer disease be prevented or avoided?

  • Stress and spicy foods don’t cause ulcers.
    • However, they can make them worse.
    • Smoking and alcohol can cause a peptic ulcer.
    • Men should limit alcohol to no more than 2 drinks per day.
    • Women should have no more than 1 drink per day.
    • Talk to your doctor if you take aspirin, ibuprofen, or naproxen regularly.

Peptic ulcer disease treatment

  • Your doctor may begin by prescribing medicine.
    • Your doctor may suggest other treatments for other causes.
  • If you have H. pylori, your doctor will treat the infection with specific therapy.
  • Your doctor may recommend medicines to neutralize your stomach acid.
    • This will protect the lining in your stomach, too.
    • These include:
      • Protein pump inhibitors.
      • Histamine receptor blockers.
      • Cytoprotective agents. This includes sucralfate
    • If NSAIDs cause your ulcer, you may need to stop or reduce the amount you take.
      • You may need to switch to another type of medicine for pain.

Living with peptic ulcer disease

  • Most ulcers heal within about 8 weeks.
    • Peptic ulcers come and go.
      • You have to do what you can to reduce your risk.
      • If you smoke or chew tobacco, ask your doctor about how to quit.
      • Eat a well-balanced diet.
      • Avoid foods that cause discomfort.
        • These include
          • alcohol,
          • coffee,
          • caffeinated soda,
          • fatty foods,
          • chocolate,
          • and spicy foods.
          • Avoid eating late at night.
          • Talk to your doctor about alternatives to NSAIDs.

Take all medicines with plenty of water.

Lymphedema: An Interview with Joan White, Lighthouse Lymphedema Network

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Lymphedema
North Fulton Studio
Lymphedema: An Interview with Joan White, Lighthouse Lymphedema Network
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Lymphedema

Lymphedema: An Interview with Joan White, Lighthouse Lymphedema Network (Episode 80, To Your Health with Dr. Jim Morrow)

Joan White with the Lighthouse Lymphedema Network was Dr. Morrow’s guest on this episode of To Your Health. She and Dr. Morrow discussed what lymphedema is, what causes it, and the evolution of treatment over the years. They also talked about how to find certified therapists, the need for research on children with lymphedema, the future of treatment, and more.

To Your Health is brought to you by Village Medical (formerly Morrow Family Medicine), which brings the care back to healthcare.

Lighthouse Lymphedema Network

Lymphedema is a chronic medical condition that occurs when a blockage in the lymphatic system prevents lymph fluid from draining well, resulting in swelling. Often in the arms of breast cancer survivors and legs of prostate cancer patients, lymphedema can be located in any part of the body.

Since its founding around a dining room table in 1993, the Lighthouse Lymphedema Network (LLN) has grown to become one of the most recognized, respected and fast-growing non-profit organizations dedicated to promoting education and awareness about this disease we call lymphedema and providing assistance and support, not only for those afflicted with this disease but for their families, friends and even their healthcare providers.

The LLN has many goals and their mission is constantly expanding.

It seems as soon as one project is completed, another slips into its place. The LLN Board of Directors is very dedicated to serving those in the world of lymphatics and lymphatic disorders. They have no paid staff; only patients, medical professionals and community volunteers who donate their time and energy to keep the organization moving in a positive direction.

Company website | Facebook | Instagram | Twitter

Joan White, Director, Lighthouse Lymphedema Network

Joan White is the Director of the Lighthouse Lymphedema Network. The LLN is a highly respected nonprofit that White started in 1993 around her kitchen table.

The organization sponsors an annual medical conference which includes patients, caregivers, family members, and medical professionals. The LLN will be sponsoring the 24th annual medical conference on October 22, 2022 at the ROAM Perimeter, Atlanta, GA. The LLN has a Bandage and Garment Fund to assist underserved patients who cannot afford them. The fund receives assistance from It’s The Journey through a grant and donations from many generous donors to assist patients in getting garments, bandages, and other items to give them the best quality of life.

The LLN publishes a quarterly newsletter, maintains a database of over 1,400 individuals, participates in It’s The Journey annual walk, and has a first-rate website lighthouselymphedema.org.

The LLN has been selected as the charity of choice for the spring golf and cornhole outing that is sponsored by the Southern Loss Association at Chateau Elan. The LLN is thankful for a strong board of directors and volunteers.

About Village Medical (formerly Morrow Family Medicine)

Village Medical, formerly Morrow Family Medicine, is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Village Medical one that will remind you of the way healthcare should be.  At Village Medical, we like to say we are “bringing the care back to healthcare!”  The practice has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Village Medical offers a comprehensive suite of primary care services including preventative care, treatment for illness and injury, and management of chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD) and kidney disease. Atlanta-area patients can learn more about the practice here.

Dr. Jim Morrow, Village Medical, and Host of To Your Health with Dr. Jim Morrow

Covid-19 misconceptionsDr. Jim Morrow is the founder of Morrow Family Medicine. He has been a trailblazer and evangelist in healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook | LinkedIn | Twitter

The complete show archive of To Your Health with Dr. Jim Morrow addresses a wide range of health and wellness topics.

Music Therapy: An Interview with Allison Jarrell, Metro Music Makers

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Allison Jarrell
North Fulton Studio
Music Therapy: An Interview with Allison Jarrell, Metro Music Makers
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Allison Jarrell

Music Therapy: An Interview with Allison Jarrell, Metro Music Makers (Episode 79, To Your Health with Dr. Jim Morrow)

Allison Jarrell, Founder and CEO of Metro Music Makers, was Dr. Jim Morrow’s guest on this episode of To Your Health. Allison defined music therapy, talked about working with both elderly and neonate clients, the impact of music therapy on behavior, various other therapy methods, and much more.

To Your Health is brought to you by Village Medical (formerly Morrow Family Medicine), which brings the care back to healthcare.

Metro Music Makers

Since beginning with a focus on in-home private instruction, Metro Music Makers has expanded to offer our services online all over the country, and to schools and healthcare providers as well.

Their team of trained, dedicated, and passionate teachers have all received extensive training in teaching online and in-person, and they bring their passion for music and education into homes and lives everywhere.

MMM’s mission is to extend the benefits of musical ability to people of all ages and abilities through superior music instruction and therapy. Their students can study virtually any instrument, and they offer multiple performance opportunities throughout the year, including traditional recitals, festivals, and community events, as well as virtual recitals and showcases for our online students.

They believe that music is for everyone and that any individual is capable of learning how to play an instrument regardless of age, gender, skill level, disability, and ethnic background. To ensure that they uphold the highest standards in music education, they provide a professional development program for their instructors to cover topics related to music and the fine arts, teaching music, learning styles, child development, online teaching, and business basics for professional musicians.

Company website | Facebook | LinkedIn

Allison Jarrell, Founder and CEO, Metro Music Makers

Allison Jarrell, Founder and CEO, Metro Music Makers

Allison Jarrell founded Metro Music Makers as a private Atlanta-based music studio offering in-home music lessons. She has been teaching since 1992 (sometimes as many as 78 students per week herself), with students ranging from 3 years of age to senior citizens, and those with special needs. In addition to overseeing a variety of instructors in the Metro Music Makers family, she is a board-certified Music Therapist licensed in the State of Georgia. Allison’s music therapy experience includes working in special needs classes, in private behavioral therapy and research with children diagnosed with autism, in music therapy and research with neonates, as a music therapist at a drug and alcohol rehab for teens, and as a music therapist in mental health settings working with adults diagnosed with a range of disorders including schizophrenia, PTSD, depression, bipolar disorder, anxiety, and dissociative disorders.

Originally from Easley, South Carolina, Allison attended the Greenville Fine Arts Center, and earned her Bachelor of Music in Music Therapy from Florida State University (cum laude). She also served a six-month internship at San Antonio State Hospital (a mental health institution). Allison pursued a career as a singer/songwriter after college, recording three EPs and one full-length album. While touring, she was hired by Mars Music, Inc. to implement the Babies Make Music program in the metro Atlanta area.

In addition, Allison was a finalist in the Greenville Symphony Orchestra Russian Music Festival Piano Competition in 1990 and a semifinalist in the Young Keyboard Artists Association International Piano Competition in 1990. She toured with the band Life As Mary from 2000-2003, including an exciting showcase with A & R exposure at the 2002 Atlanta Music Conference.

Allison’s flexibility working in diverse positions and environments gave her the training needed to begin Metro Music Makers in 2002. As parents learned about her music therapy background, she began to get requests for adaptive lessons for students who might not otherwise find success in traditional lessons.

Allison is currently a member of the National Guild of Piano Teachers, the Music Teachers National Association, the Georgia Music Teachers Association, the North Fulton Music Teachers Association, and the Music Therapy Association of Georgia. Additionally, Allison serves as a judge for events sponsored by the National Guild of Piano Teachers and the Georgia Federation of Music Clubs.

Allison’s students have achieved many honors over the years. She has seen over 225 of her students make top marks in the National Piano Guild Auditions and National Federation of Music Clubs Festival since 2003.

Allison believes that the process of learning how to play a musical instrument and learning how to create music relates to everything else that we accomplish in life. “We are teaching the future leaders and innovators of tomorrow,” she says. “As a teacher, when I really think about that and about the influence that lessons may have in my students’ lives, I’m overwhelmed with gratitude for the opportunity to work one-on-one with young people over the course of many years.”

In fact, now that Allison has been teaching for a number of years, her favorite times are catching up with prior students over lunch or coffee. “It’s exciting to see what my former students do with their lives as they grow into adulthood,” she says.

Allison also was a one-time snake handler (a long story involving removing a baby snake from her house that turned out to be a copperhead!) and a one-time opera singer, (I Pagliacci) in 1991). She and her husband David have an adorable young son, Elliott, who began music classes at the age of six months. Elliott loves strumming the family’s guitars and playing the piano keys.

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About Village Medical (formerly Morrow Family Medicine)

Village Medical, formerly Morrow Family Medicine, is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Village Medical one that will remind you of the way healthcare should be.  At Village Medical, we like to say we are “bringing the care back to healthcare!”  The practice has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Village Medical offers a comprehensive suite of primary care services including preventative care, treatment for illness and injury, and management of chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD) and kidney disease. Atlanta-area patients can learn more about the practice here.

Dr. Jim Morrow, Village Medical, and Host of To Your Health with Dr. Jim Morrow

Covid-19 misconceptionsDr. Jim Morrow is the founder of Morrow Family Medicine. He has been a trailblazer and evangelist in healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

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The complete show archive of To Your Health with Dr. Jim Morrow addresses a wide range of health and wellness topics.

Heat Illness

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Heat Illness
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Heat Illness

Heat Illness (Episode 78, To Your Health with Dr. Jim Morrow)

On this episode of To Your Health, Dr. Jim Morrow of Village Medical offered common sense information about heat illness. After a brief update on monkeypox, Dr. Morrow discussed how to recognize heat illness, how to prevent it, what causes it, ways to treat it, when to call 911, and much more.

To Your Health is brought to you by Village Medical (formerly Morrow Family Medicine), which brings the care back to healthcare.

About Village Medical (formerly Morrow Family Medicine)

Village Medical, formerly Morrow Family Medicine, is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Village Medical one that will remind you of the way healthcare should be.  At Village Medical, we like to say we are “bringing the care back to healthcare!”  The practice has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Village Medical offers a comprehensive suite of primary care services including preventative care, treatment for illness and injury, and management of chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD) and kidney disease. Atlanta-area patients can learn more about the practice here.

Dr. Jim Morrow, Village Medical, and Host of To Your Health with Dr. Jim Morrow

Covid-19 misconceptionsDr. Jim Morrow is the founder of Morrow Family Medicine. He has been a trailblazer and evangelist in healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook | LinkedIn | Twitter

The complete show archive of To Your Health with Dr. Jim Morrow addresses a wide range of health and wellness topics.

Dr. Morrow’s Show Notes

What are heat exhaustion and heatstroke?

  • Heat exhaustion happens when your body gets too hot. 
    • If you don’t treat heat exhaustion, it can lead to heatstroke. 
    • This occurs when your internal temperature reaches at least 104°F. 
    • Heatstroke is much more serious than heat exhaustion. 
      • It can cause shock, organ failure, or brain damage. In extreme cases, heatstroke can kill you.

Symptoms of heat exhaustion and heatstroke

  • Symptoms of heat exhaustion are:
    • Muscle cramps
    • Heavy sweating
    • Pale or cold skin
    • Weakness and/or confusion
    • Dizziness
    • Headache
    • Nausea or vomiting
    • Fast heartbeat
    • Dark-colored urine, which indicates dehydration
  • In addition to these symptoms, warning signs of heatstroke also include:
    • Fever of 104°F or higher
    • Flushed or red skin
    • Lack of sweating
    • Trouble breathing
    • Fainting
    • Seizures

What causes heat exhaustion and heatstroke?

  • Heat-related illnesses occur when your body can’t keep itself cool. 
    • As the temperature rises, your body produces sweat to stay cool. 
      • On hot, humid days, the increased moisture in the air slows down this process. 
      • When your body can’t cool, your temperature rises and you can become ill.
  • Hot weather and exercise are the main causes of heat exhaustion and heatstroke. 
    • In hot settings, you need to be mindful of the temperature outside. 
    • The heat index is not the same as the temperature. 
      • It measures the air temperature plus the effects of humidity. 
      • A heat index of 90°F or higher calls for extreme caution. 
      • Prolonged exposure to high temperatures increases your risk of heat-related illnesses.

How are heat exhaustion and heatstroke diagnosed?

  • If a person is displaying known heat illness symptoms, 
    • take their temperature. 
    • A reading of 104°F or more means they probably have heatstroke. 
    • You should call 911 and get medical care right away.

Can heat exhaustion and heatstroke be prevented or avoided?

  • There are many things you can do to prevent heat-related illnesses. 
    • Babies, children, and elderly people are more sensitive to heat and require extra attention. 
    • You also are at greater risk if you are ill or obese, or have heart disease. 
    • People who work outside or in a hot setting also are at risk of heat exhaustion and heatstroke.
  • Don’t go outside when the temperature and heat index are high. 
  • If possible, stay indoors in air-conditioned areas. 
  • If you must go outside, take the following precautions.
    • Wear lightweight, light-colored, loose-fitting clothing.
    • Protect yourself from the sun by wearing a hat or using an umbrella.
    • Use sunscreen with a sun protection factor (SPF) of 15 or higher.
    • Drink plenty of water throughout the day. 
      • Dehydration and lack of salt contribute to heat-related illnesses. 
      • Some sports drinks can help replenish the salt in your body lost through sweating. 
      • Drink water or other fluids every 15 to 20 minutes, even if you don’t feel thirsty. 
      • If your urine is clear, you are probably drinking enough fluids. 
      • Dark-colored urine is a sign that you’re dehydrated.
    • Avoid or limit drinks that contain caffeine (such as tea, coffee, and soda) or alcohol.
    • Schedule outdoor activities for cooler times of the day — before 10 a.m. and after 6 p.m.
    • Take frequent breaks from the heat and outdoor activities.
    • Do not stay in or leave a child in your car when it is hot outside. 
      • Even if you open the windows, the intense heat can be extremely dangerous.
  • Certain medicines can put you in danger of heatstroke. 
    • They affect the way your body reacts to heat. 
      • Talk to your doctor if you take any of these or have an ongoing health problem. 
      • They can help you manage the heat with your condition. 
      • These medicines include:
        • Antibiotics
        • Allergy medicines (antihistamines)
        • Some medicines used to manage blood pressure, cholesterol, and heart disease (beta-blockers and vasoconstrictors)
        • Some medicines that treat mental health problems (antidepressants and antipsychotics)
        • Seizure medicines (anticonvulsants)
        • Water pills (diuretics)
        • Laxatives
        • Some diet pills
        • Prescription acne medicines
        • Illegal drugs, such as cocaine (amphetamines)

Heat exhaustion and heatstroke treatment

  • If you or someone else has heat exhaustion, treat symptoms in the following ways.
    • Get out of the heat quickly 
      • and into a cool place, or at least shade.
    • Lie down and elevate your legs 
      • to get blood flowing to your heart.
    • Take off any tight or extra clothing.
    • Apply cool towels to your skin or take a cool bath. 
      • This will help regulate and lower your internal body temperature.
    • Drink fluids, such as water or a sports drink. 
      • Do not guzzle them, but take sips. 
      • Do not drink fluids with caffeine or alcohol.
  • Call 911 if:
    • Symptoms don’t improve 
      • or they still have a fever of 102°F after 30 minutes of initial treatment.
    • The person goes into 
      • shock, 
      • faints, 
      • or has seizures.
    • The person is not breathing. 
    • You also should begin CPR right away to try and revive them.

Living with heat exhaustion and heatstroke

  • After you’ve had heat exhaustion or heatstroke, 
    • you will be sensitive to heat. 
    • This can last for about a week. 
    • It’s important to rest and let your body recover. 
    • Avoid hot weather and exercise. 
    • Ask your doctor when it’s safe to return to your normal activities.

Complications

  • Complications include secondary infections, pneumonia, sepsis, encephalitis, and loss of vision if severe eye infection. 
    • If infection occurs during pregnancy, still birth or birth defects may occur. 
    • The disease may be milder in people vaccinated against smallpox in childhood. 

Causes

  • Most human cases of monkeypox are acquired from an infected animal, 
    • though the route of transmission remains unknown. 
    • The virus is thought to enter the body through broken skin, the respiratory tract, or the mucous membranes of the eyes, nose, or mouth. 
    • Once a human is infected, transmission to other humans is common, with family members and hospital staff at particularly high risk of infection.
  • Human-to-human transmission is thought to occur primarily through close contact with an infected subject. 
    • There are indications that transmission occurs during sexual intercourse. 
  • Monkeypox symptoms tend to begin 5 to 21 days after infection. 

Prevention

  • Vaccination against smallpox is assumed to provide protection against human monkeypox infection 
    • because they are closely related viruses 
      • and the vaccine protects animals from experimental lethal monkeypox challenges. 
      • This has not been conclusively demonstrated in humans because routine smallpox vaccination was discontinued following the eradication of smallpox.

Treatment

Pallavi Ghanta, Help2Breathe

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Help2Breathe

Pallavi Ghanta, Help2Breathe (Episode 77, To Your Health with Dr. Jim Morrow)

On this edition of To Your Health, Dr, Morrow welcomes Pallavi Ghanta, a high school senior at Denmark High School, who founded Help2Breathe. As a nonprofit, Help2Breathe repurposes durable medical equipment and provides it to needy and homeless patients who otherwise might not have access to this needed care. They discussed the shortage of CPAP machines, her blog, how people can support Help2Breathe, and much more.

To Your Health is brought to you by Village Medical (formerly Morrow Family Medicine), which brings the care back to healthcare.

Help2Breathe

Help2Breathe (Help2Breathe.com) is a 501(c)(3) charity with the mission of collecting donations of used and unused medical equipment and with the help of medical volunteers providing them to needy and homeless patients.

The charity was started by Pallavi Ghanta, a rising senior at Denmark High School, Forsyth County. Pallavi, while volunteering at nursing homes noticed that medical equipment belonging to recently deceased residents was often disposed of.

Given her volunteer work at the Good Samaritan Health Center, a free clinic in Atlanta, she was well aware of the severe need for such equipment among the poor and homeless served at the clinic. Connecting the dots, she worked to salvage and ensure such equipment got a second life.

Company website | Instagram

Pallavi Ghanta, Founder, Help2Breathe

Pallavi Ghanta, Founder, Help2Breathe

Pallavi is a rising senior at Denmark High School. She has volunteered at several nursing homes, Northside Hospital Forsyth Case Management, and Good Samaritan. She has founded a 501(c)(3) charity Help2Breathe, which collects used and unused medical equipment and donates them to free clinics. She started a blog called Health Care Anxiety, where she interviews seniors who are still working to afford health care.

She is involved in several clubs at school (Debate, Environmental, Finance, Tedtalk). She has earned a Congressional Service Silver Award.

About Village Medical (formerly Morrow Family Medicine)

Village Medical, formerly Morrow Family Medicine, is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Village Medical one that will remind you of the way healthcare should be.  At Village Medical, we like to say we are “bringing the care back to healthcare!”  The practice has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Village Medical offers a comprehensive suite of primary care services including preventative care, treatment for illness and injury, and management of chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD) and kidney disease. Atlanta-area patients can learn more about the practice here.

Dr. Jim Morrow, Village Medical, and Host of To Your Health with Dr. Jim Morrow

Covid-19 misconceptionsDr. Jim Morrow is the founder of Morrow Family Medicine. He has been a trailblazer and evangelist in healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook | LinkedIn | Twitter

The complete show archive of To Your Health with Dr. Jim Morrow addresses a wide range of health and wellness topics.

Monkeypox

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Monkeypox

Monkeypox (Episode 76, To Your Health with Dr. Jim Morrow)

Host Dr. Jim Morrow with Village Medical discussed monkeypox on this episode of To Your Health. After a brief update on COVID-19, Dr.Morrow covered monkeypox’s similarities to smallpox and chickenpox, where it originated, its symptoms and complications, treatment, and much more.

To Your Health is brought to you by Village Medical (formerly Morrow Family Medicine), which brings the care back to healthcare.

About Village Medical (formerly Morrow Family Medicine)

Village Medical, formerly Morrow Family Medicine, is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Village Medical one that will remind you of the way healthcare should be.  At Village Medical, we like to say we are “bringing the care back to healthcare!”  The practice has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Village Medical offers a comprehensive suite of primary care services including preventative care, treatment for illness and injury, and management of chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD) and kidney disease. Atlanta-area patients can learn more about the practice here.

Dr. Jim Morrow, Village Medical, and Host of To Your Health with Dr. Jim Morrow

Covid-19 misconceptionsDr. Jim Morrow is the founder of Morrow Family Medicine. He has been a trailblazer and evangelist in healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook | LinkedIn | Twitter

The complete show archive of To Your Health with Dr. Jim Morrow addresses a wide range of health and wellness topics.

Dr. Morrow’s Show Notes

Monkeypox

  • An ongoing outbreak of monkeypox was confirmed in May 2022,
    • beginning with a cluster of cases found in the United Kingdom.
    • The first recognized case was confirmed on 6 May 2022 in an individual with travel links to Nigeria (where the disease is endemic),
      • but it has been suggested that cases were already spreading in Europe in the previous months.
    • From 18 May onwards, cases were reported from an increasing number of countries and regions,
      • predominantly in Europe, but also in North and South America, Asia, North Africa, and Australia. 
      • 1,033 cases had been confirmed as of 6 June.
  • The outbreak marked the first time the disease has spread widely outside Central and West Africa.
    • Cases have mainly but not exclusively been identified amongst men who have sex with men(MSM),
      • but health authorities emphasized that anyone can catch the disease, particularly if they have close contact with a symptomatic person.
      • Initial WHO assessments expressed the expectation of the outbreak to be contained,
        • and of low impact to the general population in affected countries.
      • A more recent statement acknowledged that undetected transmission had occurred for some time
        • and called for urgent action to reduce transmission.

Signs and symptoms

Monkeypox is an infectious viral disease that can occur in both humans and some other animals.

Early symptoms include

  •  fever, headache, muscle pains, shivering, backache, and feeling extremely tired.

Typically there are swollen lymph nodes behind the ear, below the jaw, in the neck or in the groin.

This is followed by a rash that forms blisters and crusts over;

  • most frequently in the mouth, on the face, hands and feet, genitals and eyes.

The time from exposure to onset of symptoms is on average 12 days; though ranges from 5-to-21 days.

  • The duration of symptoms is typically two to four weeks.
  • Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.
  • Three-quarters of affected people have lesions on the palms and soles,
    • more than two-thirds in the mouth,
    • a third on the genitals and one in five have lesions in the eyes.
    • They begin as small flat spots,
      • before becoming small bumps which then fill with at first clear fluid and then yellow fluid,
        • which subsequently burst and scab over.
        • There may be a few lesions or several thousand, sometimes merging to produce large lesions.
  • In each part of the body affected,
    • the lesions evolve in the same stage.
    • It looks identical to the rash of smallpox.
      • The rash typically lasts around 10-days.
      • An affected person may remain unwell for two to four weeks.
      • After healing, the lesions may leave pale marks before becoming dark
  • Limited person-to-person spread of infection has been reported in disease-endemic areas in Africa.
  • Monkeypox may be spread
    • from handling bushmeat,
    • an animal bite or scratch,
    • body fluids,
    • contaminated objects,
    • or close contact with an infected person.
    • The virus normally circulates among certain rodents.
    • Diagnosis can be confirmed by testing a lesion for the virus’s DNA.
      • The disease can appear similar to chickenpox.
  • The smallpox vaccine can prevent infection with 85% effectiveness,
    • but smallpox vaccination stopped in most parts of the world in the late 1970s,
      • resulting in very little immunity against monkeypox.
      • In 2019, a monkeypox vaccine, Jynneos, was approved for adults in the United States.
      • The current standard for treatment is tecovirimat, an antiviral that is specifically intended to treat infections with orthopoxviruses such as smallpox and monkeypox.
      • It is approved for the treatment of monkeypox in the European Union and the United States.
        • Cidofovir or brincidofovir may also be useful.
        • Reports of the risk of death, if untreated, are as high as 10% to 11% in the Congo Basin(Central African) clade of monkeypox.
  • Monkeypox was first identified in 1958 among laboratory monkeys in Copenhagen, Denmark.
    • Monkeys are not a natural reservoir of the virus.
    • The first cases in humans were found in 1970 in the Democratic Republic of the Congo.
    • An outbreak that occurred in the United States in 2003 was traced to a pet store where rodents imported from Ghana were sold.
      • The 2022 monkeypox outbreak represents the first incidence of widespread community transmission outside of Africa,
        • which began in the United Kingdom in May 2022,
        • with subsequent cases confirmed in at least 20 countries, in Europe, North America, South America, Asia, North Africa, and Australia

Complications

  • Complications include secondary infections, pneumonia, sepsis, encephalitis, and loss of vision if severe eye infection.
    • If infection occurs during pregnancy, stillbirth or birth defects may occur.
    • The disease may be milder in people vaccinated against smallpox in childhood.

Causes

  • Monkeypox in both humans and animals is caused by infection with the monkeypox virus– a double-stranded DNA virus.
    • The virus is found mainly in tropical rainforest regions of Central and West Africa.
    • The virus is split into Congo Basin and West African clades, matching the geographical areas.
  • Most human cases of monkeypox are acquired from an infected animal,
    • though the route of transmission remains unknown.
    • The virus is thought to enter the body through broken skin, the respiratory tract, or the mucous membranes of the eyes, nose, or mouth.
    • Once a human is infected, transmission to other humans is common, with family members and hospital staff at particularly high risk of infection.
  • Human-to-human transmission is thought to occur primarily through close contact with an infected subject.
    • There are indications that transmission occurs during sexual intercourse.
  • Monkeypox symptoms tend to begin 5 to 21 days after infection.

Prevention

  • Vaccination against smallpox is assumed to provide protection against human monkeypox infection
    • because they are closely related viruses
      • and the vaccine protects animals from experimental lethal monkeypox challenges.
      • This has not been conclusively demonstrated in humans because routine smallpox vaccination was discontinued following the eradication of smallpox.

Treatment

  • In the European Union and the United States, tecovirimat is approved for the treatment of several poxviruses, including monkeypox.
    • Best Practice recommends tecovirimat or the smallpox treatment brincidofovir as the first line antiviral treatment if required,
      • alongside supportive care(including antipyretic, fluid balance and oxygenation).
      • Empirical antibiotic therapy or aciclovir may be used if secondary bacterial or varicella-zoster infection is suspected, respectively.

Allergies

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Allergies (Episode 75, To Your Health with Dr. Jim Morrow)

On this episode of To Your Health, Dr. Jim Morrow discussed allergies, which can affect a lot of people in the Southeast U.S. He covered the symptoms, why you would not want to get an x-ray, the best treatments for allergic rhinitis, diagnosing food allergies, the use of an EpiPen and much more.

To Your Health is brought to you by Village Medical (formerly Morrow Family Medicine), which brings the care back to healthcare.

About Village Medical (formerly Morrow Family Medicine)

Village Medical, formerly Morrow Family Medicine, is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Village Medical one that will remind you of the way healthcare should be.  At Village Medical, we like to say we are “bringing the care back to healthcare!”  The practice has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Village Medical offers a comprehensive suite of primary care services including preventative care, treatment for illness and injury, and management of chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD) and kidney disease. Atlanta-area patients can learn more about the practice here.

Dr. Jim Morrow, Village Medical, and Host of To Your Health with Dr. Jim Morrow

Covid-19 misconceptionsDr. Jim Morrow is the founder of Morrow Family Medicine. He has been a trailblazer and evangelist in healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook | LinkedIn | Twitter

The complete show archive of To Your Health with Dr. Jim Morrow addresses a wide range of health and wellness topics.

Dr. Morrow’s Show Notes

Allergies

  • When you hear someone talk about having allergies, usually they mean rhinitis or upper respiratory symptoms (runny nose, watery eyes, itching eyes and ears and nose, sneezing).
  • Allergies also can be due to food, medications, animal dander or plants.

Allergic Rhinitis

  • The diagnosis of allergic rhinitis should be made when history and physical findings are consistent with an allergic cause
    • g., clear rhinorrhea,
    • pale discoloration of nasal mucosa,
    • red and watery eyes
    • and one or more of the following symptoms:
      • nasal congestion,
      • runny nose,
      • itchy nose,
      • or sneezing.
    • Individuals with allergic rhinitis should be assessed for the presence of associated conditions such as
      • asthma,
      • atopic dermatitis,
      • sleep-disordered breathing,
      • conjunctivitis,
      • rhinosinusitis,
      • and otitis media.
    • Specific testing (blood or skin) should be performed for patients with a clinical diagnosis of allergic rhinitis
    • who do not respond to empiric treatment,
    • or when diagnosis is uncertain,
    • or when determination of specific target allergen is needed.
  • Sinus imaging should not routinely be performed in patients presenting with symptoms consistent with allergic rhinitis.
  • Intranasal steroids should be prescribed for patients with allergic rhinitis whose symptoms affect quality of life.
  • Oral second-generation/less sedating antihistamines should be suggested for patients with allergic rhinitis and primary complaints of sneezing and itching.
  • Intranasal antihistamines may be prescribed for patients with
    • seasonal,
    • perennial,
    • or episodic allergic rhinitis.
  • Oral leukotriene receptor antagonists should not be prescribed as initial therapy for patients with AR.
  • Combination pharmacologic therapy may be prescribed for patients with allergic rhinitis who have inadequate response to monotherapy.
    • The most effective combination therapy is
      • an intranasal steroid
      • and an intranasal antihistamine.
    • Immunotherapy should be prescribed for patients with allergic rhinitis who have inadequate response to pharmacologic therapy.
    • Avoidance of known allergens or environmental control may be considered in patients with allergic rhinitis who have identified allergens that correlate with their clinical symptoms.

Allergy Testing

  • There are many types of allergies:
    • environmental,
    • foods,
    • drug,
  • An estimated 10% to 30% of the global population has an allergic disease.
  • Clinical presentations of allergic diseases, respiratory infections, and autoimmune conditions have similar features.
  • Allergy and immunologic testing can help clarify the diagnosis and guide treatment.
  • The allergens suspected in an allergy are identified through
    • antibody
    • or skin testing.
  • For patients with an inhalant allergy, skin testing is preferred.
  • In patients with food allergies, eliminating the suspected allergenic food from the diet is the initial treatment.
  • If this is ineffective, antibody or skin testing can exclude allergens.
  • Patients with an anaphylactic reaction to an insect sting should undergo specific antibody or skin testing.
  • Skin testing for penicillin can help when penicillin administration is indicated
    • and there are limited alternatives.
    • Testing for other drug allergies has less well-determined sensitivity and specificity,
      • but can guide the diagnosis.
    • Patch testing can help identify the allergen responsible for contact dermatitis.

Food Allergies

  • Patients with suspected food allergies are commonly seen in clinical practice.
  • Although up to 15 percent of parents believe their children have food allergies,
    • these allergies have been confirmed in only 1 to 3 percent of all Americans.
  • Family physicians must be able to separate true food allergies from
    • food intolerance,
    • food dislikes,
    • and other conditions that mimic food allergy.
  • The most common foods that produce allergic symptoms are
    • milk,
    • eggs,
    • seafood,
    • peanuts,
    • and tree nuts.
  • Although skin testing and blood assays may help in the evaluation of suspected food allergies,
    • they should not be performed unless the clinical history suggests a specific food allergen to which testing can be targeted.
  • Furthermore, these tests do not confirm food allergy.
    • Confirmation requires a positive food challenge
      • or a clear history of an allergic reaction to a food
      • and resolution of symptoms after eliminating that food from the diet.
    • More than 70 percent of children will outgrow milk and egg allergies by early adolescence,
      • whereas peanut allergies usually remain throughout life.
    • The most serious allergic response to food allergy is anaphylaxis.
      • It requires emergency care that should be initiated by the patient or family using an epinephrine auto-injector,
        • which should be carried by anyone with a diagnosed food allergy.
  • There are no recommended medications to prevent allergic reactions to food.
    • Allergen-specific immunotherapy or immunotherapy with cross-reacting allergens
      • is not recommended to treat food allergy.
    • Some environmental allergens cross-react with foods, such as:

 

ENVIRONMENTAL ALLERGEN                  CROSS-REACTIVE FOODS
Birch pollenCarrots, celery, fresh fruit (e.g., apples, cherries, nectarines, peaches, pears), hazelnuts, parsnips, potatoes
Grass pollenKiwi, tomatoes
Ragweed pollenBananas, melons (e.g., cantaloupe, honeydew, watermelon)

 

Nonallergic Rhinitis

  • Chronic nonallergic rhinitis encompasses a group of rhinitis subtypes
    • without allergic or infectious etiologies.
  • Although chronic nonallergic rhinitis represents about one-fourth of rhinitis cases and impacts 20 to 30 million patients in the United States,
    • its pathophysiology is unclear
    • and diagnostic testing is not available.
  • Characteristics such as no evidence of allergy or defined triggers help define clinical subtypes.
  • There are several subtypes with overlapping presentations, including:
    • nonallergic runny nose,
    • senile or geriatric rhinitis,
    • gustatory rhinitis,
    • drug-induced rhinitis,
    • hormonal rhinitis, and
    • occupational rhinitis.
  • Treatment is symptom-driven and similar to that of allergic rhinitis.
    • Patients should avoid known triggers when possible.
  • First-line therapies include
    • intranasal corticosteroids,
    • intranasal antihistamines,
    • and intranasal ipratropium (a drying agent).
  • Combination therapy with decongestants and first-generation antihistamines can be considered
    • if monotherapy does not adequately control symptoms.
  • Nasal irrigation and intranasal capsaicin may be helpful but need further investigation.

Fitness Trackers and Exercise

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Fitness
North Fulton Studio
Fitness Trackers and Exercise
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Fitness

Fitness Trackers and Exercise (Episode 74, To Your Health with Dr. Jim Morrow)

On this episode of To Your Health, Dr. Jim Morrow covered the benefits of fitness trackers and wearables to track your heart rate, to improve your chances of exercising, and track your diet. He gave a formula for determining your ideal heart rate during exercise, the best kinds of activity and fitness trackers, and much more.

To Your Health is brought to you by Village Medical (formerly Morrow Family Medicine), which brings the care back to healthcare.

About Village Medical (formerly Morrow Family Medicine)

Village Medical, formerly Morrow Family Medicine, is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Village Medical one that will remind you of the way healthcare should be.  At Village Medical, we like to say we are “bringing the care back to healthcare!”  The practice has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Village Medical offers a comprehensive suite of primary care services including preventative care, treatment for illness and injury, and management of chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (COPD) and kidney disease. Atlanta-area patients can learn more about the practice here.

Dr. Jim Morrow, Village Medical, and Host of To Your Health with Dr. Jim Morrow

Covid-19 misconceptionsDr. Jim Morrow is the founder of Morrow Family Medicine. He has been a trailblazer and evangelist in healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce.  He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook | LinkedIn | Twitter

The complete show archive of To Your Health with Dr. Jim Morrow addresses a wide range of health and wellness topics.

Dr. Morrow’s Show Notes

Tracking Your Fitness

Exercise

  • The frequency of cardiorespiratory training is limited more often by patient compliance than by physiology.
    • It is not inappropriate for one to exercise daily, but few people do.
  • The ACSM recommends a duration of 20–60 minutes of continuous or intermittent exercise
    • and a frequency of 3–5 days per week for cardiorespiratory fitness and body composition enhancement.
    • Intermittent exercise is described as a minimum of 10-minute bouts accumulated throughout the day.
  • The recommended intensity is 65%–90% of maximum heart rate in healthy adults
    • and 55%–65% in very unfit individuals.
  • The challenge, of course, is to know one’s maximum heart rate.
  • Usual equations for HRmaxis 220—age in years
    • Healthy adults should maintain a subjective rating of perceived exertion (RPE) of “moderate” to “heavy” or about 13–15 on the scale.
    • Beginners can improve compliance by limiting intensity to “light” to “moderate” (RPE 11–13).
    • It is not uncommon for athletes to reach “very, very heavy” (RPE 19–20) for short bursts, particularly during interval training such as wind sprints, but there is little reason to recommend these levels for patients.

 

Wearable Technology: Activity Trackers and Smart Watches

  • There is a variety of wearable technologies available in the market that monitor energy expenditure and heart health.
    • Physical activity trackers help measure personal metrics involved in fitness,
      • such as the number of steps walked, heart rate, quality of sleep, etc.
    • They come predominantly in the form of wristbands and smartwatches.
      • Wristbands are the most popular brand of activity trackers
      • Other wearable technologies include chest, patches, strips, and shirts (e.g., Zephry Shirt).
    • Activity trackers typically sync to smart devices and/or upload to computers using wireless connectivity.
      • The companion apps, depending on the product, also enable the users to record and track things like food consumption, activities, weight, ECG, heart rate, and temperature;
        • and can share the data with trainers and medical professionals.
      • Researchers have demonstrated that the data from a wearable device and its companion smartphone app can be integrated into electronic health record systems
      • While wearable devices do require certain degrees of user inputs for accurate tracking,
        • research seems to indicate that they may be suitable as physical activity monitoring platforms
        • and are reasonably accurate for estimating heart rate, number of steps, distance, and sleep duration
      • Wristbands have also been shown to be an accurate, reliable, and efficient tool for physicians to track the adoption and maintenance of physical activity programs
      • However, there is some skepticism regarding their benefits for monitoring physical activity and other
        • Research also shows that the heart rate monitoring function is more accurate at rest than during moderately active exercise
          • and may not be suitable in helping clinicians advise their patients about health issues
        • Manufacturers are in a race to make medical-grade monitoring available with wearable devices.
          • A recent partnership between Fitbit and Dexcom is promising to bring continuous glucose monitoring (CGM) by integrating the popular Dexcom G5 sensor to the Fitbit Ionic.
        • Medical equipment manufacturers like Omron are poised to enter the market with their smartwatch that can provide medical-grade blood pressure measurements and sleep tracking.
        • There are also products on the horizon (e.g., Cronovo smartwatch) that can provide accurate heart rate functions
          • along with prescribing fitness regimens based on individual physical characteristics
          • and guiding the user through video tutorials, calorie, and dietary intake tracking, and integrating these functionalities with voice-based recipes
        • Given the risk factors associated with CVD, there are a lot of applications and technology aimed at generic health factors such as diet and exercise that decrease users’ CVD risk despite not being explicitly marketed for this purpose.
        • Activity trackers have huge user bases (recent filings indicate there are approximately 19 million registered users with over 9 million “active” users,
          • and research indicates that usage of wearable devices such as these does show an increase in physical activity
          • Similarly, diet trackers and calorie counters such as MyFitnessPal™ also show efficacy when used on a regular basis,
            • with research suggesting users of this technology were able to maintain dietary changes better than those who did not use them
          • Similar generic applications are also available for blood pressure, smoking cessation, and other associated risk factors.
        • For CVD-specific mobile health applications or devices, the first priority for management needs to be personal risk awareness.
        • While social media is a good medium for improving general awareness, mobile health needs to be more personalized, where the user gains an awareness of his/her own risk factors and identifies what he/she needs to be doing in order to minimize his/her chances of suffering from the relevant condition
          • In addition to personal awareness, ideally, the application or device should provide users with information on what they can do to minimize or mitigate any identified risks.
        • This is a potentially complicated issue to address,
          • as ideally the aim should be to not only provide users with as much relevant information as possible,
          • but also to prompt them to seek advice from their health professional when warranted.
          • Lastly, these applications should have a monitoring component so users can see if they are making progress,
            • and track whether any changes in health behavior lead to changes in the risk of having an adverse event

Electronic Activity Monitors

  • Pedometers continue to be useful tools to monitor physical activity,
    • but are dinosaurs compared to the wearable electronic activity monitoring devices that have been developed in recent years.
  • These sophisticated fitness trackers can be
    • worn on the wrist,
    • clipped to clothing,
    • or incorporated into smartphones.
  • Most utilize an accelerometer to monitor movement, even during sleep,
    • and some versions add GPS technology.
  • Optical sensors for heart rate are common and provide useful data to optimize exercise intensity.
  • Virtually all monitors sync with smartphones or personal computers for tracking and graphic display of physical activity, calorie expenditure, and more.
  • Publications like PC Magazine publish online annual reviews of these tools and can provide comparative data for the latest models.
  • It is worth noting that not all activity monitors are water-resistant.
  • Like most consumer electronics, function increases, and cost decreases almost exponentially each year, so there are devices for patients in all economic groups.

 

Three Types of Fitness Trackers

  • There are 3 basic types of fitness trackers:
    • Basic fitness trackers
      • Count the approximate number of steps you take and calculate the distance you’ve traveled using that data.
      • These are best for walkers and runners who want to track distance-based activity.
    • Heart rate monitoring trackers
      • Do everything a basic fitness tracker can, but they also have sensors that can monitor changes in your heart rate.
      • These can help you determine the number of calories you’ve burned throughout the day
    • Heart rate monitoring trackers with GPS
      • Can do all of the above, plus communicate with satellites to triangulate your position anywhere on the globe (provided you’re not inside).
      • This is a great option if you’re a cyclist or like to hit the trails.

 

The 3 Best Fitness Trackers

Garmin Vivofit 3 – Best Fitness Tracker Under $100

Fitbit Charge 2 – Best Heart Rate Monitoring Fitness Tracker

Garmin Vivosmart HR+ – Best Heart Rate Monitoring and GPS Fitness Tracker

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