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  • Key points:

    • Wear a mask. 
    • Stay in your homegroup.
    • Stay six feet away from others.
    • If you get sick, isolate at home. 
      Stay in touch with your doctor.
    • If you are exposed to COVID-19, quarantine. 
    • If you have the virus, you can still infect others. 
      Even if you feel fine.
    • You are not alone. Help is available. 

    If you get sick:  

    The most common symptoms of COVID-19 are: 

    • Runny Nose
    • Congestion
    • Fever
    • Cough
    • Headache
    • Fatigue
    • Muscle or Body Aches
    • Loss of Taste or Smell
    • Sore Throat
    • Nausea
    • Diarrhea

    Stay home except to get medical care. Most people with COVID-19 have mild illness. 
    Most people recover without medical care. 

    Go to the emergency department if you have serious symptoms:

    • Trouble Breathing
    • Pain or Pressure in Chest
    • New Confusion
    • Inability to Wake Up or Inability to Stay Awake
    • Blue-Colored Lips or Face

    Call 911. Notify the operator that you or the other person may have COVID-19. This list does not include all possible serious symptoms. Call your medical provider for symptoms that are concerning. 

    If the symptoms are not serious, call your physician. Do not go there without calling. If it’s an emergency, call 911. Tell them your symptoms.  

    If you do not have a primary care provider (PCP):

    Take care of yourself. Rest, eat well, stay warm, and drink plenty of water. Talk to your doctor about over-the-counter medications. 

    Monitor your symptoms. Get care immediately if you are having serious symptoms. 

    Stay in touch with your doctor. Please do not call the health department with questions about your care. 

            

    If you are sick or have tested positive for COVID-19, you should ISOLATE:

    • For 10 days after your test or after the beginning of symptoms, avoid contact with other members of your household and pets. Stay in a separate room. Sleep in a separate room. Use a separate bathroom, if possible. Do not share personal items, like towels or utensils. Do not go anywhere, including school or work. Wear a mask when around others. 
    • Tell your household and close contacts to quarantine (see below).
    • Wash your hands frequently with soap and running water for at least 20 seconds.
    • Clean and disinfect frequently touched surfaces and objects (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks). Include the bathroom if sharing with others. 
    • Cover your cough or sneezes with a tissue and throw it away. Wash your hands with soap and running water after touching the tissue. If you do not have a tissue, cough or sneeze into your elbow, not your hands.
    • If you must leave isolation, wear a mask, stay 6 feet apart from others, wash your hands frequently, and clean all touched surfaces.
    • Even if you do not feel sick, you can spread COVID-19 to others. Protect everyone as though they could become seriously ill.
    • Information from the CDC on isolation is at: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/isolation.html

    If you are not sick but have to QUARANTINE: 

    • Stay home for 14 days after your last contact a person with COVID-19. Do not go to work or to school, and do not run errands or visit with friends. 
    • Watch for fever (100.4◦F), cough, shortness of breath, or other symptoms of COVID-19. If any of these occur, notify your physician. 
    • If possible, stay away from others in your home, especially people who are at high risk.
    • Consider getting a COVID-19 diagnostic test 5 to 7 days after the last exposure.
    • People who are unable to safely isolate or quarantine should call their doctor, or for Erie County residents, call (716) 858-2929. 

    If you were tested for COVID-19:

    • If you have symptoms, stay home. 
    • If you were in contact with someone with COVID-19, stay home.
    • Otherwise, wear a mask, stay six feet from others, and stay in your homegroup. 
    • If you were tested for a procedure and you have no symptoms, you do not need to stay home.

    When the test results come, discuss them with your doctor.

    If your test is positive...

    A government contact tracer will call you.

    Notify people you’ve been in contact with. Tell them to quarantine and to call their doctor. Tell them to consider getting a COVID-19 test. 

    If you have symptoms stay home until:

    • You feel better.
    • It’s been 10 days since you got sick. 
    • You had no fever for one day.
    • You haven’t taken fever medicine for 24 hours.

    If you do not have symptoms:

    • Stay home for 10 days after the test.

    If your test is negative...

    And you were in contact with someone with COVID-19:

    • You could still have COVID-19.
    • Stay home for 14 days after you saw the person. 

    And you have symptoms: 

    Talk to your doctor. While you have symptoms, stay away from work and school. Stay away from other public places. Consider getting another test.

    And you do not have symptoms, protect yourself like always: 

    • Keep to your homegroup.
    • Stay six feet away from others.
    • Wear a mask.

    If you do not have enough food, or you need health insurance, legal help or anything else:

    • There is a list of community resources on the Erie County health department’s website:https://www2.erie.gov/health/coronavirus
    • If you are in isolation or quarantine and need help with basic needs, call 2-1-1(www.211wny.org) 
      or the Erie County COVID-19 Information Line at 858.2929.

    If you want or need a test: 

    If you want more information, call your doctor, the county, or the state: 

    • Erie County Department of Health COVID-19 Information Line: 858.2929; 
      Foreign language interpreting available (open 8:00 am - 8:00 pm M-F and 8:00 am - 12:00 pm Sat-Sun)
    • NYSDOH COVID-19 Information Line: 888.364.3065; Ask a Question Online at NYSDOH COVID-19 Website

    You can find answers to Frequently Asked Questions about COVID-19 at: 


  • BUFFALO, New York, November 29, 2020 – Great Lakes Cardiovascular and Wyoming County Community Health System are pleased to announce an all-new approach to cardiac care as Dr. Joseph Gomez, MD, FACC, steps into the role recently vacated by retiring physician, Dr. Joseph Lanigan. 

    Dr. Gomez, who completed his medical training at the University of Rochester School of Medicine after earning his M.D. at Georgetown University, is looking forward to providing comprehensive inpatient and outpatient care to local cardiac patients, saving them lengthy trips to Buffalo or Rochester for regular treatment. 

    “We have all the necessary, up-to-date technology to give our community’s patients the cardiovascular care they need, just minutes from home,” Dr. Gomez says. “We’ll be seeing patients in our office for checkups and testing, and working hand-in-hand with the hospital to offer evaluation and consultation to any heart patients there.” 

    Joseph L. McTernan, Chief Executive Officer of Wyoming County Community Health System, agrees: “Wyoming County Community Health System is excited to welcome Dr. Gomez to our organization. Our partnership will further strengthen cardiology care in Wyoming County and provide a new level of service for our patients.”

    That level of service will include a cooperative approach with Great Lakes Cardiovascular’s team of surgeons to ensure continuous care with minimal disruptions. For example, if a local patient needs to travel to Buffalo for surgery at Buffalo General Hospital, Dr. Gomez says, “We’ll take over follow-up care of that patient as soon as possible to allow the patient to recover close to home.”

    Dr. Vijay Iyer, Medical Director for Great Lakes Cardiovascular, sees this as a great benefit to patients. “We are happy to partner with WCCHS in providing all outpatient and inpatient cardiology services for the patients of Dr. Joseph Gomez and PA Kelsey Adams in Wyoming County. Great Lakes Cardiovascular works hand-in-hand with the physicians at the world-renowned Gates Vascular Institute in Buffalo, and we look forward to serving the Warsaw-area patient community.” 

    Dr. Gomez, who has been with Great Lakes Cardiovascular for two years, is excited to bring the practice’s renowned, world-class cardiovascular care to Wyoming County. To learn more about Dr. Gomez and the services he provides, visit https://www.greatlakescardiovascular.com/physicians/cardiology/joseph-gomez-md-facc. To learn more about Wyoming County Community Health System, visit https://www.wcchs.net. More information about Great Lakes Cardiovascular can be found at https://www.greatlakescardiovascular.com.


  • Many women experience some form of abnormal uterine bleeding throughout their lifetime.

    Abnormal uterine bleeding can be described as bleeding or spotting between periods, bleeding after intercourse, heavy bleeding during your period, menstrual cycles that are longer than 35 days or shorter than 21 days, periods that last longer than 8 days, or bleeding after menopause. These are all scenarios where it is important to be evaluated by an Ob/GYN. 

    Abnormal bleeding can occur at any age, but it is more common to have irregular bleeding when a woman first gets her period or when a woman nears menopause. There are many causes of abnormal bleeding. The most common causes are problems with ovulation, uterine polyps, fibroids, endometriosis/adenomyosis, bleeding disorders, medications, pregnancy or miscarriage, and certain forms of uterine cancer.  

    Most causes of abnormal bleeding can be easily diagnosed by an Ob/GYN. It can be helpful to track your menstrual cycle before seeing your doctor. Based on the symptoms that a patient is having an ob/GYN will do a physical exam. They may do a pregnancy test, cultures, or bloodwork. 

    If there is a concern for a structural abnormality an imaging study such as a pelvic ultrasound may be done. If there is a concern for uterine cancer if may be necessary to have a biopsy taken from the endometrium, which is the lining of the uterus. Depending on the cause of the bleeding, it may be treated with medication. This includes hormonal birth control such as the pill or an IUD. 

    If there is a polyp or a fibroid inside the uterine cavity this may require surgery. If medication does not control the abnormal bleeding, endometrial ablation may be discussed. This is an outpatient procedure that destroys the endometrial lining of the uterus and reduces heavy menstrual bleeding. In some cases, if medication or ablation are unsuccessful a hysterectomy may be needed. 

    If there is any concern that a patient is experiencing abnormal uterine bleeding they should contact their ob/GYN.

    If you have any questions or would like to make an appointment with Dr. Sarah Schmitz call 716.656.4077.


  • You’re not alone! And for women with this medical issue, we have great news for you. If you are living with stress urinary incontinence (SUI), whether it’s from childbirth, surgery, or age, we are excited to offer you an innovative new therapy.

    Until recently, the best treatment options for SUI were surgical or device-based. Now, you can talk to Dr. Armen Kirakosyan, a board-certified urogynecologist at General Physician, PC, to discuss whether you are a candidate for Bulkamid®. Bulkamid is a non-mesh, nonsurgical, long-lasting treatment that quickly relieves the symptoms of SUI in women. 

    Recently FDA-approved in the United States, Bulkamid is a water-based gel that is injected into the soft tissue of the urethra using a syringe. The natural, safe hydrogel thickens the urethral tissue close to the opening of the bladder and creates a seal that helps prevent the loss of urine when the bladder is met with sudden pressure.

    The minimally invasive procedure is performed in the doctor’s office and takes just 10-15 minutes. There is no downtime after the procedure, and you can usually resume normal activity the same day. The majority of women treated with Bulkamid report symptom improvement as soon as the procedure is completed and long-term studies have demonstrated greater than 80% success rates lasting more than 5-7 years.

    To learn more about this state-of-the-art option or to make an appointmentwith Dr. Kirakosyan, please call our Snyder office at (716) 656-4077.


  • All year long, Western New Yorkers have one thing on our mind. I hear it time and time again as I sit down and talk to my patients on a daily basis. 

    “WHEN WILL SUMMER BE HERE?”

    The first moment the sun shows up and we feel the warmth, albeit only 50 degrees and sunny, we let our skin show. Now as the summer days are long, and the sun is bright, we stay outdoors as long as we can. We are so grateful to finally have warmth on our bodies that we forget about sun safety.

    The Centers for Disease Control and Prevention (CDC) along with the National Institute for Occupational Safety and Health (NIOSH) provide wonderful reminders to keep our skin safe while still enjoying those warm and kind sun rays.

    They remind us first and foremost that ultraviolet (UV) rays are part of sunlight that is an invisible type of radiation. UVA and UVB cause aging and damage to the skin cells and are the most dangerous and cancer-causing types of sun rays. We also know that skin cancer is the most common form of cancer in the United States. The most common types of skin cancers include basal cell carcinoma, squamous cell carcinoma, and melanoma.

    In order to protect our patients and ourselves, there are several things we can do to minimize our risk of skin damage. They include regular and routine use of broad-spectrum SPF 15 or greater sunscreen even when in the shade. Remember to reapply if you stay out in the sun for more than two hours and after swimming, sweating, or toweling off. Wear clothing made from tightly woven cloth with SPF protection when possible, stay in the shade, wear a wide-brimmed hat, and sunglasses that preferably block UVA and UVB rays. 

    Lastly, if you do get too much sun, by accident of course, here are some simple tips to help your body recover: stay hydrated to prevent fluid loss, comfort skin burns with cool baths or clothes, take over-the-counter Tylenol or ibuprofen for fever or headaches, and remain out of the sun until you are feeling better.

    Katherine Sumner, PA-C is accepting new patients at 1091 Main Street, Suite 301, Buffalo. For more information on health safety or if you are worried about damage to your skin, call our office at 716.248.1420 to schedule an appointment.


  • Millions of Americans have “learned to live” with pain, numbness and tingling in one or both of their hands. These symptoms can range from being painful to downright crippling. The good news is, you don’t have to live with pain. A single visit, microinvasive solution, is available.


  • COVID-19 and the Aging Population: A Collaborative Effort for the Successful Solution for Sub-Acute and Long Term Care Patients.
    Dr. Paul Shields, VP Clinical Services Post Acute Care at General Physician, PC, explains the process, the efforts of those involved, and the outcomes. Taking the virus head-on and beating it, advocating for our patients and working together to provide care for patients where and when they need it. https://youtu.be/Nh-y47AKWoI
     

  • The Hidden Danger of COVID-19: Ignoring other illnesses can be deadly during the pandemic

    Heart attacks and strokes don’t care about COVID-19. They just keep on coming.

    Unfortunately, there is anecdotal evidence that an increasing number of people are delaying seeking care for symptoms during COVID-19. That can be a real problem, according to Great Lakes Cardiovascular Interventional Cardiologist Dr. Vijay Iyer.

    When we are talking about certain cardiac episodes, the difference between life and death can be a matter of minutes,” he says. “Delaying treatment can be a fatal decision.”

    There appear to be two primary reasons people would delay seeking medical care for non-COVID-19 symptoms during the pandemic. First, there is the altruistic belief that they would be taking a bed away from someone who needs it more than they do.

    “People need to leave decisions like that to the medical professionals,” Dr. Iyer says. “We assess every patient, and we admit people who have a need for urgent care, so if a doctor admits you to a hospital, it is because you need that level of care, there is no more or less than the next person.”

    Additionally, in most parts of the country outside of New York City, social distancing has led to a flattening of the curve, and hospitals have the capacity to admit patients as needed. The shortage of beds that was expected early on, and was seen in some communities, is now much better.

    Even if there was a shortage in beds, Dr. Iyer says that’s no reason to delay or skip treatment.

    “Calling and coming in to be examined still gives us the opportunity to assess your condition and take action outside of hospitalization,” he says. We treat many patients in the office, and there may be simple medications we can prescribe to help. But we don’t know that if a patient doesn’t reach out.”

    The second, more common reason, is simply fear. Erie County has the second-highest number of confirmed cases of COVID-19 in the state. Governor Cuomo issued and reissued a Stay in Place Order. People are required to wear a mask in public. There is an understandable level of fear in the community and for many patients, that translates into a hesitation to go to a doctor’s office or hospital for fear of being exposed to the virus. While there is no guarantee, Dr. Iyer says healthcare providers across the community have done an outstanding job of implementing measures to keep patients and staff safe.

    “We are part of General Physician, PC and together we have more than 70 offices,” Dr. Iyer says. “At every office, we took immediate and comprehensive steps to ensure everyone who comes through our doors is safe.”

    Dr. Richard Charles is the Chief Medical Officer of General Physician, PC. He says those steps included increased training for staff and providers as soon as COVID-19 broke.

    “Keeping our patients safe during this time begins with keeping our staff safe and making sure they have the education and the tools to execute best practices in all offices,” he says.

    Dr. Charles says at every General Physician, PC and Great Lakes Cardiovascular office, the following safety precautions have been implemented:

    • No one is allowed to enter an office without having their temperature taken (fever is a primary symptom of COVID-19).

    • Access is retracted to employees, patients, and their caregivers only. No outside vendors or visitors are allowed in any office.

    • All staff and providers wear personal protective equipment.

    • Many offices offer video and telephone visits for added safety.

      “We understand the apprehension our patients feel, and we have taken every step possible to mitigate any risk for those individuals visiting our offices,” he says.

      Dr. Iyer says the same is true for the hospitals he cares for patients in — each is operating at a heightened level of safety and patient protection.

      “The advice I give my patients today is the same as it was before COVID-19 and the same it will be after COVID-19,” he says. “If you feel something, say something. If you have symptoms, call your doctor or hospital. It could absolutely save your life.”

      Dr. Vijay Iyer has offices in Buffalo and Olean. To schedule an appointment at any Great Lakes Cardiovascular office, call 716.710.8266.


  • When you think of hearts in February, many people think about candy hearts and chocolate hearts. We’re here to remind you about the other heart you should be thinking about this month.

    Heart disease is the leading cause of death in the United States. More than 635,000 Americans die each year from heart disease. The good news is, you don’t have to be one of them.


  • With Covid-19 changing daily routines and canceling all sports and activities for the last few months, many sports enthusiasts and athletes have been out of commission for far too long. As we gradually return to a “new” normal and implement our fitness routines, it is essential to ease back in to avoid injury. After a period of inactivity, your body needs to adapt and slowly increase activity as tolerated.

    You may ask, “How do I go about this safely?” The answer is - make a plan.


    Return to play:
    Whatever your end goal - whether you are a collegiate athlete, a weekend warrior, an avid yoga goer, a once a week golfer or a high school track star - you have to start back at square one after being off your game for a few months.


    Before you jump back in, start by creating a daily stretching plan, then slowly incorporate a strengthening workout to complete every other day. Core strengthening and cardio or aerobic exercise are also essential to do every day as you gradually increase your baseline activity.

    If you were used to running 5 miles a day or squatting 250 pounds, do NOT start working out at that previous intensity. Instead, begin at HALF of your “normal” activity (in weight, distance, duration, intensity, etc.), and slowly increase as tolerated, provided you do not feel pain while doing it, that night, or the next day.


    Recovery:
    It is very common to be sore after returning to an activity that you have not done in a while. Soreness is okay and expected, but do not neglect persistent pain that continues for more than a few days. Sharp shooting pain felt during activity could be an overuse injury and a sign you tried to do too much too soon. LISTEN to your body. If your body is telling you that you need a rest day, take it. Your body will thank you later.


    If you are feeling tightness in your muscles, applying heat to them before stretching will help warm up and loosen your muscles to allow for maximum mobility. If stretching and heat do not help feeling sore after exercise, try applying ice or taking anti-inflammatories.


    Any training regimen, whether rebuilding or maintaining, is not complete without proper nutrition. If you are not fueling your body with a balanced diet of fruits, vegetables, complex carbs, and lean protein, as well as maintaining good hydration before, during, and after exercise, you will not be able to reach your peak performance. When you ask your body to perform on an empty tank, it is harder for your body to train and recover, and most importantly, injuries can often occur.


    Injury prevention:
    Preventing injury is key to any training or participation in athletic activity. The last thing that you want is to sustain an injury, sidelining you or setting you back when trying to return to your sport. Your chances of avoiding injury are best if you can develop and stick to your training plan. Gradually increase activity intensity, incorporate strength, conditioning, and core workouts, stretch before and after exercise, maintain a healthy diet and hydration, get a good night’s sleep and always listen to your body.

    Dr. Lisa Daye and her Sports Medicine Orthopedics team are here for you. Whether you need to get your training back on track, avoid injury, or are injured and need treatment, Dr. Daye and her team can work with you to develop a plan that’s right for you.


    Call 716.500.BONE(2663) for more information or to schedule an appointment.


  • Are you sick and tired of feeling sick and tired? Visiting your primary care physician might just help you change that. It’s good practice to call your doctor when you’re feeling under the weather, but it’s an even better practice to call your doctor before you’re sick.

    Preventative care is a critical part of your overall health and well being. Your primary care physician isn’t here just to help you when you’re sick, they’re here to keep you from getting sick by keeping a watchful eye over your health.


  • The Summer season is finally here! While many people have been emotional and stress-eating, as well as skipping physical activity during COVID-19, warm weather, sunshine, and fresh produce of the season offer you the perfect opportunity to make positive, healthy lifestyle changes.  

    Now is the perfect time to retrain your body and taste buds, particularly if you have been munching on sweets and snack foods like chips or pretzels over the last few months. Take advantage of the abundance of in-season fruits and vegetables, aiming for 1-2 pieces of fruit and at least 2-3 cups of vegetables a day. Fruit is a naturally sweet snack that comes with unique health benefits and phytonutrients. This time of year, WNY farms are brimming with U-pick strawberries, raspberries, and blueberries. The summer months also boast an abundance and variety of homegrown vegetables. Try incorporating 2-3 vegetarian dinners a week. Not only is it a good way to take advantage of fresh produce, but it is an easy, healthier, and less expensive meal to prepare.  

    To help keep your weight, blood pressure, diabetes, cholesterol, and overall health in check, get out and walk! Even 15-20 minutes a day can make a big difference. Whether you are walking or participating in another outdoor activity you love, try to go early in the morning or in the evening to prevent overheating and avoid prime time sun exposure. Getting outside can also boost your mood and vitamin D levels adding additional health benefits. 

    Hitting the great outdoors has many health benefits, but it is essential to stay hydrated to keep your body functioning optimally. Aim for 48-64 oz of water every day. If you are active, your intake of water needs to increase. The rule of thumb is for every pound lost by sweating drink an extra 16 oz of water. 

    Decide today that the changes you make this summer will last all year. Write them down, use an app, find someone or something to make you accountable! Most of all, get outside, move your body and enjoy all that summer has to offer.


  • According to the CDC, diabetes affects more than 122 million Americans today, this includes both diabetes and prediabetes. It takes an incredible amount of work to keep your diabetes under control, and for the average person, managing diabetes is no small feat. Here are a few tips:

    Know Your Numbers

    After consulting with your doctor about your blood glucose targets, check them frequently to learn your trends. Your doctor will check your A1C every three months to determine your average blood glucose level. Also, check with your doctor on your blood pressure and cholesterol targets to keep those under control. Knowledge is power, and this will help you manage your diabetes. 

    Get Active

    It is essential to take care of yourself, both physically and mentally. COVID-19 may keep us socially distanced, but getting outside to walk just 10-15 minutes each day can significantly improve your health. Regular exercise has been shown to improve blood glucose levels and is an excellent tool for diabetes management. 

    Eat Right

    Healthy eating is a huge part of diabetes management. Food is a powerful tool, and it is essential to fuel your body with healthy foods to keep blood glucose levels low. Incorporating foods that are naturally rich in nutrients and low in fat and calories such as fruits, vegetables, and whole grains, is an excellent place to start!

    Take a Diabetes Education Class

    Classes are led and taught by Certified Diabetes Educators and are offered to the community in 4-week sessions. These classes can help you learn how your diet impacts your diabetes, how to plan healthy meals and snacks, interpret your blood glucose and A1C readings, find group support, and more.

    Virtual Diabetes Classes:

    December Session: 2, 9, 16, and 23,
    January/February Session: Jan 20 and 27, and Feb 3 and 10 
    Wednesday nights from 5:30 pm to 7:30 pm. 
    Call our Williamsville office at 716.631.8400 to register or if you have any questions.

    Dunkirk - In-Person Diabetes Classes

    February Session: 2, 9, 16, 23 
    Tuesday nights from 4:30 pm - 6:30 pm
    3898 Vineyard Drive, Suite 1 
    Dunkirk, NY 14048
    Call our Dunkirk office at 716.363-6960 to register or if you have any questions

    Or click here for more information: www.gppconline.com/specialties/clinical-support/nutrition-services

    Don't Stress

    Managing diabetes can seem overwhelming. If you feel stressed, anxious, or depressed, give your doctor a call. They can provide assistance and additional resources. You are not alone.

    See Your Doctor

    Get your flu shot and stay up-to-date on all other vaccinations. Make sure you have an annual foot and eye exam and check your feet daily to make sure there are no cuts, redness, swelling, corns, calluses, or sores. See your doctor regularly to eliminate any potential health risks that may arise with diabetes.

    Use this month to take some time to reflect on your diabetes management and continue to be vigilant in your care. Diabetes can feel overwhelming at times, but remember, it is a disease that can be controlled!

     

    Resources: 

    www.diabetes.org/diabetes

    www.cdc.gov/diabetes/index.html


  • It has been a very challenging few months. Due to COVID-19, many women had to delay their annual exams and screenings such as PAP smears and mammograms. 

    The primary purpose of the annual exam and screening is to catch a disease as early as possible and address it in a timely fashion. While waiting for a month or two is not usually a problem, delaying your healthcare visit for a more extended period could be a problem. 

    Even more pressing issues like seeing a doctor for a problem or renewing medications have been delayed because of the COVID-19 crisis. As you probably know, the Coronavirus pandemic forced us to stop all non-urgent surgeries in NY State and nationwide. Even though we restarted performing same-day procedures recently, the majority of elective surgeries are still on hold.

    What are elective surgeries? Elective surgeries are planned operations that are scheduled weeks or months in advance. Delaying surgical treatment is negatively impacting patients by prolonging symptoms, decreasing quality of life, and sometimes could make surgery more difficult.

    At General Physician PC, your safety and well-being are our primary priorities. We don't want you to delay your care. Rest assured that at all our offices, we have implemented robust procedures to ensure a safe and clean environment. We have changed our routine significantly by incorporating an initial screening upon entrance to the office, eliminating the need to wait in the waiting area, utilizing extreme sanitary measures to clean exam rooms as well as full mask regimen. All these changes are necessary to ensure patient safety in our offices. 

    We understand, however, that some people may still be concerned about coming to the office. We now offer telemedicine visits so you can talk to your doctor via phone or video. This type of appointment is an excellent way to discuss your concerns with your doctor, renew or change medication, follow up on chronic issues, and get all of your questions answered. If the problem is more challenging and requires a physical examination, we would recommend you schedule an in-person visit with your doctor.

    We are happy to see a definitive decline in the number of COVID-19 cases in NY State. With these positive changes, it is an excellent time to start thinking about your routine health again and take care of yourself.

    For more information or to make an appointment with Dr. Kirakosyan please call 716-656-4077.

    Armen Kirakosyan, MD, FACOG, FPMRS, FACS 
    https://www.gppconline.com/armen-kirakosyan-md
    Women's Health, Urogynecology 
    https://www.gppconline.com/specialties/medical-specialties/urogynecology


  • More than 800,000 Americans die every year from cardiovascular disease, making it the number one killer in America. The good news: those numbers are in decline, thanks, in part, to people taking a more proactive approach to their heart health.


  • Disney World closed. Broadway closed. The NBA, NHL, MLB, XFL, and NLL all suspended. Here in Buffalo, The St. Patrick’s Day Parade, a cultural must in our town, cancelled.

    COVID-19 is here, and it is here for the foreseeable future. At General Physician, PC, we are working every day to make sure not only our patients, providers and staff are informed and well-prepared, but also our community at large.


  • Many people often complain of leg pain that is accompanied by leg swelling, heaviness, cramping, itching, varicose veins, skin discoloration, hair loss, and/or ulceration. Some people will experience pain at rest or pain with activity. Disease states that are responsible for these symptoms are related to disorders of the arteries and veins of the legs. 

    Deep Vein Thrombosis

    Blood clots in the leg, also called Deep Vein Thrombosis (DVT), can form in the lower leg, thigh or pelvis. DVT is caused by prolonged rest or travel, family history, obesity, pregnancy, blood disorders, and cancer. When clots form they block the flow of blood from the lower extremity back to the heart. This produces leg swelling and heaviness which then leads to leg pain, warmth, and redness. These blood clots can travel from the leg to the lung and cause blood clots trapped in the pulmonary arteries, called a Pulmonary Embolism (PE) producing shortness of breath and chest pain. This can be life threatening and must be treated emergently. Call 911 if you think you may be suffering from a PE. Untreated DVT can also cause post-thrombotic syndrome (PTS) which results when DVT causes long-term damage to the valves in the veins. Symptoms of PTS include pain, swelling, discoloration, scaling of the skin and ulcers. In some cases, PTS can lead to permanent disability. 

    Treatment for DVT includes blood thinners and minimally invasive surgery. If medication doesn’t work or symptoms are too severe minimally invasive surgery using advanced medical technology can rapidly remove the blood clot from the veins restoring blood flow, resolve the symptoms, and prevent PE and PTS. The goal of treatment is the rapid relief of symptoms and improvement in the quality of life.

    DVT prevention is also critical. The best thing you can do is keep mobile and hydrated during times of rest. Squeezing your calves or flexing your calves and wearing compression stockings can keep blood flow moving. Stay hydrated, make sure you drink at least four 16 oz bottles of water a day. This will keep your blood thin.

    Venous Insufficiency

    Veins that can no longer return the blood back to the heart are called insufficient. This can be caused by prolonged standing or sitting, previous DVT, family history, and obesity. Veins have one-way valves that direct the flow back to the heart. When these veins become damaged, like from DVT or from prolonged standing, they can no longer direct flow back to the heart, and the blood pools in the feet and ankles resulting in leg pain at rest, leg swelling, heaviness, and varicose veins. When this goes on for too long it can result in skin discoloration, skin thickening and ulcerations. Sometimes small blood clots form in the varicose veins causing inflammation and pain. In some cases, this can lead to permanent disability.

    Treatment of Venous Insufficiency is done using compression stockings and minimally invasive techniques using a small catheter to close the diseased vein by using heat or glue. This a rapid and efficient treatment that will reroute blood from your legs to your heart using healthy veins significantly improving your symptoms. 

    Venous Insufficiency prevention is critical. The best thing you can do is wear compression stockings if you are in jobs that require prolonged standing, prolonged sitting, intense labor, or lifting heavyweight. Take a rest when you can!

    Peripheral Arterial Disease

    Peripheral Arterial Disease (PAD) occurs when the arteries become blocked or narrowed and can no longer deliver their cargo efficiently. Arteries of the leg are the delivery system of nutrients and blood to bone, muscle, and skin. Reduced blood flow can result in leg pain with activity, hair loss, loss of muscle tone, skin discoloration, and ulcerations. PAD is caused by plaque build-up in the artery the narrows the space within the artery and can eventually lead to artery blockage. This plaque buildup can be caused by genetics, family history, diet, smoking, chronic renal disease, coronary artery disease, stroke, and diabetes. 

    Claudication is a common presenting symptom of PAD. Claudication is described as pain with walking. If you develop muscle cramps and pain after walking short distances it can be a sign of arterial narrowing. Occasionally, the arteries can be blocked rapidly and cause quick onset leg pain that is unbearable called Acute Limb Ischemia. This should be treated emergently. If your leg has suddenly turned blue or pale in color, has lost a pulse, feels numb or overly sensitive call 911. 

    Critical Limb Ischemia is commonly seen in people that have chronic kidney disease, diabetes, and who smoke cigarettes. The common symptoms are pain at rest, muscle wasting, and ulcerations.

    Treatment of PAD is done using medication and minimally invasive surgery with catheters to restore the normal size of the artery to return normal blood flow to the leg. Medication is used to thin the blood to prevent blood clots and reduce plaque build-up which usually are lifelong medications. In some cases, untreated PAD can lead to permanent disability.

    PAD prevention is also very critical. Maintaining a healthy active lifestyle is the best choice you can make. Activity and exercise promote arterial health. A heart-healthy diet or caloric restricted diet is important to keep weight off and prevent plaque build-up. You should not smoke and if you do, I encourage you to quit. There are many support groups and medications that can help you fight the urge and be smoke-free.

    Vascular Interventional Radiology is the future.

    At Great Lakes Medical Imaging, our Vascular Interventional Radiologists are here for you now. They are highly trained physicians that have expertise in the latest methods to manage and treat arterial and venous disease using x-ray technology and minimally invasive surgery with small catheters – thin tubes that are threaded through the diseased vessel to reduce your symptoms and improve your quality of life. Call Dr. Chohan and his team of Vascular Interventional Radiologists at 716-836-4646 to speak more about leg pain and if there is a treatment option for you!

    Great Lakes Medical Imaging www.greatlakesmedicalimaging.com


  • Living in Western New York, you can’t avoid cold, snow, and ice during the winter, but you can prevent serious winter-related injuries. In an earlier blog post, Dr. Riegel discussed heart attack risks. This week, Dr. Falcone, an orthopedic surgeon, offers tips for protecting your bones, joints, ligaments, tendons, and muscles.Thousands of people every year suffer from preventable injuries during the winter months. To protect yourself, observe some basic safety tips to prevent yourself from being one of them.

    Protect Your Body, Inside and Out

    Cold temperatures make muscles, tendons, and ligaments more prone to injury, so you’ll want to mitigate the risks of spending time outside by:

    • Keeping your body warm. Wear appropriate outerwear and layer your clothing to accommodate your body’s constantly changing temperature. Your layers should be light, loose, water-resistant, and wind-resistant.
    • Stretching. Warm up your muscles before shoveling, putting up or taking down holiday lights, or performing other outdoor home-care tasks.
    • Staying Drink enough water! It’s natural to worry about dehydration in the heat of summer, but in winter, don’t forget our bodies are often working harder to move under extra or heavier clothing, breathing harder from exertion, and sweating when we’re inside over-heated buildings. If your body becomes dehydrated, lactic acid builds up in your muscles, which can cause cramps and bodily strain—greatly increasing the chance of falling and other injuries. Proper hydration helps keep your muscles and ligaments healthy, and it even helps with pain relief and healing.
    • Wiping your shoes thoroughly when you enter a building. Snow and ice build up in the soles and can cause you to slip when you step onto a smooth, hard floor. 

    Beware of the Biggest Problem

    Falling or slipping on icy outdoor surfaces, of course, is the biggest issue we face in the winter months. Both can cause broken bones, wrenched backs, sprained joints, or head injuries. We all take walking for granted, but if you try to walk in the winter like you do in the summer, you’re putting yourself at risk.Two things are essential to injury prevention: wearing boots or shoes designed for maximum safety on ice and snow and changing the way you walk. Slip-resistant footwear is key. So is taking shorter steps with slightly bent knees and taking things slow—try not to rush or run. If you have the choice between walking on potentially icy pavement or snowy grass, choose the grass. That way, if you fall, you’re less likely to be hurt. And, when you’re out and about, use handrails whenever possible, treat every walkway as though it has black ice, and keep your hands out of your pockets – you may need your arms for balance or to catch yourself. In fact, if you have to navigate black ice, walk like a penguin: widen your stance, spread your arms, and do your best to balance.

    And if you do fall? Bend your elbows and knees to help your arms and legs absorb the impact, and be mindful of how you get up.

    Prepare to Drive Differently

    Winter driving can be harmful to your body, including preparations. Scraping ice and snow off your car—be sure to clear both windshields!—can bring about damage to joints, tissue, and muscles. Shoveling, with all the lifting, twisting, and throwing it requires, can cause muscle strains, sprains, and soft tissue injuries. Try pushing the snow away instead of lifting it onto your shovel. If you lift it, protect your back by keeping a slight bend in your knees. And listen to your body: if something is starting to hurt, take a break. Finally, pay attention to severe weather warnings. If you don’t have to be out on the roads when conditions are snowy or icy, don’t go anywhere. But if you do, take proper precautions to avoid abrupt stops, skids, and collisions—which can cause concussions, whiplash, back injuries and broken bones.

    One final note: if you have any pre-existing orthopedic conditions, including and especially joint implants or any kind of surgical reconstruction, be sure you talk to your physician about any extra precautions you might have to take in the winter weather. We want everyone to enjoy the great outdoors this winter – safely!


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