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If you get sick:
The most common symptoms of COVID-19 are:
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:
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:
If you are not sick but have to QUARANTINE:
If you were tested for COVID-19:
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:
If you do not have symptoms:
If your test is negative...
And you were in contact with someone with COVID-19:
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:
If you do not have enough food, or you need health insurance, legal help or anything else:
If you want or need a test:
If you want more information, call your doctor, the county, or the state:
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.
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.
Back to school means back to busy schedules, and when we’re busy we need lunch ideas that are easy and convenient. Often healthy eating goes by the wayside, replaced by fast food. With minimal planning, eating healthy can be easy. And when we eat better, we feel better! Eating a well-balanced lunch helps pave the way for the rest of the day and also helps overcome that midday slump. Having a good balance of complex carbohydrates, protein, and good fat brings greater satisfaction and more energy. Things to keep in mind for kids include awareness of food allergies, knowing which foods they are more likely to eat, and choosing non-perishables for field trips. When packing your own lunches, consider whether your office has refrigeration, microwave, or toaster oven.
The following are some basic lunchbox basics.
Kelly Cardamone, MS, RDN, CDCES, CDN, IFNCP, is a Nutrition and Diabetes Program Manager, practicing at General Physician, P.C. She sees patients at 3980A Sheridan Drive, Suite 200 in Amherst, 1091 Main Street, Suite 301 in Buffalo, and 705 Maple Road, Suite 300 in Williamsville. For nutritional counseling appointments or more information, call 716-631-8400.
Linda Fuller, ANP-BC, CDCES, has been taking care of people for about two-thirds of her life. She became a registered nurse in 1982 and has worked as a visiting nurse and in doctors’ offices and hospitals throughout Chautauqua County for her whole career.
The more Linda works with her patients, the more she wants to be able to help them. Since the ’80s she had seen an increasing number of people coming in with severe diabetes that affects every aspect of their lives, so in 2008, she studied to become a Certified Diabetes Care and Education Specialist.
In this role, she works one-on-one with each patient to manage their individual diabetes risk factors and symptoms to reduce the effects of the disease. But as a nurse without a prescribing license, Linda wasn’t able to help manage her patients’ medications – an important part of controlling diabetes for many. She went back to school to become an Adult Nurse Practitioner, which now allows her to meet all of her patients’ diabetes and overall health needs.
Born and raised in Randolph, Linda is a country person who comes from a farming family and firmly believes that a day out in the fresh air and sunshine is some of the best medicine. She’s an avid crafter who makes most of the gifts she gives to friends and family (whether they like it or not, she jokes). She’s kept company by her two dogs – an 11-pound Yorkipoo and a 145-pound St. Weiler (a cross between a St. Bernard and a Rottweiler).
3898 Vineyard Dr., Ste. 1, Dunkirk, NY 14048
To schedule an appointment, visit www.gppconline.com/scheduling
New Patients Welcome • Same-Day Appointments Available
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.
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.
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.
Or click here for more information: www.gppconline.com/specialties/clinical-support/nutrition-services
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!
While February might be American Heart Month, cardiovascular health is an important cornerstone of overall health that’s worth celebrating and maintaining 365 days a year. For some everyday tips to keep hearts going strong, we spoke with Dr. Vijay Iyer, Medical Director of Cardiology at Great Lakes Cardiovascular and Chief of Cardiology at Buffalo General Medical Center and Gates Vascular Institute.
1. Know your family health history.
“Knowing your family history and whether anyone developed heart disease at an early age helps you understand your preexisting risk,” says Dr. Iyer. “If you’re at high risk because of family history and you have other risk factors like diabetes, high blood pressure, and so on, it’s important to get more aggressive with prevention and work with a cardiologist and come up with a plan.”
2. Exercise for at least 15 minutes a day.
“It’s important to do the little things to move more,” says Dr. Iyer. Even simply walking briskly for 15 minutes is a great start and is a short enough timeframe to fit into even the busiest schedules.
3. Quit smoking.
“Absolutely refrain from smoking,” says Dr. Iyer. “It’s the worst thing you can do for your heart.”
While quitting can be challenging, it’s always worth it. Finding the right smoking cessation program and having a support network are crucial. Your doctor—and friends who have successfully kicked the habit—are great resources to find a strategy that fits your personality, habits, and budget. And if one method doesn’t work for you, try another.
4. Improve what’s on your plate.
Keto? Paleo? Mediterranean? Juice? There’s no shortage of diets and food trends claiming to be the healthy way to eat. And while many of them do have valid heart benefits, going from a daily burger to a life of quinoa and kale overnight isn’t realistic or sustainable—but finding healthier replacements for certain red-flag foods whenever possible is a no-brainer.
“There’s so much info out there about healthy eating that it’s daunting,” says Dr. Iyer. “But we know the basics: cut back on fried foods, red meats, and saturated fats. A little bit in moderation is fine, but don’t overdo it.”
5. Start young.
“Heart health starts in your 20s; you can’t wait to think about it until you’re in your 50s,” says Dr. Iyer. “Cardiovascular issues generally don’t develop in two years—it takes a long time for heart disease to progress, so it takes a sustained effort to prevent it, too. You should know your family history and cholesterol profile by age 25. And if you never start bad habits in your early years, you never have to quit them later.”
6. Don’t wait for a crisis.
“Prevention is hard,” admits Dr. Iyer. “We don’t change if nothing has happened yet. Most of the time we say we need to have a wake-up call to change, but that’s a heart attack or stroke in this case. We want to avoid that. It’s hard to be motivated if you haven’t had an event yourself or had friend or family member experience a heart attack or stroke. The reasons behind not adopting healthy habits aren’t that people are unaware, but it’s more of an ‘it hasn’t happened to me yet’ phenomenon.”
7. Get heart healthy together.
There are few things that sabotage a diet faster than a well-meaning spouse or best friend showing up with a pizza or a box of donuts. Whether you’re trying to eat better, be more active, or give up cigarettes, one of the surest ways to success is to share your journey with those around you.
“Life is busy—it’s hard to make changes and sustain them, but it’s easier with support,” says Dr. Iyer. “Lifestyle improvements are often decisions to make as a family or as a couple, not as an individual. For example, if you’re a couple, both people need to commit to stop smoking. It’s not going to work if one person is trying and the other is not.”
Dr. Vijay Iyer is an interventional cardiologist specializing in structural heart interventions. His clinical practice includes general cardiology, interventional cardiology, and complex valvular heart diseases. He directs the complex valve clinic at Buffalo General Medical Center, as well as structural heart interventions at the Gates Vascular Institute and Buffalo General Medical Center. https://www.greatlakescardiovascular.com/physicians/interventional/vijay-iyer-md-phd
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-mdWomen'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.
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
Urinary Tract Infections (UTIs) account for roughly 8.1 million annual doctor visits, and about 60 percent of women will experience a UTI in their lifetime. To understand why UTIs occur, it is helpful to understand the urinary tract, which makes and stores urine in the kidneys, and travels down the ureters to the bladder where it is stored until emptied. Urine is emptied through the urethra, a tube that connects the bladder to the skin. The opening of the urethra is at the end of the vaginal opening in females. Normal urine doesn’t have bacteria in it, but bacteria can get into urine through the urethra.
UTI symptoms include a need to urinate more often, and burning or pain when urinating. It can also cause a strong urge to urinate even when you don't have much urine in your bladder. The urine may also smell bad and appear cloudy or even bloody. It is important to call your health provider if you experience any of these symptoms. Noticing any blood in the urine may indicate a sign of something more serious, making the need to call your health provider more urgent.
One of the primary causes of UTIs in women is that they have shorter urethra than men. However, some women are more prone to UTIs compared to others. Women who are going through menopause typically have a higher chance of getting a UTI due to a reduction in their estrogen levels. Some women are genetically predisposed to UTIs. Sexual intercourse can trigger and also increase the frequency of UTIs, as can the use of diaphragms and condoms with spermicidal foam.
Sometimes the cause of UTIs is an abnormality in the urinary tract. Such abnormalities include diverticula that harbor bacteria in the bladder or urethra or blockages, such as an enlarged bladder, that prevents the body from completely draining urine from the bladder. Individuals with diabetes are also at a higher risk, as their bodies don’t fight germs off as well.
To decrease the risk of UTI, it is helpful to drink plenty of fluids, refrain from putting off urinating, or not fully emptying the bladder due to being in a rush to urinate. Drinking cranberry juice or taking over-the-counter cranberry supplements can also help prevent UTIs.
Fortunately, most women have simple UTIs that can be successfully treated with a short course of antibiotics, after which symptoms are alleviated. Postmenopausal women who experience UTIs can often be helped with topical hormone replacement with estrogen. When a UTI is complicated, a longer course of antibiotics is required, sometimes intravenously at a hospital. Women who get UTIs often should see their health provider for testing and treatment.
Armen Kirakosyan, MD, FACOG, FMPRS, FRCSC, FACS is a board-certified urogynecologist at General Physician, PC. He is experienced in treating a wide range of issues, from the most basic to complex surgeries. Learn more. To make an appointment with Dr. Kirakosyan, click here or call 716-656-4077.
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