We've Moved! New Office Location

DC Medical has moved to a new location and will see patients there starting 09/21/2021!!!

Our new address is 266 Harristown Rd Suite #305, Glen Rock, NJ 07452 .

The new location is only 1.2miles (2 minutes) away, the next exit on 208 North (exit on Maple Avenue). I know you will love the new professional building, with ample parking, right off the highway and a modern and spacious elevator to our third floor location. The new space has been totally renovated and is luxurious and practical.

As always, we are committed to excellent care, and we hope to continue to do so from our new location. Please feel free to call the office (201-475-9421) to schedule your next appointment and get your flu shot.

Re-opening Plans

Hello everyone, as July is thunderously setting in I am, once again, reaching out to you with news of DC Medical Care and our reopening schedule.
 
We live in unprecedented times, and I look around daily at our changed world: everyone wearing a mask, many wearing gloves, people passing each other in the street with averted eyes, turning their backs... I go to the supermarket early, early in the morning or late at night, and look first at the parking lot: Too many cars? I will come back another time...
 
I never imagined a world so devoid of human touch, laughter, and togetherness. Yet, I still don’t think we are doing enough to prevent another spike of the virus, which may shut our barely open doors once again. We still don’t have reliable prevention, or treatment, of this potentially deadly disease, and the cases are slowly climbing up again in many states. Not surprisingly, the average age of people contacting the disease is decreasing as younger people return to a modicum of “normal” life.
 
Our doors at DC Medical are open again, and we are seeing patients in the office every Tuesday, Wednesday and Thursday for full days. Mondays and Fridays we “see” people through telemedicine, as many types of follow-ups can now be easily accomplished this way. To minimize risk we strive for minimal office wait times, and disinfect everything aggressively between patients. The waiting room is transformed to accommodate only a few (distanced) people. I am in touch with many, many specialists, and through my ACO (Accountable Care Organization), I work hard to be up to speed with the latest COVID-19 guidelines. There is presently minimal risk in coming to the doctor and I am encouraging everyone who is due for their yearly physical, or simply has any medical issue, to come in without hesitation.
 
However, we are also seeing that some medical problems can actually be addressed remotely, such as medication checks, discussion of routine, periodic blood work, and chronic disease management like diabetes, cholesterol or asthma. It is easy and convenient to set up an appointment either virtually through video or just a simple phone call, so I advise you to take advantage of this option as well. . Anyone who feels sick, and is concerned that it may be a coronavirus, should still call the office for instructions and advice but not come in. To this end, we are NOT doing COVID testing, but we are still doing antibody testing. The office is open daily during regular business hours, so please reach out.
 
To all of you who have been my patients for many years and always ask about my family, I can report that we try our best to stay upbeat and active. This week we are on vacation in Delaware (Bethany Beach). We drove straight through Tropical Storm Fay and arrived on the hottest and most humid week, yet there is nothing as soothing to the spirit and senses as the waves of the ocean breaking against the beach. As I walk along the beach collecting shells with my boys I realize that the beach is the ONLY place I now feel comfortable without a mask. But protection and caution is, for now, the key to staying healthy and putting this pandemic behind us.

Updates from Dr. Cernea

Hello everyone, 
 
I hope my message finds you well during these crazy times. It has been challenging at best, between social distancing, the presence of masks and gloves everywhere, and the sheer uncertainty of the future. Out friends and neighbors have become “remote“, our jobs and learning “virtual”. We are dependent on Amazon for anything other than food, and even the supermarkets have become dangerous places, with the potential of infection.
 
Everyone feels at risk, fearful and uncertain, and it is difficult to be upbeat and hopeful. But, the numbers are indeed consistently decreasing in New Jersey, and the curve has flattened considerably. Slowly, cautiously, things will open again and DC Medical Care is no different. Our office is now open every Wednesday and Friday 8:30-1:30 for all in person visits. You can also reach us by phone/video for telemedicine Monday, Tuesday and Friday 8:30am-12:30pm for anything else you may need. We urge everyone who is due for a physical examination to schedule it in person, as well as any routine procedure such as knee injections, glucose monitoring for diabetics, heart monitoring, etc.
 
As the medical future of COVID-19 is still very uncertain, it is time to commit again to your health, as it was clearly shown that, regardless of age, people with lung disease, hypertension, diabetes and obesity are at much higher risk for severe complications of the virus.
 
I would like to remind everyone that:
a. Remote, tele-visits which are linked to COVID are now completely paid for by insurance, so reach out if you have symptoms such as body aches, cough, fever, sore throat and exhaustion. The virus can give you a wide range of symptoms, let us help you decide if you should be tested and treated.

b. Dietician visits (which are done via tele-visits) are now free with all insurances in order to encourage weight loss, and overall well-being. Please schedule one to start on your journey.

c. We are doing antibody testing (free with all insurances) and everyone who was either sick during March through early May, or had any contact with COVID suspected patients, should test. While having antibodies does not offer a guarantee of protection for COVID, it does offer some reassurance that your body reacts to fight the virus, and in turn protect you. There are over 90 tests out there, and many are unreliable, so where you test is important. We are using the best test available, the only one approved by the FDA.
 
Last but not least I want you to know we are here for you, with easy and constant access and can refer you to specialists and send you for testing, if necessary, in a safe and efficient way.
 
Everyone always asks me about my family, and how we are weathering the storm. We have all been very careful to avoid infection but are trying every day to find a sparkle of something special and uplifting.  We created and planted a vegetable garden and summer flowers, we try to stay in shape by walking, hiking and biking. We are working on several family albums. We try to strike a balance between privacy and togetherness. Most importantly, I work on cooking new interesting dishes for at least one meal per day, exploring different ethnic cuisines: Indian, Spanish, Thai. I try to expand my vegetarian options yet keep the meal balanced. It literally adds spice to our days! 
 
As always, please contact us with any questions you may have and keep following the updated guidelines to stay safe,
Dana Cernea, MD

COVID-19 Antibody Testing

Antibody testing is finally here, and we have it available in our office on Fridays and Wednesdays, 10am to 12:30pm. The first testing date is this Friday, May 1. The test checks for an immune response to the COVID-19 virus. A positive test shows that you have been exposed and that your body responded successfully by creating specific protective cells. Testing for antibodies is only performed on healthy people who have currently no symptoms. In order to be tested you must make an appointment with the office which is open between 9-12:30 daily. It is very important you come on time as we can only see a couple of patients at a time for safety reasons. The test is free if you have insurance, meaning there is no copay, or deductible payment. 

There are a few important questions to be answered before you consider testing:

A. Who should be tested?

·      Patients who have had a positive COVID test OVER TWO WEEKS ago and recovered, to see if they acquired immunity.

·      People who are a direct household contact of a coronavirus patient but were never sick themselves.

·      Patients who had all the symptoms attributed to COVID-19 but were not originally tested due to lack of testing kits

·      People with occupations which involve contact with many potentially infected (e.g. medical personnel, teachers, clergy, police force).

B. When should you test?

You should test a minimum of TWO WEEKS after your positive COVID-19 test or after you completely recuperated from your illness. It takes that long to develop an immune response which can be tested. 

C. Why be tested? What do the results mean?

COVID-19 has been a virus with difficult to predict characteristics. If positive, the test shows that your exposure to the virus (either through illness or contact) has been sufficient to produce an immune reaction and create antibodies. In simple terms, positive results means the person had a form of coronavirus. Unfortunately, it does not mean that you are protected from reinfection with the same or very similar virus, or that it is safe to socialize or be less vigilant about hygiene or protection. It also does not mean that you can not infect another person, and therefore you still need to practice social distancing. In other words, a positive antibody test result is not an “immunity passport”. This information is not yet fully known in the scientific community. However, testing will, within several months, provide enough data to help us better understand this disease, our response to it, and how to prevent infection and potentially re-infection.

 

Within weeks antibody testing will become available at LabCorp service centers and other commercial places. There are over 90 types of tests available and not all of them equally good, or even approved by the FDA. If you can not come to the office contact us for a prescription, if warranted, to be tested elsewhere and we will advise you accordingly.

As always, please contact us with any questions you may have and keep following the hygiene guidelines to stay safe,

Dana Cernea, MD

Insights and trends on Coronavirus

Hi everyone,
 
As promised I am writing a quick follow up on... you guessed it, COVID-19!

I know you are inundated daily with conflicting reports, scary statistics, and even tougher news of family members and friends who tested positive or have been hospitalized. Lately I have spent countless hours on researching national and international data on trends, treatments, prevention and predictions. Here are a few tidbits I can summarize:

Trends: our area, Bergen County has been severely hit, and the towns closest to NYC have the largest number of COVID-19 cases. To date, in Bergen County there are 10,426 positive cases and 550 deaths here. In New Jersey, there are almost 70,000 positive cases and more than 2,800 deaths. However daily new cases are fewer now (about 500) than last week, showing the positive impact of social distancing. It is still impossible to predict when a leveling off will occur. 

Prevention: there is a lot of circumstantial evidence on the benefits of vitamin C and Zinc, as well as aspirin when appropriate and elderberry extract. We developed a regimen to maximize your chances to stay healthy.  The best prevention though remains to stay home and reduce contact with anyone other than the people living in your house, wear a mask, gloves, and wash your hands and face.

Symptoms: very confusing! Almost any organ can be involved and severity can range from mild to severe. Diarrhea, loss of taste, loss of smell, dizziness, fever, aches, chills, dry cough, chest pressure alone and in combination have all been reported. The key is to stay vigilant if you don’t feel well, and call us ASAP if your condition worsens. We now have access to refer you for testing with rapid results outside of the hospital, and can evaluate your situation virtually and excuse you from work if appropriate.

Office news: The office is open daily, and we are now doing all consults virtually. Please call for a consultation if you need your medications refilled, have been exposed to COVID-19, or not feeling well.  The co-pays for office visits (now called telemedicine) have been suspended! That makes many services, such as dietician visits FREE!!! So if you have high cholesterol, blood pressure, etc. now is the time to take advantage of a virtual nutrition counseling session which you can use now and later. 

Surviving: It is very difficult to be at home for so long, and all of us are irritable and somewhat bored. We spend a lot of our lives in social situations, and isolation creates anxiety and depression. Everyone eats too much, exercises too little and sleeps poorly. Please reach out to us if you feel anxious or depressed, we really can help!

Last but not least, have faith! Together we will conquer this disease and make the world a better place.

Best,
Dana Cernea, MD

Updates on Coronavirus (COVID-19)

Dear Patients, 

I am seriously considering a sideline to my medical career: writer, specializing in medical thrillers with impossible scenarios... Wait, we are living through one right now!
In a situation which is constantly evolving, with very few firm answers and many unanswerable questions this is what we know for sure:
 
1.  This epidemic is serious and its course is unpredictable. Unfortunately, the situation is going to get more complex in the next several days, as the number of people affected will increase, and our ability to contain the infection will decrease proportionally.

2. It is really important to act now by attempting at all costs to minimize our contacts outside of the people living in our household. This cannot be understated. Social distancing is very, very difficult both psychologically and logistically, but it must be done. It is the only way to contain the virus and decrease the spread, and therefore the number of people infected. (For interesting graphs on the spread and the power of staying at home: https://www.washingtonpost.com/graphics/2020/world/corona-simulator/ )

3. The symptoms of COVID-19 are very non-specific, the fear of it is great, and testing is scarce. Who should be tested? Only people who are very sick and have a minimum of these 3 symptoms: persistent fever over 100.5 degrees, severe, unrelenting dry cough, and shortness of breath on minimal exertion. All others, who are only mildly ill, will increase their chances of getting COVID-19 if they go to hospital emergency rooms, walk-in clinics or urgent centers where the very sick people congregate.
 
At DC Medical Care, our goal is to help you through these difficult times while also protecting the health of our staff and larger community. Therefore, we are not encouraging people to leave their homes to even visit our office. Instead, we will be switching to an on-line, virtual mode of tele-medicine in the following few days. To schedule appointment via our online mode, please call the office as you would to make an appointment in our usual hours of business.  

Please read our website posts for our hours of operation, but all visits which can be done virtually will be done this way. All non urgent procedures will be rescheduled. In some ways this may prove to be much more convenient for many of you, and so feel free to call and request a virtual appointment with any and all concerns.


All the best, 
Dr. Cernea 

Information about Coronavirus (COVID-19)


Dear Patients, 

Coronavirus is currently on everyone's mind, but the information coming through is more overwhelming than helpful.  As the guardians of your health, we would like to give you a brief update, and we will organize it in two parts: facts about coronavirus and this novel coronavirus, and health recommendations in line with the ones posted by the CDC (Centers for Disease Control).
 
There are several countries with posted numbers of infected persons on the CDC website (or World Health Organization website), with the largest number of patients in China and Taiwan, but also European and African countries. The spread is faster than in previous epidemics as more people travel around the world. Currently, THERE ARE NO REPORTED CASES IN NEW JERSEY, and only 70 cases in all of the U.S.A., so no reason for immediate alarm.
 
What are the coronaviruses?
Coronaviruses are a class of viruses which cause upper respiratory illnesses (and even the common cold). Some of them (like the current novel COVID-19) are more aggressive than others, and can cause deathly illnesses. Though many of us have had a coronavirus infection, they do not create immunity, so everyone is susceptible to getting the infection
 
What are the symptoms?
The symptoms can range from a mild upper respiratory "cold" to severe pneumonia, but they are mainly related to the lower respiratory tract such as cough, shortness of breath, chest pain/pressure, fever and chills.
 
Who is at risk?
Theoretically everyone, though children represent a very small (comparative to other epidemics) percentage of patients. It is believed that they have partial immunity due to their many common viral illnesses of childhood, some of which are due to less virulent coronaviruses. While everyone can be infected, the patients at risk for severe illness from COVID-19 are the ones with either a low immune system or history of any lung disease such as smoking, asthma, emphysema, etc.
 
Most importantly, how can infection be prevented?The same way we prevent all other types of respiratory infection: primarily hand washing, cleaning all surfaces with anti-bacterial solution, isolating the sick at home, avoiding crowded places. These simple things can not be understated. It is also best to be hyper aware about touching your face as infection enters through your nose and mouth. Wearing masks mostly protects others from the viruses harbored by the mask wearer, not the other way around. So if a person is ill and is coughing or sneezing, they can wear a mask but those without symptoms will not really benefit from mask wearing. In fact, the US Surgeon General warns that wearing a mask (because they are uncomfortable and most people aren’t used to them) encourages more people to touch their faces which actually enables the spread of infection faster. 

If you have any questions or concerns please call the office. 

All the best, 
Dr. Cernea 

How Can We Stop America’s Silent Killer: Heart Disease

2020 will have monthly blogs, each focusing on one topic which seems to surface often in our daily conversations with our patients. I will try to pick subjects that are “ hot”, and offer some helpful hints. Knowledge is power, so read on even if you don’t think a given topic is pertinent to you at this moment. The February topic is: 

How Can We Stop America’s Silent Killer: Heart Disease

Imagine that four passenger jets crashed DAILY for the whole year killing everyone on board. As a community we would be outraged, terrified, and would work feverishly to do something (anything!!!) to stop the crashes. So many innocent people dying, such preventable deaths...

Incredibly enough this is roughly the same amount of people that die annually from heart disease in America!  Know that about 80% of these deaths can be prevented, but despite having the ability to prevent these hypothetical crashes, our patients continue to board the planes every day. How can this be? Few realize that heart disease is the underlying cause of one out of three U.S. deaths, and kills more patients than all forms of cancer combined. In spite of this people fear cancer more and are willing to invest in preventing it, while not even examining their personal cardiovascular risk. 

There are, to be sure, many myths about heart disease, risk and prevention. It is often difficult to understand the risk factors: is high cholesterol as seen in the level of LDL (low density lipoproteins) the most important indicator of risk, or is it the heart specific inflammation factor (hs-CRP)? What causes most heart attacks: fat clots or calcium deposits inside the arteries? How often should you have a cardiovascular profile checked, and what kind of testing should the check-up include? 

To answer: As it turns out it is the combination of both high LDL, high hs-CRP and low HDL that is most dangerous. Additionally, your family history, body mass index, and blood pressure contribute to stratify your risk factors. However, the answer to each of these questions underscores the need to analyze each individual’s personal profile to increase their chances of avoiding a cardiovascular event.  Medicine, after all is both a science and an art!

A 2019 national health survey showed that only 14% of Americans have had their inflammatory index and 54% their cholesterol levels checked within the last 12 months. DC Medical prides itself in being a preventive medicine practice. Therefore, we check both these indexes yearly as part of the routine wellness examination. We tailor further testing (such as EKG or HOLTER monitoring, arterial circulation indexes or heart calcium scores) to each patient’s personal medical profile which include factors such as smoking, family history, body mass index, etc.

Most importantly we work with you to create a lifestyle plan for optimizing your heart health. This includes young patients as well because the decisions one makes in their 20s and 30s will affect them decades later. A patient-doctor partnership is probably the most important pathway to prevention. Ask us what your personal risk is!

Goodbye 2019!

Hi everyone, it is hard to believe that 2019 is drawing to an end. Our "office party" this year consisted of a trip in New York City to see the Broadway show Waitress. It was fantastic, a feel good story with great music and characters. A great time was had by all! I invited everyone on this adventure to show how grateful I am for their hard work, but also to celebrate the end of the year in a fun and uplifting way together.

dcmed-waitress.jpeg

I have been talking to you for the past year about the changing medical landscape. The health system is now so complex that navigating it truly takes an advanced degree to understand. I wanted to take this chance to explain what that means because many have asked. Most independent physicians, both primary care and specialists, sold their practices to the local hospitals, which in turn merged with other hospitals or sold to investor owned management companies. These large conglomerates now have offices all over the state, and own all the walk-in clinics, radiology offices, and run the emergency rooms of all the major hospitals. What does that mean for you, the patient? 

It means that now services are more fragmented, as going to a walk-in clinic is likely to result in referrals for follow up to several specialists all in the same "system". Under pressure to increase patient visits to specialists, walk-in clinics and emergency rooms routinely provide "band-aid care" and refer out for both diagnostics and evaluation following a brief screening and intervention. Similarly, Primary care doctors are only allowed to make referrals to specialists and facilities in their own group and not to the physician who is most qualified to meet the individual patient's needs. For each patient this  means more appointments, more copays, and more time investment. And so  most of the times patients get shifted from specialist to specialist and from test to test in an effort to sustain a large, top heavy organization.

In contrast independent practices work on your behalf only. They try to minimize your visits and refer to specialists only when absolutely necessary, as it is in their best interest to diagnose and treat most conditions in their own office. When they refer, they choose the specialist that is best for you, for example most accessible, best in their field, or a good diagnostician, etc., as they have no pressure to "feed" the doctors in their network. Here at D.C. Medical Care we are attempting to function more and more as an antidote to this trend in medicine by remaining an independent, patient-centered practice. We do this by customizing our medical care and always considering the needs and desires of the patient first and foremost. Our success is determined by your happiness and, more importantly, health and we are looking to optimize that metric over any other. To that end, we added some cosmetic small procedures and wellness maintenance to our menu of offerings, we have a new dietician on staff and we are experimenting with two new weight loss and weight management protocols. An exciting new addition for January 2020 is vitamin infusions.

The best advice for the holidays is to enjoy celebrating with friends and family, forget about counting calories for now and look forward a healthy and successful 2020!

A Nutritious Summer!

Summer 2019 has been jam packed with activities. In spite of the heat (and torrential rains) it feels like it's gone by with lightening speed. Nevertheless much was accomplished and, most importantly, a lot of good food has been consumed.

In every blog post I try to address a topic which I receive a lot of questions about. This time I will focus on nutrition and try to untangle the yarn of organic vs. local vs. conventional (aka shipped from afar) groceries. Is organic more nutritious? Is tastier a sign of healthier? Is it worth paying 30-50% more for organic produce? Can you tell that fruits and vegetables are organic by taste alone? Apart from having fun at the local farmer’s market, is the food there better for you?

A summer lunch for my family with garden tomatoes!

A summer lunch for my family with garden tomatoes!

In order to answer any of these questions I first looked at many review articles published in medical journals. Sadly there are not enough rigorous studies about the impact of nutrition in both disease prevention and health indexes, as the variables are too many to account for. But I did come up with a few “gold nuggets” which I would love to share with you.

Research shows that “time is the enemy of nutrition” and that the time that elapses between when a vegetable is harvested and when it is served at the table is the biggest enemy of nutritional content whether the produce is organic or conventional. Loss of vitamins in fresh produce is astounding: seven days after harvesting levels of vitamin C dropped significantly, in carrots 10%, spinach 75% and green beans 77%, as an example. A produce laden truck takes more than seven days to cross the country. Moreover breaks in the “cold chain”, as when the produce is not kept at the strictest temperature controlled environment during packaging and loading, expedite the nutrition decrease. Roughly every hour at room temperature is equivalent with a day in the refrigerator. Nutrition (such as calcium, iron, vitamin A and thiamine) is also affected when produce is bred to increase yield, and picked unripe to resist long term transport. In other words the produce of our parents’ generation, when this technology was not possible, was more nutritious than most of what we buy at the store today.

Is organic more nutritious? Original studies showed that organic produce was not much healthier than conventional produce, though better designed, more recent studies showed organic to have higher levels of antioxidants, vitamin C and phenolic compounds. Nutrition is not necessarily what organic is all about. It is primarily about the environment - chemicals used, erosion, depletion of topsoil, greenhouse gas emissions and biodiversity. Nevertheless many organic farmers apply stricter standards to harvesting and transportation methods, allowing fruit to ripen on the vine and assuring that shipments arrive at the store in no more than 48 hours. Taste, however, is about what is going on in the plant itself. There is much debate among both agronomists and gourmet cooks whether organic actually tastes better. I leave it up to you to do your own “controlled study” with different kinds of produce, and let me know what you think.

Where does this leave us now? I think there is no argument that we should seek out locally grown produce, regardless of whether it is farmed by strict organic standards or not. Local farmers don’t need to store and transport their fresh produce. Usually they pick and sell within a couple of days. They sell only in season and don’t breed for “early” or cold resistant crops. Buy produce which is in season. For once “cheaper is better” as produce which is in season is more abundant and less expensive.

Interestingly enough frozen fruits and vegetables also tend to keep their vitamin content intact if freezing occurs immediately following picking.

So head out to that farmers’s market and enjoy!!! And during the cold months hit the freezer section of your store with less apprehension.

Feeling Like Fall

The weather has been tricky, alternating between tropical forest humidity and heat, to chilly fall nights and mornings. Unfortunately, this leads to worse asthma and allergy symptoms for anyone who suffers from Fall allergies. Please remember “an ounce of prevention is better than a pound of treatment” and come in for your allergy injections and renewal of medication. 

Speaking of coming in to the office, we are giving the flu shot to everyone who takes it on a yearly basis. While the vaccine is widely available at any pharmacy, it is best to get it from your doctor. There are many types of flu vaccines, with different potencies, modes of administration, and effectiveness. This is why I recommend getting the vaccine from your medical provider who knows your medical history and needs, not the “one size fits all” from the pharmacy. In our office, we have high-grade (specifically designed for people over 60 which covers the widest variety of flu strains) and flu-zone. As always, no appointment, copay or even wait is needed, just show up when we are open.

The fall is when I finally begin to contemplate the end of yet another year. This one seems to be passing by so very fast!  For me as my professional and personal life blend together so much, it means taking stock on what we have achieved, and how we should improve before the year truly ends. Although I am still reminiscing about the Summer sun (see picture below), now I am personally grateful for the blessings of a busy, and mostly fun everyday: soccer games (even for Nathan, my six year old!), music classes, reading together or even playing board games. Professionally, I am looking for ways to make our patient/provider interaction more meaningful. In an age of corporate mergers where hospitals, pharmacy chains, and insurance agencies gobble each other to create huge conglomerates, the patients become “widgets”, and medical care loses its human aspect. In response, I strive to keep my practice rather small, know my patients as individuals, and stay away from conveyor belt type medicine. This approach is difficult to maintain and implement but results simply in a healthier patient. But more about that in our next installment. For now, start digging up your favorite fall receipts, and share the best ones!

Wishing I could go back to enjoying Summer on the beach with my sons Nathan(5) and Benjamin(9).

Wishing I could go back to enjoying Summer on the beach with my sons Nathan(5) and Benjamin(9).

Summer Vacation Travel TIps

I start looking forward the summer months in mid-January, but once here, the summer seems to fly by.  The long days are still not quite long enough, “relaxed atmosphere” means I have responsibility for more after-camp games, swim sessions, and far more running either with (literally) or after my kids. 

Of course there is also the summer family vacation, which we all look forward to. Every year we try to do something a bit different and cater to our family’s diverse age groups and interests. A very rigorous hike for one of my daughters, kayaking for another, a beautiful beach for another, Shakespeare outdoors for the adults, some classical music for me and one of the boys, anything involving ships, planes, rockets for the other…The trick is to find somewhere where you can have at least 80% of the above, and go there at a time when camp/work and internships all ended, but of course, before the new school year starts. If this does not sound challenging enough add the demands of my practice, and the fact that “time off” for me is still being on call 24/7 as long as I am in the USA. 

They say that “necessity is the mother of invention” and this is how I got to be a good and flexible traveler. If you are contemplating a vacation this summer I have a couple of items of medical advice.

I am frequently asked what to bring along for travel (especially international), even if it at a resort destination. Medical care, and medication differ widely in both name and composition from country to country, and access to a doctor and pharmacy is many times difficult even from a luxury resort. Therefore, being prepared is well worth it. First pack a sufficient supply of your regular medications (such as for blood pressure, thyroid or migraines), as it is more difficult than you think to find an equivalent in Europe, South America or the islands. Second, I will share with you the contents of my traveling medicine bag.

  1. NSIDS such as Advil/Motrin or Tylenol which work for both fever and minor aches and pains. I have these in both pill and liquid forms.
  2. Benadryl tabs (25mg), as well as Claritin (10mg) because they work in different ways to counteract allergic reactions and can be taken together for a better response.  These too I stock in both pill and liquid forms.
  3. Imodium AD, and Pedialyte powder packets. These items are invaluable for the routine diarrhea that accompanies summer travel and the need for re-hydration and electrolyte replenishment that follows. I also take some over-the-counter(OTC) mild laxatives as the first, little known consequence of dehydration is constipation.
  4. Prescription pink eye drops as well as drops for ear infections. Pool and ocean swimming increases the frequency of eye and ear infections, and they are very annoying!! I also recommend over-the-counter swimmers’ ears drops that actually dry the water in the ears after a day at the beach and in so doing prevent the infections to a large extent. 
  5. Hydrocortizone and antibiotic (Bacitracin) OTC ointments, and many different sizes and shapes of band aids, non-adherent dressing pads, and surgical tape. You have no idea how useful, for many purposes these can be…and how much of a time saver it is to have them with you.
  6.  A sharp pair of nail scissors, a needle nosed tweezers and a medium size ACE bandage. Together with my traveling wine opener (for me, not the “patient”)  these tools have performed miracles in many of my travels.

If I travel abroad I may also take along a Z-pack (and am happy to provide one for you) as it works well for a nasty cold, as well as for a stomach bug which Imodium alone can not control. It is relatively safe as there are few allergic reactions, and the once per day for five days regimen makes it easy to take, even on vacation.

Happy travels!

Spring? Is that you?

This May turns out to be one of the strangest yet: wet and freezing one day, breezy, luminous and warm the next... Nature (and your own body) are justly confused. If you usually get spring allergies you are likely to get them a bit later than in previous years, but they will be back for sure! Start taking your Singulair and come in for a Solu-Medrol shot which temporarily tunes down your body's response to allergens..

There's a chance you have not yet met Nadisha Hoseini our Physician Assistant, who has been part of the practice for almost a year now. Nadisha has considerable experience in  a primary care setting, an in depth approach to chronic disease treatment, and a friendly, caring bedside manner. She also has a special interest in weight management, and has worked with our new dietician, Caroline, to better marry the theory of weight loss regimens to the frustrating practice. She is combining diet and exercise with some of the newest medication regimens and achieving considerable success. As the options increase in safe weight loss medications, the surgical options become less attractive, and more people are losing weight in a healthier way. Make an appointment to explore this with her if you are worried about the (hopefully) upcoming beach season!!

Medical care delivery in northern Bergen County is changing even faster than the weather. Most internal medicine and multi-specialty practices have sold out to either Valley Medical Group,  Hackensack University Medical Center (HUMC) partners, or even Summit Medical Group. For you,  that means that there is a financial incentive for doctors to send patients from "hand to hand", from specialist to specialist, from radiology to pathology etc. In this system the medical conglomerate keeps revenue flowing, but the patient is at a loss without anyone taking full responsibility for the whole person, and closing the loop between diagnosis and appropriate treatment.

DC Medical Care is one of the last few independent internal medicine groups which remains functional. MY goal remains to provide personalized quality care, and take full responsibility for the health of our patients. That includes preventive medicine, as well as acute (sick) care, and long term management for chronic conditions. We are also unique as we keep a small number of same day appointments open for sick visits DAILY in order to better serve our patients, and avoid unnecessary emergency room visits. 

Today medical practices must partner with patients to keep our services accessible and deliver the highest quality of care at the same time. In this vein we added a section for "Frequently Asked Questions" to our website to help you better understand our policies. Let us know if there are other ways in which we can serve you better.

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Powering Through The Winter

February turned out to be an upside down month. First, the temperature varied much more than usual from teeth-chattering cold to balmy, June-like (!!!) sunny days. This is the type of weather which really messes with your upper respiratory tract and your immune system, so many have been experiencing seasonal allergies way before the expected time. If this sounds like you, head in for your "magic shot" (SoluMedrol, a weak steroid)  which dials down your response to the spring allergens. As it takes a few days to kick in and only lasts for 10 weeks or so, now is the prime time to get it. 

We also have seen an increase in the number of flu cases left untreated. As your body is mobilizing to respond to the viral infection it can become more susceptible to bacterial supra infection such as bronchitis, sinusitis, etc. Don't "wait it out", but give us a call as medication is still quite effective against the flu IF taken EARLY after you become symptomatic. To make matters worse, only approximately 25% of the strains of flu virus now colonizing the Northeast were contained in the 2017 vaccine, an unusual situation which nevertheless results in the vaccine offering little protection against the disease. Therefore, be on the look out for early symptoms-we are here too help!

However, while it's still winter, What better way to ward off the boredom of dark, early evenings than experimenting with good food? For the last year we have all been trying to eat meatless meals during the week and only eat meat on Friday night and Saturday, following my daughter, Rebecca's, example. This has many benefits: we cut our family consumption of red meat substantially, and we increased our vegetable/fruit and "healthy food" intake.  You can debate the ethical and environmental impact as is in style these days, but for me it boils down to this: I have to plan, buy and cook creatively every day so my family will embrace this. Daily this proves to be a bigger challenge than even keeping my patients healthy, or filling in the mounds of paper/on-line work I have to do. Here is my latest go-to,  which Benjamin, my 9 year old, calls " bird in the nest":

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Ingredients: 

  1. 10oz frozen hash browns, defrosted
  2. 6 large brown eggs
  3. 4oz. shredded cheese, and 1oz. finely shaved aged Parmesan cheese

Carefully butter (or spray) a 6 muffin deep tin, and line it with shredded potatoes, pressing them firmly up the sides. making sure it is lined well all around so the eggs don't sip out. Place in heated 375F oven for 8-10mins or until lightly browned,

Remove pan and sprinkle the shredded cheese in each muffin then break an egg on top. Season with salt and pepper and dust evenly with the parmesan cheese.Place back in the oven, lower the temperature to 350,  until the eggs are set and the tops are brown. Enjoy!

Holiday Season Reminders!

What would the holidays be if they were all picture perfect? If all the stress of juggling year end reports and parent-teacher conferences were not enough, you now have to clean, cook a feast, and think of putting up with your in-laws! No, we are not offering you medication for that, but here are a few helpful tips:

  1. All home baked good freeze beautifully and keep for minimum of three months. Make your desserts now, and enlist the kids help, they will be very proud to take full credit.

  2. Stock up now on essential items both non perishable foods and toiletries that guests may need, so you don’t have to run out at odd hours to replace a toothbrush.

  3. Start your holiday shopping early and set a goal to finish before Black Friday because those savings are minimal when you compare to the stress of battling long lines and traffic.

Most importantly, to make this holiday season great you need to look and feel your best. Everyone wants to fit into their sexy black dress for the Holiday parties. It’s time to lose a few extra pounds that have been hanging around since the last set of parties. How should you do it? Exercise is a good thought and a must no matter what. Unfortunately, decreasing the number of calories you take in is the primary step and it is the real, unpleasant but necessary step. You can come in and see our dietitian, and can even consider weight loss medication. We have a strong integrated approach that is quite successful with almost everyone. It’s well worth passing up a few boring high calorie take out meals now and dream of those delicious upcoming holiday treats like Christmas cookies, eggnogs, and potato latkes instead. You can also think of rehabbing (lightening up) some of your family favorites by using less fat and sugar or coming up with new traditional treats you can have while wearing your skinny jeans.

Give yourself the gift of health by scheduling your Physical ASAP, because they are free for each calendar year. If you don’t use it, you lose it. Physicals are important because they can discover issues you didn’t know you had such as high blood pressure, thyroid problems, etc., and fixing those will allow you to start 2018 healthy!

Healthy Choices for October

Your health is important to us at DC Medical Care and we thought we would check in with a couple of tips to ensure you are healthy and happy this month.

With the Fall officially here, it is time to be aware of the inherent health risks of this time of year.  Therefore, October is the month to get your Flu Shot so you can be covered the entire Influenza season. You can come in with no appointment or copay, and most importantly, no waiting time because flu shots are administered by by the Nurse and billed through the insurance directly. This is an easy step to safeguard your health and the health of your loved ones.

October is also very close to the end of the year, so if you have not had a Physical this year you have wasted a lot of money on your monthly insurance premiums. A physical is meant to check up on your overall health, and setup your goals for next year. The yearly Physical is a must because anything we find we can correct before symptoms appear. That is the power of prevention and it is in your hands to make it happen.  Money should not be an excuse as IT IS ALWAYS FREE! (i.e. it’s covered by insurance 100% in almost all cases)

This year we have been blessed with warm weather late into the Fall season. That means sunny Sundays with your family, but also that Fall allergies may start later than usual. If you have symptoms not resolved with OTC Claritin or Zyrtec, please come in soon. Allergy medication takes approximately 2 weeks to relieve the symptoms so the earlier you start, the less discomfort you will endure.

July in NJ: Tick Alert!

July is the month to be outdoors, it's not as hot and humid as August, but more consistently sunny than June. We want everyone to be outside enjoying the sun (with sunscreen SPF 30 and above) and hiking, biking, or just gardening.

In New Jersey though, we have to be aware of ticks because Lyme Disease is a real possibility. Don’t get too worried though, not all ticks carry it and not all bites result in infection.

Here is an easy way to look at it:

At the end of the day, especially a day spent being active outdoors, check your whole body for a tick. I mean the WHOLE body. This summer, we found one hidden behind my 7 year old son’s ear just by the hairline! If you find one, you can extract it yourself by grasping it with a pair of tweezers and pulling up and out. Inspect that the mouthpiece is not left in the skin. Disinfect the wound with alcohol. Do not worry about saving the insect.  A Lyme carrying tick, as opposed to other ones, are very, very small.

You will need a blood test for a baseline to verify that you do not have antibodies to Lyme disease, and a second one about 6-7 weeks later. If the second test is negative it means that you have not been infected from that particular tick bite. If positive you will receive treatment before any actual disease develops. This approach works well and decreases the anxiety associated with a tick bite.

Enjoy the outdoors!!!