International Travel Preparation by Alison Sims M.D.

Board Certification: Internal Medicine
THE PRE-TRAVEL CONSULTATION
 
People of all ages will travel far and wide for many reasons without any hesitation.  Some of the reasons for international travel include: traveling for work, vacations, revisiting family in one’s country of origin, and even for medical procedures abroad.  Travel planning always requires a laundry list of things to do, and yet only a small percentage of people review their health and medical preparation with the same care as they do when packing their suitcases.  I hope that these recommendations will both help everyone to protect themselves and their families from preventable travel illnesses, and also to prevent major medical mishaps from interrupting long-anticipated trips.

THE PROPER TIME TO SEE YOUR DOCTOR

A pre-travel consultation should be at least 4 weeks before the date of departure.  If you are not a seasoned traveler and you know you need vaccines, be sure to allow at least 4 weeks of time for the vaccinations to stimulate your body’s blood cells to boost your protective antibodies to effective levels.  If you need a series of booster injections, you may require 6 to 8 weeks of preparation time.

3 THINGS TO BRING TO YOUR OFFICE VISIT

To be sure that you will receive the vaccinations and medications needed, carefully prepare and bring these 3 documents to your doctor: your vaccination and health records, your itinerary in detail, and a list of other medications you will need.

VACCINATION AND HEALTH RECORDS

You must bring a complete record of vaccinations with dates and doses for each person who is traveling.  Prepare a medical history for each person including their allergies and medication lists.  Be careful to note any health states that may be more of a risk such as pregnancy, breastfeeding, weakened immune systems, diabetes, heart disease, lung disease, very young children or infants, and travelers over 60 years old.

ITINERARY FOR YOUR TRIP

Be very specific about your itinerary (the what, where, and when) of your trip.  Outline the dates for each region and planned activities.  View the Traveler’s Health page on the Center for Disease Control website, www.cdc.gov.  Find your destination(s) and print out the travel health recommendations specific to your locale(s).  Additionally, print out a Malaria map for your travel destination if applicable.  This site will provide explanations of the vaccines recommended for your destination and a list of the current outbreaks in the area.  You may address any questions or concerns about these items with your doctor.

MEDICATION REQUEST LIST

Make a list of the medications you wish to have for prevention of illnesses and conditions specific to your travel activities.  Examples include: altitude sickness hiking in extreme conditions, insomnia in unfamiliar places, flight anxiety, motion sickness on boats, traveler’s diarrhea, skin infections from insect bites and accidental wounds, respiratory infections, bladder infections from sitting on long flights, and “as needed” medications such as Epi Pens for bee sting allergies, and albuterol inhalers for acute asthmatic attacks from unusual weather or pollution.

PREVENTIVE MEASURES

Be sure to print out and review carefully the Travel Health Kit page as outlined on the CDC website.  It includes education on how to effectively prevent insect-borne diseases, foodborne and waterborne illnesses.  It is much better to avoid contracting a disease or illness such as malaria or cholera than it is to treat it.  It also includes recommendations for over-the-counter medications such as sunscreen and antihistamines to prevent or self-treat simple problems such as sunburn and mild allergic reactions.

VACCINATIONS FOR CONSIDERATION IN PRE-TRAVEL CONSULTATION

Vaccinations are divided on the CDC site into 3 categories: Routine, Recommended, and Required.  Please see the last page for a copy of the list as it appears on the CDC website.

DOCUMENTATION AND WRITTEN RECORDS

It is always recommended that you keep a copy of all of your important health records, vaccinations, medication lists, allergies, and both physician contact numbers and family contact numbers with you at all times during your travels in case of an emergency.

Be safe, and enjoy your trip!

Dr. Alison Sims

 

VACCINATIONS FOR CONSIDERATION IN PRE-TRAVEL CONSULTATION

Vaccinations are divided on the CDC site into 3 categories: Routine, Recommended, and Required.

Routine vaccinations are given according to the age and risk factors of the patient regardless of travel plans, and should be updated as necessary before travel.  These include:

Diptheria

Hepatitis A

Hepatitis B

Hemophilus influenza type b (Hib)

Herpes zoster (shingles)

Human Papilloma Virus (HPV)

Influenza

Measles (rubeola)

Meningococcal

Mumps

Pertussis

Pneumococcal

Polio

Rotavirus

Rubella

Tetanus

Varicella (chickenpox)

Recommended travel-related vaccines are specific to your destination. The most commonly requested vaccines for travel are:

Hepatitis A

Hepatitis B

Japanese Encephalitis

Meningococcal

Polio

Typhoid Fever

Yellow Fever

Required vaccines are country-specific and can change at any time. You must check on the CDC website for your destination’s requirements.  Some common ones:

Yellow Fever

Meningococcal

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
 

 

 


 

Are You Healthy Enough for Exercise? by Nathan Kiskila, M.D.

Dr. kiskila webA recent study showed that for some individuals, exercise may increase heart risk.*

Starting a new exercise program or sport may be a good idea but if you have had a past injury or problem, are over the age of 40, overweight, previously inactive or have a history of any medical condition such as diabetes or heart problems, you may want to have an exam before starting something new.

Based on your risk factors a doctor may want to ask about your personal and family medical history, assess heart disease risk factors such as cholesterol levels and smoking. Simple blood and urine tests may be obtained and if indicated an exercise stress test. Based on your results, your doctor may make limitations on an exercise regimen. If you have any chest pain or excessive shortness of breath while exercising, stop immediately and call your doctor right away.

*Bouchard C, Blair SN, Church TS, Earnest CP, Hagberg JM, et al. (2012) Adverse Metabolic Response to Regular Exercise: Is It a Rare or Common Occurrence? PLoS ONE 7(5): e37887. doi:10.1371/journal.pone.0037887

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
 

 

 


 

 

Health Travel Tips by Minnie Alcantara

Staying healthy while traveling is the primary goal of every traveler. Here are a few tips to stay in good health for your upcoming trip:

Before the trip:
 

  • Make sure to check on any vaccinations you might need by either consulting with your primary care physician or Centers for Disease Control (http://www.cdc.gov/) and get vaccinated prior to your trip. Also make sure to keep a copy of your vaccination records or any important medical records and have it on hand for your trip.

  • Arrange for a window seat if you are prone to air or motion sickness.

  • If traveling with your medications, make sure to bring the original bottles with the pharmacy label to avoid having problems with Customs or Transportation Security Administration (TSA). It’s advised to keep at least a week’s worth of medications in your carry-on luggage instead of your checked baggage.

  • Pack an extra pair of glasses or contact lenses, sunglasses and sunblock (if traveling to a sunny destination).

  • Prepare a mini medical kit for your trip that includes: pain medications (acetaminophen, aspirin, ibuprofen), antacids, topical disinfectants, bandaids, a sealed bottle of alcohol (3oz of less), lubricating eye drops, mild laxative, cough drops, cough suppressants, antibacterial wipes/sanitizers and your own digital thermometer.

  • Take your vitamins, immune boosting formulations in the recommended doses will help counter stress which is then helpful to lower resistance to common ailments.


 
During the trip:
 

  • Avoid air sickness by minimizing or avoiding alcohol 24 hours before a flight and on the flight, as well as reading during the flight. Be aware of where the air sickness bags are in the seat pockets in front you in case you need it.

  • Jetlag is defined as extreme fatigue experienced by a person after being on a long flight across several time zones. Get enough rest before your flight. To help overcome jetlag, scheduling outdoor activities for the first few days at your destination will be helpful. Spending time in the daylight will help you adjust quickly.

  •  
  • Keep hydrated with plenty of fluids, such as water and juices, and eating well balanced meals. This will help relieve being jetlagged as well. Stock up on purified bottled water especially in areas where a safe source may not exist. As a back-up, there are oral rehydration solutions that contain salts and simple sugars such as glucose to counter GI disorders and heat exhaustion.

  • Relieve ear pain by trying a decongestant medication (pseudoephedrine) before getting on the plane. Chewing gum and swallowing often will

  •  
  • If you suffer from deep vein thrombosis (blood clots), place as little as possible under and in front of your seat so that you are able to stretch and exercise your feet and ankles. Unless the flight crew advises you otherwise, try to get up to walk and stretch your calf muscles during the flight. Drinking water and wearing support stockings may also be useful.

  • Aircrafts have extremely low humidity levels that can often cause discomfort and dryness in the nose and throat, and wearing a face mask will help this issue. Covering your nose and mouth when sneezing will help prevent the spread of germs as well as avoiding touching your eyes, nose and mouth which are the most common entry ways to your system.

  • Always wear sunblock and sunglasses in tropical destinations or high altitudes.

  • Never purchase local medications unless you are already familiar with them.

  • Wash your hands or wipe your hands often with antibacterial wipes or sanitizers that contain at least 60 percent alcohol, the minimum that will kill most germs on contact.


These are just a few helpful tips to keep in mind for your next vacation. Happy travels!
 
The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
 

 

 

 

 

 


 

 

 

 

7 Effective Exercises for Your Body by Your Marque Team

 

 

Don't have time to get to a gym?  These effective exercises are not only  good for your overall health and fitness, but also provide a user-friendly way to get in shape.  The best part is that most of these exercises can be done in the comfort of your own home!

#1 Walking

Beginners can start at around 5 to 10 minutes at a time and gradually move up to 30 minutes per session.  As you progress, lengthen the time of your walks before boosting your speed or incline.

#2 Interval Training

Adding interval training can boost your fitness and burn more calories as well as help you lose weight. The basic idea:

Vary the intensity of your aerobic workout to challenge your body instead of remaining in your comfort zone.

How: Push up the pace for a minute or 2. Then back off for 2-10 minutes depending on how long you work out and how much recovery time you need to do throughout your workout.

#3 Squats

Why? Squats work various muscle groups such as your quads, hamstrings and gluteus all at once.

How: Keep your feet at a shoulder width apart with your back upright and straight. Bend your knees and lower your rear as if you were about to sit down on a chair with your knees directly over your ankles.

#4 Lunges

Like squats, lunges work all the major lower body muscles. That also helps improve your overall balance.

How: Take a big step forward keeping your back straight. Bend your front knee approximately 90 degrees. Keep your weight on your back toes and drop your back knee toward the floor. Don’t let it touch the floor.

#5 Pushups

Pushups strengthen the chest, shoulders, triceps and any other core muscles.

How:  Face down, place hands slightly wider than a shoulder width apart. Place toes or knees on the floor creating a smooth form with your body from shoulders, knees to feet. While keeping your rear end muscles and abdominals engaged, lower and lift your body by bending and straightening elbows while keeping torso stable through the movements.

#6 Abdominal Crunches

A-     Begin lying on your back with feet flat on the floor and palms supporting your head. Press your lower back down and contract your abdominals and raise first your head, then your neck, shoulders and upper back off the floor.

B-     Do the same but lift feet off the floor with knees still bent. This may help to avoid arching your back as well as strengthen hip flexors.

#7 Bent over Row

Works all major muscles as well as upper back & biceps.

How:  Stand with feet a shoulder width apart. Bend knees & flex forward at the hips. Next, engage the abdominals and extend spine to add support. Hold weights beneath the shoulders with hands at a shoulder width apart. Flex elbows and lift both hands toward sides of body. Pause then lower hands to starting position.

 

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
Organic Apples and Peanut Butter to Snack on

Do I Yourself Snacks: 100 Calories or Less! by Your Marque Team

 

 

In Southern California- it’s time to get in shape!  It’s so easy to eat healthy when you have tasty snacks like these to choose from:


½ cup of slow churned ice cream

Who would have thought ice cream could be a healthy snack?  Look for slow or double churned because the process reduces fat and calories while retaining the creamy texture.  A ½ cup has just 100 calories plus protein and calcium.

6 cups microwave popcorn

When you want a large snack with a small calorie count, popcorn delivers. Only some brands will work though. Popcorn is high in fiber which will help you feel full longer.

Mini quesadilla

Sprinkle an ounce of grated low fat cheddar cheese over a corn tortilla. Fold it in half and microwave 20 seconds. It’s a quick and tasty snack that has only 100 calories and 1.3 grams of saturated fat.

Cottage cheese and cantaloupe

Cottage cheese is a protein powerhouse with ½ cup delivering 14 grams. Protein will help you stay full longer. So go with a low carb cottage cheese with a fruit of your choice. A small wedge of cantaloupe brings the total calories to 100.

3 crackers with cheese

Whole grain crackers are the key to this snack. The fiber will keep you full, while the cheese provides calcium and protein. To stay under 100 calories cut up 1 slice of cheese and split it onto 3 crackers.

14 almonds

You can eat 14 almonds which are less than 100 calories. They’re high in fiber and protein which will keep your hunger at bay. They are a great “stuck in traffic” snack.

6 whole grain pretzel sticks

This snack is cholesterol free, low in fat and sugar, and will provide you with approximately 3 grams of fiber.

Baked apple

Apples are still one of the healthiest snacks around. If you bake an apple it’s a treat and is still rich in vitamins. You can even sprinkle cinnamon without the calories.

Blueberry smoothies

Try blending 1/3 cup of nonfat yogurt with 2/3 cup frozen blueberries and some ice. It’s very refreshing and cold. That slows down your ability to drink quickly. Snacks that take more time to finish are often more satisfying.

1/3 cup of edamame

A 1/3 cup has more than 8 grams of protein and 4 grams of fiber. As a bonus you’ll get nearly 10% of your recommended daily iron intake.

8 baby carrots with hummus

2 tablespoon of hummus will feed your craving.  Plus carrots are full of vitamins and nutrients.

Apple slices with peanut butter

Mixing sweet and salty is a great way to satisfy your munchies. Measure ¾ cup of apples and spread a thin layer of unsalted peanut butter on each slice. Don’t use more than 2 teaspoons of peanut butter.

Half a baked potato with salsa

Microwave one half of a regular sized (not jumbo) baked potato for an easy snack that’s loaded with vitamin C and not calories (80 calories to be exact). Keep the skin on it because it’s packed with nutrients. Use a tablespoon of fresh salsa to spice things up without adding any extra calories.

Pistachios

Don’t let the high fat content scare you! Eat 20 pistachios and you’re only getting 80 calories!

Frozen banana pops

Slice several bananas in half and insert a popsicle stick. Dip each half in a half ounce of plain yogurt. Freeze and serve. Only 80 calories a pop!

1 cup of tomato soup

It’s full of disease fighting nutrients but contains only 74 calories. Look for the low sodium tomato soup.  Not creamed!

1 cup of grapes

They are loaded with water which means a whole cup only has 62 calories. The water keeps you feeling full and hydrated

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

Why it is Beneficial for Your Children to Visit the Doctor Every Year by Lynn Stanton, MD

 

Dr.-Stanton-224x300It is good for children to become comfortable and familiar with the medical environment. They won’t be children forever.  Eventually, as children grow older, they may need to discuss something with the doctor that can’t be discussed with their parents.  Children and young adults are very uncomfortable about personal matters and distress. This is amplified when dysfunction runs in the family unit.  If children have a solid foundation built from good face-to-face experiences with the doctor during yearly visits, ultimately they will be more comfortable in a medical setting which will be beneficial long-term.

 

 

 

 

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
 

 

 

closeup of pink high heels

The Hidden Health Hazards of Fashion by Your Marque Team

Fashionistas take note! Trendy skin-tight jeans, platform shoes and even jewelry can sometimes be prelude to oncoming health hazards.  Even the battle to button up pants or knot neckties too tightly might unknowingly cause nerve damage, digestive issues or potential blood clots.

We've heard doctors warn that spike-heeled pointy pumps and boots lead to sprains and strains, disfigured toes and arthritis.  Yet with these warnings, it fails to stop many women from taking their chances with styles that could leave them sprawled on a sidewalk.  Blame fashion magazines and celebrity style if we must.  It makes us look good, but is it truly worth the pain?

Combine a hot style trend and a possible health hazard and what do you get?  The answer could be a chance of having any of the following:

  • High Platform Heels, Wedges or Pumps = bunyons, calluses or orthopedic injury

  • Tight Pants or Skirts = Lipoatrophia Semicirularis- a persistent pressure from too-tight material that impairs circulation, especially for those who sit for a long period of time.

  • Tight Skinny Jeans = Meralgia Paresthetica- a condition where nerves running from the pelvis into the outer thigh are affected by tight restriction and can cause tingling, weakness and possible blood clots.

  • Tights, Panty Hose or Spanx = pelvic pain, yeast infections or itching and irritation

  • Tight Neckties and Button Shirts = may restrict blood flow through in the neck and cause musculoskeletal injuries.

  • Waist Cinching or Empire Belts = can compress delicate nerves in the abdomen or constrain breathing and deprive heart and brain of needed oxygen.

  • Large Looped Earrings or Long Necklaces = too much weight that pulls on neck muscles can cause repetitive pain. Ear lobes can be torn accidentally if caught on clothing material.


But wait… let’s stop and think for a moment… Who hasn't tried to squeeze into a too-small pair of shoes, or wiggle into too-tight jeans? We do it all for the sake of fashion, however, being aware of its extremities is important too. Let’s think that comfortable is what can be healthy.  We can try to remember loose and light fitting with less restriction on clothing is always wise.  We should also remember too small or too tight, doesn’t always make us look our best. With all this in mind, it's enough to make you think the ancient Romans in their togas had it right the first time, but that may not be the fashion trend any time soon.

 

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.

Healthy Eating by Eryn Shelton

Are you trying to lose weight?  I have found that eating 5 small meals a day and replacing carbs with protein and vegetables to be most effective.  Additionally, substitute the chips with some fruits or alternative healthy snacks.  Drinking water instead of soda is a big factor when trying to get rid of the HARD to lose last couple pounds.  I also recommend switching from regular pasta to whole wheat pasta or even brown rice.  The better food choices you make the more beneficial it will to be to your long term health.

It is also important to help your children make better food choices.  Healthy food can be YUMMY!  Kids love sugar and salty treats, but what they don’t know is how bad junk food is for them.  I suggest introducing small amounts of healthy alternative snacks such as veggies with a dip or fruit with yogurt or whipped cream.  Organic juices or flavored water are great replacements for soda.  If you start introducing healthy options it will not only benefit their health but they will no longer be finicky when it comes to trying new foods!

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.
 

 

 

Helpful Health Tips by Magda Austin

We all have asprin in our medicine cabinet.  Not only is it used as a pain and inflammation reliever, but it also prevents blood clot formation.  Many people will take a low dose of aspirin on a daily basis to prevent a heart attack or stroke.  Aspirin therapy is especially beneficial for patients with certain risks factors like diabetes, high cholesterol, smoking, or elevated blood pressure. However, taking aspirin is contraindicated for patients with stomach ulcers, asthma, gout, and patients who are on other type of anticoagulant therapy. Never use aspirin for children under 12 years old to treat fever or viral infection because it can cause very serious brain swelling and liver damage known as Reye’s Syndrome.

Did you know that there are different ways to position the ear lobe while administering ear drops to adults versus children?  When you are going to administer drops to an adult you need to pull down and back on the ear lobe. As when you are administering ear drops to a child you would want to gently pull the ear lobe up and back. These tips will help with the effectiveness of your medication.

Many of us stop taking medications as soon as we start feeling better thinking the drug did its job and we are cured. However, we should always finish the entire course of antibiotics, or other prescribed treatment. We should not save pills for “next time”, nor share them with other people who potentially may need them.  As we stop taking medicine sooner than suggested by our physician, we are susceptible for infection relapse or secondary infections which often are more difficult to treat and the whole process of “getting better” is much longer than expected.

The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.