What is Occupational Medicine?

Occupational Medicine 

"Occupational Health aims for the promotion and maintenance of the highest degree of physical, mental and social well being of workers in all occupations; the prevention among workers of departures from health caused by their working conditions; the protection of workers in their employment from risks resulting from factors adverse to health; placing and maintenance of a worker in an occupational environment adapted to his physiological and psychological equipment and, to summarize, the adaption of work to people and of each person to their job."

http://en.wikipedia.org/wiki/occupational_medicine

In today's working environment, many medical issues influence both employers and employees.  Occupational medicine looks at both treatment and prevention of workplace illness and injuries.  

Occupational Medicine took its current form after The Occupational Safety and Health act in 1970.  The Occupational Safety and Health Administration oversees legislation and enforces standards of workplace safety and Health.  

Employers now take a proactive approach in prevention of illness and injury with seminars and training programs, proper protective equipment, inspections, and record keeping.  

Medical Professionals who work in Occupational medicine treat workplace injuries, and perform fit for duty physical exams, as well as perform site visits to the workplace, and work hand in hand with employers on developing safety protocols.

At MD Care we are developing an occupational medicine program, and are happy to work with any businesses large or small to meet your specific needs.  From Employee physicals, drug screens, to work related injuries, come to us for your comprehensive occupational medicine program.

Common Summer Ailments Part #6 (Food Poisoning)

Family, food and fun are all ingredients for the ideal summer. Amidst all the fun, it is important to be mindful of dangers such as; food poisoning which can occur when food is improperly prepared. A great defense from illness is thorough hand-washing. The symptoms of food poisoning include nausea, vomiting, and diarrhea.

Prevention

The United States Department of Agriculture (USDA) recommends the following four simple steps to ensure food safety:

1. Clean – Wash your hands and any food preparation surfaces often with warm, soapy water, particularly after handling raw food and going to the restroom.

2. Separate – Pack raw food in a separate cooler from any ready-to-eat food items. Always rewash plates, cutting boards, and utensils that have touched raw food before using them again for cooked food.

3. Cook – Cook food at temperatures high enough to kill harmful bacteria. Poultry should be cooked until an internal temperature of at least 165ºF is reached. Ground beef hamburgers should be cooked until an internal temperature of at least 160ºF is reached.

4. Chill – Keep perishable items at below 40ºF by using ice cubes and ice packs. Leftovers should be put in a cooler as quickly as possible. Foods that should be kept cold are considered unsafe when left at 90ºF for more than one hour.

What to do if you do get food poisoning

Short episodes of vomiting and small amounts of diarrhea lasting less than 24 hours can usually be cared for at home.

• Do not eat solid food while nauseous or vomiting but drink plenty of fluids.
  
  • Small, frequent sips of clear liquids (those you can see through) are the best way to stay hydrated.
    
  • Avoid alcoholic, caffeinated, or sugary drinks. Over-the-counter rehydration products made for children such as Pedialyte and Rehydralyte are expensive but good to use if available.
    
  • Sports drinks such as Gatorade and Powerade are fine for adults if they are diluted with water because at full strength they contain too much sugar, which can worsen diarrhea.
    
  • Home remedies for nausea or diarrhea such as tea with lemon and ginger can be used for relief from symptoms. There are no proven herbal food poisoning cures. Consult a health care practitioner before taking any natural food poisoning remedies.
  
  
• After successfully tolerating fluids, eating should begin slowly, when nausea and vomiting have stopped. Plain foods that are easy on the stomach should be started in small amounts. Initially consider eating rice, wheat, breads, potatoes, low-sugar cereals, lean meats, and chicken (not fried). Milk can be given safely, although some people may experience additional stomach upset due to lactose intolerance.
  
• Most food poisonings do not require the use of over-the-counter medicines to stop diarrhea, but they are generally safe if used as directed. It is not recommended that these medications be given to children. If there is a question or concern, always check with a doctor.

When to Seek Medical Care

Contact your doctor if any of the following situations occur:

• Nausea, vomiting, or diarrhea lasts for more than two days.
  
• The ill person is a child younger than three years of age.
  
• The abdominal symptoms are associated with a low-grade fever.
  
• Symptoms begin after recent foreign travel.
  
• Other family members or friends who ate the same thing are also sick.
  
• The ill person cannot keep any liquids down.
  
• The ill person does not improve within two days even though they are drinking large amounts of fluids.
  
• The ill person has a disease or illness that weakens their immune system (for example, HIV/AIDS, cancer and undergoing chemotherapy, kidney disease).
  
• The ill person cannot take their normal prescribed medications because of vomiting.
  
• The ill person has any nervous system symptoms such as slurred speech, muscle weakness, double vision, or difficulty swallowing.
  
• The ill person is pregnant.

Go to the nearest hospital's emergency department if any of the following situations occur:

• The ill person passes out or collapse, become dizzy, lightheaded, or have problems with vision.
  
• A fever higher than 101 F (38.3 C) occurs with the abdominal symptoms.
  
• Sharp or cramping pains do not go away after 10-15 minutes.
  
• The ill person's stomach or abdomen swells.
  
• The skin and/or eyes turn yellow.
  
• The ill person is vomiting blood or having bloody bowel movements.
  
• The ill person stops urinating, have decreased urination, or have urine that is dark in color.
  
• The ill person develops problems with breathing, speaking, or swallowing.
  
• One or more joints swell or a rash breaks out on the ill person's skin.
  
• The ill person or caretaker considers the situation to be an emergency.

If you think you may have food poisoning:

Come to MD Care

400 Westfield Ave. Elizabeth, NJ

(908) 691-3800

Common Summer Ailments Part #5 (Prickly-heat rash)

Heat rash is the generic group name for a number of skin problems that arise or worsen because of heat exposure or overheating. Common names for heat rash include prickly heat or miliaria. Other heat rashes include heat urticaria (hives) and sweat retention. Heat rash is most common in the summer months and particularly in humid climates. The condition usually is self-limited and resolves in hours to a few days without treatment. Rarely, it may be more severe requiring professional medical care.

Heat Rash Types (Miliaria)

Miliaria is the medical term for the heat related skin condition where tiny, pinpoint, pink to clear bumps form over a body area like the face or neck. It is caused when small sweat particles are trapped in the skin. This trapping of sweat may cause inflammation and itching around the sweat pores. Miliaria is very common in infants but may also occur in adults. This condition occurs especially after repeated episodes of sweating in a hot, humid environment. Miliaria may look like small clear blisters or like gooseflesh.

There are four types of miliaria:

1. clear (miliaria crystalline),
   
2. white/yellow (miliaria pustulosa),
   
3. red (miliaria rubra),
   
4. deep (miliaria profunda).

Heat Rash Risks

Anyone can develop heat rash especially when in the certain environments. Some individuals are more prone to heat rash including:

• Babies (infants)
  
• Children under age 4
  
• Athletes or people who exercise in hot environments
  
• Obese or overweight persons
  
• Bedridden and non-ambulatory patients
  
• Individuals with congenital absence or decreased sweating
  
• Military troops

Heat Rash Symptoms

Heat rash usually appears as very small pinpoint bumps at the entrances to small hair follicles. In some areas, there may be red or pink patches of skin. More advanced heat rash may have greater degrees of irritation and large welts, hives, and raised red bumps. Some people with heat rash are very itchy while others may have no irritating symptoms.

Any body part may be affected. Characteristic heat rash areas include:

• the face,
  
• neck,
  
• back,
  
• abdomen,
  
• groin,
  
• under the breasts,
  
• elbow folds, and
  
• buttocks.

Self-Care at Home

Most heat rash resolves without treatment, often within a day after changing to a cooler environment. The following self-care steps and remedies may help with heat rash.

First step: The first step in treating heat rash is to wash the affected area with a gentle soap (for example, Dove non-soap cleanser or something similar).
Next, rinse the area with water and gently pat dry with a towel. Washing several times a day and especially after exercise, prolonged walking, or heat exposure is recommended.

• Remain in a cool environment and allow for adequate ventilation of the skin.
  
• Take cool showers or baths
  
• Rest in an air-conditioned room at 70-72 F (21-22 C) is therapeutic. If no air conditioning is available at home, safe retreats include indoor shopping malls, grocery stores, movie theaters, hotel lobbies, ice skating rinks, bowling alleys, etc.
  
• Avoid skin-to-skin contact by placing a clean cotton washcloth or material between skin folds like under the breasts or abdomen.
  
• Apply direct applications of packs of frozen peas or cool packs over the affected areas (do not leave packs on longer than 20 minutes per hour).
  
• Mild cortisone creams like hydrocortisone (Cortaid) or prescription cortisone creams like triamcinolone may be helpful for resistant rashes or resultingeczema.
  
• Oral or topical antibiotics may be prescribed as needed for bacterial infections.
  
• Oral antihistamines, such as diphenhydramine (Benadryl) or loratadine(Claritin), can help decrease itching.

Clothing and Heat Rash

Getting naked may keep the body cooler but it does not avoid the problem of sweat buildup especially under the breasts, abdomen fold, between buttock folds, and places where skin overhangs. It may be best to wear light, cotton, absorbent fabrics that separate out skin fold areas. Individuals who do not wear underwear usually notice more retained sweat and therefore more irritation in areas between the buttocks and groin. Short sleeves tops and shorts are often helpful.

Drinking Water

• Drinking water is always helpful for overall hydration and body temperature regulation.
  
• Water can help maintain cooler body temperatures.
  
• Dehydration may lead to weakness and generalized malaise.

If the rash is not getting better or going away with home treatment above or becomes worse after several days, the patient should see a physician to be sure there is not a bacterial infection or other cause for the rash.

Seek medical care immediately if the patient has:

• fever,
  
• headaches,
  
• nausea,
  
• dizziness, or
  
• vomiting

http://www.emedicinehealth.com/heat_rash/article_em.htm

If your heat rash isn't getting better, come to

MD Care

400 Westfield Ave Elizabeth, NJ

(908) 691-3800

Common Summer Ailments Part #4 (Insect Bites)

Insects do not usually attack unless they are provoked. Most bites and stings are defensive. The insects are usually protecting their hives or nests.

A sting or bite injects venom composed of proteins and other substances that may trigger an allergic reaction in the victim. The sting also causes redness and swelling at the site of the sting.

• Bees, wasps, hornets, yellow jackets, and fire ants are members of the Hymenoptera family. Bites or stings from these species may cause serious reactions in people who are allergic to them.
  
  • When a bee stings, it loses the entire injection apparatus (stinger) and actually dies in the process. A wasp can inflict multiple stings because it does not lose its injection apparatus after it stings.
    
  • Fire ants inject their venom by using their mandibles (the biting parts of their jaw) and rotating their bodies. They may inject venom many times.
•  Bites from mosquitoes typically do not cause significant illnesses, unless they convey "vectors," or microorganisms that actually live within these mosquitoes. For instance, malaria is caused by an organism that spends part of its life cycle in a particular species of mosquitoes. West Nile virus is another disease spread by a mosquito.
  
• Other types of insects, bites, and diseases 
• Various mosquitoes spread viral diseases (such as equine encephalitis;dengue and yellow fever in humans and other animals).
  
• Ticks can transmit Lyme disease and other illnesses through their bites or stings.
  
• Other insects such as chiggers and mites typically cause self-limited localized itchiness and swelling.
  
• Serious bites from spiders, which are not insects, can be from the black widow or brown recluse.

The response to a sting or bite from insects is variable and depends on a variety of factors. Most bites and stings result in pain, swelling, redness, and itching.

When to Seek Medical Care

If you start to experience symptoms that are not just at the site of the bite or sting (and you don't have a history of severe reactions), seek medical attention. These symptoms (systemic symptoms affect the whole body) may progress to fatal anaphylactic shock.

Hives are the most common systemic symptom. They appear as irregular, raised, red blotchy areas on the skin and are very itchy. If hives are the only systemic symptom present, they are often treated at home with an antihistamine.

If the bite appears infected (redness with or without pus, warmth, fever, or a red streak that spreads toward the body), see a doctor.

If you don't know what bit you, it is important to keep watching the area closely to be sure it does not become infected. Call your doctor if there is an open wound, which may suggest a poisonous spider bite.

People who have a history of severe reactions should go to the nearest hospital's emergency department after a bite or sting if they experience any symptoms. Those who have no history of severe reactions should also go to the emergency department if they have any of the following symptoms:

• Wheezing
  
• Shortness of breath
  
• Chest tightness or pain
  
• Sensation of the throat closing or difficulty speaking or swallowing
  
• Faintness or weakness
  

A sting on the tongue may cause throat swelling and death because of airway obstruction.

Stings from large hornets or multiple (hundreds or thousands) bee stings have been rarely reported to cause muscle breakdown and kidney failure.

Bites from a fire ant typically produce a pustule, or a pimple-like sore, that is extremely itchy and painful.

Self-Care at Home

Treatment depends on the type of reaction. If there is only redness and pain at the site of the bite, application of ice is adequate treatment. Clean the area with soap and water to remove contaminated particles left behind by some insects (such as mosquitoes). These particles may further contaminate the wound if not removed. Refrain from scratching because this may cause the skin to break down and an infection to form.

You may treat itching at the site of the bite with an over-the-counter antihistamine such as diphenhydramine (Benadryl) in cream or pill form. Calamine lotion also helps relieve the itching.

People who have a history of severe reactions to bites or stings may have been prescribed an anaphylaxis kit. The kit contains an epinephrine injector (you give yourself an injection), tourniquet, and an antihistamine. The kit should be used according to the doctor's instructions.

http://www.emedicinehealth.com/insect_bites/page6_em.htm

If you believe that you need Medical Care for your insect bite, Come to

 MD Care 

400 Westfield Ave Elizabeth, NJ

(908) 691-3800

Common summer Ailments Part #3 (Poison Ivy)

Poison Ivy


We have all heard of the nasty stuff, but what can you do to prevent it, and treat it?


The first step is learning to identify what Poison Ivy looks like, so you can avoid it.
The following link is a great resource, since poison Ivy takes on many different appearances, it can be a bit tricky: 
 http://www.poison-ivy.org/index.htm
The old addage "leaves of three" does ring true.  So learn its appearance and avoid it!


If you are looking to do some yard work in an area that possible has Poison Ivy, cover up, from head to toe.  This means long sleeves, gloves, hat, long pants, and socks or boots pulled over your pants.  If you are going to be attempting to cut or remove the Poison Ivy in any way, also wear a face mask.


If your think you have been exposed, before the rash starts, immediately wash yourself in a COLD shower, to try and remove the oil before it soaks in.  Wipe down all of your shoes with Alcohol, wash all of your clothes twice in hot water.


Some OTC washes exist to try and stop the oil from binding to your skin; there isn't one magic cure, but it can't hurt!  Some also say to wash with "brown laundry soap," the brand name is Fels Naptha.


Remember that pets cannot have a reaction from Poison Ivy, but they can carry the oil on their skin or fur.  So if they have been in areas with Poison Ivy, you should cover up, and bathe them immediately, as to not spread the oil around your home.


The rash that appears is typically linear, or in patches.  It is red with small vescicles(blisters).


If the rash does appear, the treatment focuses on the reduction of symptoms(itching) and letting time pass for it to resolve on its own.  Some self-treatment methods are baths or showers, antihistamines,  Calamine lotion, or OTC Hydrocortisone cream.


Any of the following should prompt you to seek medical care:


-Rash covering large areas of your body


-Rash involving your face, particularly your eyes or mouth


-Swelling of eyes or mouth


-Shortness of breath, chest pain, or burning in chest


-Rash is persistent despite over the counter remedies




  If you need medical Care for your Poison Ivy, come to:

MD Care Urgent Medical Center

400 Westfield Avenue

Elizabeth, NJ

(908) 691-3800

Common Summer Ailments Part #2 (Swimmer's ear)

Otitis Externa (Swimmer's ear)


Otitis externa is a bacterial or fungal infection of the outer ear canal (from the eardrum to the outside of the ear).

It is typically caused by water remaining in the ear after swimming or bathing, or from swimming in dirty water.  Some people can introduce bacteria into their ear by cleaning it to vigorously with a Q-tip.

Often you experience itching or burning in the ear, then pain, decreased hearing, difficulty laying that ear on your pillow, and sometimes drainage of pus from the ear canal.

The best way to avoid swimmers ear, is to gently blot the ear with a tissue or cotton ball after swimming. People who are prone to frequent ear infections should wear ear plugs while swimming.

Some home care remedies in the early stages of infection include:
    -sleeping with your head raised
    -Ibuprofen or Naproxen for pain and swelling
    -Making a small bottle of equal parts white vinegar and rubbing alcohol. Put 3 or 4 drops into the affected ear while lying down; keep that ear pointed up.  You should repeat this on the other side, even if it is not infected.  Do this three times per day.

If your symptoms have not improved after 3 days of home care, or you start to experience the following, you should seek medical care:
    -Temperature over 101 degrees
    -pus draining from the ear
    -swelling or pain on the outside of the ear, down your neck, onto your face, or along your jaw
  
If you live in the Union County, NJ area, and need to be treated for your Swimmer's ear, come down to MD Care, No appointment needed.

MD Care Urgent Medical center

400 Westfield Avenue 

Elizabeth, NJ 

(908) 691-3800

Common Summer Ailments Part #1 (Sunburn)

Sunburn


-Sunburn results from too much sun or sun-equivalent exposure. Almost everyone has been sunburned or will become sunburned at some time.
-Sunburn is literally a burn on your skin. It is a burn from ultraviolet (UV)radiation. The consequence of this burn is inflammation of the skin. Injury can start within 30 minutes of exposure.
-Certain light-skinned and fair-haired people are at greater risk of sunburn injury.
-Mild and uncomplicated cases of sunburn usually result in minor skin redness and irritation
-Initially, your skin turns red about 2-6 hours after exposure and feels irritated. The peak effects are noted at 12-24 hours.
-More severe cases (sun poisoning), are complicated by severe skin burning and blistering, massive fluid loss (dehydration),electrolyte imbalance, and infection.


-When to seek medical treatment:
     -Severe pain
     -Severe blistering 
     -Headache 
     -Confusion 
     -Nausea or vomiting 
     -Fainting 


-Self Care at home:
     -Medications such as aspirin, ibuprofen, and naproxen are useful, especially when started early. 


     -For mild sunburn, cool compresses with equal parts of milk and water may suffice. You may also use cold   
     compresses with Burow solution. You can buy this at a drugstore. Dissolve 1 packet in 1 pint of water. Soak 
     gauze or a soft clean cloth in it. Gently wring out the cloth and apply to the sunburned area for 15-20 minutes.
      Change or refresh the cloth and solution every 2-3 hours. 


     -over the counter Aloe is soothing


     -Cool (not ice cold) baths may help. Avoid bath salts, oils, and perfumes because these may produce    
     sensitivity reactions. Avoid scrubbing the skin or shaving the skin. Use soft towels to gently dry yourself.
      Don't rub. Use a light, fragrance-free skin moisturizer. 


     -Avoid lotions that contain topical anesthetic medications because you can become sensitized and then 
     allergic to that medicine. 


     -Obviously, stay out of the sun while you are sunburned.


-Prevention

  

     The best prevention is to avoid the sun. This is often not practical or desired many times. 

     -Other, more practical strategies include wearing wide-brimmed hats, long-sleeved shirts, and long pants. 

     -If this is not possible, a variety of sun-blocking agents are available for use. Some are just for the lips and face. Others are for more general-purpose use. Pay attention to the sun protection factor (SPF) and whether or not PABA is in the product. PABA should be avoided in children younger than 6 months because it can cause skin irritation.

     -The higher the SPF number, the more protection the sun-blocking agent may have. SPF is actually a ratio of the time it takes to produce a skin reaction on protected and unprotected skin. Thus, a 30 SPF sunscreen would in theory allow you to be exposed 30 times longer than with no sunscreen.However, this is usually not true in practice. 

     -People seldom apply enough sunscreen or rarely reapply it. Sunscreen should be applied in generous amounts in layers and reapplied after being exposed. Activities such as sweating and swimming degrade its effectiveness. Sunscreens are not waterproof. The US Food and Drug Administration is banning what it calls misleading labeling on sunscreens. The use of the words sunblock, waterproof, and all day protection will no longer be used

     -Certain drugs can sensitize the skin to radiation injury. If you take them, avoid the sun. Your doctor or           pharmacist can further advise you about your medications and sun sensitivity. 

     -Mind-altering drugs (including alcohol) can diminish your awareness of getting sunburned and should be avoided. 

     -Short and sequential exposure times can lead to skin pigment changes, which most of us call tanning. This can lead to increased sun tolerance but can also lead to long-term problems such as skin cancer. Getting a tan is often a primary reason people go out in the sun with maximum skin exposed in the first place.

     - Sunburn is most common in children and younger adults. 

     -Avoid tanning beds entirely. Most tanning parlors make safety claims that the US Food and Drug Administration
considers false.

Please watch this amazing video on Melanoma, truly touching!  http://www.thatvideosite.com/video/dear_16yearold_me

www.emedicinehealth.com

Come to MD Care at 400 Westfield Avenue Elizabeth, NJ for all of your summer ailments... and more!

(908)691-3800

Insomnia

An Overview of Insomnia

Insomnia is  characterized by difficulty falling and/or staying asleep. You may have:

• Difficulty falling asleep
• Waking up often during the night and having trouble going back to sleep
• Waking up too early in the morning
• Feeling tired upon waking

Types of Insomnia

• Primary insomnia: Primary insomnia means that a person is having sleep problems that are not directly associated with any other health condition or problem.
• Secondary insomnia: Secondary insomnia means that a person is having sleep problems because of something else, such as a health condition (like asthma,depression, arthritis, cancer, or heartburn); pain; medication they are taking; or a substance they are using (like alcohol).
• 
  

Acute vs. Chronic Insomnia

Insomnia also varies in how long it lasts and how often it occurs. It can be short-term (acute insomnia) or can last a long time (chronic insomnia).

Causes of Insomnia

Causes of acute insomnia can include:

• Significant life stress (job loss or change, death of a loved one, divorce, moving).
• Illness.
• Emotional or physical discomfort.
• Environmental factors like noise, light, or extreme temperatures (hot or cold) that interfere with sleep.
• Some medications (for example those used to treat colds, allergies, depression,high blood pressure, and asthma) may interfere with sleep.
• Interferences in normal sleep schedule (jet lag or switching from a day to night shift, for example).

Causes of chronic insomnia include:

• Depression and/or anxiety.
• Chronic stress.
• Pain or discomfort at night.
• 
  

Symptoms of Insomnia

Symptoms of insomnia can include:

• Sleepiness during the day.
• General tiredness.
• Irritability.
• Problems with concentration or memory.

Diagnosing Insomnia

If you think you have insomnia, talk to your health care provider. An evaluation may include a physical exam, a medical history, and a sleep history. You may be asked to keep a sleep diary for a week or two, keeping track of your sleep patterns and how you feel during the day. Your health care provider may want to interview your bed partner about the quantity and quality of your sleep. In some cases, you may be referred to a sleep center for special tests.

Treatment for Insomnia

Acute insomnia may not require treatment. Mild insomnia often can be prevented or cured by practicing good sleep habits

Good sleep habits, also called sleep hygiene, can help you get a good night's sleep and beat insomnia. Here are some tips:

• Try to go to sleep at the same time each night and get up at the same time each morning. Try not to take naps during the day.
• Avoid caffeine, nicotine, and alcohol late in the day. 
• Get regular exercise. Try not to exercise close to bedtime because it may stimulate you and make it hard to fall asleep. 
• Don't eat a heavy meal late in the day. A light snack before bedtime, however, may help you sleep.
• Make your bedroom comfortable. Be sure that it is dark, quiet, and not too warm or too cold.
• Follow a routine to help you relax before sleep. Read a book, listen to music, or take a bath.
• Avoid using your bed for anything other than sleep or sex.
• If you can't fall asleep and don't feel drowsy, get up and read or do something that is not overly stimulating until you feel sleepy.
• If you find yourself lying awake worrying about things, try making a to-do list before you go to bed. This may help you to not focus on those worries overnight.

 If your insomnia makes it hard for you to function during the day because you are sleepy and tired, your health care provider may prescribe sleeping pills for a limited time. 

Use of over the counter melatonin is thought to help correct sleep/wake cycles

Treatment for chronic insomnia includes first treating any underlying conditions or health problems that are causing the insomnia. If insomnia continues, your health care provider may suggest behavioral therapy. Behavioral approaches help you to change behaviors that may worsen insomnia and to learn new behaviors to promote sleep. Techniques such as relaxation exercises, sleep restriction therapy, and reconditioning may be useful.

http://www.webmd.com/sleep-disorders/guide/insomnia-symptoms-and-causes

If good sleep habits aren't helping your insomnia, come down to

MD Care

400 Westfield Ave

Elizabeth, NJ

(908) 691-3800