Sisselman Medical Group Health & Medical Blog

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September 17, 2021

By Sisselman Medical Group 0 Comments Uncategorized Hormones, Low T, Testosterone, Testosterone Therapy

Men, Here are 10 Signs and Signals You May Have Low Testosterone

Testosterone is the primary male sex hormone in charge of regulating fertility, producing red blood cells, and distributing fat. The hormone is produced by the testicles and influences various processes in the body, including sperm production, sex drive, and sexual development.

Although women produce low levels of testosterone, low levels in men can result in reduced bone mass, erectile dysfunction, and weakened sex drive. According to the Food and Drug Administration, a normal range for testosterone is generally 300 to 1,000 nanograms per deciliter (ng/dL). Only a doctor can provide a low T diagnosis. Physicians typically diagnose low T when levels of the hormone drop below 300 ng/dL, but often men are alerted by the subtle, but sometimes dramatic effects of low testosterone.

1. Erectile Dysfunction

One of testosterone’s functions is to stimulate the sex drive in males. The hormone incites penile tissue to generate nitric oxide, which is the molecule responsible for activating the reactions that cause erections. Low testosterone can impact a man’s ability to have an erection before engaging in sex, as well as may cause spontaneous erections to occur.

Research regarding the efficacy of testosterone replacement therapy (TRT) as a treatment for erectile dysfunction is inconclusive. However, the hormone is not the only factor that contributes to erectile issues. Other health problems, such as high blood pressure, depression, and diabetes may also contribute to erectile dysfunction.

2. Reduced Semen Production

Testosterone is also in charge of stimulating semen production. Semen is the fluid responsible for guiding sperm cells to eggs. Low semen production can suggest low testosterone and, if left untreated, can cause fertility issues.

3. Low Sex Drive

Men with low-T may often experience a reduced sex drive. Testosterone is a critical component of the male libido. Although a reduced sex drive is a symptom that commonly occurs with age, a drastic drop in the desire to have sex is common for individuals with low T.

4. Increased Body Fat

Someone with low-T may also experience an increase in body fat. Gynecomastia, a condition that causes large breasts to develop, is a particular sign that a man may have low testosterone. An imbalance of testosterone and estrogen is theorized as the cause of the condition.

5. Decreased Muscle Mass

Testosterone is partially responsible for building muscle. Therefore, someone with low T may experience substantially reduced muscle mass. Although the hormone affects muscle mass, research suggests that it does not impact muscle strength or function.

6. Reduced Testicle Size

Low levels of testosterone can help cause smaller testicles. The body needs testosterone for the development of both the penis and testicles. Low-T levels could, therefore, add to excessively small-sized penis or testicles compared to someone with normal levels. Low-T may also cause the scrotum to feel softer than normal.

7. Reduced Bone Mass

Osteoporosis is a condition in which bone mass progressively becomes thinner. Although osteoporosis is usually connected to women, men with low T are susceptible to developing the condition as well. Individuals with osteoporosis are at an increased risk of breaking or fracturing bones.

8. Hair Loss

Hair loss is commonly experienced by men and women as a natural part of the aging process. Testosterone contributes to hair production, so a loss of facial or body hair could be a sign of low T.

Researchers from a study conducted in 2012 found that TRT supported some hair regrowth in women who were also receiving treatment for sex hormone deficiencies.

9. Fatigue

Having low testosterone may severely impact energy levels, resulting in persistent fatigue. Men with low T report feeling extremely tired – despite having a full night’s sleep – as well as having trouble becoming motivated to exercise.

10. Mood Swings

Testosterone contributes to several physical body processes, including the processes that affect mood and mental capability. Research has found a link between men with low T and mood changes, such as depression, inability to focus, and irritability.

When to See a Doctor

Symptoms of low testosterone are often subtle, and some only learn about the condition after routine exams. However, experts suggest that individuals who experience one or more of these symptoms should seek help from a doctor. More and more men are taking advantage of online support groups, as well as specialized hormone therapy clinics.

A doctor typically completes a physical examination to evaluate symptoms and may order additional testing to confirm whether any treatment is needed.

Treatment

Testosterone replacement therapy (TRT) is the most common treatment for low T. After confirming the diagnosis, physicians generally write TRT prescriptions when an individual has multiple symptoms, and blood test results indicate that there is a hormone deficiency.

Prescriptions can be written for several different delivery methods, including:

Dissolvable tablets
Injections
Skin patches
Surgical implants
Gels

Injections are one of the more commonly prescribed forms of TRT and are typically administered by a doctor. They require fewer doses than other prescription methods. Regardless of the delivery method used, symptoms typically begin to disappear within 4 to 6 weeks of beginning therapy.

Some over the counter treatments include natural supplements that can help raise hormone levels. These supplements work by targeting specific processes to increase testosterone or preventing the hormone from converting into estrogen. Some of the best over the counter supplements include vitamin D, Fenugreek, and ginger. However, it’s important to be aware of common supplements that have a negative impact on men.

Takeaway

Low T commonly occurs in men, especially as they age. When hormone levels drop too much, undesired symptoms can occur. Many treatments are available, but a physician needs to confirm a diagnosis before a treatment can be prescribed. It is important to be aware of any other underlying conditions that may contribute to the symptoms that an individual is experiencing. Identifying all causes of low T is crucial in effectively treating unwarranted symptoms.

Each person is unique and therefore they will respond to treatment differently. Routine lab tests every 6 to 12 months are important in ensuring that hormone levels do not only return to normal but also stay normal. Checkups help evaluate symptoms, identify root causes for those symptoms, and draft treatment plans to address those symptoms.

March 31, 2020

By Sisselman Medical Group 0 Comments Sisselman News

Telehealth Updates for Sisselman Medical Group

We hope you’ve all been well and staying safe. We have done over 300 Telehealth visits in the past two weeks and our patients love the convenience and flexibility of having an office visit from their own home.

Telehealth visits are great for medication refills, quick check-ins and if you are sick and staying home. Lots of people have questions about the COVID-19 Coronavirus outbreak and this is a good way to help answer these concerns.

To schedule a Telehealth visit, call the office during normal business hours and our staff will set it up for you. After hours, you can reach Dr. Stephen Sisselman at doxy.me/drss from any internet device with camera and microphone such as computer, laptop or smartphone.

Of course if you’d rather come into the office for a visit and/or bloodwork, we are open daily as well. We are only seeing well patients for routine care. Our staff is taking various measures including disinfecting in between each patient to ensure your safety. Anyone with symptoms of COVID-19 we remind you to say home and utilize our new Telehealth option. This, of course is for the safety of our staff, providers and the community. Please call to schedule your appointment or if you have any questions regarding the safety measures we are taking for each patient.

Be well and stay safe!,
Sisselman Medical Group

March 17, 2020

By Sisselman Medical Group 0 Comments Health Allergies, Allergy Season

How Long Islanders Can Skip the Allergies This Spring

Every spring, people take in the beauty of blooming trees and flowers. Unfortunately, the scene is not nearly as ideal for the millions of individuals suffering from seasonal allergies. This is a time for annoying symptoms including runny noses, congestion and sneezing. Numerous people are miserable due to allergic rhinitis and hay fever. There are steps you can take to avoid allergies this year including decreasing the triggers for your allergies. There are some good options below.

• During windy or dry days, remain inside. Wait until after a good rain to spend time outside because the rain removes a lot of pollen from the air.

• If you are performing chores outside, wear a pollen mask.

• Check with a local radio or television station, the internet or a local newspaper to determine both current and future pollen levels.

• Hire a professional or have a friend or family member take care of any gardening tasks triggering your allergies such as pulling weeds.

• Do not hang your laundry outdoors because your towels and sheets will attract pollen.

• When the local forecast predicts high pollen counts, use your allergy medication prior to seeing any symptoms.

• Take off the clothes you wore while outside, then take a shower to remove the pollen from your hair and skin.

• Avoid performing any activities outside during the early morning because the pollen count will be higher.

• Keep your windows and doors closed when pollen counts are the highest such as at night.

• Make certain the air inside your home remains clean.

Eliminating Allergens from Your Home

It is currently impossible to remove 100 percent of all allergens from your home. You can make a difference by using the following suggestions:

• Use high-efficiency filters for the air conditioning and heat in your home. You should also adhere to a consistent maintenance schedule.

• A dehumidifier will ensure the air in your home remains dry.

• Use the air conditioning in both your vehicle and home.

• Use a vacuum cleaner containing a HEPA filter for cleaning your floors.

• Use high-efficiency, portable HEPA filters in your bedroom.

• Ask your physician about the best over-the-counter remedies.

For more suggestions, see here from Mayo Clinic.

Nonprescription Medications

According to the FDA

Since you can’t always stay indoors when pollen counts are high, your health care provider may recommend prescription or over-the-counter (OTC) medications to relieve symptoms. The U.S. Food and Drug Administration (FDA) regulates a number of medications that offer allergy relief.

There are different nonprescription medications available for allergies including the following:

Decongestants: Oral decongestants may offer you temporary relief. You should not use this type of medication for more than a few consecutive days or you may be risking making your congestion worse.

Oral Antihistamines: Antihistamines can offer relief for itching, sneezing, watery eyes and a runny nose.

Nasal Sprays: Nasal sprays can help with the symptoms of your allergies with no serious side effects. Most physicians recommend using a nasal spray prior to the start of your symptoms.

Combination Medications: Certain medications combine a decongestant and an antihistamine.

Rinsing Nasal Passages: One of the most effective, fastest and least expensive options is using a saline solution to rinse your nasal passages. You can flush out allergens and mucus from your nose with a neti pot or squeeze bottle. The water should be sterile, distilled, boiled and cooled. The same type of water should be used for cleaning the device every time it is used.

Alternative Allergy Treatments

You can treat the symptoms of hay fever with alternative treatments. You should consult with your doctor prior to using any alternative treatment option. Although the safety and benefits remain unclear, you may find relief with extracts of spirulina or the shrub butterbur. Certain individuals believe the prevention of allergies and the accompanying symptoms is possible with acupuncture. There is a little evidence showing acupuncture is effective.

If you have not achieved prevention, your best option is to talk with your doctor. Numerous individuals find relief with over-the-counter medications. If nothing seems to be making a difference for your seasonal allergies, there are treatments available. Some physicians recommend treatments for asthma or seasonal allergies such as eliminating specific foods or prescription medications. Your doctor may also recommend blood or skin tests to determine which allergens are triggering your symptoms.

Allergy Tests and Treatments

One option is called allergen immunotherapy or desensitization. This is when you are regularly injected with extremely small amounts of whatever is responsible for your allergies. As time passes, the reaction of your immune system is decreased to reduce your symptoms. Another option is an allergy skin test. Your skin will be exposed to potential allergens to determine if an allergic reaction appears. The combination of the tests and your medical history can help confirm what is causing your symptoms.

Allergen patch tests are diagnostic tests applied to the surface of the skin. Patch tests are used by healthcare providers to determine the specific cause of contact dermatitis, and are manufactured from natural substances or chemicals (such as nickel, rubber, and fragrance mixes) that are known to cause contact dermatitis.

The issue may be something you are touching, the foods you consume, bee venom or something in the air. The results of your tests may help your physician with the development of the best possible treatment plan. Allergy skin tests are frequently used for the diagnosis of allergic conditions including:

• Dermatitis
• Penicillin allergy
• Hay fever
• Bee venom allergy
• Food allergies
• Allergic asthma
• Latex allergy

Allergy skin tests are usually dependable for diagnosing allergies resulting from airborne substances including dust mites, pet dander and pollen. Sometimes, food allergies can be diagnosed as well. In some cases, additional procedures or tests are necessary due to the complexities of food allergies. Prior to offering a recommendation for a skin test, your physician will ask about your medical history, symptoms and the treatments you have used.

Your doctor may try to detect the cause of your symptoms through a physical exam. Prior to making an appointment for a skin prick test, you need to provide your physician with a complete list of all over-the-counter medications you are taking. Certain medications can suppress your allergic reactions, others may increase your risk of an allergic reaction while taking your test, and a few can prevent your test from showing an accurate result.

To ensure the medications are out of your system, your physician may ask you to discontinue using them for 10 days before your test. You will most likely have your skin prick test at your doctor’s office. The test is usually administered by the nurse, while the results are interpreted by your doctor. You should allow 20 to 40 minutes for your test. Depending on the test, you may receive your results immediately or you may have to wait a few days.

Patch Test

Patch testing is to determine if your allergic skin irritation is caused by a specific substance. Delayed allergic reactions can be detected. This may require a few days to develop. As opposed to a needle, patch tests apply allergens to patches placed on your skin. During your test, you may be exposed to 20 or 30 substances potentially responsible for your allergies including medications, preservatives, metals, latex, fragrances, hair dyes and resins. The patch remains on your arm for 48 hours.

Histamine

Histamine usually results in a skin response. If you do not have a reaction, an allergy may not be shown by your test even if there is one. Saline and glycerin do not usually cause a reaction. A reaction may indicate sensitive skin. Your tests must be interpreted correctly to eliminate a false diagnosis. If there is an itchy, red, raised bump, your testing has revealed an allergy. The size of your bump is then measured by the nurse.

Puncture or Scratch Test

A puncture or scratch test is often referred to as a skin prick test. The test instantly checks for approximately 40 different substances simultaneously. The test is generally performed to look for allergies to mold, dust mites, pollen, foods and pet dander. The test is usually performed on the forearm for adults. The upper back is generally used for testing children. This test is not painful.

Skin Injection Test

You may receive a test using a needle for the injection of tiny amounts of allergen extracts. The injection is given on your arm. An allergic reaction should appear within 15 minutes. The test may be recommended to check for allergies to penicillin or insect bites.

If you normally suffer from allergies each spring, you can take steps to prevent them this spring. Contact our office today to schedule a consultation and discuss your allergy issues one-on-one with your physician.

March 13, 2020

By Sisselman Medical Group 0 Comments Health Coronavirus, Covid-19

Important Safety Information Regarding Coronavirus Covid-19

Can I be tested for COVID-19?

New York State DOH has expanded the criteria for testing for COVID-19:

An individual has come within proximate contact (same classroom, office, or gatherings) of another person known to be positive; or
An individual has traveled to a country that the CDC has issued a Level 2 or Level 3 Travel Health Notice (China, Japan, South Korea, Italy, Iran), and shows symptoms of illness; or
An individual is quarantined (mandatory or precautionary) and has shown symptoms of COVID-19 illness; or
An individual is symptomatic and has not tested positive for any other infection (swabs negative for influenza, RSV, and negative RVP); or
Other cases where the facts and circumstances warrant as determined by the treating clinician in consultation with state and local department of health officials

How does the virus spread?

This virus was first detected in Wuhan City, Hubei Province, China. The first infections were linked to a live animal market, but the virus is now spreading from person-to-person. It’s important to note that person-to-person spread can happen on a continuum. Some viruses are highly contagious (like measles), while other viruses are less so.

The virus that causes COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in some affected geographic areas. Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected.

How can I help protect myself and my family?

Clean your hands often

Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
Avoid touching your eyes, nose, and mouth with unwashed hands.

Avoid close contact

Avoid close contact with people who are sick
Put distance between yourself and other people if COVID-19 is spreading in your community. This is especially important for people who are at higher risk of getting very sick.
Stay home if you are sick, except to get medical care. Learn what to do if you are sick.

Wear a facemask if you are sick

If you are sick: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room. Learn what to do if you are sick.

If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.

Clean and disinfect

Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.

I need a check-up but I do not want to come into the office because of sick people being there. What can I do?

We offer virtual visits – telehealth – with our healthcare providers where you can communicate live with video – like a facetime call – and receive care and treatment.
To start a virtual visit – call our office for scheduling and more information on how to register.

February 14, 2020

By Sisselman Medical Group 0 Comments Health Coronavirus

Understanding 2019-Novel Coronavirus

Coronaviruses are a large family of viruses that cause respiratory illness ranging in severity from the common cold to severe diseases, such as Severe Acute Respiratory Syndrome (SARS-CoV) and Middle East Respiratory Syndrome (MERS-CoV). Coronaviruses are zoonotic; they can be spread from animals to humans.

The newest strain of coronavirus is being referred to as 2019-novel coronavirus (2019-nCoV) because it had not been seen in humans prior to reports made in December, 2019. The first case of 2019-novel coronavirus was first reported in Wuhan, China. Since then, cases have been reported in other countries, such as the United States. The disease appears to be transmitted from one person to another.

Signs and Symptoms of Coronavirus

According to the Centers for Disease Control and Prevention (CDC), 2019-novel coronavirus can cause an illness that ranges in severity from few or no symptoms to illness that leads to death. Common signs and symptoms of the infection include cough, fever, breathing difficulties, and shortness of breath. Severe acute respiratory syndrome (SARS), pneumonia, kidney failure, and death can occur in severe cases.

What to Do If You are Sick

There are several things you need to do if you feel sick with a cough, fever, and breathing difficulties and have been to China within the past 14 days. First, seek medical attention; call your doctor or nearest emergency room before you go. Tell them about your symptoms and your recent travel history. Do not travel while you’re feeling ill, and avoid contact with other people. When you cough or sneeze, cover your mouth and nose with a tissue or your sleeve. Use soap and water to thoroughly wash your hands immediately after coughing, sneezing, or blowing your nose. If soap and water aren’t available, you can use an alcohol-based hand sanitizer with at least 60% alcohol. Do not share dishes, such as plates, coffee mugs, drinking glasses, or utensils, towels, or bedding with infected people. These items should be washed with soap and water before anyone else uses them.

Are There Reported Coronavirus Cases on Long Island or in New York?

Though a few people have been tested for the virus, there are no confirmed cases of coronavirus on Long Island or in New York at this time.

Types of Human Coronaviruses

According to the CDC, there are seven types of human coronaviruses: SARS-coronavirus, OC43, 229E, MERS-coronavirus, NL63, HKU1, and 2019-novel coronavirus. People are commonly infected with the human coronaviruses 229E, HKU1, NL63, and OC43.

Where Do Coronaviruses Come From?

It’s believed that the human coronaviruses SARS and MERS originated in bats. It’s not yet known where 2019-novel coronavirus originated.

MERS-Coronavirus – What to Know

Middle East Respiratory Syndrome is caused by the MERS-coronavirus. According to the CDC, people affected with MERS develop respiratory symptoms similar to those seen in people infected with 2019-nCoV. Approximately three or four out of every 10 people with a MERS-coronavirus infection die.

MERS was first reported in Saudi Arabia in September 2912. Thus far, all MERS cases have been linked to residency in or travel to countries in and around the Arabian Peninsula. MERS can be spread from one person to another. Those most at risk for contracting the disease are those who have close contact with someone who has MERS, such as those living with or caring for an infected person.

Travel to countries in or around the Arabian Peninsula is not currently prohibited. If you have respiratory symptoms and have traveled to a country in or near the Arabian Peninsula within the past 14 days, seek medical treatment from your physician or emergency room. Call your physician or hospital before you arrive there. You can reduce your risk of contracting the disease by taking basic precautions, such as washing your hands thoroughly after sneezing, coughing, or blowing your nose, keeping unwashed hands away from your face, and not sharing dishes, towels, or bedding with people who are sick.

Take Precautions if Traveling

The CDC has an advisory out regarding traveling to China. The organization recommends that people should avoid all nonessential travel to the People’s Republic of China. The U.S. Department of State has issued a Level 4 Travel Advisory, requesting that people do not travel to China at this time due to 2019-nCoV). These advisories apply only to mainland China and do not apply to Macau, Hong Kong, or the island of Taiwan.

If you must travel to China, there are precautions you can take to protect yourself from respiratory illnesses like 2019-nCoV. Avoid having close contact with people who are ill, and avoid alive and dead animals, products that comes from animals, such as raw meat, and animal markets. Another precaution you can take to protect yourself is to wash your hands thoroughly and often. The CDC recommends washing your hands for 20 seconds with soap and water often, especially before eating, after using the bathroom, and after coughing, sneezing, or blowing your nose. If soap and water aren’t available, you can use an alcohol-based hand sanitizer with an alcohol content of at least 60 percent. Avoid touching your face with unwashed hands.

If you are entering the United States and have been to China in the last 14 days, you’ll be routed to one of 11 U.S. airports where CDC officials will perform a health screening and ask you questions about your health and travel. As a precaution, those who are entering the United States from the mainland of China will be placed under a federal, state, or local quarantine.

Prevention and Treatment

There is currently no vaccine for the prevention of 2019-nCoV. The CDC asserts the best way to protect yourself from the virus is to not come into contact with it.

There are currently no antiviral medications specifically for the treatment of 2019-nCoV. Instead those who are affected with the virus receive supportive treatment to help relieve symptoms. If you believe you have been exposed to coronavirus, you should contact your doctor right away.

The CDC is conducting an ongoing investigation to learn more about 2019-novel coronavirus. The CDC often posts news and updates about 2019-nCoV as the situation is constantly evolving.

January 9, 2020

By Sisselman Medical Group 0 Comments Health Flu, Flu Season, Influenza

Long Island Flu Cases Increasing As Influenza Season Peaks

Hacky cough, runny, congested nose, sore throat, body aches, fever, chills, headache – the flu is misery. It’s not just a cold. It hits hard and fast and knocks you down.

Influenza is also preventable. All you have to do is get a flu shot. You’ll be protecting not only yourself but also your family, your neighbors, your co-workers, everyone you meet. The more vaccinations there are, the fewer flu cases there are. It’s that simple. While the flu shot isn’t guaranteed to prevent the illness, you are much more likely to have a mild case. The flu vaccine does not cause flu.

Is it Typical Memory Loss, Dementia or Alzheimer’s

According to the Alzheimer’s Association, dementia is not one single disorder but rather a group of disorders with related symptoms.

The main symptoms that characterize dementia include declines in memory, cognition, problem-solving and outright loss of memory.

Alzheimer’s disease accounts for an estimated 60+ percent of dementia diagnoses, but is far from the only type of dementia. Since patient symptoms can vary even within a single disorder, a range of memory loss screening tests are available today to evaluate overall function.

This article describes the main types of diagnostic screenings that are used to evaluate whether and/or to what degree a patient may be suffering from dementia, including but not limited to Alzheimer’s disease.

Did you know that Sisselman Medical Group offers Dementia and Memory Loss Screening at both of our Long Island Locations? If you or a loved one are concerned about memory loss or early onset dementia, contact our office today to schedule your screening.

A Dementia Diagnosis Typically Requires a Treatment Team

A patient’s diagnostic treatment team may consist of the family physician (who is often the first to spot a problem with memory), a neurologist, a geriatrician, a neuropsychologist and a psychiatrist-geriatrician, among other specialists.

Dementia and Memory Loss Screenings

The following describes a typical progression towards a definitive diagnosis of dementia.

Initial personal and family history.

The first phase of diagnosis always involves a medical history, both family history and personal history.

In particular, the physician taking this initial medical history will ask about whether other immediate or extended family members have been diagnosed with a dementia-related disorder.

Personal physical examination.

The patient will undergo a thorough physical examination. This is typically like an annual well exam but with more detail.

The physician’s goal will be to conduct a thorough medical workup to establish a baseline from which to evaluate symptoms and arrive at a diagnosis.

This initial exam will include each of the following:

– Baseline of daily diet.

– Alcohol, tobacco, substance use habits.

– Medications (prescription, OTC) and supplements, frequency and amount.

– Blood pressure, temperature and pulse.

– Check heart and lung function (listen to heart, breathing).

– Do a CBC and other blood work (thyroid function, hormone levels, et al) as deemed necessary.

– Urine sample.

– Head to toe physical exam.

– Symptoms questionnaire.

This last may include questions about all of the following and more:

– Depression or anxiety, mood disturbance.

– Sleep problems, sleep apnea or insomnia.

– Delirium.

– Energy level during the day.

– Daily schedule and habits.

Personal neurological examination.

Neurological means disorders of the nervous system and nerve functions. So this examination will look for possible brain-based causes for memory impairment. Examples can include stroke, Parkinson’s disease, encephalitis, tumors and similar causes.

Neurological exams commonly include testing hand-eye coordination, balance, memory, reflexes, eye movement, speech, muscle tone and strength, touch sensation.

The neurologist may order brain imaging scans such as MRI, CT or DAT scan to look more closely at brain function or malfunction.

Screen for dementia at home.

While a number of home screen kits exist that purport to permit patients and caregivers to identify dementia, these kits have a significant margin for error and thus may do more harm than good.

To date, the medical field as a whole has not arrived at a single all-inclusive way to deliver a definitive diagnosis of dementia. This is always a complex disorder with symptoms that can vary over time.

Mental function.

These exams may include problem-solving, cognition (thought processes), awareness of date/time/year, location, understanding and awareness of symptoms that may indicate dementia, simple math problems, follow simple instructions, memorization of a word list.

Two particular exams are often used here: the MMSE (mini mental state exam) and the Mini-Cog (mini cognition).

Food & Drug Administration (FDA) cognitive (computer)exams.

The FDA has approved the use of certain computer-driven memory screenings that may be ordered in addition to or instead of the MMSE and Mini-Cog.

Both have pros and cons. One advantage of the computer-facilitated screenings is precise and impartial administration, where exams administered by physicians may include personal bias.

Mood assessment test.

Because memory loss and dementia often includes a psychiatric component, mood testing is an important part of the diagnostic process. Specifically, screenings evaluate for depression/anxiety, apathy, delirium and similar symptoms that may impair memory.

Genetic testing.

Genetic testing for risk genes is available today for the purposes of family planning. However, genetic tests are not typically prescribed as a method of diagnosis.

Brain imaging tests.

MRI (magnetic resonance imaging) and CT (computed tomography) are commonly prescribed as part of the diagnostic process. A DAT test is sometimes now being used to diagnose Parkinson’s.

Brain imaging tests can reveal tumors, strokes, head trauma, fluid accumulation, beta-amyloid levels, dopamine uptake and other important clues that can support accurate diagnosis by working from the most complete patient information available.

Did you know that Sisselman Medical Group offers Dementia and Memory Loss Screening at both of our Long Island Locations? If you or a loved one are concerned about memory loss or early onset dementia, contact our office today to schedule your screening.

November 11, 2019

By Sisselman Medical Group 0 Comments Health Oral Health

Wisdom Teeth & Heart Disease: What’s the Connection?

Oral health is very important when it comes to your overall health, and gum disease could negatively impact your heart health. Although it hasn’t been conclusively proven, it is believed that dental issues such as gingivitis and periodontitis are connected to heart disease. In addition, dental surgeries such as tooth extractions can increase your risk of having a heart attack.

The Arrival of Wisdom Teeth

Wisdom teeth, which are also called third molars, are the last permanent teeth to erupt in an adult’s mouth. They usually arrive between the ages of 18 and 25. If they are impacted, this might lead to decay and infection. This is because wisdom teeth are located in the back of the mouth. They are hard to reach and thoroughly clean with your toothbrush. As a result, bacteria grow around them and infect the gums.

The Risk of Gum Disease

Tooth extractions can cause jawbone infections and lead to different types of health issues such as coronary disease. It has been proven that if you have dental problems, you probably have more bacteria around your wisdom teeth than any others in your mouth. When this happens, the gums in that area of your mouth become inflamed.

This increases your risk for coronary problems and other illnesses such as diabetes. Bacteria enter the bloodstream and attach to various blood vessels. The chance of getting heart disease is higher.

Thus, there is a connection between wisdom teeth and heart disease when dental bacteria spread to other parts of your body via the bloodstream. Just as inflammation occurs in the mouth, the same inflammation can infect the inner lining of the heart and cause a stroke.

The Removal of Wisdom Teeth

As a result of the suspected connection between wisdom teeth and coronary problems, many people choose to have them removed, even if pain is nonexistent. It is advised that they are removed as early as possible, which is a great way to avoid future dental problems that could lead to dental issues.

Sadly enough, when they are removed at a later stage in life, it gives the roots and nerves more time to grow deeper. This makes it harder to surgically remove them. Opting for wisdom tooth removal at a later time in life increases the risk of encountering coronary health problems. Speaking with your favorite dentist is the first step to understanding the entire process. They’ll advise on when it’s best for you or a family member to have your wisdom teeth extracted.

The Importance of Oral Health and the Impact On Your Body’s Health

Although the evidence is strong, the connection between wisdom teeth and heart disease hasn’t been definitively proven. A smart way to reduce your risk of experiencing coronary problems is to focus on your dental health. Practice good oral health habits. Pay attention to your mouth and smile. Look for possible dental problems such as infections, cavities or abscesses.

Healthy gums should be light pink and firm. If they are receding, bleeding, swollen or red, then it’s time to make a dentist appointment. It’s also time to visit a dentist if your mouth hurts when you chew or bite food. These are all signs that you might have the following dental problems:

• Gingivitis- This is the early stage of gum disease. At this point, the symptoms are mild. Bacteria exist between your gums and teeth. It’s still possible to get back to normal, if the condition is caught in time.

• Periodontitis- This is a more advanced stage. The gums are inflamed due to released toxins from bacteria. If left unchecked, this stage could lead to bone damage and receding gums.

• Cavities- These are holes in your tooth that could turn into gingivitis or periodontitis.

According to the American Dental Association, health care leads to improved heart health. Here are some steps you can take to prevent heart disease when it comes to oral care:

Brush teeth twice a day with an ADA-accepted fluoride toothpaste.
Clean between teeth daily with floss or an interdental cleaner.
Eat a balanced diet and limit between-meal snacks.
Visit your dentist regularly for oral examinations and professional cleanings.

In Conclusion

The thought of getting heart disease can be pretty scary, especially if there is a connection to your regular dental habits. Oral health is an integral part of taking care of yourself, which means it must be taken seriously. No one can prove that there is a connection between tooth extractions and dental infection, but there are a few studies that have been done on the subject.

Many of these studies claim that if you have dental problems such as gingivitis or periodontitis, you are at a greater risk to acquire heart disease than someone who has optimal oral health. All in all, bad dental health could be a warning sign for other health related problems such as coronary problems or diabetes.

October 7, 2019

By Sisselman Medical Group 0 Comments Health Flu, Flu Season

2019 Flu Season: Flu Vaccination Information

Influenza is a viral disease that is highly contagious and can lead to a number of dangerous medical complications. Getting influenza can be particularly hazardous for young children, older people and individuals who have other medical conditions. To prevent influenza, the CDC recommends getting an annual flu shot, which is highly effective and can protect you from the most severe complications of the disease. Here are a few facts to keep in mind as you plan to get your immunization for the 2019 influenza season.

When Is Flu Season?

Influenza viruses circulate through the U.S. population throughout the year, but at certain times of the year, generally the fall and winter, these viruses become more prevalent. Flu season peaks from December to February, but you can still catch the influenza virus well into May. Individuals should receive their influenza vaccine early in the season, because it takes two weeks for the antibodies to provide protection against influenza.

Types of Vaccines To Protect Against Influenza

Influenza viruses come in many different types, and these viruses mutate quickly from one form to another. Vaccines are created to protect individuals against the most common forms of the influenza virus that are circulating among the population. Your vaccine may be “trivalent,” that is, designed to protect against three different forms of the virus, or “quadrivalent,” which protects against four of the most common types. Some vaccines are available to provide a boosted immune response against the virus, such as for older people. Nasal spray vaccine is available for individuals who cannot take the injected vaccine. Some types of influenza vaccine are made with small amounts of egg protein, which can be a problem for individuals with egg allergies. Vaccines that are created from cells, instead of egg protein are available for these patients. Talk to your physician about the best influenza vaccine for your and your family’s needs.

Expected Severity of 2019 Influenza Season

Scientists look to locations around the world, to see where influenza season has already occurred, as well as what type of influenza virus was prevalent in the previous season, to help them determine how severe it will be in the United States, The number of hospitalizations for influenza last year indicates that a more dangerous influenza virus may be prevalent in 2019-2020. Influenza always involves the risk of serious complications, and individuals should make a point of getting their shots before the season begins.

Benefits of Flu Vaccine

Your influenza shot can help prevent you from getting influenza. If you do get the flu, the shot can help you avoid the most serious symptoms. Flu shots are especially important in protecting children from the most serious complications of influenza. Your flu shot also helps to prevent complications if you have a serious, chronic illness. Pregnant women and their babies can be protected from the serious complications from influenza. Getting your vaccination also helps protect those who can’t get the shots, such as those who are too young, are allergic or have compromised immune systems, from being exposed to the influenza virus.

Symptoms of Influenza

Influenza causes a number of uncomfortable symptoms, including fever, generally above 100.4 degrees Fahrenheit, aching muscles, dry cough, persistent headache, fatigue, weakness, sweating, chills, sore throat and nasal congestion. If not carefully treated, either through self-care or a doctor’s attention, influenza can develop into signs of bronchitis, pneumonia, ear infections and even heart involvement. Pneumonia is the most serious complication from influenza and can lead to death. If you do not experience improvement in symptoms over a few days, see your doctor immediately for additional treatment. Antiviral medications can help to reduce severe symptoms of influenza.

How To Help Prevent Influenza Transmission

You can help to avoid getting influenza and other illnesses this season by talking to your doctor about getting an influenza shot in September or October. Avoid crowded areas where germs can spread easily. Cover your mouth and nose with a tissue, and then throw the tissue away, or sneeze into your elbow. Avoid touching your eyes, nose and mouth, which is the prime way to transmit germs. Wash your hands frequently during the day with soap and water or an alcohol-based hand sanitizer. Regularly clean work surfaces to remove germs. If you do get sick, stay home, and don’t return to school or work until your fever is gone for 24 hours. Stay at least 3 feet away from anyone who appears to be sick.

Because the viruses that cause influenza can mutate so rapidly, it’s hard to predict exactly which form of the virus will be prevalent during the season. Your best protection is to receive you annual flu shot, to ensure that you can avoid the most severe symptoms that can occur. Make sure everyone in your family that is eligible gets their 2019 influenza shot.

For more information on flu and flu vaccines, please visit the Center for Disease Control (CDC).

To schedule your flu shot for the upcoming 2019 flu season, contact Sisselman Medical Group today. We offer flu shots and vaccines at our Commack and Massapequa locations.

September 9, 2019

By Sisselman Medical Group 0 Comments Health Parkinson's Disease

Diagnosing and Treating Parkinson’s Disease

Parkinson’s disease (PD) is increasingly common in America and around the world. According to Parkinson’s Foundation, as many as 10 million adults worldwide may have Parkinson’s disease.

Yet research into what causes and triggers PD to arise and how to effectively diagnose and treat the condition is still in its early stages.

Part of the challenge is that Parkinson’s itself is not one specific condition but rather a group of related neuro-degenerative disorders that share many symptoms in common.

What Causes Parkinson’s Disease?

Parkinson’s can occur at any age and stage of life. Early onset PD typically occurs on or before the age of 50 but it can even occur in children. Early onset Parkinson’s is more closely associated with heritable PD.

While most cases of Parkinson’s are considered idiopathic, or arising from non-specific or unknown causes, a smaller percentage are known to be heritable.

When Parkinson’s is diagnosed later in life, it is more likely to arise from environmental causes, including traumatic brain injury, exposure to toxins, prolonged use of certain medications, stroke and the presence of co-occurring conditions.

Parkinson’s arises when cells in an area of the brain called the substantia nigra start to become damaged or die off. These cells have a very important job – making dopamine.

Dopamine is a vital neurotransmitter that controls movement, motor function, cognition, sleep and emotion. The less dopamine the brain has, the more disruption there will be in these areas.

Diagnosing Parkinson’s Disease

Parkinson’s is usually diagnosed by a neurology physician, but sometimes it is first detected by the patient’s primary care doctor.

There is one test that is now being used to diagnose Parkinson’s. It is called the DaTscan and it was FDA-approved in 2011 specifically to for use as a Parkinson’s diagnosis.

In addition to the DaTscan, a physician will look for four major categories of symptoms to make a definitive diagnosis of Parkinson’s disease:

– Tremor or shaking.

– Bradykinesia (slowness of movement).

– Rigidity or stiffness, especially in arms, legs, trunk.

– Postural instability, including falls or trouble balancing.

At least two of these four major criteria must be present consistently for some prior period of time before a doctor will consider Parkinson’s as a possible diagnosis.

There is also genetic testing that is now available to help with family planning and future planning.

Treatment for Parkinson’s Disease

As with understanding the underlying causes and triggers for Parkinson’s disease, treatment for PD is still in its early stages. At this point, all medications available are designed to address the symptoms of PD. There is no medication as of yet to prevent or cure Parkinson’s.

PD patients today can choose from two treatment tracks: traditional medication and non-traditional medication. Some patients may combine elements of each, although patients who take this approach should always talk with their physician to avoid side effects.

Traditional Medications for Parkinson’s Disease

Traditional medication offers limited options at the moment. The primary medication is a synthetic form of levodopa. Levodopa is an amino acid the body makes naturally. It is a precursor or building block to dopamine.

Levodopa-carpidopa works to add back dopamine to the brain and lessen PD symptoms.

Additional traditional medication options include these:

– MAO-B inhibitors. These medications act to prevent the brain from breaking down dopamine.

– COMT inhibitors. These medicines can increase the impact of levodopa.

– Anticholinergics. These medications are sometimes used to treat tremors.

– Amantadine. This medicine only treats early-stage PD symptoms.

– Deep brain stimulation. This is not a medication but a procedure that is used to decrease dyskinesia (involuntary muscle movements), tremor and other PD symptoms.

Non-Traditional Medications for Parkinson’s Disease

Non-traditional medication is also available to help alleviate the symptoms of Parkinson’s disease.

Cannabis or medical marijuana is one non-traditional medication that is receiving increased attention from both patients and researchers.

The reason is because the cannabis plant contains natural cannabinoids like THC and CBD that can cross the blood-brain barrier (BBB) in ways that many other medications cannot.

The reason medical marijuana can cross the BBB is because THC and CBD are quite similar to the cannabinoids the body makes naturally. So when the brain sees medical marijuana cannabinoids coming, it doesn’t prevent them from crossing over.

This makes medical marijuana an exciting option for patients who want an alternative to traditional medications and for patients who haven’t responded well to a traditional course of treatment.

To date, a number of limited scope research studies have highlighted potential cannabis benefits for Parkinson’s patients, including improvements in dyskinesia and tremors, motor symptoms, psychosis, sleep disturbance, movement slowness and overall quality of life.

While there is much more research to be done, the same can be said for every aspect of understanding, diagnosing and treating Parkinson’s.

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