Tuesday, October 23, 2012

How to Prevent Winter Weather Illnesses

Dr. Pat Romano, Family Medicine, Riddle Hospital

 When the temperature drops and summer suddenly turns to fall, we make adjustments. We start warming the car up in the morning, bringing in potted plants or summer decorations so that they won’t deteriorate in colder weather, we bring out heavier jackets and put away our summer wardrobes. Just as we prepare our homes for the beginning of fall and winter, we can prepare our health, as well.

Although sickness can strike at any point and in any season, you’re less likely to be struck with a bout of bronchitis in the middle of July than you are in December. Lower temperatures and more time spent indoors in rooms with poor circulation can lead to an increase in respiratory infections, which is why it’s important to arm yourself with the knowledge of how to prevent or reduce your risk of being affected. Below, find some background and prevention tactics for three common winter weather illnesses.

Almost everyone has been affected by the flu at some point. If you haven’t had it, chances are that you know someone who has. The symptoms are very similar to that of a common cold, including a runny nose, sneezing and sore throat. But keep an eye out for additional symptoms, as well, like a fever, achy muscles, headache, fatigue, and chills, which could be signs that your cold isn’t all the common and could be the flu.

Your best defense against contracting the flu is to receive the flu vaccination, which is often distributed at local hospitals or pharmacies. The Centers for Disease Control and Prevention recommends the vaccine for anyone over the age of six months, especially for groups that are prone to the flu, like young children, pregnant women, and older adults. The vaccine is often available either as an injection or as a nasal spray.

Bronchitis is a virus that has become associated with a dry, painful cough. Like many other respiratory infections, the virus can stem from another illness, like a cold or even the flu, which then develop into bronchitis. In addition to coughing, bronchitis sufferers may also report symptoms like fatigue, chest discomfort, and a slight fever and chills.

To prevent bronchitis from affecting you this winter, stay away from some environmental irritants that might trigger a cough or cold, like cigarette smoke and chemical fumes. Getting vaccinated to prevent the flu can also prevent bronchitis, as the flu can be one of the causes for this virus.

Like bronchitis, sinusitis can occur as a result of earlier illnesses, like the cold or flu. However, other triggers for sinusitis include bacteria, allergies, and fungal infections. Although it may sound like allergies are out of the question during the colder months, the fall and winter can be just as difficult for allergy sufferers, due in part to moldy areas in the home or dusty ventilation systems. Whether it’s caused by environmental factors like these or a prior illness, most people who suffer from sinus issues will notice symptoms like pain or swelling around the eyes, cheeks, nose and forehead, a cough, and aching in the jaw and teeth.

Acute sinusitis, which most people who are diagnosed will experience, can be prevented by avoiding cigarette smoke, getting the flu vaccine to decrease your risk for respiratory illnesses, using a humidifier, and managing your allergies. If you are an allergy sufferer, cleaning out particularly moldy or dusty areas of your home before the fall and winter can help decrease your risk for sinusitis.

If you find yourself experiencing any of these symptoms or think you may be getting sick, call your doctor to make an appointment.

Pat Romano, D.O., is board-certified in family practice medicine and currently practices at Riddle Hospital. He attended medical school and completed an internship and residency at Philadelphia College of Osteopathic Medicine. For more information on Dr. Romano, visit www.mainlinehealth.org.

Thursday, July 12, 2012

Understanding and Diagnosing Dementia

Understanding and Diagnosing Dementia

As more adult children take on the role of caretaker for their aging parents, understanding dementia and its effects on the lives of those who suffer from it is becoming increasingly important.

What is Dementia?
Dementia is a loss of brain function that can occur either on its own or as a result of another disease. Although dementia can happen to anyone, there are certain factors that can put you at a higher risk for it, including age and family history. Although family history is a risk factor, there are many people who have had a family member with dementia and never been affected.

Although no one can control their age or family history, there are some risk factors that are shown to lead to an increased risk of dementia that can be controlled, including high cholesterol, high or low levels of blood pressure, diabetes and other medical conditions.

Symptoms of Dementia
Although most people think of dementia as a disease within itself, it is actually a group of symptoms that affect a person’s intellectual ability and behavior. Memory loss is the symptom most commonly associated with dementia, but there are other physical and behavioral symptoms that may point to it, as well, including:
·         Personality changes
·         Odd or inappropriate behavior
·         Difficulty with motor skills and coordination
·         Difficulty expressing oneself verbally
·         Inability to learn or retain information
·         Paranoia or hallucinations

It is important to remember and recognize these additional symptoms, as memory loss alone does not necessarily constitute dementia. If you recognize two or more of these symptoms in an aging parent or loved one, you can schedule a visit with a doctor who can help determine if it is dementia and, if so, what form.

Treatment Options
Treatment of dementia will not get rid of the condition, but it can help to slow down or minimize the development of associated symptoms.

Depending on what form of dementia is being presented, a doctor can prescribe the appropriate medication. In addition, a person with dementia may be prescribed medications that help to treat its underlying symptoms.

Caring for a parent or senior who is suffering from dementia can be an emotionally and physically draining task. Look for local support groups, speak with a family counselor or keep a journal about your experiences as ways to de-stress and cope with dementia.
Understanding the signs and symptoms of dementia is an important part of helping to recognize and cope with the disease, but dementia is still a difficult diagnosis. Stay tuned for an upcoming blog post from my colleague, who will further discuss the emotional effects of being a patient who has been diagnosed with dementia.

David Thomas, D.O. practices neurology and neuroscience psychology at Riddle Hospital. He completed his neurology residency and Ph.D. at Temple University, and earned his medical degree from the Philadelphia College of Osteopathic Medicine. Dr. Thomas is board certified in neurology and serves as the Chief of Neurology at Riddle.

Monday, May 21, 2012

Do I Have a Stomach Problem?

Do I Have a Stomach Problem?

Is it Heartburn?

We all have heartburn, or acid reflux, at one time or another. It often feels like a burning sensation welling up in our chest.
Acid reflux begins at the lower end of the esophagus, a muscular ‘tube’ through which food passes into the stomach. Once the food is in the stomach, the muscle at the bottom of the esophagus contracts to prevent the back up of food and acid into the esophagus. Reflux occurs when the muscle, known as the lower esophageal sphincter, is weak or becomes relaxed, allowing liquids in the stomach to wash back into the esophagus.
It May be GERD
When the condition becomes worse or causes uncomfortable symptoms, the acid reflux is reclassified as gastro esophageal reflux disease or GERD. In addition to heartburn, which is the most common symptom of GERD, less common symptoms include:
·         Stomach or chest pain
·         Chronic cough and asthma
·         Difficulty or painful swallowing
·         Persistent hoarseness or sore throat
·         Sense of a lump in the throat
·         Recurrent pneumonia
·         Chronic sinusitis.
These symptoms may however be indicative of a more serious problem and if experienced, you should see a physician.
GERD is usually diagnosed based upon symptoms. Testing is required when the diagnosis is unclear or if there are more serious symptoms such as pain when you swallow, chest pain, vomiting blood or dark-colored stool, or unexplained weight loss.
Treating the Problem
GERD is treated according to its severity. Lifestyle changes are the first things that are recommended to alleviate the symptoms. They include:
·         Weight loss
·         Raising the head of the bed six to eight inches using blocks of wood under the legs of the bed or placing a foam wedge under the mattress
·         Avoid reflux inducing foods, such as coffee, soda or drinks with caffeine, chocolate, alcohol, peppermint, and fatty foods
·         Quit smoking
·         Avoid large and late-night meals
Patients with more severe or persistent symptoms usually require treatment with medications. These include over-the-counter antacids, which are commonly used for short-term relief. Other medications, known as histamine blockers and proton pump inhibitors are stronger and generally very effective in treating GERD symptoms.

I will be writing periodically about digestive disease topics. Let us know what you would like to see discussed.


Joseph J. Herdman, MD, practices Gastroenterology at Riddle Hospital. He graduated from Pennsylvania State University and received his medical degree from Jefferson Medical College. He completed his Internal Medicine residency and Gastroenterology fellowship at Temple University Hospital.  He is board certified in both Internal Medicine and Gastroenterology.

Wednesday, March 14, 2012

Treating Back Pain...There is a Doctor for that!

Treating Back Pain
“There is a doctor for that!”

As a Physical Medicine and Rehabilitation doctor, I am a physician who treats pain and disability resulting from disease or injury. Many patients come to my office complaining of back pain and may be worried that they need surgery.

My first step is to figure out what is causing the pain.  Instead of an operation, I like to use conservative treatments such as bracing, medications, injections, and physical therapy.

History is Important
When I see a new patient, my goal is to determine the cause of their pain with a thorough history and physical exam. This is an assessment of the pain and includes learning how it started, whether the pain becomes better or worse with certain activities, and if there are related symptoms such as leg pain or weakness.

Back Pain Causes
Back pain can have a number of different causes. I ask targeted questions to learn if there was a specific problem that is causing, or may have caused, the pain or injury.
I also try to identify issues that might contribute to, or prevent, the pain from improving. Sometimes a problem might be unrelated to the body part that is affected. For instance, back pain may actually be due to poor posture or arthritis of the hip.

Physical Therapy
I often refer patients who have muscle and back pain to a physical therapist. A physical therapist can help to resolve the problem through different modalities such as heat and ultrasound.  In addition, they spend time teaching stretches and exercises that can resolve and prevent the pain from recurring, which is instrumental in a patient’s care.

Albert Huang, MD, practices Physical Medicine and Rehabilitation at Riddle Hospital. He graduated from the University of Pittsburgh and received his medical degree at the Temple University School of Medicine. He completed his residency at Temple Hospital. He is a member of the American Academy of Physical Medicine and Rehabilitation.

Thursday, February 16, 2012



Many patients ask me about the interaction of alcohol and breast cancer.

There has been new awareness concerning the risk of alcohol consumption and breast cancer. When reviewing information about alcohol consumption, it is important to first know how a drink is defined. Twelve ounces of beer, 5 ounces of wine, and 1.5 ounces of liquor are considered a drink. The risk of breast cancer is influenced by how much you drink, how early in life you start, and how much of your life you continue.
It is a cumulative effect.


A recent Nurses Health Study published in the Journal of the American Medical Association (JAMA) looked at “cumulative average consumption” over a 28-year-period of more than 100,000 women. There was a significant increase in breast cancer cases in those women who drank as little as 3-6 drinks per week. This increased risk of 3-6 drinks per week was small but real. The greater the amount of alcohol consumed on average per week, the greater the increase in breast cancer risk.


Another important study was published recently in the journal Cancer. This study evaluated the effects of alcohol and family history on the risk of benign breast disease, a known risk factor for breast cancer. This study looked at daughters from the Nurses Health Study II. The study confirmed an increased risk of benign breast disease for girls who drank at a level of greater than 1 drink per week at age 16, greater than 2 drinks per week at age 18, and 3 drinks per week at age 19 and who had a family history of breast cancer or maternal benign breast disease. These girls had a significant increase in the incidence of benign breast disease over girls without family history of breast cancer or alcohol use. Girls without a family history did not have an increased risk with alcohol consumption.


These two studies show the influence of alcohol on breast cancer risk. The main consideration is the amount of alcohol over time. Delaying the beginning of drinking alcohol until you are older and then drinking moderately will reduce effects.

I recommend limiting yourself to 3-6 drinks per week maximum. Less if you are young and/or have a family history of breast cancer. I also recommend red wine if you like it because of the extra advantage of heart benefits.

Jessie W. DiNome, MD received her medical degree from the University of North Carolina School of Medicine, and served a residency and fellowship in Radiation Oncology at the State University of New York at Stony Brook. She is board certified in Radiation Oncology. Dr. DiNome is an attending physician in the Jefferson Health System and Medical Director of the Jefferson Cancer Center at Riddle Hospital. She has been on the Riddle Hospital staff since 2004.
For physician information, appointments, locations and more, please call
1.866.CALL.MLH or 484.580.1000

Thursday, January 5, 2012

Visiting a Gynecologist - A Users Manual

Visiting a Gynecologist—A Users Manual

As an obstetrician/gynecologist, I am often asked at what age girls should begin to see a gynecologist and then how frequently? Older readers may be surprised at these newest guidelines.

Today, it is recommended that adolescent girls see a gynecologist for the first time when they are between the ages of 13 and 15 years. More often than not, this visit won’t include a Pap Test but will be more of an educational give-and-take with both parties asking questions. If the girl is sexually active, though, the physician may do a pelvic exam.

The regular pelvic exam is a way for doctors to look for abnormalities in the uterus, cervix, fallopian tubes, ovaries and bladder. It is first done when the patient is sexually active or becomes 21 years old—and then continues annually. This is the same age at which the Pap Test, which is done during the pelvic exam, is begun.

A Pap Test is an investigation of a sample of cells taken from a woman's cervix. The test is used to look for changes in the cells of the cervix that show cervical cancer or conditions that may develop into cancer. It is the best tool to detect precancerous conditions and hidden, small tumors that may lead to cervical cancer.
Routine Pap screening is recommended every two years until a woman reaches age 30. Then, for certain women who have had three consecutive normal screening test results, testing can be done every three years.
The technology for Pap Tests has changed. Now a woman can have it done during her menstrual cycle, whereas before, she had to wait until it was over.

As part of the routine visit, I also do a breast exam and check a patient’s heart and lungs. Many women also consider their gynecologist to be their primary care physician. It is for this reason that I check with my patients to confirm this. If they aren’t also seeing a primary care physician, I conduct a more-thorough examination.

I will be writing periodically about various gynecology issues. Please submit questions below and let me know what you would like to discuss.

Joseph T. Sincavage, MD, received his medical degree from Hahnemann University Hospital, served an internship and residency at Western Pennsylvania Hospital and received additional training at MD Anderson Hospital in Houston. He is board certified in Obstetrics and Gynecology and has been on the Riddle Hospital staff since 1997.

Thursday, November 17, 2011

The Importance of a Mammogram

The Importance of a Mammogram
Once a woman reaches age 40, the majority of medical institutions recommend a baseline mammogram and yearly mammograms, essentially forever. For many women, though, this is truly a no-brainer; it is something they do each year after they see the gynecologist or on a similar anniversary. And, it provides them with peace of mind.
The exception may be if you have symptoms or changes in your breasts, or if you have a family history of breast cancer. Your doctor may then recommend that you have a mammogram at an earlier age.
Best Screening Tool
The mammogram, an x-ray picture of the breast, remains the best screening tool to detect breast cancer. Screening mammograms check for masses, distortions, and calcifications in the breast. Mammograms can detect a cancer early when it is easier to treat and before it is big enough to feel or cause symptoms. Also, when caught early, localized cancers can be removed without requiring a mastectomy (breast removal).
Breast and Skin Cancers
Aside from non-melanoma skin cancer, breast cancer is the most common cancer among women in the United States. It is also one of the leading causes of cancer death among women of all races and origins.
Mammography does not replace the monthly breast self examination or the examination by a doctor. Physical examinations, though, typically find breast cancers when they are much larger than those detected by mammography. Like so much else, the technology has changed since the screening mammogram was introduced in the 1970s.
Today, modern-day mammography only involves a tiny amount of radiation — equal to the amount normally acquired from a year of background radiation.
Make it a Good Experience
Here are some tips to ensure your mammogram experience is a good one:
  • Try not to have your mammogram the week before you get your period or during your period. Your breasts may be tender or swollen then.
  • Bring your past mammogram films/results with you.
  • If you’ve been to the same facility before, make sure your past results are available to whoever is reading the study.
  • Once you find a facility in which you have confidence, try to go there every year, so that your mammograms can be compared from year to year.
I will be writing periodically about the various radiology issues.  Please submit questions below and let me know what you would like to discuss.

Tina R. Stein., MD, received her medical degree from the Medical College of Pennsylvania and served a residency in Radiology and a fellowship in Nuclear Medicine at the University of Pennsylvania. She is board certified in Diagnostic Radiology and Nuclear Medicine. She has been on the Riddle Hospital staff since 1989.