Fisher Titus

Category: Primary Care & Pediatrics

  • World Stroke Day

    World Stroke Day is October 29. Stroke is the number five cause of death and the leading cause of disability in the United States. This World Stroke Day, educate yourself about stroke so you can take steps to prevent it and know how to recognize it in yourself and your loved ones.

    What is a Stroke?

    Stroke is a disease that affects the arteries leading to and within the brain. There are two types of stroke. An ischemic stroke occurs when a clot obstructs blood flow to the brain. A hemorrhagic stroke occurs when a blood vessel ruptures and prevents blood flow to the brain.

    Risk Factors of Stroke

    Strokes can happen to anyone at any age. In fact, about one in four people worldwide will have a stroke in their lifetime. However, there are several risk factors that put you at higher risk for having a stroke.

    • High Blood Pressure is the number one preventable risk factor for stroke. Normal blood pressure is below 120/80. If you have high blood pressure, work with your doctor to take steps to lower it. Not only will this lower your risk of stroke, it will also help your brain to function better for longer.
    • What you eat. A diet high in saturated fat, trans fat, and cholesterol can raise blood cholesterol levels. Diets high in sodium (salt) can increase blood pressure. High-calorie diets can lead to obesity. All of these things can increase your risk of stroke. Eat lots of fruits and vegetable and work with your doctor on creating a healthy diet that can help lower your risk of stroke.
    • Diabetes more than doubles your risk of stroke. Every two minutes, an adult with diabetes in the U.S. is hospitalized for stroke. If you have diabetes, you should work closely with your doctor to ensure you are properly managing your condition and reducing your risk of stroke.
    • High cholesterol increases the risk of blocked arteries. If an artery leading to the brain becomes blocked or throws a clot, a stroke can occur. Get your cholesterol checked regularly and work with your doctor to make sure it stays under control.
    • Smoking damages blood vessels, leading to blockages and stroke. Don’t smoke and avoid second-hand smoke.
    • Atrial fibrillation (AFib) is an irregular heartbeat that causes the hearts upper chambers to quiver rather than beating in an organized, rhythmic way. AFib increase the risk of stroke by five times. The fluttering may cause blood to pool and clot then traveling to the brain. If you have AFib, proper management is the key to lowering your risk of stroke.
    • Sleep-related breathing issues may increase stroke risk. Seek medical treatment right away if you suspect sleep apnea or a similar problem.

    How to Prevent Stroke

    Up to 80% of strokes are preventable through changes in lifestyle and proper management of conditions like high blood sugar, cholesterol, and blood pressure. Not only will these changes help reduce your stroke, they can help reduce your risk of other conditions and help you lead an overall healthier lifestyle. Some lifestyle changes you can make are:

    • Managing your blood pressure numbers, aiming to keep them under 130/80. Work with your doctor and stick to the medication and lifestyle plan they created with you.
    • Eating vitamin-rick fruits and veggies. This can lower blood pressure and improve brain function.
    • Swap salty snacks for almonds or fruits.
    • Taking regular walks or introducing other physical activity into your routine. This can help lower blood pressure and help you maintain a healthy weight both of which reduce your risk of stroke.
    • Get good sleep every night. 7-9 hours of sleep each night can improve your brain function.

    How to Recognize a Stroke?

    While it’s important to take all these steps to prevent stroke, it’s still important to understand what stroke looks like so you can recognize it in yourself and others should it ever occur. Knowing the common stroke warning signs and what to do someone is having a stroke can be the difference between recovery and disability. The acronym BE FAST can help you remember these signs:

    • B – Balance. Is the person suddenly having trouble with balance or coordination?
    • E – Eyes. Is the person experiencing suddenly blurred or double vision or a sudden loss of vision in one or both eyes?
    • F – Face drooping. Does one side of the face droop or is it numb? Ask the person to smile.
    • A – Arm Weakness. Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
    • S – Speech Difficulty. Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence like, “The sky is blue.” Is the sentence repeated correctly?
    • T – Time to call 911. If the person shows any of these symptoms, even if the symptoms go away, call 911 and get hem to the hospital immediately.

    Stroke Care at Fisher-Titus

    Fisher-Titus is a certified Primary Stroke Center through the Healthcare Facilities Accreditation Program. This means that we have the ability to stabilize and treat acute stroke patients, provide acute care, and administer tPA and other acute therapies safely and efficiently.

    Additionally, Fisher-Titus received the 2020 American Heart Association/American Stroke Association’s (AHA/ASA) Get with the Guidelines Stroke Gold Plus achievement award. We were also recognized as a recipient of the Target: Stroke Elite Plus Honor Roll with Target: Type 2 Diabetes Award.

  • The Importance of a Primary Care Provider

    The Importance of a Primary Care Provider

    Your Primary Care Provider plays a vital role in the care of your health throughout your lifetime. Learn more about the importance of a primary care provider.

    What is a Primary Care Provider

    Your primary care provider is a doctor, nurse practitioner, or physician’s assistant who manages your overall health over time. Your PCP is someone you can develop a trusted relationship with. They get to know you, your history, and your family history and they have the best picture of your overall health.

    Primary care providers may work in family medicine, internal medicine, obstetrics and gynecology, or pediatrics.

    Here are some examples of things to see your primary care provider for:

    • Regular health screening or wellness visits
    • Management of chronic conditions
    • Something is causing you concern or advice for a health problem
    • Fever, cough, sore throat, cold earaches or rashes
    • Unexplained weight changes
    • Lingering pain
    • Prescription refills
    • Minor injuries such as sprains, back pain, minor cuts and burns, minor broken bones, or minor eye injuries
    • Bladder or urinary tract infections
    • Vaccinations
    • Migraine headaches

    Benefits of a Primary Care Provider

    There are many benefits of having a primary care provider, including:

    • Understanding your history. Your primary care provider has access to all of your medical records as well as your family history. This helps them see the full picture when it comes to your health rather than the snapshot other providers may get from a single visit at an urgent care or emergency room.
    • Building a relationship. You get to know your primary care provider throughout your life and come to build a relationship with them. Because you become more comfortable with each other, they are able to better understand your medical situation, and you may feel more comfortable bringing issues to them and asking questions you may have.
    • Prevention and early detection. Your primary care provider can recommend regular tests and screenings based on your personal and family history. These regular checkups, tests, and screenings with the same provider make it more likely that any potential health issues will be caught early when they are most treatable.
    • Condition Management. If you do happen to encounter a more complex health issue, they are crucial in coordinating care. They can refer you to necessary specialists, review all tests, prescriptions, and make sure everyone on your care team is working together. When multiple specialists are working together or you have multiple health challenges, your primary care provider is the link between them all.

    Primary Care vs. Convenient Care vs. Emergency Care

    There are many circumstances where you may require medical attention but are unable to see your primary care provider. This could be because it is outside of regular office hours or there are no available appointments and you need to care soon. This is where Convenient Care and the Emergency Department come in.

    At convenient care, patients can walk in and receive services on a first-come, first-serve basis for minor illness and injury. Typically, the insurance co-pay is the same as a regular office visit. The convenient care provider will follow up with your primary care provider to let him/her know you were seen.

    The ER is open 24/7 for any situation where you need immediate medical attention. The Emergency Room provides care for serious, and/or potentially life-threatening medical situations. If you are considering going, you probably should. If it’s a serious emergency, don’t hesitate to call 9-1-1.

    When you arrive at the ER, you will be triaged and receive care based on the severity of the situation. You may have to wait a bit longer if there are other patients there with more serious conditions. The ER is also usually costlier than primary care and Convenient Care so it should be reserved for emergency situations where you cannot wait for care.

    Convenient Care and the ER are not replacements for Primary Care. After you visit Convenient Care or the Emergency Room, you should still follow up with your Primary Care to talk about your visit and determine if any follow up with them is necessary.

    If you don’t currently have a primary care provider, it’s never too late to find one. Fisher-Titus has providers accepting new patients several locations. To find a provider, visit www.fishertitus.org/find-a-physician.

    About Dr. Canfield

    Dr. Christina Canfield is a physician with Fisher-Titus Family Medicine in Wakeman and is the Chief Medical Officer of Fisher-Titus Medical Care. She has been practicing in the area since 1994. Fisher-Titus has six Family Medicine locations in Bellevue, New London, Norwalk, Milan, Wakeman, and Willard. For more information, visit fishertitus.org/locations.

  • Sepsis Awareness Month

    Sepsis is responsible for more than 270,000 deaths a year in the United States. Although 65% of Americans say they know the word “sepsis,” only 12% can identify the most common symptoms. September is sepsis awareness month. Take the time this month to familiarize yourself with sepsis so you can recognize it yourself and your loved ones.

    What is Sepsis?

    Sepsis is the body’s overwhelming response to infection or injury. It can lead to tissue damage, organ failure, amputations, and death. Your immune system usually works to fight germs and prevent infection, but sepsis occurs when your immune system stops and turns on itself.

    When patients develop a set of signs and symptoms related to sepsis they may be diagnosed with the disease. Sepsis progresses to severe sepsis when in addition to these initial signs and symptoms, the patient shows signs of organ dysfunction such as difficulty breathing, low or no urine output, abnormal liver tests, and changes in mental status. Nearly all patients with severe sepsis will require treatment in an intensive care unit (ICU).

    While there is no simple test or cure for sepsis, it can be prevented by preventing infections and can be treated successfully in most cases with early recognition and treatment.

    Causes and Risk Factors of Sepsis

    Sepsis starts with the presence of an infection. The infection can be viral, bacterial, or fungal or even caused by a parasite. This infection can start anywhere in the body from something as small as a cut or bug bite to a larger infection like pneumonia or meningitis.

    Sepsis can affect people of all ages and health levels. However, it is more likely to affect very young children, older adults, people with chronic illnesses, and those with weakened immune systems.

    Symptoms

    The major symptoms of sepsis can be remembered using the phrase “It’s about time.” Watch for these four things:

    T – Temperature that is higher or lower than normal.

    I – Infection present or have other signs/symptoms of infection.

    M – Mental Decline characterized by confusion, sleepiness, or lethargy/difficult arousing.

    E – Extremely Ill including severe pain, discomfort, and shortness of breath

    Time is of the essence when it comes to sepsis. The risk of death from sepsis increases by as much as 8% for every hour treatment is delayed.

    If you see any combination of these symptoms especially if the person has a recent history of a cut, surgery, invasive procedure, or infection, you should immediately call 911 or go to the nearest hospital and let the caregivers know you are concerned about sepsis.

    How to Prevent Sepsis

    Sepsis cannot always be prevented but there are steps you can take to prevent or treat infection as quickly as possible and be on the look out for sepsis when infection does occur.

    • Get Vaccinated. Vaccinations can protect you from contracting certain viral infections that could lead to sepsis.
    • Properly care for open wounds. Cuts, scrapes, or other breaks in the skin can allow harmful bacteria to enter your body. Be sure to always care for these wounds by cleaning them as quickly as possible after injury and keeping them clean, monitor them for signs of an infection (redness, warm to the touch, increased pain, discharge from the wound), and consult a doctor if there are signs of infection.
    • Take antibiotics correctly when they are prescribed. When you are prescribed antibiotics, be sure to take them exactly as prescribed. Follow all the directions for use, take them on time, finish the full course even if you feel better sooner, and store the antibiotics as directed.
    • Wash your hands frequently. Always practice proper hand hygiene with warm water and soap before eating or handling food, after using the bathroom, after blowing your nose or coughing, after touching pets or other animals, and after being outside the home such as at school or shopping.
    • Sound the alarm. If you suspect your or a loved one may have sepsis, see a medical professional immediately or call 911 and say “I am concerned about sepsis.”

    About Cyndi

    Cyndi Whetstone, RN is a Performance Improvement Specialist at Fisher-Titus and is stroke coordinator at Fisher-Titus. Fisher-Titus is a Certified Primary Stroke Center. For more information about sepsis, visit sepsis.org.

  • Schedule Your Medicare Annual Wellness Visit

    As we enter the second half of the year, you may be thinking about some of the annual appointments you need to check of your yearly to-do list. If you have had Medicare Part B for longer than 12 months you qualify for a yearly wellness visit.

    In most cases this visit will be covered with no out-of-pocket cost to you by Medicare. Some additional costs could accrue if your primary care provider feels additional testing is necessary based on your medical history and risk factors.

    During your Medicare Annual Wellness visit, your provider will go over several things.

    • A review of your medical, surgical, and family history
    • Updating a list of your current providers and prescriptions
    • Height, weight, blood pressure, and other routine measurements
    • Assessment of preventative measures such as ensuring you are up to date on all recommended vaccinations, screening labs, and diagnostic testing
    • Personalized health advice
    • A list of risk factors and treatment options for you
    • Advance care planning (a plan for care you would get if you become unable to speak for yourself)
    • Memory testing which will detect early signs of memory issues

    All the of the information gathered during the visit will be used to form a personalized care plan that will be updated at each yearly visit.

    About Dr. Schwerer

    Dr. Kaitlin Schwerer is a physician with Fisher-Titus Family Medicine-Milan. Dr. Schwerer earned her Doctor of Osteopathic Medicine at Ohio University Heritage College of Osteopathic Medicine and is board certified in family medicine. She currently has same-day and next-day appointments available. Call 419-660-2900 to schedule.

  • Electromyography: Diagnosing Nerve and Muscle Conditions

    Beginning June 25, Fisher-Titus will be offering Electromyography clinics. There are two parts of the clinic: needle EMG and Nerve Conduction Studies. These diagnostic tests evaluate the health of muscles and nerves and can assist in finding nerve dysfunction, muscle dysfunction, or issues with nerve-to-muscle signal transmission.

    These procedures are done to help determine if a patient has a nerve or muscle disorder. EMG results can help diagnose many conditions including:

    • Muscle disorders such as muscular dystrophy or polymyositis
    • Diseases affecting the connection between the nerve and the muscle, such as myasthenia gravis
    • Disorders of nerves outside the spinal cord (peripheral nerves), such as carpal tunnel syndrome or peripheral neuropathies
    • Disorders that affect the motor neurons in the brain or spinal cord, such as amyotrophic lateral sclerosis, or polio
    • Disorders that affect the nerve root, such as herniated disk in the spine

    There are many common symptoms that indicate these and other conditions that may prompt your doctor to order an EMG. These can include:

    • Tingling
    • Numbness
    • Muscle weakness
    • Muscle pain or cramping
    • Certain types of limb pain

    If you are experiencing these symptoms, you should talk to your doctor about your concerns. They can determine whether you may need an EMG and can refer you to the EMG clinic at Fisher-Titus.

    During a nerve conduction study, electrodes are applied to the skin to measure the speed and strength of signals traveling between two or more points. The electrodes are placed in various locations on your skin depending on where you are experiencing symptoms. These electrodes will read and interpret tiny electrical currents, transmitted by the healthcare professional, that you may feel as a twinge or spasm.

    In a needle EMG, the neurologist will assess whether there is electrical activity that should not be there when the muscle is at rest and the degree of activity when you slightly contract the muscle. To do this, they will give you instructions on when to rest and when to contract a muscle. During a needle EMG, a needle electrode is inserted directly into a muscle and records the electrical activity in that muscle. The needle may cause discomfort or pain that usually subsides after the needle is removed.

    After the EMG, the neurologist will interpret the results and send them to your primary care provider or the doctor that ordered the test. They will then discuss the results with you at a follow-up appointment.

    About Jordan

    Jordan Manlet, RN, R.NCS.T is the Director of Emergency Services and Neurosciences at Fisher-Titus. Fisher-Titus Electromyography clinics will be offered twice monthly beginning June 25. Tests and studies will be read by a board-certified Neurologist. If you are experiencing symptoms of a nerve or muscle condition, talk to your primary care provider about Fisher-Titus EMG clinics.

  • The Uniqueness of Caring for Men’s Health

    My wife, Dr. Vicki Brown, and I have been in practice together for 25 years. I typically have the unique opportunity to provide care for mainly husbands as she cares for their wives—just the way things go in a rural setting.

    It has always been fairly known that women tend to manage (or steer) the health care of the family more than men and thus direct the husbands in for appointments when they commonly might not do so otherwise.

    Additionally, with social media and so much access to the internet both men and women have a lot more information to sift through both legitimate and not so legitimate about their health care needs.

    For these reasons, I do think it is important to highlight men’s health and encourage them to take responsibility/control of their own health and seek assistance from a primary care physician. This men’s health month, take the time to think about your health and whether you are doing everything you can to care for it.

    Read the full article on NorwalkOhioNews.com.

  • Keeping Kids Active at Home

    Do your kids have energy to spend without their usual outlets like gym class and recess or organized sports? Keeping kids active in the same ways they are accustomed to while participating in school activities is difficult but also important. Whether you’re looking for fun ways to keep your younger kids active or trying to help older kids stay in shape for athletics, here are some ideas for staying active at home.

    For Younger Kids

    Simon Says Fitness – Simon says “do 5 jumping jacks!” Simon says “run in place!” Turn a game your kids already love into a fun way to be active. Get creative with your prompts and don’t forget to try and trick them with some “Simon didn’t say so!”

    Treasure Hunts – This is a game you can play inside or outside to get the kids up and moving. Either hide items around the house or come up with a list of items you know they will be able to find. See who can find the most items or who can find them the quickest.

    Bike Rides – With everyone getting stir-crazy, a bike ride is a great way for the family to get out of the house together. In addition to riding around the neighborhood, we are also lucky to have the reservoir and North Coast Inland Trail here in Norwalk as great places to go for a ride.

    Obstacle Course – Set up some obstacles around the yard and take turns going through the course. Time yourselves to see who can complete the challenge the fastest and then rearrange the obstacles and try again!

    For High School and Junior High School Kids

    Yoga – There are lots of online resources for yoga and it’s a great exercise for core strength, balance, and flexibility. Find a video on YouTube you like and you’re ready to go!

    Body Weight Exercises – There are many exercises that use your own body weight and require no equipment and you’re probably already familiar with them. Pushups, lunges, reverse lunges, squats, and planks can all easily be done at home.

    Jump Rope – Jumping rope is great exercise and the only piece of equipment required—rope—is easy to find. Be sure to jump on a flat surface and remove any obstacle like rocks or sticks. Challenge yourself to see how many jumps you can get in a set amount of time and have fun with the exercise.

    Line Jumps – Draw a line with chalk on the driveway or mark it with tape. Make sure wherever you are doing your drills is an even surface to prevent injury. Using the line as your guide, jump in-place or down-the-line jump alternating using both feet or one foot at a time moving forward and backward and side to side. Use the balls of your feet to jump and keep your body weight on the instep and big toe.

    About Jake

    Jake Rospert, ATC is an Athletic Trainer with Fisher-Titus. Fisher-Titus Athletic Training Services work within Huron County and surrounding area schools to provide athletic training services. For more information, visit fishertitus.org/athletic-training.

  • How to Manage Seasonal Affective Disorder

    Seasonal Affective Disorder is a clinical depression where problematic symptoms occur for longer than two weeks during a season change reoccurring for two years in a row. According to the National Institute of Mental Health, over 10 million Americans are affected yearly. Seasonal Affective Disorder (SAD) is different from the “winter blues” which can be described as a minor period of time where one has less energy, wants to sleep more, and can feel more down than usual.

    Have you noticed your mood being impacted by the weather, especially in the Fall and Winter months? Do you notice others around you saying, “Get over it because you should be used to this Ohio weather?” It may actually not be so easy to “get over it” as it  you could be suffering from a medical condition called Seasonal Affective Disorder or commonly known as SAD.

    Seasonal Affective Disorder Symptoms

    Symptoms of SAD can include being less physically active and engaging in social isolation. When the weather gets colder out and it’s dark outside when people wake up and get off of school or work, it impacts their mindset. People can even demonstrate a weight gain due to finding comfort in foods and not getting out of the house as often as they would in the Spring and Summer months. Some even suffer from physical aches and pains due to the cold weather and “heaviness” of depression. Many people complain of fatigue even though they are sleeping more either by taking more naps or sleeping longer periods of time at night. SAD can cause feelings of hopelessness, guilt, indecisiveness, and criticism towards themselves and others.

    The exact reason why Seasonal Affect Disorder impacts some people and not others is not known. However, it is believed that those who have family history of depressive disorders are more likely to be effected by SAD. It is also thought that chemicals in the brain are a huge influencer as the darker days can lead to more melatonin being produced causing fatigue. Additionally, the lack of sunlight causes dysregulation in serotonin levels as well as vitamin D, according to National Institute of Mental Health. Due to these chemical contributors, treatment for SAD can range from supplements or medication to therapy.

    How to Fight Seasonal Affective Disorder

    There are many things you can do to combat these feelings including becoming more physically and socially active, eating vitamin D enriched foods and taking supplements, or a referral to a mental health specialist for talk therapy and medication management. Light therapy can also be a benefit for many individuals. Being outside for at least 30 minutes can help boost your morale and serotonin levels. If you cannot go outside, then be mindful of where you sit, choosing to sit near windows where you can enjoy the sunlight. You can also invest in a light lamp you can sit under for 30 to 60 minutes a day in intervals. The bright artificial light mimics outdoor light for a period of time to regulate your brain and mood. This technique is so common that even some libraries in bigger cities allow their patrons to check out light lamps along with their books.

    If you are concerned that you or a loved one is affected by SAD then you should speak to your doctor to find the best option for you. And keep in mind, Spring is right around the corner!

  • Men: Stay Healthy at Any Age

    By: Dr. John Hughes

    Men, it’s never too early or too late to start caring about your health. Men die an average of 5 years younger than women and lead 9 out of 10 of the top causes of death. They also have a higher suicide death rate and do not see physicians for a physical exam as often as women.

    So, what can you do to stay healthy and prevent disease? Make your annual appointment. June is Men’s Health Month. This month, schedule your annual exam and have a conversation with your doctor about your overall health and wellness.

    What to expect at your annual exam

    Your annual exam is an opportunity for your doctor to get a snapshot of your overall health. It’s also an opportunity for you to ask any questions and discuss any concerns you may have so make a list before you go to help you remember your questions once you get there. Here are some things your doctor may check during your appointment.

    History: Your doctor will ask you questions about your lifestyle and medical history as well as the medical history of your immediate family. They may ask you about smoking, alcohol use, sexual health, diet, and exercise. It’s important that you’re honest with your doctor because this helps them determine your risk for certain diseases and helps create the best plan for keeping you healthy.

    Depression: If you’ve felt “down,” sad, or hopeless, and have felt little interest or pleasure in doing things for two weeks straight, talk to your doctor about whether he or she can screen you for depression.

    Sexually Transmitted Diseases: Talk to your doctor to see whether you should be screened for sexually transmitted diseases, such as HIV.

    Vital signs: Your blood pressure should be less than 120/80 and anything over 140/90 is considered high. A healthy heart rate is typically between 60 and 100 and respiration between 12 and 16 breaths per minute is considered normal. A temperature of 98.6 is average but yours may be slightly higher or lower and still be normal.

    Heart: By listening to your heart with a stethoscope, your doctor can hear if you have an irregular heartbeat, a heart murmur, or may hear other clues that can indicate heart disease.

    Lungs: Again, using the stethoscope, your doctor will listen for crackles, wheezes, or decreased breath sounds which may indicate lung disease.

    Head and Neck:  Your doctor will likely have you open your mouth and say “ah” so he can get a good look at your throat and tonsils. He’ll also look at your teeth and gums as they can indicate other health problems as well. He’ll also probably look in your ears, nose, eyes, check your lymph nodes, and may check your thyroid and carotid arteries.

    Abdominal: Your doctor may have you lay down and do a series of exams in order to check liver size, presence of abdominal fluid, listen for bowel sounds, and checking for tenderness.

    Neurological exam: Your nerves, muscle strength, reflexes, balance, and mental state may all be assessed.

    Skin: The doctor might check your skin and nails as they can be indications of problems or disease.

    Arms and Legs: He may check your arms and legs for physical and sensory changes, check your pulse in both the arms and the legs, and examine your joints.

    Male physical exam: Your doctor will likely check each testicle for lumps, tenderness, or changes in size. He or she may also examine your genital area for signs of sexually transmitted diseases. He or she will also do a hernia exam to check for weakness in the abdominal wall between the intestines and scrotum. Finally, he may check your prostate size and screen for any abnormalities that could indicate prostate cancer.

    Although the thought of going to the doctor may be intimidating and some of the exams performed and questions done can be uncomfortable, it’s important in order to stay healthy. So, don’t shy away from discussing and caring for your health. Make your annual appointment today!

    About Dr. Hughes

    Dr. John Hughes is a physician with Fisher-Titus Primary Care-Norwalk. To find a primary care physician close to home, visit fishertitus.org/findaprovider or call 419-660-2900 to schedule an appointment.