Current Health Issues

January 2009:
Local Publix Pharmacy Declining At A Rapid Rate In Quality

December 2008:
Does Depression And Stress Cause Asthma?

November 2008:
Why Choose a Nurse Practitioner As Your Healthcare Provider?

October 2008:
October is National Breast Cancer Awareness Month
Local 22-Year-Old Woman Diagnosed With Breast Cancer
The Healthiest and Least Healthy Cereals According to Consumer Reports

September 2008:
Information and Facts About the Flu (Influenza) and the Flu Shot
Fish Oil May Be Effective In Helping Patients With Chronic Heart Failure

August 2008:
Staying Safe and Healthy In a Hurricane
Weight Loss Can Help Keep Type 2 Diabetes Under Control

July 2008:
Back to School: School and Sports Physicals, and Free Vaccines for Children

June 2008:
Vitamin D Can Help Prevent Death From Breast Cancer

May 2008:
May Is Arthritis Awareness Month

April 2008:
Local Case of Tuberculosis

Local Publix Pharmacy Declining At A Rapid Rate In Quality
January 6, 2009

For years now Health Circle has encouraged out patients to attend the nearby Publix Pharmacy at 18409 Miramar Parkway, in the Shops at Sunset Lakes; however, we can no longer continue that policy. The quality of this Publix's Pharmacy has deteriorated to the point at which we cannot encourage our patients to pick up their prescriptions at this pharmacy, nor can we guarantee their safety if they choose to do so.

The decision about which pharmacy to go to is entirely up our patients, but just a few examples should be mentioned to illustrate our dissatisfaction with this Publix Pharmacy. On numerous occasions medically necessary [and non-habit forming] medications were not filled, and on other occasions it took nearly a week to fill them. Multiple patients were denied painkillers despite the fact that they were written by Doctor Tomchik himself, and no determination was made that the patient was either previously abusing the medications or that they intended abuse the medications.

We recommend finding a different pharmacy near to you; these may include, but are not limited to: CVS, Pill Box Pharmacies & Medical Supply, Walgreens, or Walmat

Does Depression And Stress Cause Asthma?
December 8, 2008

A survey conducted in 2006, which will be published in the journal Chest this month, showed that there might be a link between depression, stress, and/or general poor mental health and asthma. The study made sure to account for many of the other variables that cause asthma; however, the study was only conducted on adults and did not account for family history and any complications the participants had during their birth. This study is not definitive proof; however, they did discover at least a tenuous link between depression and stress, and asthma. The longer the participants reported experiencing stress and/or depression the more likely they were to report having asthma.

You can read more about this study by reading the article by WebMD.

Why Choose a Nurse Practitioner As Your Healthcare Provider?
November 20, 2008

Penny Cuoco our Nurse Practitioner (NP) has worked with us for almost a year now. But what exactly is a Nurse Practitioner, why should you pick Nurse Practitioner Penny Cuoco as your provider?

What are Nurse Practitioners (NPs)?
NPs are advanced practice nurses who provide high-quality healthcare services similar to those of a doctor. NPs diagnose and treat a wide range of health problems. They have a unique approach and stress both care and cure. Besides clinical care, NPs focus on health promotion, disease prevention, health education and counseling. They help patients make wise health and lifestyle choices. They are truly your Partners in Health.

How long have NPs been providing health care?
NPs have provided excellent health care for more than 42 years. The first NPs were educated at the University of Colorado in 1965. Programs soon spread across the U.S. As of 2007, there are about 120,000 practicing NPs. Close to 6,000 new NPs are prepared each year at over 325 colleges and universities.

How are NPs educated?
NPs have graduate, advanced education and clinical training beyond their registered nurse preparation. Most have master's degrees and many have doctorates.

Where are NPs licensed to practice and how are they licensed?
NPs are licensed in all states and the District of Columbia. They practice under the rules and regulations the state in which they are licensed. Most NPs are nationally certified in their specialty area and are recognized as expert healthcare providers. The faith that patients have in NPs is shown by the almost 600 million visits made to NPs each year.

Where do NPs practice?
NPs practice in rural, urban, and suburban communities. They practice in many types of settings. These include clinics, hospitals, emergency rooms, urgent care sites, private physician or NP practices, nursing homes, schools, colleges, and public health departments, to name a few.

What services do NPs provide?
From treating illness to advising patients on maintaining a healthy lifestyles, NPs provide a full range of services. Patients who see NPs report an extremely high level of satisfaction with the care they receive. Among the many services that NPs provide, they:

• Order, perform and interpret diagnostic tests such as lab work and x-rays
• Diagnose and treat acute and chronic conditions such as diabetes, high blood pressure, infections and injuries
• Prescribe medications and other treatments
• Manage patients' overall care
• Spend time counseling patients
• Help patients learn how their actions affect their health and well-being

NPs specialize in many areas, including:

• Acute Care
• Adult Health
• Family Health
• Gerontology Health
• Neonatal Health
• Oncology
• Pediatric/Child Health
• Psychiatric/Mental Health
• Women's Health

NPs also often practice in subspecialty areas such as:

• Allergy & Immunology
• Cardiovascular
• Dermatology
• Emergency
• Endocrinology
• Gastroenterology
• Hematology & Oncology
• Neurology
• Occupational Health
• Orthopedics
• Pulmonology & Respiratory
• Sports Medicine
• Urology

More and more people are choosing NPs as their primary, acute and/or specialty healthcare provider. In addition to being top-notch healthcare providers, NPs deliver a unique blend of nursing and medical care. They provide comprehensive, personalized health education and counseling. NPs assist patients in making better lifestyle and health decisions.

• Diagnose and treat acute and chronic conditions such as diabetes, high blood pressure, infections and injuries
• Prescribe medications and other treatments
• Manage patients' overall care
• Spend time counseling patients
• Help patients learn how their actions affect their health and well-being

October is National Breast Cancer Awareness Month
October 17, 2008

October is National Breast Cancer Awareness Month. To find out more about this event, the groups that support it, and to get more information on breast cancer please visit the National Breast Cancer Awareness Month's web site at nbcam.org

Local 22-Year-Old Woman Diagnosed With Breast Cancer
October 16, 2008

Sade Greenaway, a 22 year old Miami resident, was recently diagnosed with breast cancer after a biopsy of a lump on her breast showed an infiltrating ductal carcinoma, according to NBC6 News. Greenaway is potentially one of the youngest women ever diagnosed with breast cancer, and definitely the youngest her doctor, Leonardo Henriquez, a breast cancer specialist at the University of Miami, has ever treated. Sade is the mother of a 3-year-old girl.

The Healthiest and Least Healthy Cereals According to Consumer Reports
October 9, 2008

In their November 2008 edition, Consumer Reports ranked 27 popular cereals according to the number of calories, the amount of dietary fiber (in grams), sugar (in grams), and sodium (in milligrams). Each cereal received a rating of: Very Good, Good, and Fair.

Here is a preview of the four most nutritious cereals rated and the four least.

Information and Facts About the Flu (Influenza) and the Flu Shot
September 15, 2008

• 5% to 20% of people get the flu each year
• 200,000 people are hospitalized every year
• 36,000 people die each year
• The flu shot contains an inactive virus so you cannot get the flu from it
• The flu shot is 70% to 90% effective in preventing the flu

Most people are recommended to get a flu shot but for the following people it is especially important:

• Children aged 6 months up to their 19th birthday
• Pregnant women
• People 50 years of age and older
• People of any age with chronic medical conditions
• People who live in nursing homes and other lone-term care facilities
• People who live with or care for those at high risk for complications from flu

For more information on influenza please visit the CDC's web site.

Fish Oil May Be Effective In Helping Patients With Chronic Heart Failure
September 8, 2008

A new study published in the medical journal The Lancet and announced at a meeting of the European Society of Cardiology in Munich showed that omega-3 fish oils may be more effective than Crestor in helping patients with chronic heart failure. This new study adds to the growing list of positive benefits that fish oils derived from salmon and tuna offer to the heart and brain. The fish oil in the study was a prescription strength formulary; however, the doctors that conducted the study noted that omega-3 supplements should offer similar benefits. For more information please see the article in CNN.

Staying Safe and Healthy In a Hurricane
August 22, 2008

With the arrival of hurricane season and Tropical Storm Fay it is important to talk about staying safe and healthy during and after a hurricane strikes. The following are some tips for preparing for a hurricane and staying healthy after a hurricane strikes:

Preparing for a Hurricane
1. The most important step in preventing illness before a hurricane is ensuring that you and your family are up-to-date on your tetanus shots. It is recommended that everyone receives a tetanus shot once every ten years. However, if you have not received a tetanus shot in the past five years and you receive a significant wound you should receive a tetanus shot.

2. When putting up shutters or performing other physically demanding work make sure to wear protective clothing (including thick work gloves), pace yourself, and make sure to stay hydrated. Shutters are notoriously heavy and sharp so be as careful as possible when putting them up. And do not forget Florida is extremely humid, meaning that your sweat's ability to cool you off is limited. This means your body will continue to sweat causing you to lose a lot of water; make sure you replace it by drinking a lot of water.

During a Hurricane:
1. If you have a generator do not run it inside. Carbon monoxide poisoning is a very serious risk and can cause death. Wait until the hurricane has passed and then place your generator outside to run it.

2. Do not go outside. While it may seem safe, it is just wind after all, it is not the wind that injures and kills most people, rather it is the objects that the wind carries that cause the most damage. Objects as seemingly benign as coconuts (just to use one example) are infamous for causing many injuries and fatalities.

After a Hurricane:
1. Listen to the radio for public announcements to boil/disinfect your water. If such an warning is issued make sure to disinfect all tap water by boiling it for one minute, or if you are unable to boil the water add a 1/8 teaspoon of bleach to every one gallon of water.

2. If you lose power try to keep your refrigerator and freezer closed as much as possible. Remember meat can spoil within a few hours and milk will spoil shortly thereafter. Fruits, vegetables, cheese, and bread tend to last the longest; however, for extended power outages canned foods are the best.

3. If any food or water comes into contact with storm water or flood water do not consume it, just throw it away.

For more information and tips please visit the CDC's web site on hurricane safety.

Weight Loss Can Help Keep Type 2 Diabetes Under Control
August 14, 2008

A new study published in the online journal Diabetes Care, a journal of the American Diabetes Association, shows that weight loss, even temporary weight loss, after being diagnosed with type 2 diabetes helps patients keep their blood sugar levels under control. The study was conducted on 2,500 adults who were diagnosed with type 2 diabetes from 1997 until 2002. It is interesting to note that most patients were unable to keep off the weight they lost initially, but nonetheless still had less difficulty maintaining their blood sugar levels than patients that did not lose any weight. You can find more information about this study by reading WebMD's article.

The authors of the study, and we at Health Circle, still stress the need for people that suffer from type 2 diabetes do everything they can to keep the weight off and maintain a healthy lifestyle and diet.

Back to School: School and Sports Physicals, and Free Vaccines for Children
July 7, 2008

Summer is coming to an end and school is starting on Monday, August 18, and you know what that means. Time to go back to school shopping? Maybe, but it is also means that your children need to have all their vaccines up-to-date and might require school and sports physicals.

Here at Health Circle we offer free Vaccines for Children (VFC) from the State of Florida. If you come to our office any and all of your children's vaccines will cost $10 for an administration fee. That means no matter how many or how few vaccines your child requires all you pay is $10 in total for each child. That's not $10 per vaccine, but $10 per child, and NO appointment is required. Simply come in and bring your child's vaccination records. We have lollipops and smilie face bandages ready to go.

For children coming from out of state we also transfer their vaccine records over to the required Florida vaccination forms for $10.

We also perform school physicals and sports physicals for $80. Appointments are required for all physicals. To make an appointment for a physical please call us at (954) 450-3550.

Vitamin D Can Help Prevent Death From Breast Cancer
June 2, 2008

Last month a study performed by Pamela Goodwin, M.D. from the University of Toronto concluded that women who are not getting enough Vitamin D out of their diet are more likely to die if they develop breast cancer than women who are not deficient in Vitamin D. This is startling considering that many women, and men, are deficient in Vitamin D. Just to take one example, a 2007 study of childbearing women in the northern United States found insufficient Vitamin D levels in 54% of African-American women and in 42% of Caucasian women. For more information please read WebMD's article.

This news comes just as Health Circle is offering our physician administered vitamins and supplements, including of course: Vitamin D!

May Is Arthritis Awareness Month
May 13, 2008

May is Arthritis Awareness Month. In addition, the Arthritis Foundation is currently celebrating it's 60th year anniversary. This is especially important to us at Health Circle, because Starley M. Tomchik, Doctor Tomchik's wife and the office manager here, died on March 2, 2008 due to complications from medications she was taking to treat her Rheumatoid's Arthritis. To find out more about arthritis, Arthritis Awareness Month, the Arthritis Foundation, and how you can help fight this disorder please visit the Arthritis Foundation's web site at: http://www.arthritis.org/. Please also consider donating to the Starley Tomchik Memorial Fund:

Starley Tomchik Memorial Fund
18475 Miramar Parkway
Miramar, Florida 33029
(954) 450-3550

Local Case of Tuberculosis
April 30, 2008

On April 11, 2008 the Broward County Health Department finally began notifying parents and students that at least 200 students at Everglades High in Miramar, Florida were directly exposed to a student who was diagnosed with tuberculosis. The Health Department had known about this infected student a week before, but chose not to inform the parents and students until Spring Break ended.

When we at Health Circle heard the news we immediately went in action. We placed an overnight/weekend order on tuberculosis tests (to ensure we did not run out) and began to inform news organizations, radio stations, Everglades High School, the Broward County School Board, and the Health Department that we were ready to assist in testing exposed students. Unfortunately, we received a lukewarm response from the television news organizations and radio stations, and Everglades High School, the Broward County School Board, and the Health Department flat out refused to inform parents and students about our willingness to help. This was most disconcerting considering that the Health Department's letter that was available to parents and students referred them to physicians that worked at the Health Department, half of whom were unavailable to help.

This is disturbing, but hardly new. Health Circle has been open for practice since 1999, and has not once had to close our doors during an emergency, including when hurricanes struck South Florida. Unfortunately, most of our patients and the residents of Miramar, and the surrounding cities, were unaware that we were even open due to a similar resistance on the part of news organizations, hospitals, and government agencies (i.e. the Health Department) to inform people of this fact.

For more information on tuberculosis please read this article from WebMD.