Thank you for watching and stay safe out there!
Shelter in place.
Thank you for watching and stay safe out there!
Thank you for watching and stay safe out there!
Shelter in place.
Older adults and people who have severe underlying chronic medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19 illness. Please consult with your health care provider about additional steps you may be able to take to protect yourself.
Most common EPA-registered household disinfectants will work. Use disinfectants appropriate for the surface.
Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against corona viruses when properly diluted.
You cannot turn on the news today without hearing about the Corona virus. Words like pandemic are being tossed around and people in hazmat suits decontaminating the public transportation systems in China are quite jarring images. This leaves many people wondering about their risk and how much should they really be worried about this new pathogen.
Let’s start with what it is: The Corona viruses, in general, are a family of viruses that cause everything from the common cold to pneumonia. The one making all the headlines is currently being called COVID-19 (“CO” for Corona, “VI” for virus, “D” for disease, and “19” for the year it started).
The symptoms for COVID-19 range from a mild illness to more severe symptoms, including death and include fever, cough, and shortness of breath. While it is not clear exactly how COVID-19 spreads, it is assumed to be through respiratory droplets from an infected person coughing or sneezing. The incubation period, (the time from exposure to illness) is presumed to be between 2-14 days.
There is currently no cure for Corona virus and the only recommended treatment is to not catch it. Avoiding people that are sick, avoiding travel to China, proper hand washing, and wiping down commonly touched items (that includes your cell phones) are ways to avoid exposure to the virus.
Currently, there are 14 cases in the United States, with California having the most, a total of 8, and Massachusetts having 1. Given this knowledge, let’s go back to our original question; should I panic.
The short answer is “no”. We should absolutely be careful. But, allow me to provide a little context. There are currently 45,000 cases of Corona virus. 1,100 people have died because of the infection. Compare that to the flu where it is presumed 19million people have been ill. 180,000 hospitalized and 12,000 have died. Annually, the flu kills 290,000-650,000 people worldwide.
COVID-19 is new and there is a lot we still don’t know about it. There is no vaccine and it is reasonable to be concerned. However, there is a much more common virus, capable of causing severe illness and death, going around right now FOR WHICH WE HAVE A VACCINE. If you have not already gotten your flu shot, it is not too late. Yes, it seems they missed the mark with one strain (Influenza B) , but the second wave of flu is going around and it appears that the vaccine is quite effective against Influenza strain A. Please make an appt. with your healthcare provider today to get vaccinated.
BROOKE RIETH NP
I have finally concluded that no one, not my husband, not my dogs, not mysterious eldritch creatures, absolutely NO ONE has been replacing my pants with amazingly similar replicas that happen to be one size smaller. I came to this realization with great sadness but a steadfast determination to change. (Yes, I ate all the left-over Christmas cookies first. Don’t judge.) I decided the best way for this was a 60 days fitness challenge consisting of 5 days on and 2 days off.
“Yippee for me”, I know, but I assure you, I’m not putting myself on blast for moral support or approval. I decided to discuss this because, while I desire better health and, quite frankly, more loose-fitting clothing, I absolutely… with every fiber of my being… did not want to take the first steps towards initiating change. You see, wanting to change and starting to change are entirely different animals.
Nevertheless, January 4th found me in my room, outfitted in my (slightly too tight) work out clothes. My dogs, separated from the bedroom by a baby gate, yet free to roam the entire rest of the house, stared anxiously into the only room they could not occupy for half an hour, certain they should surely die from neglect.
Day 1: Against my better judgement, I pressed play. The next 30 minutes are a horrible blur of hopping, squatting, lunging, contemplating my life choices, push-ups and sweating. It finally ended. I was WAY more tired than I should have been. I wholeheartedly regretted this 60 day commitment.
Day 2: EVERYTHING HURTS. Seriously, everything. Once I actually managed to get out of bed I zombie shuffle-limped down the hallway while 3 exuberant dogs, stoked about life and mornings and sunshine, did their best to commit matricide by repeatedly running between and against my already unsteady jello legs.
Somehow, through some supernatural force or witchery, I again found myself in my room, workout clothes on, suffering dogs peering through the gate, workout on the computer. I pushed play. The muscles that had survived the first workout were brutally punished for continuing to function at a somewhat normal ability.
Day 3: EVERYTHING STILL HURTS only now I can’t easily lift my arms. I currently live in the mid-range…if something I want is positioned too high, I don’t need it. If I drop it on the floor, it lives there now. I still have a third work out to do today. I am afraid. Opting to get it out of the way before anxiety wins, I pressed play before the clock struck 11am. Did I get it done? Yes, I did. Did I enjoy it? No, I did not.
Day 4: The only time the workout can be squeezed in today is before work. 6:30 in the morning, now in the living room, not really sure what is going on, dogs have abandoned me for a cozy bed and more sleep, I press play.
So, I’m not going to lie. There’s a person doing modified exercises whilst the class jumps like caffeinated rabbits around her. She does not hop. She does not leap. She modifies her push-ups. She is my person. Today was a slog.
Work has noticed that I am having, shall we say, motor issues. They are amused.
Day 5: I am no longer walking like a toddler with a full diaper. This is an improvement. My legs and arms feel almost normal. My back hurts across the shoulder blade region but is manageable. This is to be the final day of the workout before 2 blissful days off. I couldn’t get it done in the morning so it will be waiting for me when I get home. I’ve tried to imagine several scenarios where I do not need to return home and do this, but dogs would legit starve. (Ok, they would actually be fed when my husband came home but if you are about 2 hours late, they lose the will to survive and sad Sarah McLachlan songs mysteriously play from nowhere.)
In the living rooms, dogs rolling about the floor, STILL IN MY WORK CLOTHES, I throw my sneakers on and push play. 50% of the time, I was following the modified work out, I took breaks, I didn’t feel like doing it, I was hungry…but I got it done.
Day 6: I woke up actually feeling pretty ok. A little sore, but nothing too intense. Today and tomorrow are the “off” days before I repeat the whole process. Best not to think about that now. I’ll check back in post workout, hopefully not in agonizing pain. Thanks for reading!
Brooke Rieth, NP
Whether you have flown to another coast or another continent, you have likely noticed you felt a little worn out or “off” afterwards. Sometimes that feeling would last for days, cutting into precious vacation time. The more time zones, the worse that feeling can be. We can blame this on jet lag.
Jet lag, also known as jet lag disorder, is a temporary sleep problem affecting anyone who travels quickly across multiple time zones. Your body’s internal clock wants to remain synced with your time zone. This discrepancy between internal and actual can cause various symptoms ranging from a general unwell feeling to gastrointestinal problems, daytime sleepiness and inability to stay alert. It is temporary but can definitely interfere with your vacation plans. Worse yet, it may take several days before you are able to make the adjustment and feel like yourself again.
It may be impossible to completely come away from long travel unscathed, there are little things you can do to stack the odds slightly in your favor.
As we face the long months of winter, we hope you will be able to use these tips to escape somewhere warm and sunny.
Brooke Rieth NP
As 2020 is ushered in, we reflect on 2019.
Lots to be thankful for, especially the continued support of our patients who stayed with us through this transition away from corporate style medicine; bringing back healthcare the way it used to be.
We participated in health fairs, attended medical conferences to help us become more informed about advances in understanding and treating health issues.
We held wellness classes /workshops on: nutritional cooking, strategies for emotional balance, meditation, yoga, massage, reiki, acupuncture, diet/exercise, CBD & medicinal marijuana, and “Fixing our broken sleep.”
During the last week of 2019, we went caroling to some of our home bound patients.
Our community based outreach activities included a toy drive for foster children, a food drive for Holbrook food pantry, and making “welcome home baskets” to help homeless families through Father Bill’s/ Mainspring shelters.
About a dozen 3rd year medical students from Tufts University rotated through our site offering a fresh, bright component to our practice.
We welcomed a new canine addition to our staff- Joey, therapy puppy in training.
In October, we celebrated our 2nd birthday/anniversary being a direct primary care practice.
Small employers who struggled with rising health care coverage for employees joined our DPC practice. We’re able to provide easy access to family medicine needs in a comprehensive, affordable & personal way.
We encourage you all to join us for our future health events in 2020 which may be found on our website calendar and in personal email invitations.
Lastly, what would you like to see with Action Medicine in the coming year? How may we help you reach your goals?
Our team wishes you the very best of health,
Dr. Mike, Brooke, Danielle, Max & Jane
Singing. Before we can even form words, we are trying to string together sounds and syllables to make music. Some of us do it well… and well, some of us do it with enthusiasm.
We sing along with music, we sing alone in the shower, we sing for others and we sing for ourselves. It’s something that has happened since humans could make noise. And for once… FOR ONCE… something we enjoy IS GOOD FOR US!
Making music helps people feel connected. It gives us a way to relate to one another. It helps improve our mood. It helps us understand emotions when we cannot articulate them. Recent studies even show that music and music therapy help improve memory and cognition.
Action Medicine believes in the power of music… so much so, that we brought music to our home-bound patients. With Dr. Tremblay on guitar and the rest of the Action Medicine team on vocals, we went house to house singing songs of holiday cheer. Were we completely in sync, no. In tune, definitely not. Did we have a wonderful time bonding with our patients who sang along, absolutely.
So, our dear patients, don’t hold back. Let go of your inhibitions and enjoy belting out whatever moves you. You may be surprised how good you feel afterwards. Even if you’re not a “singer”, happiness is contagious, and we could all use a little more of that.
Brooke Rieth NP
Your heart works hard for you all day, every day. It’s important to keep the pipes clean to allow adequate blood supply to this hard-working muscle; you definitely don’t want it running out of gas. How are we to know what our coronary arteries are doing, though? How do we know our cardiovascular risk?
Obviously, lifestyle plays a huge part in having a general knowledge of your cardiac health. We monitor cholesterol levels and perform stress tests but short of a nuclear scan, it can be difficult to assess whether or not the plaque is building up on your cardiac vessels. One easy, non-invasive way to check for this is the Coronary Artery Calcium Score (CAC).
The CAC is a non-contrast CT scan. It looks at the heart and shows calcium deposits in the coronary vessels which are associated with atherosclerosis. You get a score based on how many areas and how much calcium you see. Zero is ideal. Up to 10 is a very minimal amount of plaque and low risk for a coronary event, like a heart attack. 11-100 shows you have some plaque and moderate risk for a coronary artery event. 101-400 is a moderate amount of plaque and anything over 400 is a large amount of plaque. The risk for a cardiac event is high in the latter to categories. (Keep in mind, there are some adjustments made for age, what might be considered high risk in a 30 year old is likely a very low risk for an 80 year old.)
When calcium has built up in the vessel, it is monitoring damage done. There has already been inflammation and damage to the endothelial cells of the arteries. There is no way to treat the calcium build up, per se. You are essentially on notice to try to stop further development of plaques with diet, exercise, and sometimes medication (generally a cholesterol lowering medication, like a statin).
If you have concerns about your heart health, sit down and have a conversation with your provider. If you don’t have a provider, then come see us. We’d be happy help you on your journey to wellness.
-Brooke Rieth NP