Category Archives: Family Health
Introducing Dr. Margaret Wang
People sometimes ask if I have always wanted to be a doctor. No, but it is certainly one of the top-rated dreams for an Asian immigrant.
Growing up in Beijing in the ‘80s, I rarely visited the pediatrician, and my family usually depended on traditional Chinese medicine. For example, whenever a runny nose and a fever set in, I would be given a sweetened herbal medication called Ban Lan Gen and be forced under a stack of blankets until my pajamas were soaked with sweat, which means that the fever had broken and I would soon recover.
When it comes to medicine, the average Chinese person seems quite torn between their traditional medicine and Western practices. Not many are well-versed in traditional medicine — featuring powerful potions and genuine side effects — but every Chinese person has been steeped in a unique mixture of culture, tradition filled with anecdotes and myths, and a dependence on nature and a distrust for the man-made.
I myself harbor a great interest in acupuncture and toxicology. While I studied at Georgetown University School of Medicine, I took a class on alternative and complementary medicine, which taught me traditional Chinese medicine is not to be trifled with, and that Asian people who are scared of strong Western medications should exercise equal caution over Chinese potions.
Although I share in this cultural understanding about the human body and health, my systematic training in Western medicine remains the pillar of my practice as an internist. This can sometimes be challenging with Asian patients. They often see little value in preventative care and regular checkups, which I appreciate as the basis of sound medical care. Patients can also give pushback about starting a medication, because they believe — and rightly so — that everything with an effect has a side effect.
In the end, it comes down to communicating outside of typical Western medical care — more in the realm of preference, philosophy, and faith. These human discussions provide an important context for medical care and is what makes primary care most interesting for me. Not all doctors share this view, but that is okay. I think it enhances my effectiveness and benefits my patients.
2024 marks my tenth year practicing as an internal medicine doctor. I first spent some time as a hospitalist and at an urgent care center, but I seem to have settled in the right spot at MPCP, for which I am truly thankful. And if you’ve read this article to the end, I wish you a blessed new year.
Dr. Wang is a Maryland Primary Care Physicians partner and is certified by the American Board of Internal Medicine. She received her medical degree from Georgetown University School of Medicine. She cares for patients in MPCP’s Columbia office.
What To Do? Emergency Department vs. Urgent Care vs. Your Doctor’s Office
By: RAFEENA BACCHUS, M.D., MEDICAL DIRECTOR
Having an illness or injury often results in a good deal of anxiety and worry. You want medical attention and relief from your symptoms as quickly as possible. But where should you go to get the best, most appropriate and cost-effective care? The following are the most widely used treatment options and suggestions about when each might be best suited to meet your particular medical needs.
The emergency department
Most emergency departments are part of hospitals, although there are free-standing emergency departments in Bowie and Queenstown. The ED is designed and equipped to handle serious or life-threatening emergencies. It is always open, including nights, weekends and holidays. Patients are seen according to how sick or injured they are. The most serious cases jump to the front of the line, even if they arrive later than everyone else. Physicians in the ED are trained to look for life-threatening conditions, and the tests you will receive in the ED will help them decide if you have any of these.
The emergency department is the right place to go if you have a serious or potentially life-threatening illness or injury: chest pain, sudden weakness on one side of your body, a new seizure, severe headache, persistent heavy bleeding, poisoning, or a large broken bone.
The emergency department is probably not the right place to go if you have a milder illness or a longstanding issue. You are likely to wait longer for treatment. The emergency department doctors do not have access to your medical records. Your visit will be much more expensive — as much as 4-6 times as expensive! Remember, they have to keep all that life-saving equipment available all the time. That’s great if you need it, but it’s just an extra charge if you don’t.
Urgent care centers
There are lots of these in our area. They often have extended hours, including evenings and some weekend hours. They are designed and equipped to handle medical problems that need attention the same day but are not life-threatening. Patients are usually seen in the order they arrive, so your wait will depend on how many other people go to the urgent care center at the same time you do. Many urgent care centers have X-ray and blood testing equipment.
An urgent care center is the right place to go if you have a new illness or injury that occurs when your doctor’s office is closed, such as sprains and strains, painful urination, ear pain, severe cough or wheezing.
An urgent care center is probably not the right place to go if your doctor’s office is open or if you have a serious or life-threatening condition. A visit to an urgent care center is more expensive than a visit for the same condition at your doctor’s office. The provider in the urgent care center does not know you and will not have access to your medical records. Urgent care centers are not equipped with life-saving equipment or providers trained to treat life-threatening illnesses or injuries.
Your doctor’s office
No one knows you like your own doctor. Your doctor is equipped to treat many illnesses and injuries, and can arrange any testing you may need. Your primary care doctor has your medical records and knows your medical history. Patients are seen by appointment. Maryland Primary Care Physician offices reserve appointments for patients who need same-day treatment. Many MPCP offices have evening and/or Saturday hours for your convenience. Call or check our website, www.mpcp.com, for a list of hours at your doctor’s office.
Your doctor’s office is the right place to go if you have a new problem, such as sinus pain, ear pain or flu, cuts or other wounds, sprains or strains, cough, or a flare up of an old problem, such as back pain or migraine headache, or an ongoing problem that may require more testing or treatment, such as persistent stomach problems or joint issues. You will pay the lowest copay at your primary care doctor’s office, and many times you will be able to get an appointment the same day you call. For extra convenience, all MPCP offices offer telemedicine visits after hours, in addition to evening and weekend appointments at some sites.
Your doctor’s office is the wrong place to go if you have a serious or life-threatening condition. If you need care in the next hour, go to the emergency department.
If you’re not sure what to do, call your primary care provider
Even when the office is closed, there is always someone on call who can direct you to the care you need. If you ever need to go to the emergency department or an urgent care center, take a list of all your medications and allergies with you. Let the staff know who your primary care provider is, and schedule a follow up appointment if needed.
Dr. Bacchus is a MPCP partner and is certified by the American Board of Internal Medicine. She sees patients in the Columbia office and serves as MPCP’s Medical Director.
Hypothyroidism
By: NISHA ABRAHAM PARAMBIL
The thyroid gland is a small gland, but it plays a significant, complex role in your body. When it does not work properly, it can seriously impact your health.
Located in your neck under your voice box, the thyroid gland controls several things, including your metabolism, body temperature and heart rate.
Hypothyroidism (also known as an underactive thyroid) is a common disorder where the thyroid does not release enough thyroid hormone. This causes your metabolism to slow down. Symptoms of hypothyroidism can include fatigue, weight gain, and cold intolerance. In extreme cases, it can cause life-threatening conditions, such as low body temperature, coma and heart failure.
Hypothyroidism affects people of all ages, but it is especially common among women over 60.
What causes hypothyroidism?
The most common cause of hypothyroidism is an autoimmune condition called Hashimoto’s disease, which causes your body’s immune system to attack and damage your thyroid gland. Other causes include thyroiditis (inflammation of the thyroid), iodine deficiency and thyroid surgery.
How it is diagnosed
Symptoms of hypothyroidism can be similar to other conditions. The main method to diagnose hypothyroidism is with a blood test. If your thyroid is enlarged, your healthcare provider may be able to feel it during an exam. If you have symptoms of hypothyroidism, ask your provider about testing.
If you have hypothyroidism
Hypothyroidism is a life-long condition. It cannot be cured, but it is very treatable. It is typically managed with medication that replaces the hormones your thyroid gland is not making.
Many people with hypothyroidism struggle with gaining weight, so adopting healthy habits is important. Daily exercise can help raise your metabolism, reduce your fatigue and decrease muscle pain.
MPCP’s endocrinology staff specializes in diagnosing and treating glandular conditions like hypothyroidism. You can also learn more with this helpful resource:
Hypothyroidism (Underactive Thyroid) — National Institute of Diabetes and Digestive and Kidney Diseases
Dr. Parambil is an endocrinologist who diagnoses and treats disorders of the endocrine glands, such as diabetes, pituitary disease, hypothyroidism, hyperthyroidism and osteoporosis. See the MPCP Specialists webpage to learn more.
Headaches: When to Call the Doctor
By: TRANG M. PHAM, M.D.
Headaches are our most common form of pain and a major reason for trips to the doctor. While most headaches are just a temporary nuisance, sometimes they can warn you about a serious health problem that needs immediate attention.
Causes of headaches
Headaches happen when nerve endings in your body react to triggers and send pain messages to your brain. Chemical activity in your brain, the nerves or blood vessels surrounding your skull, or the muscles of your head and neck can play a role in headaches.
A primary headache is caused by problems with pain-sensitive nerves in your head and is not a symptom of another medical problem. Primary headaches can be triggered by lifestyle factors, such as stress, alcohol (especially red wine), certain foods (such as processed meats with nitrates), poor sleep and poor posture.
A secondary headache is related to medical conditions that trigger pain-sensitive areas in the neck and head, including a neck injury, eye problems, and infections in your jaw, teeth, or sinuses. More serious causes of secondary headaches can be brain tumors, aneurysms, and meningitis.
Types of headaches
There are many types of headaches, but three of the most common are tension, cluster, and migraines.
Tension headaches are the most common kind and are often brought on by stress and tight muscles. Symptoms include:
- Gradual start
- Head usually hurts on both sides
- Pain is dull or feels like a band or vice around the head
- Pain may involve the back part of the head or neck
- Pain is mild to moderate
- Typically, does not cause nausea, vomiting or sensitivity to light
Cluster headaches usually occur in a series that may last weeks or months. They are more common in men than women and may be caused by alcohol use, smoking cigarettes, bright light, exercise/exertion, hot weather or water, and foods with nitrates, such as bacon or lunch meat. Symptoms of cluster headaches include:
- Severe pain on one side of the head, usually behind one eye
- The eye that is affected may be red and watery with a droopy lid and small pupil
- Swelling of the eyelid
- Runny nose or congestion
- Swelling of the forehead
Migraines mostly affect women. The average migraine lasts from four hours to three days, but severe attacks can last longer, badly impacting your work, family, and social life. In addition to headache pain, migraines can include:
- Nausea and vomiting
- Lightheadedness
- Sensitivity to light and other visual symptoms, such as flashing spots, wavy lines, and blurred vision
Treatment depends on the headache
Effective treatment depends on what type of headache you have. It may include:
- Avoiding known triggers, such as certain foods and beverages
- Stress management
- Changing eating habits
- Exercise
- Resting in a quiet, dark place
- Over-the-counter medications or prescriptions from your healthcare provider
Migraine and cluster headaches may need specific medicine management:
- Preventive medicines: Prescribed by your healthcare provider and taken daily to reduce the onset of headaches.
- Abortive medicine: Prescribed by your healthcare provider and acting on specific nerves and blood vessels in the head to stop a headache in progress.
- Rescue medicines: Over-the-counter pain relievers to stop the headache.
When you should call your doctor
Most headaches can be treated with over-the-counter medicine and will go away on their own. But there are times when they can be a symptom of serious medical conditions, such as a blood clot, aneurysm or tumor in the brain, concussion, encephalitis, meningitis, or stroke. Call your healthcare provider immediately if you experience a sudden, severe headache with:
- Fever
- Nausea
- Vomiting
- Convulsions
- Shortness of breath
- Confusion
- Muscular weakness
- Double vision
- Change in level of consciousness
If headaches are an unpleasant part of your life, contact your MPCP healthcare provider to discuss what can be done to help you feel better.
Dr. Pham is a MPCP partner and cares for patients in the Pasadena office. She holds her medical degree from Jefferson Medical College and is certified by the American Board of Family Medicine.
