 Know your Status. Get Tested
Ana Palomo, Vista Community Clinic
Did you know that HIV testing can be completely confidential? As protected by law, HIV testing does not require a name or other identifiable information. All you need to know is that HIV testing is an important part of routine health care.
HIV stands for human immunodeficiency virus. This is the virus that causes AIDS. HIV is different from most other viruses because it attacks the immune system, the system which gives bodies the ability to fight infections. HIV finds and destroys a type of white blood cell (T cells or CD4 cells) that the immune system must have to fight disease.
HIV is primarily found in the blood, semen, or vaginal fluid of an infected person and is transmitted in 3 main ways:
- Having sex (anal, vaginal, or oral) with someone infected with HIV
- Sharing needles and syringes with someone infected with HIV
- Being exposed (fetus or infant) to HIV before or during birth or through breast feeding.
HIV is not transmitted through day-to-day activities such as shaking hands, hugging, or a casual kiss. You cannot become infected from a toilet seat, drinking fountain, doorknob, dishes, drinking glasses, food, or pets. You also cannot get HIV from mosquitoes.
To prevent HIV use a latex condom during sex, do not share needles, and make sure to get tested. Talk about HIV and other STD’s with each partner before you have sex. Ask your partners if they have recently been tested for HIV; and encourage those who have not been tested to do so.
The Center for Disease Control (CDC) estimates there are approximately 1 million people in the United States infected with HIV and about twenty-five percent of those individuals do not know that they are infected. Everyone is at risk of contacting HIV but, according to the CDC, individuals aged 25-44 years old have the highest risk of infection.
Some people think HIV doesn’t happen here. That is not true. People of all ethnicities, ages, genders, sexual orientations and socioeconomic status are at risk. Public Health Services of County of San Diego reported that between the years of 2001-2005, 162 individuals in North San Diego County were diagnosed as HIV positive. Of those 162 cases reported, eighty-six percent were male.
National HIV testing day will be celebrated on June 27, 2008. On this day, initiated in 1995 by the National Association of People with AIDS (NAPWA-US), community based organizations throughout the country will encourage people to voluntarily get tested for HIV.
Testing options have improved over the past years. Individuals can now opt for rapid testing and receive the results that same day. Rapid testing can be done through finger prick or oral swab, and a standard blood test takes at least one week for results.
Are you ready to get tested? Your private physician should be able to help you. Testing is also available at the five Vista Community Clinic sites located in Vista and Oceanside. Appointments can be made by calling 760-631-5000. Walk-ins are welcome at the Testing Clinic at Vista Community Clinic’s Tri-City Branch located at 161 Thunder Dr., Suite 103A in Vista. Walk-in testing hours are: Mondays 1:00pm-4:00pm and Tuesdays 3:00pm-6:00pm.
If you are HIV positive, there is help available. At Vista Community Clinic, newly diagnosed individuals can access primary care, case management, psychosocial services, health education and risk reduction counseling. Programs are also available for those who have been previously diagnosed but not currently accessing care. Just give us a call and we can tell you about the options available.
Getting tested is the first step – a step everybody should take. We encourage everyone to get tested on June 27th, National HIV testing day.
Know your status. Get tested now.
Ana Palomo is a project coordinator with Vista Community Clinic. For more information on free HIV testing call the HIV prevention programs at (760) 407-1220 x 182 or visit our website at www.vistacommunityclinic.org
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Skin Safe This Summer
Nona Hanson, MD, Vista Community Clinic
This year, approximately 1.3 million Americans will hear from their physician the frightening words, “You have skin cancer.”
Skin cancer is the most common malignancy in the United States; and, fortunately, it is one of the easiest to catch in the earliest stages. Unlike any other organ in the body, the skin is completely visible, making it is easy for both the doctor and patient to examine. If caught early enough, skin cancer is nearly one hundred percent curable.
The three main types of skin cancer are: squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and malignant melanoma (MM). All three are most commonly found on sun-exposed areas (like the forearm, face, or ear) of lighter-skinned people, especially those raised in sunny climates like San Diego.
SCC is made up of squamous cells from the upper most part of the skin. Patients usually see a flaky or scabby area on their skin that just won’t heal. They might also find that it can be peeled off and may disappear for a short while, only to return later in the same spot.
BCC is made up of basal cells from the bottom part of the skin. Patients might notice a lesion with a shiny bump that may have an open sore or scab in the middle. Sometimes the lesion may have small blood vessels visible within them.
MM, the most deadly by far, causes nearly seventy-five percent of all skin cancer deaths. It is twenty times more common today than it was sixty years ago. MM is made up of cells known as melanocytes, or pigment-producing cells. These cells are what cause people to tan when they go out in the sun. Patients with MM usually notice a brown or black area that can either be flat or raised. It often looks like a mole or can start growing within a mole that previously hadn’t changed for years.
What should you look for? There are five warning signs that a mole or spot should cause concern.
Asymmetry: it is a different shape on one side than the other.
Border: the border is irregular or difficult to distinguish.
Color: the color is not uniform or there are many colors within the spot.
Diameter: the size is greater than six millimeters or approximately ¼ inch.
Evolution: it is changing.
Not every spot that falls into these categories is a melanoma; but, any spot that does should be checked by a physician as soon as possible.
How can you protect yourself and your family this summer? You can decrease your risk of skin cancer by protecting your skin from over-exposure to the sun. Use sunscreen, protective clothing and avoid the midday sun. Keep in mind that complete avoidance of the sun can cause vitamin D deficiency which can lead to bone weakness. For good bone health, enjoy 5-10 minutes of sun 2-3 times a week along with an oral supplement. Finally, an annual skin check by a physician and a monthly self-check at home will help keep your skin in good health.
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Dr. Nona Hanson is an Family Medicine physician at Vista Community Clinic. For more information or to schedule an appointment, call 760-631-5000 or visit www.vistacommunityclinic.org
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Heart Disease
Brian Bedolla, MD Vista Community Clinic
Roughly 700,000 people DIE from heart disease each year. Cardiovascular disease is the leading cause of death in both men and women in the United States and has been the leading cause of death in the United States for the past 80 years! According to the Centers for Disease Control and Prevention (CDC), approximately 61 million people in the United States have heart disease. What exactly is heart disease? Heart disease has many different meanings. These include cardiovascular disease, coronary heart disease (CHD), and coronary artery disease. All of these definitions mean that there is clogging, if you will, of the small arteries of the heart.
It is estimated that in 2008, 770,000 Americans will have a NEW heart attack and roughly 430,000 Americans will have a recurrent heart attack. A heart attack (or myocardial infarction) is when one of the small arteries of the heart is blocked and then this compromises the blood flow to that part of the heart. Hence, some cells of the heart die. This can cause weakening of the heart and even death.
Signs of a heart attack can be tricky. The most common sign of a heart attack is chest pain and it is often associated with difficulty breathing. Sometimes this pain can move to the jaw or even the left arm. Other times, nausea and “indigestion” can be symptoms of heart disease. So if you have any of these symptoms, it is very important to seek medical attention-especially if you have some of the risk factors for heart disease. Knowing these signs and symptoms and CALLING 911 is crucial to having a positive outcome after having a heart attack.
Although it is the most common cause of mortality, many people do not know the top risk factors for heart disease. Risk factors for heart disease are:
- Family history of heart attack (i.e. myocardial infarction) before the age of 55 for men and 65 for women.
- Diabetes mellitus
- Hypertension
- High Cholesterol (Dyslipidemia)
- Smoking
- Obesity
Prevention is key! Modify your risks! Your chance of developing heart disease can be reduced by taking steps to control those risk factors which contribute to heart disease.
- Know your family medical history.
- Monitor your blood pressure
- Cut back on sweets and carbohydrates (such as breads, rice, tortillas, pasta)
- Eat less salt.
- Walk 15-30 minutes a day
- Eat less red meat and fast foods.
- Quit smoking.
- Monitor your weight.
So Take Action! Educate yourself and get moving. Everyone can do a little more to prevent heart disease. Ask about your family history with your siblings, parents. Eat fewer desserts and sweets. Eat less fast food. Cut back on the salt. Eat less fast food and red meat. Pick a date to stop smoking. Lose weight. The more you do, the better off you will be in the future. Your heart and body will thank you for it.
Brian Bedolla, MD is a family medicine physician at Vista Community Clinic. For more information or to schedule an appointment please call (760)631-5000.
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Partnering for those with Rheumatoid Arthritis
Wendee Theilemann, San Diego Arthritis Foundation & Vista Community Clinic
Aches, pains, rheumatism, creaky, crackly, swollen and noisy. You guessed it. We are talking about joints.
While most of us remember our grandparents talking about aches and pains, it is important to keep in mind that arthritis does not play favorites; it can affect men, women, and even children. If you happen to be one of the thousands of people in the U.S. who battle a specific form of arthritis – Rheumatoid Arthritis (RA) – almost any day can be a challenge.
RA is typically characterized by painful, swollen joints, though it can include other symptoms. Patients often describe their joints as feeling hot, a feeling commonly referred to as a “flare.” If RA goes untreated, it can cause serious damage to the joints and prevent you from enjoying the simplest aspects of living.
In order to keep RA from wreaking havoc, it is crucial that the patient seek treatment from a qualified medical professional and, if possible, a board certified rheumatologist. A rheumatologist can make an accurate diagnosis and create a personalized treatment plan for the patient in order to save their joints from destruction.
Fortunately life with RA these days is better than it was even ten years ago. There have been incredible strides in treatment and, in many cases, patients can lead normal active lives.
As with any disease, early diagnosis is key to successful treatment; however, not all of us are fortunate enough to have health insurance. If you happen to be one of the thousands of people in North County with RA but are not currently covered by health insurance or Medi-cal, there is some good news.
For four years Vista Community Clinic and the Arthritis Foundation San Diego Chapter have partnered to provide uninsured RA patients throughout North County with care from a board certified rheumatologist. Together, we provide examinations, follow-up visits, lab work, x-rays and medications free of charge to patients who qualify.
“I am so grateful that I found you. I was almost bedridden, but after getting medical care at the arthritis clinic I am now back to work and supporting my family once again,” said patient Valentin Salgado.
The Arthritis Clinic is staffed by a volunteer medical staff, including Dr. Kathy Nguyen, Dr. Rashad Ansari and Dr. Roger Cornu as well as Arthritis Foundation volunteers, Maria Maytorena, Cindy Miller RN and Yolanda Salcido. Vista Community Clinic provides the facility as well as medical assistants and access to an excellent pharmacy department headed by Ted Kessler, PharmD.
If you or someone you know suspects that they may have Rheumatoid Arthritis and are not eligible for health insurance or Medi-Cal, contact Yolanda Salcido at the San Diego Arthritis Foundation (858)492-1090 x120. The Arthritis Foundation can assist you in finding the care you are looking for as well as referrals to specialized exercise programs, health events, self-help programs and more.
Wendee Theilemann is an integral part of the Arthritis Clinic at Vista Community Clinic and participates through the San Diego Arthritis Foundation. For information about Vista Community Clinic please call (760)630-5000.
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Responsible Parenting
Silvia Alcantar, Vista Community Clinic
With the many responsibilities that come with parenting, it is difficult to define what exactly is a ‘responsible parent.’ One of the keys factors is knowing your child. This happens when parents stop and observe, getting to know their child’s unique personality, temperament, interests and challenges. It is also important to maintain preventative healthcare schedules and to learn the developmental stages children will move through.
A child’s personality and temperament can tell you how they might react to certain situations and how to best parent that child. Observe your child to determine where they need your guidance and when you can step back. As parents, we often address situations in the moment; and, these immediate responses tend to be emotion-driven. Wherever possible, allow your child to work things out on their own. You can always talk about the situation again later.
When was the last time you gave your child undivided attention? Children need attention and they need to be engaged. Use their interests as positive reinforcement and give your child the attention they desire. Children tend to misbehave as way of asking for attention or asking for help engaging in an interesting activity. Could this be driving their behavior?
You may have heard the term “preventative care”. Well, this term applies to kids as well as adults. We can not stress enough the importance of managing your child’s health by maintaining regular immunizations, physicals and dental exams. Immunizations are scheduled at two, four, six, twelve and fifteen months. Physicals are due shortly after birth and at two, four, six, nine, twelve, eighteen, twenty four months and yearly thereafter. Preventative health is a key factor in healthy development and a healthy child is a happy child.
It is important to understand the developmental stages of your child. This will help you know if they are reaching the appropriate developmental milestones. A delay can significantly impact your child’s behavior. For example, children who are unable to speak have a tendency to begin biting and might exhibit other behavior changes. They may become aggressive towards other children. If this is the case, your pediatrician will be able to assess and refer your child for help as necessary.
“Developmental delays that are caught quickly are less likely to have serious consequences. Regular checkups with a pediatrician can help make sure your child stays well and grows strong,” says Dr. Kelly Motadel, Medical Director and pediatrician at Vista Community Clinic.
A prompt response to speech and other developmental delays can help your child be ready to learn in school and avoid academic problems. You will be the first to notice your child’s changing behavior. If you are concerned, schedule an appointment with your child’s pediatrician and be prepared to ask questions. They can conduct an assessment or refer your child to a specialist if necessary. For more information about your child’s developmental stages visit the website at www.howkidsdevelop.com.
Observing your child, and staying informed in regards to preventative healthcare and child development are two key elements of responsible parenting. The Dads Club, Baby Connection and Rays of Health programs at Vista Community Clinic are committed to teaching responsible parenting through educational sessions.
Silvia Alcantar is a Program Manager in the Maternal Child Health Center at Vista Community Clinic. She is also a parent. For more information please contact Silvia at (760) 407-1220 Ext. 113.
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The benefits (and myths) of breastfeeding
Melinda Bender, Vista Community Clinic
Choosing whether to breast or formula feed can be a very difficult decision for new moms and their families. In some cases, breast feeding is not an option. However, the majority of women can breastfeed but are bombarded with conflicting information and discouraging misconceptions.
Many scientific studies have shown that breastfeeding is far superior to formula feeding and has benefits for babies, mothers and society. In this article we will look at both the benefits of and the myths surrounding breast feeding.
Breastfeeding benefits babies. Children who are breastfed have shown to have less acute illness such as ear infections, Bronchiolitis, upper respiratory infections, diarrhea and vomiting. Breastfed children also have lower risks for some inflammatory bowel diseases like Crohn’s disease and ulcerative colitis. It can also lower the risk for childhood cancers such as Hodgkin’s disease and leukemia as well as decrease the risk for obesity and diabetes. Additionally, breast milk provides protection against asthma, eczema, and allergies and can lead to fewer cavities or the need for braces.
Breast feeding benefits moms. Mothers who breastfeed often have a quicker recovery from childbirth and a deceased risk of postpartum bleeding. There is less risk for anemia and delayed return of the menstrual cycle. These mothers often see a quicker return to their pre-pregnant weight.
Just as important- breastfeeding encourages the important bond between mother and child.
Beyond the value added to the family, breastfeeding offers economical and environmental benefits for our society. By improving the health of mother and baby, breastfeeding decreases the costs associated with avoidable medical conditions, sick days, and the expense of purchasing formula.
Mothers who breastfeed use less packaging and plastic products than those who purchase formula. Additionally, they avoid the use of electricity and fuel needed to prepare formula; thus making breastfeeding a more environmentally friendly decision.
With all these benefits, why are many mothers still choosing to formula feed? Unfortunately, there are myths in our society that say formula feeding is a symbol of modern progress and affluence. Furthermore, some still believe incorrectly that breastfeeding will lead to saggy, drooping breasts and many mothers worry that their babies are crying because of insufficient milk. None of these myths are correct but their existence does prevent moms from making a fully informed decision.
Health educators, physicians, nurses and health practitioners are in a unique position to fully inform their patients of the benefits of breastfeeding. At the Vista Community Clinic, we provide new moms with at least one home visit to answer any questions about infant care, encourage breastfeeding and pediatric wellness. First time and at-risk moms are followed closely through the Baby Connection Program.
For more information about breastfeeding, please visit the United States Breastfeeding Committee at www.usbreastfeeding.org, the U.S. department of Health and Human Services, Maternal Child Health Bureau at www.mchb.hrsa.gov, the American Academy of Pediatrics at www.aap.or/breastfeeding or ask your physician.
Melinda Bender, MSN, RNC, PNP is a pediatric nurse practitioner a Vista Community Clinic. She works with the Baby Connection Program to provide home visits for first time and at-risk moms. For more information please visit www.vistacommunityclinic.org or call (760)631-5000.
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