Author: Roseman Medical Group

Jessica Peralez – April Clinic Spotlight

Posted on by Roseman Medical Group

Meet Jessica Peralez, lead Medical Assistant at Roseman Medical Group. Jessica plays a vital role at the clinic, interfacing between patients and the medical staff, keeping the daily processes moving and communicating to multiple parties.

We had the opportunity to learn more about Jessica and understand how her values guide her work with patients.

Q: Where are you from originally?
A: I’m originally from Orange County, California

Q: How did you end up in Las Vegas?
A: My family and I were seeking new lifestyle changes and adventures.

Q: Describe your professional journey and how it led to your current position.
A: Compassionate, loving and warm-hearted care for others in the medical setting.

Q: What is your favorite part of your job?  
A: Interaction with patients from all ages and cultures and seeing the results of making them feel important and well taken care of.

Q: How do you make patients feel comfortable and well-taken care of at the clinic?
A: First impressions are important in any interaction with a patient. Body language, appearance and giving my full undivided attention to just listen and empathize with their needs are so important.

Q: What does RMG do that is above and beyond other practices?
A: I have witnessed firsthand RMG providers and staff go above and beyond. RMG staff are indispensable in the healthcare community, and it’s just not because they understand how to draw blood and check vital signs. They go above and beyond the call of duty for their patients every day, ensuring a safe and nurturing environment where patients feel secure and reassured during the most difficult times.

Q: Do you have a favorite hobby or pastime?
A: My favorite thing to do is just spend every moment with my family, making memories, seeking new adventures or just simply enjoying a cozy night at home playing board games or watching the latest movie.

Q: How have you been practicing your own self-care amidst a global pandemic?
A: Now more than ever, it important to practice self-care for my emotional health and well-being. Practicing better hand hygiene, making more time for physical, emotional, spiritual, or mental health are all how I stay well.

Lending an ear, sharing a smile, and caring for your well-being is what we do. Our friendly, caring staff and providers are here for you. Call 702-463-4040 to schedule an appointment today.

Everything You Need to Know About Parkinson’s Disease

Posted on by Roseman Medical Group

What is Parkinson's Disease?

Parkinson’s Disease, also known as PD, is a progressive neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra. In simple terms, Parkinson’s Disease is a nervous system disorder that affects movement. PD is considered a diverse disorder that develops slowly over time and is different for everyone – no two people experience PD in the same way. Approximately 60,000 Americans are diagnosed with PD each year and over 10 million people worldwide are living with it.

What are the Causes of Parkinson's Disease?

Although the cause of Parkinson’s Disease is unknown, it is believed to be a combination of genetics, environmental factors and lifestyle choices that collectively determine whether someone will develop PD or not. With PD, certain nerve cells, known as neurons, in the brain gradually break down or die. Many of the symptoms of PD are due to a loss of neurons that produce dopamine, a chemical messenger in your brain. When dopamine levels decrease, it causes abnormal brain activity, leading to impaired movement and other symptoms of PD.

According to experts, genetics cause roughly 10 to 15 percent of all PD. Researchers have found over the years specific genetic mutations that can cause PD. These mutations are uncommon except in the few cases where multiple family members are affected by PD and therefore carry the same genetic mutation. These genetic mutations are inherited or passed down from generation to generation.

Over the years, scientists have discovered dozens of gene mutations that are linked to Parkinson’s Disease; however, if someone has one of these gene mutations the probability of developing PD is low.

Environmental causes of Parkinson’s Disease include such things as:

  • Traumatic Head Injury
  • Area of Residence
  • Occupation
  • Exposure to Metals
  • Solvents & Polychlorinated Biphenyls (PCBs)
  • Pesticide and Herbicide Exposure
  • Age
  • Gender

Through years of research, scientists have also found that there are certain factors that may reduce the risk of developing Parkinson’s Disease such as:

  • Caffeine
  • Uric Acid or Urate
  • Anti-inflammatory Drugs
  • Smoking
  • Cholesterol Levels
  • Vitamin D
  • Exercise

What are the Symptoms of Parkinson's Disease?

There are both movement and non-movement symptoms of Parkinson’s Disease to be aware of. PD symptoms usually begin gradually and get worse over time. The rate at which the symptoms progress differs among everyone diagnosed with PD. 

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Parkinson’s Disease movement symptoms include:

  • Bradykinesia (Slowness of Movement)
  • Dizziness or Fainting
  • Drooling
  • Dyskinesia
  • Dystonia
  • Facial Masking
  • Postural Instability (Trouble with Balance & Falls)
  • Rigidity (Stiffness)
  • Stooped Posture
  • Tremor
  • Trouble Moving or Walking

Of the movement symptoms listed above, there are three (3) that are significant symptoms that help doctors make a PD diagnosis. The three (3) symptoms are Bradykinesia, tremor and rigidity.

Bradykinesia

Bradykinesia is defined as slowness of movement and is one of the symptoms that must be present to be diagnosed with Parkinson’s Disease. There are various ways in which individuals will experience slowness of movement. Someone diagnosed with PD may experience a reduction of automatic movements which are things like blinking. They may have trouble initiating movements like getting up out of a chair. They may experience general slowness in physical actions, or they could have abnormal stillness or a decrease in facial expression.

Tremor

A tremor, also defined as shaking, usually begins in a limb, often your hand or fingers. Those diagnosed with Parkinson’s Disease typically experience a resting tremor which means the shaking occurs mostly at rest and lessens during sleep and when the body part is actively in use. In most cases, PD patients experience the tremor in their hands, but tremors can also appear in other parts of their body, including their lower lip, jaw or leg. As the disease progresses the tremor, that typically only affects one side of the body, can progress to both sides.

Rigidity

Rigidity is defined as stiffness or tightness in limbs. Rigidity can occur on one or both sides of the body and can contribute to a decreased range of motion. This decrease in motion can lead to problems with achiness or pain in the muscles or joints affected.

To be diagnosed with Parkinson’s Disease, Bradykinesia plus either tremor or rigidity must be present.

Although Parkinson’s Disease is a neurological movement disorder, most individuals diagnosed with PD will also experience other health problems not related to movement. Some of these “other health” problems also labeled as non-movement symptoms include:

  • Anxiety
  • Apathy
  • Breathing & Respiratory Difficulties
  • Cognitive Changes
  • Constipation & Nausea
  • Dementia
  • Depression
  • Fatigue
  • Hallucinations/Delusions
  • Loss of Smell
  • Pain
  • Skeletal & Bone Health
  • Skin Changes
  • Sleep Disorders
  • Small Handwriting
  • Speech & Swallowing Problems
  • Urinary Incontinence
  • Vertigo and Dizziness
  • Vision Changes
  • Weight Management

What are the Stages of Parkinson's Disease?

There are various ways in which doctors describe the stages of Parkinson’s Disease. The Parkinson’s Foundation separates PD into five (5) stages. These stages correspond to both the severity of the movement symptoms and how much PD is affecting a person’s daily activities.

Stage One (1)

In Stage One of PD, symptoms are mild and typically do not interfere with daily activities. During this stage tremors and other movement symptoms begin on only one side of the body.

Stage Two (2)

In Stage Two of PD, symptoms start to get worse and tremors and other movement symptoms such as rigidity start affecting both sides of the body. Daily tasks take longer and are more challenging to complete.

Stage Three (3)

In Stage Three of PD, also known as the mid-stage, loss of balance and slowness of movements are the most common symptoms. Individuals with PD that advance to this stage fall more often, and dressing and eating become very difficult. They are still independent, but daily life is progressively getting more challenging.

Stage Four (4)

In Stage Four of PD the symptoms are severe and very limiting. Individuals with PD at this stage can stand on their own, but most likely require a walker to move anywhere. At this stage individuals with PD are no longer able to live alone.

Stage Five (5)

In Stage Five of PD the disease is the most advanced and the symptoms are debilitating. Individuals with PD who have advanced to this final stage are unable to walk and require a wheelchair or are bedridden. In addition, they require 24/7 care. 

Is there a Cure for Parkinson's Disease?

There is no cure for Parkinson’s Disease; however, there are a variety of things that can assist with relieving symptoms. Treatment includes such things as

  • Prescription Medications
  • Physical Therapy
  • Occupational Therapy
  • Surgical Options
  • Medical Marijuana
  • Over the Counter & Complementary Therapies
  • Exercise
  • Clinical Trials

It is important to note that there is no standard treatment for Parkinson’s Disease and treatment is different for everyone based on their symptoms.

Treating Parkinson's Disease at Roseman Medical Group

At Roseman Medical Group (RMG), the clinical practice of Roseman University’s College of Medicine, our neurologists provide empathic, patient-centered, evidence-based care. If you have a friend or family member who suffers from Parkinson’s Disease, let RMG’s expert neurologists help! Contact us today!

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Donate Your Brain for Research

Posted on by Roseman Medical Group

Article courtesy of NIH News in Health from the National Institute of Health (NIH)

Your brain lets you think, feel, move, and breathe. But when something goes wrong, it can cause devastating disorders. Brain donations help researchers study brain disorders that affect millions of people.

Scientists need donations from both people who have suffered from brain disorders and those who were healthy. These donations help researchers learn about brain injuries and diseases like Alzheimer’s disease. A better understanding of brain disorders may bring new treatments in the future.

Anyone over 18 can choose to donate their brain. Scientists need brains from diverse groups. It’s important to study brain diseases in many populations.

One donated brain can make a huge impact. It could provide information for hundreds of studies.

If you’re considering brain donation, note that being an organ donor on your driver’s license is different. Brain donation is a separate process.

First, talk with your family and friends. Let them know early in your decision-making process. This may reduce stress and misunderstandings at the time of donation.

You might also consider enrolling in a clinical study. Researchers learn the most from the brains of people who participate in studies while they’re still alive. This lets them track changes in memory, thinking, language, and behavior over time.

Roseman Medical Group Provider Perspective

David Ginsburg, MD
Neurologist
Roseman Medical Group

“From both the personal and professional levels, I have witnessed first-hand the devastating effects neurodegenerative diseases have on my patients and their families.  For example, I have seen countless numbers of patients with Alzheimer’s disease and ALS relentlessly deteriorate cognitively and physically, to the point where they are completely dependent on others for their basic survival needs.  Since brain biopsies are not routinely performed in the evaluation of such patients, researchers are completely dependent upon the generosity of brain donors in order to help identify the causes and treatments of such overwhelmingly destructive diseases.  Brain donations also help provide a sense of closure for the families of patients, in that their diagnoses can be confirmed or excluded.”

A special thank you to NIH News in Health from the National Institute of Health (NIH) for sharing this informative, shareable article. Learn more about why people donate their brains, the process of donation, and how you or someone you know can enroll to make a generous gift for future generations, visit National Institute on Aging for more information.

Dr. David Ginsburg is dedicated to providing patient-centered care and specializes in the diagnosis and treatment of the nervous system and neurological disorders such as dementia, Alzheimer’s, Parkinson’s, Huntington’s, and ALS. To schedule an appointment with Dr. Ginsburg, call 702-463-4040.

The Stories Your DNA Tells About You

Posted on by Roseman Medical Group

On Thursday, February 18th, Dr. David Rawlins, Associate Professor in Roseman’s College of Pharmacy, presented to roughly 60 guests via Zoom for the February Neighborhood Health Series event entitled, “The Stores Your DNA Tells About You: From Your Ancestry to How You Might Respond to a Medication.” This event was made possible by the partnership with Clark County Credit Union, the Series sponsor. The Series was created to bring our community together to discuss important healthcare topics in a supportive and collaborative environment. All NHS events are free to the public, and before COVID-19, were held in person at Roseman’s Summerlin Campus.

The presentation focused on the basics of Genetics including chromosomes and inheritance, Genes, mutations and alleles, Genetic Markers and how we use them, including polymorphisms, forensic investigations, and ancestral tracing and Pharmacogenomics, including what genes impact medications and genes of concerns.

A Review of DNA

Dr. Rawlins opened the presentation of a review of DNA. Our 20,000-25,00 genes contain roughly 27,000 nucleotides per gene and our genes are a segment of our DNA that codes for a functional component of the cell. The gene is considered the “unit of heredity”. Each person has 46 chromosomes that carry the traits that are most evident like hair color and height. Our DNA can be damaged, repaired, and also can mutate. Some of these mutations can be passed down to our children, with a greater likelihood if both parents are carriers. Dr. Rawlins went on to explain mitochondrial DNA and Neanderthal DNA, which has recently been linked to a lower chance of contracting deadly viruses, including COVID-19.

Analysis of DNA Through Test Kits

There has been a proliferation of home DNA test kits, direct to consumer, that allow consumers direct access to their ancestry, to learn more about their genetics, and what diseases they may be more susceptible to, as well as how their genes may determine the effectiveness of certain drugs. Genetic markers provide information that can help identify people from remains or evidence left behind, relatives through ancestral tracing, susceptibility to disease and determine how a person might respond to a medication. While at home kits may yield slightly different results, DNA sequencing is increasing in accuracy. Analysis of our DNA can also show what DNA we share with our relatives.

DNA Provides a Glimpse into Disease

Some DNA variants or polymorphisms are associated with disease and can yield clues on what diseases a particular person need look out for such as the IR gene, which is associated with Migraines, or CNP, which is associated with Autism. Most women have heard of the BRCA gene 1 and 2, associated with higher risk of breast and ovarian cancers. These variants are more likely to be found among people of Ashkenazi Jewish descent. Women who are known carriers of the BRCA gene can work with their physicians to determine if they need greater vigilance or frequency to their preventative care.  Some variants are more closely associated with increase susceptibility to COVID-19, and with more dramatic outcomes after contracting the disease.

Response to Medications

Pharmacogenomics looks at how genetic variations change our response to certain drugs. The goal is to then select the best drugs for patients before initiating treatment so that patients have the very best outcomes. This information also helps drug companies in the pursuit of drug development. Pharmaceutical response in a person is determined by multiple lifestyle factors, but genetic factors determine variability in the half-life of drugs in a person. This understanding can help determine the response to drugs including the absorption, distribution, metabolism, and excretion of the drug as well as how the immune system interacts with the drug. These discoveries are impacting how drugs are labeled and screened, and ultimately how drugs may be dosed differently by person. Dr. Rawlins took guests through different gene profiles and demonstrated the differences in how these genes determined different outcomes in a patient based on the prescribed drug and its dosage.  As we move forward, more genetic testing may be done as part of a patient’s history and initial screening, but there is also opposition to this.

Learn more about Dr. Rawlins and view the event in its entirety at speakers.roseman.edu.

In closing, one of the best things about this Series is the diversity and engagement of the audience. We enjoyed the participation of prospective students, current students, faculty, community members, all who bring different perspectives. We also welcomed some participants who were scientists themselves and had a very advanced understanding of the material. The interaction and learning at all levels are really very powerful. We hope you can join us in the future!

Roseman Medical Group is passionate about educating the community on topics of health and well-being. Stay informed by attending one of the free Neighborhood Health Series events or browse our blog for more healthcare topics.

Explore NHS Events

Article by Vanessa Maniago

COVID-19 Vaccine – How It Works

Posted on by Roseman Medical Group

At this time millions of Americans have received their first dose of the COVID-19 vaccine, and many have received their second dose. According to the federal data collected by the Centers for Disease Control and Prevention (CDC), more than 75 million doses have been administered in the U.S. While it seems like a significant number, it only accounts for 15 percent of the U.S. population.

As vaccines continue to be distributed and administered, there is still a large population that is hesitant to roll up their sleeves for the shots. According to data from a recent survey by the U.S. Census Bureau, 49 percent of respondents indicated uncertainty about receiving the vaccination. The top reasons cited behind vaccine hesitancy include concerns with possible side effects, planning to wait to see if the vaccines are safe, and the feeling that other people might need the vaccines more right now.

In addition, long-standing universal health and social inequities have placed many people of color at increased risk. According to The COVID Tracking Project, Black people have died at 1.4 times the rate of white people nationwide due to COVID-19. Additional data from the CDC demonstrates striking racial disparities in who is receiving the COVID-19 vaccine. Nationally, more than 15 percent of American adults have received at least the first dose of the COVID-19 vaccine and approximately 8 percent are fully vaccinated – but a disproportionately small number of them are people of color. Locally, we continue to see disparities in our own communities. The March 3, 2021 report from Southern Nevada Health District (SNHD) reported over 352,120 first dose administrations – 39.32 percent White, 18.57 percent Unknown, 13.98 percent Other, 11.55 percent Hispanic, 10.92 percent Asian or Pacific Islander, 5.44 percent Black, and .22 percent American Indian or Alaskan Native. 

Removing barriers for vulnerable populations, receiving accurate information from reliable resources, understanding how a vaccination works, knowing the side effects, and having more information on how and where to get vaccinated is key in stopping the spread of COVID-19.

COVID-19 Vaccines

Two COVID-19 vaccines authorized for emergency use have been administered in more than 75 million doses. The Moderna and Pfizer vaccinations which began distribution in the U.S. in December 2020 have over 90 percent effectiveness. Both the Moderna and Pfizer vaccinations are given in two doses and the vaccination is not complete until both doses are received.

In addition, on February 27, Johnson & Johnson announced that the U.S. Food and Drug Administration (FDA) issued Emergency Use Authorization (EUA) of its single-dose COVID-19 vaccine. The vaccine demonstrated an 85 percent effectiveness from a Phase 3 ENSEMBLE study. Shipments of the vaccine have begun, and Johnson & Johnson expects to deliver enough vaccines by the end of March to enable the vaccination of more than 20 million people in the U.S.

How do the COVID-19 Vaccines Work?

The mRNA vaccines utilized for COVID-19 teach the cells in the body how to make a spike protein (a small, harmless piece of the COVID-19 virus) to activate the body’s adaptive immune response.  When administered, the cells in the body work to make the spike protein. Once the spike protein is created, it sets off an alert to the immune system to recognize that it does not belong. At which time the immune system begins to make “memory” T-cells and antibodies that recognize the intruder (spike protein). The entire process trains the body how to recognize and destroy the real virus – should it ever encounter it.

The mRNA vaccines were quickly designed, tested, and mass produced because they do not contain live viruses like traditional vaccines – which requires a lengthy process of growing large quantities of infectious viruses and inactivating them. Because the mRNA vaccines do not contain live viruses, they are safer than traditional vaccines.

How do COVID-19 Vaccines Work? Vaccine teaches the body how to make spike protein. Immune system recognizes the spike protein doesn't belong. Immune system begins making antibodies that will work to protect against the real virus. Roseman Medical Group.

Are there Side Effects with the COVID-19 Vaccines?

It is typical to have some side effects from the vaccine as the body works to build protection. Side effects may affect the ability to do daily activities but should subside after a few days. Below are the common side effects according to the CDC.

  • Injection site reactions: pain, swelling, and redness
  • General side effects: fever, chills, tiredness, and headache

Helpful tips if pain or discomfort occur:

  • Contact your primary care doctor about taking over-the-counter medicine
  • Injection site: a clean, cool, wet washcloth can be applied over the area; using or exercising the arm
  • General side effects: drink plenty of fluids and dress in light clothing

It’s important to note that discomfort from fever and pain is normal. If redness or tenderness at the injection site increases after 24 hours or side effects do not seem to subside after a few days contact your primary care doctor or healthcare provider.

How do I get Vaccinated?

Current vaccination efforts are occurring throughout the U.S. It’s important to check with local authorities on the eligibility of COVID-19 vaccination. Effective March 2, 2021, SNHD identified health care workforce (previously in Tier One), Nevadans 70 years and older, Nevadans 65-69 years, public safety and security, frontline community support, and frontline supply chain and logistics as groups that are eligible for COVID-19 vaccination.

If you or someone you know falls within the above groups, book an appointment to get the first dose. Appointments in Southern Nevada can be booked through SNHD or our very own Roseman University of Health Sciences who has joined efforts to administer the COVID-19 vaccines to our communities through the Roseman University COVID-19 Vaccination PODs.

Vaccination is Important

As we continue to see COVID-19 variants emerge around the world, it’s more important than ever to get vaccinated in order to stop the spread and end outbreaks. While Roseman Medical Group is not currently administering COVID-19 vaccines at this time, we are dedicated to providing you with valuable resources to help protect yourself, your loved ones, and the community.

COVID-19 Vaccine FAQ
SNHD Vaccine Opportunities
Schedule Your Vaccine at Roseman University

The primary care providers at Roseman Medical Group are dedicated to offering patient-centered care and are here to help you in your health and well-being journey. To schedule an appointment with one of our providers call 702-463-4040.

Updated March 4, 2021 at 11:27am to include “Locally, we continue to see disparities in our own communities. The March 3, 2021 report from Southern Nevada Health District (SNHD) reported over 352,120 first dose administrations – 39.32 percent White, 18.57 percent Unknown, 13.98 percent Other, 11.55 percent Hispanic, 10.92 percent Asian or Pacific Islander, 5.44 percent Black, and .22 percent American Indian or Alaskan Native.”

Updated April 13, 2021 at 3:48pm to include CDC and FDA announcement. Additionally, following the announcement by the FDA and CDC, Roseman University is following the agencies’ directives and temporarily pausing the administration of the J&J vaccine. The health and safety of our community are our top priorities.

Article by Kristine Campo

Featured Healthcare Provider – Daniel Navarro, DNP, APRN, FNP-C

Posted on by Roseman Medical Group

Daniel Navarro, a practicing Family Nurse Practitioner at Roseman Medical Group (RMG), is dedicated to providing quality, patient-centered care based on evidence-based practice. A Bachelor of Science in Nursing, Master of Science in Nursing, and Doctor of Nursing Practice degree from the University of Nevada, Las Vegas (UNLV) are just a few of the credentials Dr. Navarro holds in regard to practicing in family health. In addition, Dr. Navarro holds a Post-Master Advanced Graduate Certificate of Psychiatric Mental Health Nurse Practitioner from University of Nevada, Reno (UNR).

As a child growing up in Venezuela, Dr. Navarro dreamed of helping others by becoming a healthcare professional. An opportunity presented itself 29 years ago when he came to Las Vegas, NV as an international student. Early in his educational endeavors, Dr. Navarro took a nursing assistant course which led him into the profession of nursing. Dr. Navarro’s professional career has spanned over 25 years – 15 years as a licensed practical nurse, registered nurse, director of nursing, and regional director of clinical services for a skilled nursing care organization and over 10 years caring for people of all ages and populations as a family nurse practitioner including his current RMG position. In addition, Dr. Navarro has had the privilege of shaping future nurses as a nurse educator and administrator.

Acheiving Healthcare Goals through Patient-Centered Care

When asked what his favorite part of his job is, without hesitation Dr. Navarro replies, “patient interaction and care.” Providing patient-centered care to patients within family health is his guiding principle. Working with patients and helping them achieve and maintain optimum health is his ultimate goal.

As a compassionate and dedicated provider, Dr. Navarro believes it’s a true partnership when it comes to patient care in family health. “I want my patients to know that we’re partners in terms of healthcare. I’m here to help them achieve their healthcare goals by covering where they are now, where do they want to be, and how they can get there.” He truly believes a patient-centered approach is essential to family health and that patient choices are important to integrate in the care and guidance of patient care. In addition, he believes that having an empathetic, consistent, caring relationship, and good/kind laugh with patients are fundamental in building a therapeutic and trusting relationship with patients.

Navigating COVID-19 Together

It’s the patient education and positive reassurance that has really helped Dr. Navarro connect with his patients through the uncertainty of COVID-19. As we’ve navigated through COVID-19 over the last year, Dr. Navarro has continued to provide quality, patient-centered care to his patients through both in-office and Telemedicine appointments. Although Telemedicine provides a different component to care, Dr. Navarro believes it has generously provided opportunities to connect with his patients in the midst of uncertainty. Whether to provide a medication refill, review lab work, or simply have a conversation about how to navigate uncertainty in a healthy way, Telemedicine has allowed Dr. Navarro to reach his ultimate goal of working with patients and helping them achieve and maintain optimum care.

In addition, Dr. Navarro shares his own self-care practices amidst the global pandemic to give insight into how we can all navigate COVID-19 together to ensure our health and well-being.

  • Practicing the guidance of the Centers for Disease Control and Prevention and health experts – wear a mask, stay 6 feet away from others, avoid crowds, wash hands often, cover coughs and sneezes, clean and disinfect, monitor health daily, and get vaccinated to protect against COVID-19
  • Caring for mental health – put things into perspective, debrief with friends and colleagues, practice mindfulness, and know we’re going to get through this
  • Utilizing technology to stay connected – video chat and phone calls

The healthcare providers at Roseman Medical Group provide quality, empathic, and patient-centered care. If you’re looking for a primary care physician that is compassionate and kind-hearted contact RMG to schedule an appointment with Daniel Navarro, DNP, APRN, FNP-C. Call 702-463-4040.

Article by Kristine Campo

March Health Monthly

Posted on by Roseman Medical Group

Dear Friends and Patients of Roseman Medical Group,

As we come out of February and move into March, we feel a renewed sense of promise that comes with Springtime. As much as Spring represents new starts, fresh buds on the trees, and suggestions of warmer days, this March holds even more hope of renewal given what we have gone through in the last year. Here in Nevada, on March 12, 2020, the world changed. Here we are a year later. While we have been faced with immeasurable loss, we are reminded of the strength of the human spirit, our tenacity and drive to work together to find new solutions, and our capacity for generosity, kindness, and service. Roseman University has volunteered countless hours to serve as a COVID-19 vaccination pod, and in doing so, has been part of a heroic effort across our community, state, region, and country to vaccinate our populations expediently and equitably. We are enormously proud of our students, faculty and staff that have come together to provide this service to our community. While every state has faced different challenges in deployment, we are making strides every week in protecting more and more of our community members. As of the end of February, Clark County had administered almost 400,000 doses.

We encourage all patients in the current eligibility groups to get vaccinated. COVID-19 vaccines will help to decrease the number of deaths and serious disease, reduce the extra burden COVID-19 is having on people already facing disparities, help our community return to normal, and increase the opportunity to improve the health and well-being of all Southern Nevadans.

Roseman University Vaccination Site Information

In this issue, read about how a balanced diet can center a health and wellness plan. Also read about vaccine hesitancy, and how vaccine rollout is being deployed nationally. In the face of COVID-19 lockdowns, we have seen a rise in children’s mental health issues. Read up on the early warning signs and how to find help if you suspect a child in your life needs help. Find out more about Daniel Navarro, DNP, one of our most beloved providers in the clinic. Humble, hard-working, compassionate, Dr. Navarro epitomizes the caliber of care we expect in the clinic.

On March 18, meet Dr. Eric Farbman, one of RMG’s Neurologists and Movement Disorder Specialists. Dr. Farbman will be presenting on the topic of Dementia, a symptom that can be suggestive of a number of different Neurological Diseases. Dr. Farbman is teaming up with Mike Kling, Estate Attorney, who will guide us through how to prepare our families for the onset of Dementia.

Register for Event

Thank you for allowing us the chance to provide your care. We are grateful every day to our patients and friends who trust us to oversee their health and well-being.

Stay healthy and well,

Andra Prum, D.O.

March Health Monthly Articles

A Balanced Diet – Covering the Five Groups
Children’s Mental Health – COVID-19 and Beyond
COVID-19 Vaccine – How It Works
Featured Healthcare Provider – Daniel Navarro, DNP, APRN, FNP-C
Roseman Dental – Orthodontic Treatment

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A Balanced Diet – Covering the Five Groups

Posted on by Roseman Medical Group

A balanced diet provides a proper amount of calories and nutrients to fulfill a person’s nutritional needs. By consuming food with nutritional value, your body receives the nutrients and calories needed to function correctly. The United States Department of Agriculture (USDA) recommends eating foods from the five groups to build a balanced plate.

  • Fruits
  • Vegetables
  • Grains
  • Protein Foods
  • Dairy

Building a balanced plate is essential to your health and can have positive effects which add up over time. To construct a balanced plate, one half should contain fruits and vegetables and the other half grains and protein. In addition, be sure to add a serving of low-fat dairy or another source of nutrients found in dairy to each meal.

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Fruits

Fruits icon from myplate.govWhen consumed as part of a healthy diet, fruits provide many health benefits. Known as nature’s candy – fruits are rich in nutrients such as potassium, dietary fiber, vitamin C, and folic acid. In addition, they are naturally low in fat, sodium, and calories. Daily consumption of fruit may be fresh, frozen, canned, or dried, and may be served whole, cut up, or pureed.

Vegetables

Vegetables icon from myplate.govLike their balanced plate partner, vegetables are low in fat and calories. Additionally they contain potassium, dietary fiber, folic acid, vitamin A, and vitamin C. Vegetables vary in nutrient count, therefore they are organized in five subgroups – dark green; red and orange; beans, peas, and lentils; starchy; and other vegetables. The USDA recommends consuming vegetables from each of the five subgroups every week in order to benefit from the various nutrients each provides.

Grains

Grains icon from myplate.govGrains make up ¼ of your balanced plate and are divided into two subgroups – whole grains and refined grains. Whole grains contain three parts of the grain – bran, germ, and endosperm. Refined grains are milled – removing the bran and germ – to provide a finer texture and improve shelf life.

At least half of the grains you consume should be whole grains. Healthy whole grains include:

  • Quinoa
  • Oats
  • Brown rice
  • Barley
  • Buckwheat

Protein Foods

Protein icon from myplate.govAs grain’s plate partner, protein foods make up the remaining ¼ of the plate. Protein foods are the building blocks for bones, muscles, cartilage, skin, blood, enzymes, hormones, and vitamins. They provide many nutrients to your body including B vitamins, vitamin E, iron, zinc, and magnesium. Selecting a variety of protein foods provides your body with an array of nutrients.

Protein foods include:

  • Seafood
  • Meat and poultry – lean or low-fat are best
  • Eggs
  • Beans, peas, and lentils – vegetarian options
  • Nuts, seeds, and soy products – additional vegetarian options

Dairy

Dairy icon from myplate.govApproximately 90% of Americans do not receive enough dairy, therefore most individuals miss out on the essential nutrients and benefits provided. Don’t be fooled by foods made from milk such as cream cheese, sour cream, cream, and butter. These foods contain little calcium, high fat content, a lack of nutrients, and are not considered dairy foods. Dairy consists of milk, yogurt, cheese, lactose-free milk, and fortified soy milk and yogurt.

Don’t consume dairy products? There are several non-dairy, calcium rich alternatives:

  • Calcium-fortified juices, cereals, breads, and plant-based milk alternatives such as almond milk or oat milk
  • Canned fish
  • Soybeans and soy products
  • Leafy greens such as collard and turnip greens, kale, and bok choy

Creating a Powerful Balanced Diet

A balanced diet is more than just making sure you eat the right amount of food from each of the five groups. Components from various foods are very beneficial when consumed together. Consuming foods in the right combinations can increase absorption of vitamins and minerals. For example, consuming vitamin C from citrus fruits and/or dark-green vegetables can enhance your body’s absorption of iron which is found in lean meat, fish, beans, and some leafy greens – when consumed at the same time. What are the benefits you ask? Well, research has shown that vitamin C combined with the phytoestrogen (plant-based compound) found in various fruits, vegetables, whole grains, and beans can constrain the oxidation of LDL (bad) cholesterol.

Maintaining a balanced diet is essential to your overall health and well-being. Consuming a diet with nutritional value provides many benefits. The primary care providers at Roseman Medical Group are dedicated to offering patient-centered care and are here to help you in your health and well-being journey. To schedule a wellness visit with one of our providers call 702-463-4040.

Article by Kristine Campo

February is American Heart Month

Posted on by Roseman Medical Group

Celebrate American Heart Month: Join the #OurHearts Movement

Did you know that people who have close relationships at home, work, or in their community tend to be healthier and live longer? One reason, according to the National Heart, Lung, and Blood Institute (NHLBI), is that we’re more successful at meeting our health goals when we work on them with others. NHLBI launched the #OurHearts movement to inspire us to protect and strengthen our hearts with the support of others.

Here are some facts, how-to tips, and resources to inspire you to join with others, even if you can’t be physically together, to improve your heart health. 

Heart disease is a leading cause of death for both men and women in the United States. Most middle-aged and young adults have one or more risk factors for heart disease, such as diabetes, high blood pressure, high cholesterol, or being a smoker or overweight. Having multiple risk factors increases your risk for heart disease.

Why Connecting is Good for Your Heart

Feeling connected with others and having positive, close relationships benefit our overall health, including our blood pressure and weight. Having people in our lives who motivate and care for us helps, as do feelings of closeness and companionship. 

Follow these heart-healthy lifestyle tips to protect your heart. It will be easier and more successful if you work on them with others, including by texting or phone calls if needed.

  • Be more physically active.
  • Maintain a healthy weight.
  • Eat a nutritious diet.
  • Quit smoking.
  • Reduce stress.
  • Get 7-8 hours of quality sleep.
  • Track your heart health stats.

You don’t have to make big changes all at once. Small steps will get you where you want to go.

Move More

Invite family, friends, colleagues, or members of your community to join you in your efforts to be more physically active:

  • Ask a colleague to walk “with you” on a regular basis, put the date on both your calendars, and text or call to make sure you both get out for a walk.
  • Get a friend or family member to sign up for the same online exercise class, such as a dance class. Make it a regular date!
  • Grab your kids, put on music, and do jumping jacks, skip rope, or dance in your living room or yard.

How Much Physical Activity is Enough?

Aim for at least 2½ hours of physical activity each week—that’s just 30 minutes a day, 5 days a week. In addition, do muscle strengthening exercises 2 days a week. Can’t carve out a lot of time in your day? Don’t chuck your goal, chunk it! Try 10 or 15 minutes a few times a day. NHLBI’s Move More fact sheet has ideas to get and keep you moving.

Aim for a Healthy Weight

Find someone in your friend group, at work, or in your family who also wants to reach or maintain a healthy weight. (If you’re overweight, even a small weight loss of 5-10 percent helps your health.) Check in with them regularly to stay motivated. Agree to do healthy activities, like walking or cooking a healthy meal, at the same time, even if you can’t be together. Share low-calorie, low-sodium recipes. Check out NHLBI’s Aim for a Healthy Weight web page.

Eat Heart-Healthy

We tend to eat like our friends and family, so ask others close to you to join in your effort to eat healthier. Together, try NHLBI’s free Dietary Approaches to Stop Hypertension (DASH) eating plan. Research shows that, compared to a typical American diet, it lowers high blood pressure and improves cholesterol levels. Find delicious recipes at NHLBI’s Heart-Healthy Eating web page.

Quit Smoking

To help you quit, ask others for support or join an online support group. Research shows that people are much more likely to quit if their spouse, friend, or sibling does. Social support online can help you quit.   All states have quit lines with trained counselors—call 1-800-QUIT-NOW (1-800-784-8669). You’ll find many free resources to help you quit, such as apps, a motivational text service, and a chat line at BeTobaccoFree.hhs.gov and Smokefree.gov.

If you need extra motivation to quit, consider those around you: Breathing other people’s smoke, called secondhand smoke, is dangerous. Many adult nonsmokers die of stroke, heart disease, and lung cancer caused by secondhand smoke.

Manage Stress

Reducing stress helps your heart health. Set goals with a friend or family member to do a relaxing activity every day, like walking, yoga, or meditation, or participate in an online stress-management program together. Physical activity also helps reduce stress. Talk to a qualified mental health provider or someone else you trust.

Improve Sleep

Sleeping 7–8 hours a night helps to improve heart health. De-stressing will help you sleep, as does getting a 30-minute daily dose of sunlight. Take a walk instead of a late afternoon nap! Family members and friends: remind each other to turn off the screen and stick to a regular bedtime. Instead of looking at your phone or the TV before bed, relax by listening to music, reading, or taking a bath.

Track Your Heart Health Stats, Together

Keeping a log of your blood pressure, weight goals, physical activity, and if you have diabetes, your blood sugars, will help you stay on a heart-healthy track. Ask your friends or family to join you in the effort. Check out NHLBI’s Healthy Blood Pressure for Healthy Hearts: Tracking Your Numbers worksheet.

Visit #OurHearts for inspiration on what others around the country are doing together for their heart health. Then join the #OurHearts movement and let NHLBI know what you’re doing to have a healthy heart. Tag #OurHearts to share how you and your family and friends are being heart healthy.

A big thank you to the National Heart, Lung, and Blood Institute for creating this informative, sharable article. We hope you’ll take advantage of the 7 healthy heart tips provided by NHLBI, as well as stay up-to-date on your wellness checks to ensure your health is in tip-top shape. Contact Roseman Medical Group at 702-463-4040 to schedule your wellness exam today!

Children’s Mental Health – COVID-19 and Beyond

Posted on by Roseman Medical Group

Childhood is often considered the best time of an individual’s life. Associated with a care-free sensibility and known as a time for discovery, childhood sets the foundation for lifelong learning, behavior, and health – mental health included.

Many factors such as genetics, environment, events, brain chemistry, life experiences, and unhealthy habits affect a child’s mental health. As a nation we’ve encountered a great deal of uncertainty, stress, fear, and grief within the last year. While COVID-19 has presented its challenges, it has help to shine light on our youth’s mental health.

Why is Children’s Mental Health Important?

Mental health is critical to overall health. Mental health encompasses emotional, psychological, and social well-being. It often affects the way one thinks, feels, and acts. In addition, it determines how an individual handles stress, relates to others, and makes choices.

The mental health of a child is vitally important as it affects the way they function at home, school, and in the community. A child with a mental health disorder may encounter delays in development and emotional milestones, as well as disruptions in learning healthy social skills and impaired or undeveloped coping skills. According to Children’s Mental Health Network, about 20 percent of children suffer from a mental health or learning disorder. Even more alarming is that nearly two-thirds of children that have a diagnosable mental health problem receive little to no help. In addition, the likelihood of an undetected childhood mental health disorder to appear in adolescences or adulthood is very high. While 80 percent of mental health disorders begin in childhood, only 50 percent begin before the age of 14 and 75 percent before the age of 24.

Infographic identifying mental health facts among children.

Mental Health During COVID-19

COVID-19 has created uncertainty, grief, fear, stress, and worry for many children. At the onset of the pandemic, children’s routines were disrupted as the nation went into lockdown. School and social interaction was drastically impacted as children were moved to virtual learning and asked to socially distance from friends and family. Amid the pandemic, many children missed rites of passage­­ such as graduations or birthdays, as well as other life events, such as family vacations or sporting events. As the pandemic continued through the holiday season many children may have been impacted by the change of traditions, loss of loved ones, or financial hardships of their families.

Although the complete impact of COVID-19 on U.S. children is still unknown, it’s important to note that even before the pandemic hit, mental health problems in children ages 6 to 17 were on the rise, according to the Centers for Disease Control and Prevention. Therefore, it’s important as caregivers, parents, teachers, family members, and doctors to identify possible warning signs during COVID-19 and beyond.

Mental Health Problem Warning Signs in Children

It can often be difficult to identify mental health problems in children because normal childhood development is ever-changing. In addition, warning signs can vary by age and younger children may not be able to explain their feelings or why they are behaving a certain way. It’s important to be aware of the warning signs that your child may be struggling as you play a critical role in knowing when they may need help.

Mental Health America has indicated that the following signs may indicate the need for help from a health care professional:

  • Decrease in school performance
  • Poor grades despite strong efforts
  • Persistent worry or anxiety
  • Repeated refusal to attend school or take part in normal activities
  • Hyperactivity or fidgeting
  • Constant nightmares
  • Continual disobedience or aggression
  • Frequent temper tantrums
  • Depression, sadness, or irritability
  • Attempts or thoughts of suicide

Additionally, it’s important to pay particular attention if your child experiences difficult situations. These situations can be hard for your child to understand on their own:

  • A major transition – new school, new home, etc.
  • Divorce or separation of parents
  • Loss of a loved one or someone close
  • Traumatic life experience – living through a natural disaster, etc.
  • Bullying or teasing
  • Difficulties in school

If your child has thoughts of suicide or attempts suicide seek help immediately. Suicide is known as the second leading cause of death for people 10 to 34 years of age, according to the CDC. As children navigate difficult situations – such as COVID-19 – the suicide risk increases. The Clark County School District in Las Vegas, NV alone has seen a large increase in youth suicides as the pandemic has unfolded. According to Nevada Public Radio, since the shutdown in March 2020, 19 children have died by suicide with 13 of those occurring after July 2020.

Ways to Support Your Child’s Mental Health

While all mental health issues can’t be prevented, there are ways to help keep your child as mentally healthy as possible during the COVID-19 pandemic and beyond.

During COVID-19:

  • Talk with your child about the pandemic – answer questions and share facts in a way that is understandable
  • Reassure your child that they are safe and it’s okay to feel upset – share helpful ways in which you deal with your own stress
  • Limit their exposure to news coverage and social media associated with COVID-19 – limiting misinterpretation and fear associated with things they may not understand
  • Try to stick to regular routines as much as possible
  • Be a role model – take breaks, exercise, eat and sleep well, and connect with friends and family even if it’s via phone, video chat, or mail
  • Spend time together doing meaningful activities such as readding, exercising, or playing board games

Beyond COVID-19:

  • Build trust by meeting your child’s physical and emotional needs
  • Foster healthy relationships with family and friends
  • Be consistent – children crave predictability and structure
  • Teach stress management and proactively identify specific things your child can do to keep their stress levels at bay
  • Establish healthy habits – diet, sleep, and exercise are essential to physical and mental health
  • Help your child develop their self-esteem
  • Take time to play together – laugh and create memories
  • Watch for red flags and seek professional help if you notice any of the warning signs mentioned in this article

Continue to be proactive about keeping your child as mentally healthy as possible. As a caregiver, you play an important role in your child’s mental health. If you have concerns about your child’s mental health, contact their healthcare provider. Your child’s social and emotional health is vitally important to their lifelong wellness.

As a parent or caregiver your mental health is important as well. If you have concerns with your own mental health, the healthcare providers at Roseman Medical Group are here to help. Schedule an appointment with one of our providers by calling 702-463-4040.

For immediate help in a crisis contact the National Suicide Prevention Lifeline at 1-800-273-8255 (en espanol: 1-888-628-9454) or the Crisis Text Line by texting HOME to 741741.

Article by Kristine Campo

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