Hello Wichita Families!

Posted on July 1, 2010 by

This is Leslie Greenberg.  I am a family medicine doctor in Wichita, Kansas, where I have lived with my family since 1995.  I trained at St. Joseph Hospital in Wichita.  I also consider myself a teacher and educator.  I  have  taught family medicine residents for 13 years.  I have “hung my shingle” and  gone into private practice.  I invite you to read my blog.  If you would like to become a patient, please call 316 778 0919.

Medical Disclaimer

The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

Posted in Uncategorized

Hoarseness

Posted on October 14, 2010 by

Hoarse voice

Today, I am hoarse.  I whispered to my family yesterday and now I can talk to my patients.  I was given the advice that I “should start on something” to bring my voice back.  Hmmmmm. . . there are guidelines for the diagnosis and management of hoarseness.

I’ll break it down for you.  A full history and physical by your physician will reveal many hints.

Look for a cause of hoarseness.

  • Medications may cause hoarseness due to cough, dry mucous membranes or chemical laryngitis.
  • Underlying conditions like reflux can cause gastric acid to inflame the vocal cords. If reflux is symptomatic,  reflux medication may help.

When should medication be given for hoarseness?  The answer is rarely.   Steroids should not commonly be prescribed unless a specific diagnosis like recurrent croup is present.  Antibiotics should not routinely be prescribed either as the condition is usually not from a bacterial infection.

There isn’t much to DO about a hoarse voice.

  • Laryngoscopy  (a look-see with a scope down the throat)should be done if hoarseness does not resolve within 3 months or if a serious underlying cause is suspected and before voice/speech therapy is initiated.
  • Surgery should only be done on suspected laryngeal cancers or if other measures for soft tissues lesions do not help.
  • Botulinum toxin  (yes, botox!) is injected for those with spasmodic dysphonia.

Some red flags of hoarseness which may suggest a serious underlying cause of hoarseness are coughing up blood, neck mass, history of tobacco or alcohol use, symptoms occurring after trauma, unexplained weight loss, or worsening symptoms.

Preventive measures are staying hydrated, avoidance of irritants (like smoke and chemicals), voice training and amplification when needed.

Hope this helps.

Posted in Pediatrics, throat conditions, throat conditions | Tagged , , , , , , , ,

PSA no longer suggested for prostate cancer screening

Posted on May 30, 2012 by

The US Preventive Services Task Force this week formalized their statement regarding PSA, prostate specific antigen test. Their standpoint is firm:  do not routinely screen for prostate cancer by PSA.

A screening test is only for those who have NO symptoms or family history or risk factors for prostate cancer.  Read on for guidelines, statistics, and the controversy.  PSA?  or not to PSA? …

http://www.webmd.com/prostate-cancer/news/20120521/us-panel-dont-get-psa-prostate-cancer-test

Posted in General Medicine- Adults, Male issues | Tagged , , , , , , , , , ,

Do you have high blood pressure OR swelling of your ankles? Getting too much salt?

Posted on May 24, 2012 by

flickr.com/ photos/chicagoceli/ 207850721/

Sodium.  A villain of sorts.  Are you one of the 90% of Americans who consume too much sodium?  10 food categories account for a great deal of our sodium intake, per the Centers for Disease Control.

The top 10 culprits are:

  • White bread and rolls,
  • lunch meats (including deli turkey and ham),
  • pizza (frozen or restaurant),
  • poultry,
  • soups,
  •  sandwiches,
  • cheese,
  • meat dishes,
  • pasta dishes, and
  • salty snack foods (think popcorn, pretzels, and potato chips).

Most American adults eat or drink twice the amount of recommended daily sodium.  Most of the sodium is NOT added at the table.  The US Dietary Guidelines recommend sodium intake at less than 2,300 mg/day.  Whereas the average American consumes 3,300 mg daily from food alone.  Those with high blood pressure, diabetes, chronic kidney disease and African-Americans are suggested to take in less than 1,500 mg/day of sodium.

How to decrease your sodium intake?  Eat more fresh (or frozen) fruits and vegetables.  Prepare more food at home.  Decrease eating out.  Decrease eating processed (or boxed) foods.

More information is available at www.cdc.gov/salt or information on the DASH low-sodium eating plan at www.nhlbi.nih.gov/health/health-topics/topics/dash.

Posted in Diabetes, General Medicine- Adults, Uncategorized | Tagged , , , , , , , , , , ,

Whooping cough coming our way!

Posted on May 21, 2012 by

I’ve been asking for a year or two for unimmunized patients if they’d like the “tetanus with pertussis vaccine.”  Pertussis is whooping cough.  It is a cough that adults may get which is annoying, lasting for months and embarrassing.  In addition, at times dangerous for your health.  But, for children it can be overwhelming and require admissions to the hospital or death.

Here is an article of a Kansas City outbreak.  Kansas City. . .  just up the road. . . Now, do you want your TdaP vaccine?  CDC guidelines state that TdaP should be given to soon-to-be new parents and grandparents or once as an adult.

http://www.kansascity.com/2012/05/16/3616188/whooping-cough-spreads-in-johnson.html

Posted in Uncategorized

The 2,3,4,5 Principle of Men’s Health

Posted on May 19, 2012 by

flickr.com/photos/ benterrett/ 2917446319

Men often do not seek health care before they desperately need it.  This means… men may not have a family doctor who knows them; that does not mean they do not need one.  The U.S. Preventive Services Task Force helped create the 2,3,4,5 Principle of Men’s Health.

Men should get physicals at a minimum of

  • two times in their 20s,
  • three times in their 30s,
  • four times in their 40s,
  • and every year in their 50s.

These are physicals—no acute problems or traumas— at the same visit.    Each patient has a unique footprint: family and personal history, surgeries, medicines, allergies, travel history.  This unique compilation of facts requires individual suggestions.  Physicals address screening lab work, vaccines, or other preventive care that may of benefit.

The more you know about your own health, the better chance you’ll be around to reach your goals, enjoy life, and love your family.

If you are man who needs a family doctor, ask around for a good reference.  If you are woman who knows a man without a doctor, please help get him to one.  Make this life a good one.

Posted in General Medicine- Adults, Male issues, Uncategorized | Tagged , , , , , , , , , , , , , ,

Chest pain may be an unreliable factor for heart attacks…

Posted on May 15, 2012 by

flickr.com/ photos/ cobalt220/ 4343621338/

Journal of American Medical Association (JAMA) recently published an article showing chest pain is often absent in young women with heart attacks.

Women with heart attacks are more likely to have a heart attack without chest pain (compared to men).  Younger women who have heart attacks without pain are more likely to die in the hospital compared to men their age.  This information comes from data or more than 1 million patients.

The numbers were… 42% of women presented without chest pain compared to 30.7% of men.  14.6% in-hospital death rate in women compared to 10.3% among men.  If women were under age 45 the in-hospital death rate was 18% HIGHER than men.

Women—be aware of your cardiac risk factors.  Stop smoking.  Watch diet.  Exercise regularly.  Know your cholesterol numbers.  Being your own watchdog may help decrease your risk of heart problems.

Posted in General Medicine- Adults, heart, Uncategorized | Tagged , , , , , , , , , ,

Bearing Beef’s Bad news

Posted on May 10, 2012 by

flickr.com/ photos/ vistavision/ 3453762429

I live in the “beef belt” with neighbors driving cars with license plates reading “EAT BEEF.”   But, I must report on studies showing eating red meat is harmful.

Eating red meat is associated with a significantly increased risk of

  • total mortality,
  • cardiovascular disease mortality and
  • cancer mortality.

Studies of nearly 38,000 men and 83,000 women were followed every 4 years (up to 28 years of follow up).   The elevated risk of total mortality for a one-serving-per-day of red meat consumption was 12% for total red meat, 13% for unprocessed red meat, and 20% for processed red meat.

Good news.  Replacing one serving of red meat with one serving of fish, poultry, nuts, legumes, low-fat dairy products or whole grains daily was associated with a 7 to 19% lower risk of death.

MOO!

Archives of Internal Medicine, 2012 referenced.

Posted in General Medicine- Adults, Uncategorized | Tagged , , , , , , , , ,

Are you a Yeast-infection-sufferer?

Posted on May 4, 2012 by

Some women don’t ever get vaginal yeast infections.  Some women seem to never be WITHOUT a vaginal yeast infection.  A new study gives options to get rid of chronic yeast infections.

First we, physicians, need to make sure that the culprit is yeast.  About 70-80% of so-called yeast infections aren’t yeast at all.  Your doctor can perform an exam and send a sample to be cultured in the lab.  The lab will confirm that it is yeast.  We all have yeast on our skin, but some immune-compromised (those with diabetes or cancer) are less able to fight it.

Probiotics have shown effectiveness against

  • chronic Candida,
  • thrush (yeast in the mouth),
  • and vulvovaginal Candida.

It is thought that the probiotic secretes a surfactant that keeps the Candida from adhering to the tissues.   The study, published in the journal Mycoses 2012, showed patients taking probiotic of Lactobacillus rhamnosus and L. fermentum had significantly less yeast after 4 weeks than those that did not take it.

Hope this helps.

Posted in General Medicine- Adults, Uncategorized, Women's Health | Tagged , , , , , , , , , ,