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Why pregnant women should receive flu vaccine and pertussis booster

Why do we recommend that pregnant women receive both the flu vaccine and the pertussis booster during pregnancy? Here are a few reasons:
 
The influenza virus, better known as the flu, has been proven over and over to have the potential to cause serious disease in pregnancy.  That includes an increased risk that when pregnant women “catch” the flu, they may require admission to the intensive care unit, require a ventilator and, less commonly, even death.  It’s serious.   Babies of women who are infected with the flu during pregnancy are more likely to be born prematurely and are at increased risk for stillbirth.

We recommend the flu vaccine at any point in pregnancy and offer the single dose, preservative free vaccine in our office to all pregnant women (with the exception of those who have a medical reason not to get it.)  A common misconception is that the vaccine causes the flu - it does not.  Another misconception is that it is not safe for the developing baby to be exposed to the vaccine itself or the immune response it generates.  There is no evidence to support this fear in almost 50 years of administrating this vaccine and close follow up of those receiving it.

We recommend the flu shot, which is an inactivated virus. The Flumist is a live attenuated virus that is not recommended in pregnancy.

Your family members should also receive the vaccine as they can pass the flu on to a newborn who has not yet gotten the vaccine.  Babies can suffer severe complications if they are infected with the virus before they can receive the vaccine.
 
The other vaccine we recommend during pregnancy is the Tdap booster.  The benefit of the pertussis booster outweighs any perceived risk.  Pertussis, or the whooping cough, is at epidemic levels especially on the west coast including Washington State.  That may be  ...

New options for genetic testing in pregancy

Congratulations!  You just found out you are pregnant and so many things start going through your mind.  When you’re not dry heaving or completely exhausted you start planning for your exciting future but in the back of your mind you wonder… how do I know everything is okay with my baby?

We are entering an exciting time in the field of obstetrics that involves less invasive and more accurate options for genetic testing in pregnancy.  ACOG, the American College of Obstetrics and Gynecology, recommends that all women, regardless of maternal age, be offered prenatal testing for chromosomal abnormalities. 

For quite sometime our options for this testing have been somewhat stagnant.  We have offered noninvasive risk profiling that involves a mixture of blood tests and ultrasounds at various times in the first and second trimesters to help evaluate the baby’s risk for Down syndrome or other lethal chromosomal abnormalities.  Depending on how these tests are processed, the sensitivity ranges from 80-95% with about a 5% false positive rate.  They are fairly accurate at identifying babies at higher risk, but can have false positive results (meaning an abnormal result followed by more invasive testing that shows normal results but of course this causes a lot of worry for the patient). 

Obviously we want to be able to offer testing that has a high rate of detection and a low rate of false positives.  More invasive testing is often offered also.  This testing involves removing a sample of placental cells called chorionic villus sampling, or removing a sample of fetal cells from the amniotic fluid called amniocentesis.  These cells are then analyzed for chromosomal abnormalities.  Although these invasive tests are the most accurate, they do carry a small risk of miscarriage or fetal loss. 

Fortunately, new testing has come out on the market called cell free fetal DNA testing.  This is ....

How to treat PFS runner's knee

Patellofemoral pain constitutes a quarter of the injuries to the knee.  Kneecap pain can be both debilitating and frustrating; prolonged pain can limit physical activity and cause those suffering from it to abandon their recreational and sporting activities. 

Patellofemoral pain usually manifests as a gradual onset of pain around the edge or underneath the kneecap during physical activities.  Common activities such as descending hills or stairs, squatting, running, or sitting for long periods of time can all aggravate the pain and cause soreness. 

How your knee works

patellofemoral pain image from http://www.moveforwardpt.com/The knee joint is made up of three bones: the femur (thigh bone), the tibia (shin bone), and the patella (kneecap).  The patellofemoral joint refers to the kneecap and the groove (trochlea) in the femur in which the patella sits.  The four muscles of the quadriceps all attach to the patella.  The patella is a sesamoid bone (the bone is embedded within the tendon) and it plays a crucial role in the function of the leg by lengthening the lever arm of the muscles and tendons of the quad to maximize power and function and by acting as a shield to protect the knee from direct trauma.  The cartilage covering the kneecap within the knee joint acts as a shock absorber, protecting the underlying bone from stress.  With running and jumping, the knee (and its overlying cartilage) can experience forces up to 8 times bodyweight.  The cartilage itself does not have a nerve supply, but the bone underneath has an extensive nerve supply and these nerves become painful when the cartilage is not functioning properly to pad and protect the bone.

In patellofemoral syndrome, or PFS (also known as runner’s knee), the cartilage undersurface of the patella become angry, inflamed, irritated, and the kneecap hurts.

How to treat PFS or runner’s knee

  1. Loosen things up.  Use a foam roller to roll out the quad muscle and the illiotibial (IT) band.  These tissues all hook into the kneecap and can contribute to pain when they are tight.
     
  2. Make things stronger.   In the early recovery period (the first several weeks when you are just starting out on your recovery journey) ....

Minor & James Medical, a Swedish Health Partner, Welcomes Seattle Urological Associates

SEATTLE, Oct. 1, 2013 – Minor & James Medical, a Swedish Health Partner, announced today that Seattle Urological Associates is joining its medical group effective Oct. 1.

As an integrated practice of Minor & James, Seattle Urological Associates can now leverage many of the same resources and health practices that are available to Minor & James physicians and patients, including its electronic health records system, online access to health information and patient services through MyChart, imaging services and more.

Managing your fall allergies and symptoms

Although it’s hard to avoid everything that triggers fall allergies, there are many things that can be done to limit or treat the side effects so everyone can enjoy the season.

What allergies present in the fall?

Dirt-based molds are the main trigger of fall outdoor allergies. Mold is in decaying that plant material in yards and parks, as well as in pumpkin patches, hay and barns. Because we tend to close up our homes as the weather gets worse, inside allergens may get worse. Indoor mold, dust mites and our pets can trigger symptoms.

How do I know I have fall allergies?

Symptoms are the same as you might experience in the spring. Congestion, sneezing, post-nasal drip and itchy, watery eyes are the most common signs of fall allergies.

How can I limit allergens and reduce allergy symptoms?

Dozens of Swedish-Affiliated Physicians Recognized as 'Top Doctors' by Their Peers



SEATTLE, August 16, 2013 - Now in its 13th year, Seattle magazine recently published the results of their annual 'Top Doctors' survey in the July issue. As in past years, dozens of Swedish-affiliated (or credentialed) physicians were recognized in the popular issue due to being nominated by their peers.

Additionally, Seattle Metropolitan magazine published the results of its 'Top Doctors' survey in the August issue, in which dozens of Swedish-affiliated (or credentialed) physicians were also featured

 

How to Treat Different Types of Acne

I recently appeared in a video where I discuss the different types of acne and various ways to treat them. Click here to see the video or watch below:

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