May is Skin Cancer Awareness Month.

Skin is one of the largest organs of your body. It plays many important roles in keeping our bodies healthy, including protecting us from the harmful radiation of the sun.

• Skin cancer is the most common form of cancer
• About 5 million Americans are diagnosed with skin cancer each year (almost 10,000 a day)
• More people are diagnosed with skin cancer each year than all the other cancers combined
• 1 in 5 Americans will develop a form of skin cancer by the age of 70
• The rates of skin cancer are on the rise.

There are three main categories of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. Early detection is key, because when these cancers are diagnosed and treated early, people have excellent outcomes. Melanoma has a 99% 5-year-survival if caught and treated early. Yearly skin checks are important- remember your ABCDE’s when looking at any moles/dark spots (asymmetry, borders, color, diameter, evolving). Please also be on the lookout for patches of skin that feel like sandpaper (especially in areas you may have sunburned even once) or spots that are not healing.

Even more important than early detection is PREVENTION. About 90% of non-melanoma cancers are caused by UV exposure. The risk of melanoma doubles If you have more than 5 serious burns in your life. That means it’s very important to wear sunscreen and choose one with a broad spectrum of SPF 30 or higher every day. Sunscreen should be worn even if you are not going outside because the UVA rays penetrate through windows. Reapply sunscreen every 2 hours and after swimming or sweating. Be liberal with the sunscreen. Most people only apply about 20-25% of the recommended amount, which leaves you lacking protection. For most adults, a shot glass full of sunscreen is needed to properly protect the body. While spray sunscreens seem quick and efficient, the aerosolized particles can be inhaled and can be a lung irritant to others in the drift. They are also the least economical as most of the product is dispersed into the air rather than onto the body where it’s needed. Sunscreens sticks and wipes are a better choice for those who don’t like lotions and creams.

Choosing sunscreen:
Choosing sunscreen can be daunting with all of the different concoctions. Must haves are either broad spectrum (covering both UVB and UVA) or ones that report UVB and PA+, which refers to how much UVA protection that a product provides. Choose a product with PA+++ or PA++++ for proper protection. Chemical sunscreen vs. mineral sunscreen is a personal choice. The best sunscreen is a broad-spectrum sunscreen that you will wear- EVERY day. Get into the habit of putting on sunscreen right after brushing your teeth. Keep extra sunscreen in beach bags, the car, or by the front door. If you have concerns about sunscreens being safe for reef and aquatic life, look for products that are labeled ‘reef safe’. To find a sunscreen that meets your needs take a look at EWG’s Safe Sunscreen Guide.

Other tips to stay safe in the sun:
The right clothing can provide more protection than sunscreens. UV-blocking clothes, swimsuits, and rashguards are great choices. Invest in a hat with a large brim, neck coverage, and tight weave.
The whole family can benefit from eye protection provided by sunglasses that block UV rays.
UV rays are strongest at mid-day. Engage in activities in early morning or late afternoon when UV rays are lower.
If you have any questions or concerns about spots or non-healing spots please call us so we can make an appointment for you to be evaluated by your provider right away. Remember. early detection is the best medicine for skin cancer.

Concussion: Understanding the symptoms and treatment.

Mild traumatic brain injury (MTBI) or concussions are a significant problem in our community. The major causes are motor vehicle accidents, falls, and athletic
activities. It is estimated that as many as 10% of all athletes in contact sports may suffer a concussion, yet as many as half of sport-related concussions may go unreported. You may think that wearing a helmet will reduce the risk of concussion, but while wearing helmets in sports like football and snowboarding is extremely important to protect the skull, they do not eliminate concussions. The brain is not in a fixed position in the skull but rather cushioned by a layer of fluid. This fluid allows the brain to move and be protected while the body performs a variety of motions. Concussion occurs when the body is stopped abruptly and the brain impacts the interior of the skull creating a bruise-like injury on the brain. In some cases, the brain can impact one side of the skull and rebound off the other side creating multiple areas of injury to the brain. In fact, you do not have to hit your head to have a concussion!

Symptoms of concussion vary and can include feeling dizzy or losing consciousness, neck pain, vision or sleep disturbance, headache, memory problems and even mood disturbances. While most people recover within a week or two, some may experience persistent symptoms referred to as Post-Concussion Syndrome. At SDSM, we have practitioners such as Physical Therapist Katie Spurrell, with advanced training in treating concussion and specialized treatment programs to help patients with mild or persistent symptoms.

Once a concussion has occurred, there are important strategies that can help prevent additional damage and speed recovery. Early removal from play and educating sideline personnel on proper injury detection is very helpful. There can be barriers to detecting concussions such as the player’s lack of recognition and reporting of symptoms, fear of removal from play, and lack of proper training for sideline personnel. Proper treatment and rehab after injury can greatly improve outcomes for the concussed athlete.

What about rest?
Rest is one of the most widely used interventions for concussed athletes and may help ease discomfort during the acute recovery. However, 24-48 hours after injury, athletes can be encouraged to start slowly with low intensity movement or exercise that can become progressively more active as long as the activity does not bring on or worsen any symptoms.

Do I need treatment and what kind?
Most individuals will recover in 10-14 days, and currently there is minimal evidence to support treatment with medication during this period of time. Athletes that have persistent symptoms may also be experiencing injury to the cervical spine (neck) and vestibular system (inner ear). Individualized treatment may include:

• Aerobic exercises that are individualized and performed at a level that produces no symptoms.
• Physical therapy for patients with cervical spine or inner ear injuries.
• Cognitive-behavioral therapy to help with mood or behavioral issues.

How long will it take to recover?
It’s not uncommon to feel symptom-free before full brain recovery, so it is important to gradually increase activity before returning to work or play. The strongest predictor of recovery from a concussion is the severity of symptoms in the first, or few days, after the injury. The time course of recovery is different for everyone and may be influenced by various risk factors including persistent symptoms.

If you believe you may have a concussion or are experiencing persistent symptoms after and head or neck injury, SDSM has the knowledge and programs to help you heal. Early treatment is always best and persistent symptoms can be improved with proper therapy. Call us right away so we can provide the treatment you need in a timely fashion.

Are we ready to reduce restrictions? Do I still need to clean like a fiend?

As life returns to normal or the ‘new normal’, do you still need to take the same precautions cleaning groceries, washing vegetables and sanitizing your home? The short answer…yes. We aren’t entirely out of the woods with COVID-19 as scientists are still trying to understand how it replicates and how to prevent a second wave. So now is not the time to lighten up on anti-COVID routines. We continue to urge anyone with an underlying health condition to take extra measures to reduce the risk of COVID-19. You should also be clear on the differences between cleaning, sanitizing, and disinfecting and how to use recommended products. While few products have been tested against COVID-19 here is a list of approved disinfectants recommended by the CDC.

Cleaning: refers to the removal of dust, crumbs and other surface dirt. Do this before attempting to disinfect or sanitize any surfaces.
Sanitizing: the reduction of bacteria and germs, but not necessarily viruses.
Disinfecting: destruction of bacteria and viruses.

What should you sanitize or disinfect? All high touch surfaces, for example:
Doorknobs
Countertops
Keyboards
Cell phones
Travel mugs and bottles
Handbags
Wallets
Steering wheels
Sink fixtures and toilet handles
Light switches

Leave products on surfaces for the right amount of time:
Check the label on your product to see how long you should leave the sanitizer or disinfectant on the surface before wiping it dry. In general, these products take at least one minute, and in some cases up to four minutes to fully sanitize or disinfect a surface. Read labels carefully to be sure you are using the product correctly.

What about food from the grocery store?
While we do not believe the COVID-19 virus is foodborne, we do have some concerns about certain foods and how to handle them. The World Health Organization recommends to avoid consuming all raw meat and raw fish as the coronavirus is believed to have originated from markets selling live animals. Thoroughly cooking all meats and animal products will destroy the coronavirus. It is very susceptible to heat and will be destroyed at 170°. For comparison the surface of a frying pan is about 500°, average baking temperatures are 350°, and boiling water is 212°. Since there can be many handlers getting food from the farm to the table, we recommend the following:
Wipe down cans, boxes, and bags with a solution of soap and water, a sanitizing wipe, or spray and wipe.
Use a fruit and vegetable wash or a solution of white vinegar and water on fresh produce you intend to store in your refrigerator, and use clean containers, not the bags that just came from the store. Coronaviruses survive quite well in the refrigerator and even in freezing temperatures.
Cook vegetables and even fruits to completely destroy the virus if you are still concerned about exposure. You will still get plenty of vitamins, minerals, antioxidants, and fiber—everything your immune system needs!
Don’t forget to wash your hands immediately before eating.

What about dining out?
It’s fine to support your local restaurants, and even recommended! Just remove the food from the takeout container, use your own plate and utensils, and wash your hands thoroughly before eating. As an additional precaution, you could reheat food to a safe temperature of 170°. This might be best for those with underlying health conditions.

What’s most important about your food and nutrition right now is getting plenty of antioxidants, vitamins, and minerals. Your immune system relies on these in order to fight all sorts of diseases including COVID-19. Good nutrition and healthier habits can create better health in a very short time, and you don’t have to spend a small fortune on special products. Try eating a little less animal protein right now, boost your diet with fruits and vegetables, some whole grains, and try snacking on nuts and seeds. These foods contain everything your body and brain need for good energy, healthy moods, good sleep, and feelings of well-being. You can get more information on how eating plants can boost the immune system here. Eating more plants can improve your overall health and we would love to see you at your next check up with lower cholesterol, lower blood sugar, and better blood pressure!

Is it time for sports physicals?

Normally SDSM providers go to local high schools to perform sports physicals. These physicals are for athletes who need to be cleared to participate in their sport. While we are unsure of when sports will begin again, athletes will still need to get their physicals prior to starting practice. Due to the fact we can’t do a large mass participation event at the schools, SDSM has opted to provide sports physicals in the office. We are screening all patients who come into the office with a questionnaire for symptoms of COVID 19, and will do so for all sports physicals.

If your child needs a well child check or sports physical please call and schedule an appointment. Well child checks are covered under insurance, and sports physicals are $75. If you are interested in having an EKG (heart screening) along with the sports physical that would be an additional $25. We look forward to seeing you in the office!

A note about SDSM Urgent Care in Pacific Beach from Nurse Practitioner, Tess Maloney.

As a former Emergency Department and ICU nurse I feel proud that our Urgent Care is contributing to the COVID-19 Pandemic by doing our part to keep those patients we are able to effectively treat here out of the ED. SDSM Family Health Center and Urgent Care has been proactive in COVID-19 screening and safety measures since mid March per the most up to date CDC recommendations as the situation evolved. For weeks now our policy has been for all patients and staff to wear masks or face coverings at all times. All patients complete a screening questionnaire upon arrival. A dedicated exam room is used for patients with concerning symptoms. All exam rooms are thoroughly disinfected between patients and our HEPA Filtration system is running and serviced regularly. We continue to see a portion of our patients via telemedicine visits if appropriate. Combined, all efforts allow our office to remain open and available for walk in Urgent Care Visits seven days a week. Our patients requiring Sports Medicine attention or laceration repair recently have voiced appreciation for our services and the ability to avoid the Emergency Department during this time.

SDSM Urgent Care in Pacific Beach is another great resource for all of our patients and the community!

Special thanks to Scripps Ranch Community Association for their donation of 30 face shields for use at
SDSM clinics! We are very grateful for the kind and generous contribution to keep our staff safe.

Remember to take care of yourself.

SDSM is open and available to help you. Our offices are thoroughly cleaned and disinfected between each patient interaction and ongoing throughout the day. We can see you in person for general physicals, annual health assessments, management of chronic conditions, treatment of injuries, and treatment of illnesses other than cold/flu/COVID-19 symptoms.

If you have cold, flu or other respiratory illness symptoms, call our office. We can provide care for you safely through Telehealth. If you are at higher risk due to chronic conditions and need to stay at home, our providers can help manage your health conditions through Telehealth as well. Remember if you have diabetes, asthma, COPD, heart problems, impaired immune function, difficulty getting enough sleep, or are experiencing high levels of stress, it is important to call us. Working together, we can keep you healthy and safe.