For the time being, Evergreen Family Health, Charlotte Family Health and Alder Brook Family Health will not be scheduling office visits for anyone with cold, cough or fever symptoms. If you are calling for an appointment for these reasons, you will be offered a “televisit” with a provider instead. A televisit is an online video visit in which your provider can see you on a screen, and you can see the provider. This type of visit requires that you are signed up/enabled to use your patient portal. Televisits are billed to your health insurance. If you have a televisit, your provider will determine whether you can treat your symptoms at home or whether you should seek care at an urgent or emergency clinic, or whether you should be referred for coronavirus testing.
If a televisit is not possible for you, a nurse and/or a provider will call you on the phone as soon as possible.
In addition, if you have a pre-scheduled appointment, expect a phone call form your office in advance of the visit to ask if you also have a cold, cough or fever.
Thank you all for your understanding in these rapidly changing times.
If you have
traveled in the last 14 days to a high-risk area (Italy, China, Iran or South
Korea) or have had known contact with someone with COVID 19, we must direct you
elsewhere for testing. Following new guidance from the Centers for Disease
Control and Prevention, returning travelers whose last day in China, Italy,
South Korea or Iran was March 4 or afterwards should stay home and monitor
their health for 14 days after returning to the United States. Travelers
returning from Japan should monitor their health for 14 days after returning to
the United All travelers who have returned from those countries in the last 14
days should call Health Department epidemiology and infectious disease staff at
802-863-7240 to discuss monitoring. We cannot see you here at our clinic. We will call you back after discussing your
case with the Vermont Department of Health.
Is it
safe for me to come to Evergreen (Charlotte or Alderbrook)?
Yes. We have not had any patient or staff with
COVID19. We are not seeing any high-risk
patients at our offices.
Is it
safe for me to travel?
If you are
someone over 60 or if you have any chronic conditions like diabetes, COPD,
asthma or take any immunosuppressing medications we cannot recommend travel at
this time. If you must travel, we
strongly recommend frequent hand washing and hand sanitizing.
I have
lots of questions about transmission, areas of concern etc?
We suggest
you visit the Vt Dept of health website, or the CDC website and click on the
COVID 19 link.
Raising Healthy Children is a supportive family program, proven to help your family handle stress, reduce your depression, and prevent depression and anxiety in your children.
If you’ve had depression and have a child age 8-15, this 8-week program may be perfect for your family.
This is a group program, run by Gary Keller, MD, a Burlington psychiatrist and held at Evergreen Family Health in Williston Tuesdays from 6pm – 8pm.
For information or to enroll call 802-865-3450 ext 926 or email rhcoping@gmail.com
They’re not all the same, but we do have tips to help you deal with all of them.
Credit…Peter Gamlen
By Emma Pattee
Feb. 26, 2020
You probably experience worry, stress or anxiety at least once on any given day. Nearly 40 million people in the U.S. suffer from an anxiety disorder, according to the Anxiety and Depression Association of America. Three out of four Americans reported feeling stressed in the last month, a 2017 study found. But in one of these moments, if asked which you were experiencing — worry, stress or anxiety — would you know the difference?
I reached out to two experts to help us identify — and cope with — all three.
What is worry?
Worry is what happens when your mind dwells on negative thoughts, uncertain outcomes or things that could go wrong. “Worry tends to be repetitive, obsessive thoughts,” said Melanie Greenberg, a clinical psychologist in Mill Valley, Calif., and the author of “The Stress-Proof Brain” (2017). “It’s the cognitive component of anxiety.” Simply put, worry happens only in your mind, not in your body.
How does worry work?
Worry actually has an important function in our lives, according to Luana Marques, an associate professor of psychiatry at Harvard Medical School and the president of the Anxiety and Depression Association of America. When we think about an uncertain or unpleasant situation — such as being unable to pay the rent, or doing badly on an exam — our brains become stimulated. When we worry, it calms our brains down. Worry is also likely to cause us to problem-solve or take action, both of which are positive things. “Worry is a way for your brain to handle problems in order to keep you safe,” Dr. Marques explained. “It’s only when we get stuck thinking about a problem that worry stops being functional.”
Three things to help your worries:
Give yourself a worry “budget,” an amount of time in which you allow yourself to worry about a problem. When that time is up (start with 20 minutes), consciously redirect your thoughts.
When you notice that you’re worried about something, push yourself to come up with a next step or to take action.
Write your worries down. Research has shown that just eight to 10 minutes of writing can help calm obsessive thoughts.
Remember: Worry is helpful only if it leads to change, not if it turns into obsessive thoughts.
What is stress?
Stress is a physiological response connected to an external event. In order for the cycle of stress to begin, there must be a stressor. This is usually some kind of external circumstance, like a work deadline or a scary medical test. “Stress is defined as a reaction to environmental changes or forces that exceed the individual’s resources,” Dr. Greenberg said.
How does stress work?
In prehistoric times, stress was a natural response to a threat, like hearing a predator in the bushes. Today, it still prompts a behavioral response, firing up your limbic system and releasing adrenaline and cortisol, which help activate your brain and body to deal with the threat, Dr. Greenberg explained. Symptoms of stress include a rapid heart rate, clammy palms and shallow breath. Stress might feel good at first, as the adrenaline and cortisol flood your body, Dr. Marques said. You might have experienced the benefits of stress as you raced through traffic to get to an appointment, or pulled together an important assignment in the final hour. That’s called “acute stress,” and the rush wore off when the situation was resolved (i.e. you turned in your assignment).
Chronic stress, on the other hand, is when your body stays in this fight-or-flight mode continuously (usually because the situation doesn’t resolve, as with financial stressors or a challenging boss). Chronic stress is linked to health concerns such as digestive issues, an increased risk of heart disease and a weakening of the immune system.
Three things to help your stress
Get exercise. This is a way for your body to recover from the increase of adrenaline and cortisol.
Get clear on what you can and can’t control. Then focus your energy on what you can control and accept what you can’t.
Don’t compare your stress with anyone else’s stress. Different people respond differently to stressful situations.
Remember: Stress is a biological response that is a normal part of our lives.
What is anxiety?
If stress and worry are the symptoms, anxiety is the culmination. Anxiety has a cognitive element (worry) and a physiological response (stress), which means that we experience anxiety in both our mind and our body. “In some ways,” Dr. Marques said, “anxiety is what happens when you’re dealing with a lot of worry and a lot of stress.”
How does anxiety work?
Remember how stress is a natural response to a threat? Well, anxiety is the same thing … except there is no threat.
“Anxiety in some ways is a response to a false alarm,” said Dr. Marques, describing a situation, for example, in which you show up at work and somebody gives you an off look. You start to have all the physiology of a stress response because you’re telling yourself that your boss is upset with you, or that your job might be at risk. The blood is flowing, the adrenaline is pumping, your body is in a state of fight or flight — but there is no predator in the bushes.
There is also a difference between feeling anxious (which can be a normal part of everyday life) and having an anxiety disorder. An anxiety disorder is a serious medical condition that may include stress or worry.
Three things to help your anxiety
Limit your sugar, alcohol and caffeine intake. Because anxiety is physiological, stimulants may have a significant impact.
Check in with your toes. How do they feel? Wiggle them. This kind of refocusing can calm you and break the anxiety loop.
When you’re in the middle of an anxiety episode, talking or thinking about it will not help you. Try to distract yourself with your senses: Listen to music, jump rope for five minutes, or rub a piece of Velcro or velvet.
Remember: Anxiety happens in your mind and your body so trying to think your way out of it won’t help.
Too worried, stressed or anxious to read the whole article?
Here’s the takeaway: Worry happens in your mind, stress happens in your body, and anxiety happens in your mind and your body. In small doses, worry, stress and anxiety can be positive forces in our lives. But research shows that most of us are too worried, too stressed and too anxious. The good news, according to Dr. Marques, is that there are simple (not easy) first steps to help regulate your symptoms: Get enough sleep; eat regular, nutritious meals; and move your body
We are pleased to announce that Evergreen Family Health has been recognized by the Vermont Department of Health for meeting the Healthy People 2020 immunization target rates for the year 2018 for children aged 24 through 35 months.
After Hours Imaging (AHI) is a well-established full-service private imaging group based in Plattsburgh, NY. In Vermont, they are currently offering ultrasounds and are located at The Retina Center (off Swift Street in South Burlington). With time, we are hopeful AHI will also provide CAT scans and x-rays here in Chittenden County. Our patients have been saving hundreds of dollars utilizing AHI close to home for ultrasounds. For patients willing to travel to Plattsburgh, we are happy to arrange your x-rays, CAT scans, or bone density exams with AHI in their NY location.
We have been very impressed with their services.
Please visit their website www.afterhoursimaging.com or ask your Evergreen provider about this alternative to the local hospital for your imaging needs.
If you were born before 1957, you are considered immune. If you were born in 1957 or after, the recommendations get a bit more complex: -If you know you have received two measles vaccines, you’re all set. It was not until 1996 that a second measles booster vaccine started being recommended. So most immunized adults born in ’57 or after have only received one measles vaccine. -If you don’t know for sure your measles vaccine status, get another one. -If you are a health care worker, college student, or international traveler, make sure you have had two measles vaccines. -It is not harmful to get extra measles vaccine(s) if you’ve already been immunized but have no way to know your prior immunization status. -Another option is a blood test to check for immunity, called a measles titer.
Do you find that, lately, you get full more quickly or your weight has started creeping up and you’re not sure why? A drop in your metabolism may be to blame. Metabolism is the rate at which your body uses energy or burns calories, and it’s dependent on a variety of factors. “It takes a certain amount of energy just to breathe, but your metabolism also includes your daily activities and all the chemical reactions going on in your body—everything from breaking down food to building cellular structures,” says Reyhan Westbrook, Ph.D., instructor of geriatrics and gerontology at the Johns Hopkins School of Medicine in Baltimore. Here are three factors that can slow your metabolism—and the steps you can take to keep it going strong. “The main reasons for the decline of metabolism are biological, but lifestyle also plays a major role,” says Zhaoping Li, M.D., Ph.D., a professor of medicine and director of the UCLA Center for Human Nutrition at the David Geffen School of Medicine. Muscle is a major calorie burner. But after age 30, muscle mass decreases approximately 3 to 8 percent per decade. Because muscle burns more calories than fat, that decline can significantly reduce the amount of energy your body needs. “People also tend to be less active as they age, which decreases their energy (calorie) output,” Westbrook says. But changes in muscle mass and physical activity are only part of the equation. Activity inside of your body’s cells also slows down with age, says Westbrook. Mental health. Anxiety can also put the brakes on your metabolism. A 2015 study published in the journal Biological Psychiatry found that stress causes a decrease in calorie burning following a high-fat meal. “Since people tend to eat high-fat meals when they’re stressed, this could be a common occurrence,” says Janice Kiecolt-Glaser, Ph.D., director of the Institute for Behavioral Medicine Research at Ohio State University College of Medicine and the study’s lead researcher. Experts also suspect a link between depression and metabolism: “Depression has a direct impact on your appetite, food choices, and activity level,” Li says. Sleep. Getting enough sleep, and going to bed and waking up at consistent times, may help you burn fat more efficiently, Westbrook says. The National Sleep Foundation recommends that older adults get 7 to 8 hours of sleep per night, but health problems and medications often get in the way. Keeping Your Metabolism Up When faced with a slowing metabolism, your first instinct may be to eat less, but that can backfire. “When you restrict calories, you run the risk of not taking in enough protein, which can result in more muscle loss,” Li says. Even if you find that you get full more easily than you once did, it’s important to make sure you’re getting the nutrients you need. Focus on eating enough protein (the building block of muscle). The Dietary Reference Intake is 0.8 gram per kilogram of body weight (about 51 grams for a 140-pound person), but experts suggest that people ages 55 and older get a bit more. “Aim for at least 20 grams of protein per meal, or make 20 to 25 percent of every meal protein,” Li says. Try to include the nutrient every time you eat, rather than having all your protein in one sitting. Along with meat and seafood, eggs, cheese, nuts, and beans all provide ample amounts of protein. Building and preserving your muscle mass through strength training can also help keep your metabolism up. “Exercise like running and swimming promotes heart health, but resistance exercise preserves muscle mass,” Westbrook says. And research shows that your resting metabolic rate stays elevated by about 5 to 7 percent for up to 72 hours after a resistance session. Try a class at your local community center or YMCA, or check out the workouts on go4life.nia.nih.gov. Aim to do strength training at least twice a week. And don’t forget the importance of mental health and sleep: If you’re feeling persistent sadness or stress, talk to your doctor; to improve your sleep, exercise daily, stick to a consistent bedtime, and avoid alcohol and caffeine before bed.
Most people who report allergies to penicillin (PCN) are not allergic. About 1 in 10 patients has a PCN allergy noted in their medical record. Many such allergies are diagnosed in childhood, often because of a rash that may have been caused by a virus, not an allergy. Even among patients with true PCN allergy, 8 in 10 are no longer allergic within a 10-year period. It is important to find out if you are really allergic to PCN. Having an unverified PCN allergy may result in other antibiotics being used, which may increase the risk of treatment failure or more dangerous side effects.
If you have had a reaction to PCN such as hives, rash, swelling, or shortness of breath – especially if it has been many years since the reaction – and you wish to learn if you are still truly PCN allergic, please ask to be referred to an allergist for evaluation.
