Approximately 50 milliion Americans have hypertension.  The chance of having high blood pressure increases with age.  Most of the time people are unaware their blood pressure is high.  Especially if the pressure has been steadily increasing over time as they may not experience any symptoms.  This is why hypertension is often referred to as the “silent killer”.  People who do not have regular health check-ups may not realize their blood pressure is too high until it is too late and it causes bigger health problems.  Hypertension is a major risk factor for stroke, heart failure, and heart attack.

When the blood presure remains too high for many years without proper control it cause the heart, which is a muscle, to grow.  As the heart gets bigger it does not pump as efficiently.  This can lead to fluid build up in the lungs and causes congestive heart failure, or CHF.  Often CHF can be maintained with medications, but sometimes requires a pacemaker to help the heart pump properly.

In most cases the cause of hypertension is unknown.  Our risks for having high blood pessure increases with obesity, smoking, and inactive lifestyle, a family history of hypertension, salt sensitivity, excessive alcohol intake, some medications, and certain medical problems.  There are things we can do in out daily lifestyle to decrease our risk.  This would include maintaining a healthy weight , staying physically active, eating a healthy-low-salt diet, drinking little to no alcohol, and not smoking.  Thirty minutes of moderately hard exercise most days of the week will not only lower blood pressure, it also helps to reduce stress and control body weight.

When lifestyle changes are not enough to keep the blood pressure under control, medications are pescribed.  Once a person is started on blood pressure medications they should not stop taking them unless instructed by their health care provider.  It is also helpful to have a home blood pressure monitor which can be purchased at local pharmacies.  This allows for a writen record of home blood pressures for a health care provider to review at check ups.

Amey Moeggenborg PA-C

The most common cause of pain in the heel is a condition called Plantar Fascitis.

 Plantar refers to the bottom surface of the foot.  Fascia refers to a dense strong connective tissue layer or ligament that covers the bottom of the foot.  It grows out of the heel bone and inserts in the bases or beginnings of the toe bones.  There is fat between this ligamant and the skin, and there is muscle structure that is found between it and the foot bones.  Itis is the medical word that means inflammation.  Now you can understand that Plantar Fascitis means inflammation of the ligament that is in the bottom of the foot and goes from heel bone to toe bones.  In way of a little further explanation, connective tissue that hooks a muscle to a bone is a tendon, and one that connects bone to bone is a ligament.

 This Plantar Fascia usually gets sore and painful, inflamed, where it inserts into the heel bone.

 We think this tissue gets tiny tears in it from repetitive trauma, such as walking on harder surfaces, or running.  When these tears happen over and over the area eventually gets sore and painful, or inflamed.  Being overweight is a strong risk factor for this condition.  Wearing footwear that does not provide good arch support may also make the condition more likely.  There are much less common causes of heel pain but by far Plantar Fascitis is the most common cause.

 The heel area usually hurts when you first walk on it in the morning and anytime that you have walked on it alot.

 It is thought that many heel spurs may be a result of the chronic inflammation of Plantar Fascitis.  A heel spur is an overgrowth of bone which forms a point coming off the front bottom of the heel bone where the plantar fascia starts.

 Most times this condition will resolve with treatment utilizing most or all of the following things, but may take many, many months.

• anti-inflammatory medications
• quality shoes
• night splints
• stretching exercises
• heel pads or other inserts
• decrease in offending activity
• steroid injections

 In some locations, shock wave therapy may be available and has shown to be helpful.  Rarely surgery is necessary.

 Written by:  Michael Beasley M.D.

The thyroid gland is a bow-tie like structure located in front of the neck.  It is basically the metabolic warehouse of the body.  The hormones it produces have a widespread effect on the body’s chemistry and dictate the rate at which other glands and organs work.

“Hypo” means less than normal, so the term hypothyroidism implies an underactive thyroid.  The thyroid hormones are tri-iodothronine and thyroxine, and in the case of hypothyroidism, are under-produced.  Since these hormones govern the speed of metabolic processes, their lack leads to a slowing down of all body functions.

The usual cause of hypothyroidism is inflammation of the thyroid gland due to an autoimmune condition (Hashimoto’s), in which the body produces antibodies that attack the gland.  These antibodies damage the thyroid, rendering it unable to produce enough hormones  to maintain the body’s normal metabolism.  This condition tends to run in families and is most common in older women, although it can be seen in all ages and both men and women.  Less common causes of hypothyroidism is lack of the mineral iodine and damage to the pituary gland in the brain.  Iodine deficiency is rarely seen developed countries due to the addition of iodine to table salt.

Some of the symptoms of hypothyroidism are as follows:

1. fatigue
2. weight gain
3. swollen face and puffy eyes
4. thickened skin
5. thinning hair
6. hoarse voice
7. brittle nails
8. inability to cope with cold temperatures
9. swelling or lump in the neck (goiter)
10. constipation
11. depressed mood

You may experience all or only some of these symptoms if you develop hypothyroidism.  These symptoms typically arise gradually and may take several years to develop.  If left untreated long term, hypothyroidism can lead to coma, and rarely, death.

There is not a method to prevent the development of this condition.  It is best detected by screening.  During your yearly physical examination, your provider will examine your thyroid and draw blood to check your thyroid hormone levels to screen for this disorder in its early stages.  If either one of these screening mechanisms are abnormal, you may be sent for a thyroid ultrasound to get a visual image of the thyroid gland.

Treatment of all cases of hypothyroidism is with daily synthetic thyroid hormone replacement in pill form.

Written by:  Keri Hodgins FNP-BC

 The liver makes this bile 24 hours a day, but you only need it after you eat, so there has to be a place to store it.  That is what the gallbladder is, a small sac hanging under the liver which stores the gall or bile until it is needed.

 When you eat, the gallbladder gets a message to squeeze, and send some of the bile into your intestines to digest the fat part of the food.

 The medical word for the bile system is “chole”.  The medical word used for a bladder, which is a fluid containing sac, is “cyst”.

 When the gallbladder is working normally you have no symptoms.  The system can have things wrong with it that makes it cause pain, or other symptoms.  Stones can grow in the gallbladder, and then when it squeeezes it can hurt.  The medical term for stones is “lithiasis”.  There is a duct (the medical word for duct in the gallbladder system is “docho”) that drains the gallbladder when it squeezes.  If a stone gets in the way of the duct and plugs it, back pressure can build up and cause pain,  If the back pressure gets high enough or is present long enough, the bile can back up through the liver, into the blood, and make you turn yellow (jaundiced).

 If the gallbladder gets irritated it can become sore and painful, just like if you had an irritated sore spot some place on your skin.  The medical word for this inflammation is “itis”.

 Sometimes the gallbladder gets so that it just can’t squeeze adequately to push enough bile out and you can also get painful symptoms from this.

 If you have gallstones it is called Cholelithiasis.

 If you have gallstones in the gallbladder and in the duct it is called Choledocholithiasis.

 If the gallbladder is irritated and inflamed it is called cholecystitis.

 Some of the symptoms of gallbladder disease are as follows:

1. Pain over the area of the gallbladder, particularly a short time after eating.  The pain can radiate toward your right shoulder and right shoulder blade, and the area over the gallbladder can be tender to touch.  
2. You can have increased passing of gas by mouth and by rectum.
3. You can have nausea, diarrhea, and sometimes vomiting.
4. You might develop a fever.
5. You may become jaundiced.
6. You could have significant pain in your middle abdomen and middle back areas.

 Tests that can be done for gallbladder disease include a physical exam and a history taking.  Blood and urine tests may be done, and imaging exams like an ultrasound or a CT scan of the area are often very helpful.  If it is suspected that the gallbladder output is diminished a test called a HIDA Scan would be appropriate.

 Common risks for gallbladder disease include:

1. Obesity
2. Age 30-40 and above
3. Increased “gas”
4. Female
5. Female with many children
6. Family history of Gallbladder Disease

 If you have a “bad” gallbladder you may be put on pain meds, sometimes antibiotics, told to follow a low fat diet , and eventually surgery will be needed.  There are emergent situations when surgery would be the appropriate 1st treatment.

Written by: Michael Beasley M.D.

Sarah Somerfield, FNP-BC

Sarah received her Bachelor’s degree from Ferris State University in 1998. After graduation she was employed at Mercy General Health Partners in Muskegon as a registered nurse. She then relocated to West Branch, where she has resided for the last seven years.

Sarah has 10 years of experience in a variety of clinical settings. She received her Master of Science in Nursing degree from Saginaw Valley State University in May of 2008. She is board certified as a Family Nurse Practitioner. Sarah resides in West Branch with her husband and their three children.

Sarah is accepting new patients for primary care.

Amey Moeggenborg PA-C

Amey originated in Hartland, MI. She attended CMU where she received her Bachelor of Science in Public Health Education. After graduation she was employed at Munson Medical Center in Traverse City. She then went on to get her Masters of Science in Medicine at WMU and her Physician’s Assistant Certification. She resides in West Branch with her husband, Brian, and their daughter.  She has always considered West Branch her ”home away from home” as her family has owned a farm here for over fifty years. Amey is now accepting new patients for primary care.

Keri Hodgins FNP-BC

Keri was raised in West Branch and graduated from Ogemaw Heights High School in 1996. She obtained her Bachelor’s degree from the University of Detroit Mercy in 2000. She has worked as an RN at Covenant in Saginaw, as a school nurse for the WB-RC district, as a public health nurse in Tuscola County, and as a home care nurse for DHD#2 for the last 4 years. Keri received her Master of Science in Nursing degree from Saginaw Valley State University in May of 2005 with a 4.0 GPA. She is board certified as a family nurse practitioner. Keri resides in West Branch with her husband, Donnie, and their three children.

Keri is accepting new patients for Primary Care.

Sue Brindley FNP-BC

Sue Brindley was born, raised, and lives locally with her husband, Rick and their 2 children. She attended Kirtland Community College and Saginaw Valley State University. She has a Masters Degree from Saginaw Valley State University and is a Certified Family Nurse Practitioner. She has 3 years of acute hospital experience as a Registered Nurse and has worked for 14 years in Home Health Care.

Sue currently has office hours at the Court Street Clinic and at the Evergreen Clinic and is accepting new patients for primary care.

Brian MacAuley PA-C

Mr. MacAuley practiced medicine as a Corpsman in the Navy for nearly twenty years prior to becoming a Physician Assistant. He attended the Physician Assistant program at the University of Florida. He has been on staff at the Evergreen Clinic for 10 years and he is accepting new patients for primary care.

Hatem M. Ataya M.D.

Dr. Ataya graduated from Damascus University of Medicine in 1992. He practiced medicine in Syria and in the Persian Gulf. Dr. Ataya is Board-Certified in Internal Medicine having completed his Internal Medicine Residency Training at the Guthrie Clinic in Pennsylvania. Dr. Ataya is now accepting new patients for Internal Medicine.