Category: News

FLUENT Study Enrollment Closing — Act Now!

The FLUENT study will be closing enrollment at the end of the month, on June 30, 2018! Those diagnosed with Multiple Sclerosis (MS) who are interested in trying Gilenya (fingolimod) for the first time may be eligible to participate. The study simply asks for a few questionnaires and a blood draw at baseline and at the standard 1m, 3m, 6m, and 12m follow-up office visits to help learn more about how this medicine affects the immune system.

Neurology Advisor reports patients who have previously tried one or more injectable therapy (iDMTs) may still see improvement with a switch to a Gilenya pill once a day! Read it here.

Need more information? Check out this website or this one to learn more about these studies. 

If you or anyone you know are interested in learning more about this trial, feel free to call our Research Director, Lindsay, at 703-313-9111 ext. 107, or email her at Lindsay@integratedneurologyservices.com.

 

Safety Awareness

 

wear a helmet

Every year National Safety Awareness is observed in June to minimize injury and death on the road, at home, and at work. Injuries are the leading cause of death for Americans ages 1 to 40. The good news? Everyone can get involved to help prevent injuries. 

This June, we encourage you to learn more about important safety issues like preventing poisonings, transportation safety, and slips, trips, and falls.

  • Poisonings: Nine out of 10 poisonings happen right at home. You can be poisoned by many things, like cleaning products or another person’s medicine.
  • Transportation safety: Doing other activities while driving – like texting or eating – distracts you and increases your chance of crashing. Almost 1 in 6 crashes (15%) where someone is injured involves distracted driving.
  • Slips, trips, and falls: One in 4 older adults falls each year. Many falls lead to broken bones or a head injury.

Raising awareness about safety issues can reduce the risk of injuries by being better prepared. Check out some of these resources to learn more about safety preparedness:

Take some classes to learn skills like CPR and first aid

Get downloadable material about safety awareness

Julie- Best of Luck!

a picture with our med student intern.

 

We had the honor and privilege of having Julie work with us for two weeks for her neurology rotation. We wish her the best of luck in her pursuit of higher education and know that she will be an amazing doctor. We will miss you and hope you’ll come to visit us! 

 

 

Dear Dr. Fishman,

Let me start out by saying what a fantastic 2 weeks I had with you! With sincere honesty, out of all 3rd and 4th year clinicals, this was by far my favorite rotation. I certainly had an interest in neurology coming in but your passion for the specialty and dedication to your patients, along with your teaching, were really inspiring. As you noted, a preceptor can shape a student’s perspective….and I am now thinking about possibly pursuing neurology further. 

Thank you for being such a wonderful role model. You are talented when it comes to teaching–your passion and great degree of knowledge were so impressive to me. But perhaps what was even more impressive was your respect for and commitment to your patients. (Having a brother with MS, this especially hit home.) I enjoyed partaking in your interactions with them in that you demonstrated the kind of relationship, a therapeutic alliance, that I hope to one day have with my patients. You not only shared your expertise but also listened compassionately each time to their thoughts and concerns–something that makes a great physician. When the pre-med student came in concerned his headaches represented a malignancy, for example, you put him at ease with reassurance and ordering of a scan.

I feel truly privileged to have had these 2 weeks with you. I have a tremendous level of respect for you and the amazing work you do every day. Thank you for all that you have taught me–whether it be neurology or just clinical pearls of medicine. 

I look forward to staying in touch, and will certainly send your way all those I know in search of a great neurologist.

Warmly,
Julie

Ps. Thank you for my FAVORITE new tool–my reflex hammer! I have been testing all the reflexes in my household and will now (at least look like I) know what I am doing on my neuro rotation at UVA…! 🙂

Stroke—You Have To Act FAST

Learning the signs and symptoms of a stroke and knowing how to act FAST can be life-saving. This month is marked by National Stroke Awareness month.

Here are the numbers:

  • About 800,000 people have a new or recurrent stroke every year.
  • That comes down to a person having a stroke about every 40 seconds.
  • It’s the 5th leading cause of death in the US.
  • Every 4 minutes someone dies from a stroke.
  • Up to 80% of strokes can be prevented.
  • It is the leading cause of adult disability in the US.

What is a stroke?

A stroke is either caused by a weakened vein leaking blood or a blocked artery. In either case, blood – and therefore oxygen – are not getting to the brain. These are called hemorrhagic and ischemic strokes, respectively. A temporary block of blood flow is called a transient ischemic attack (TIA) but is also referred to as a mini-stroke. That should not dampen the potential severity of what it is, attention should be sought immediately as a full stroke is likely to occur soon.

What is FAST?

FAST is a simple acronym for signs to be on the look-out for if you suspect a person is having a stroke.

Face drooping – Ask the person to smile and observe if the face droops.

Arms weak – See if the person is able to lift both arms overhead. Does an arm drift down or do they have trouble raising one?

Speech difficulty- Have the person repeat a person phrase. Pay attention to see if they slur or sound odd. They may have some confusion and trouble understanding you.

Time to call 9-1-1 (or your local emergency number) – Call 911 immediately if you observe any of these signs.

Other symptoms include:

  • trouble walking
  • a sudden and severe headache that may be joined with vomiting or dizziness
  • trouble seeing in one or both eyes

Why is it that so important?

In the case of many medical emergencies, stroke included, time is of the essence. Once a person starts having a stroke, it only takes a matter of minutes before brain damage can start to occur. Depending on where and the severity of the stroke, the type of damage can vary but often temporary or permanent disability can be expected. Two-thirds of survivors have some type of disability. These can include:

  • A difficulty with talking and swallowing: sometimes people can experience problems with swallowing, eating, and language due to trouble controlling muscles in your throat and nose. This can include difficulty communicating by talking, reading, and writing. Working with a therapist may help.
  • New sensations may occur in parts of the body affected by the stroke. This could be pain, tingling, or numbness. New sensitivities like to temperature changes could develop.
  • After a stroke, you may lose control of parts of your body or be paralyzed on one side like a side of your face or a leg. Physical therapy may help to return to activities like dressing, walking, and eating.
  • Some memory loss is common as well as changes to your cognitive ability like reasoning and judgment.
  • Emotional problems or depression could manifest after experiencing a stroke.
  • A person may experience behavior changes and their ability for self-care. They may become withdrawn and need help with chores, grooming, and dressing.

The success of treating these complications varies on the person and their situation.

Risk factors

Below are some risk factors that increase a person’s chance of having a stroke. While some of these are unavoidable, working on the ones that are changeable can help lower your risk level and possibly increase your quality of life.

  • Age – being over the age of 55 increases your risk of a stroke
  • Sex – men are more likely than women to have a stroke but women are older when they have one and are more likely to die of a stroke.
  • Race – African-Americans have a higher risk of stroke.
  • Hormones – estrogen-based therapies,  use of birth control, and the higher levels of estrogen during pregnancy and after childbirth increase the risk of stroke.
  • Physical inactivity
  • Heavy drinking
  • Obesity
  • Illicit drugs (cocaine, methamphetamines, etc)
  • Smoking and secondhand smoke
  • Diabetes
  • High cholesterol
  • High blood pressure
  • Cardiovascular disease (abnormal heartbeat, heart failure, defects, and infection)
  • Obstructive sleep apnea
  • A family history of stroke, TIA, or heart attack

 

Implementing simple lifestyle changes can help lower your risk but if you are concerned about your risk, speak to a healthcare professional. If you or someone know has been affected by stroke, therapy may be able to help increase one’s quality of life. Remember, if you suspect someone is having a stroke, act FAST. 

New Website Launch

Happy-new-year-2018

It’s a new year and we thought we’d start it off with a new site. We are proud to announce the launch of our new website. It has all the same great information as our old one; click around to learn more about our services. 

If you have any questions or wish to learn more about anything please do not hesitate to call us at 703.313.9111 or email us at info@integratedneurologyservices.com

Cheers to an amazing 2018 from all of us to you!

~The Integrated Neurology Services Team

Join us for World Alzheimer’s Month

  awareness-walk-alzheimers

This September marks the 6th annual global World Alzheimer’s Month. This year is following the theme “Remember Me” and emphasizes the importance of early detection and diagnosis of dementia. The Nothern Virginia area will be hosting several walks throughout the month to raise awareness of Alzheimer’s and dementia in communities. Integrated Neurology Services will be participating in the following walks:

Join us in raising awareness and say hi at our booths!

Juvenile Arthritis – Not Just Your Grandparents’ Disease

 We’re accustomed to joint problems increasing as we age into our wisest selves but there is a small population that experiences this at a young age. Juvenile arthritis (JA) is an umbrella term for several autoimmune and inflammatory diseases that can affect children.

grandparents-children-arthritis

There are 7 different types of juvenile arthritis:

  • Juvenile idiopathic arthritis – This includes several different subtypes: oligoarthritis, polyarthritis, systemic, enthesitis-related, juvenile psoriatic arthritis, and undifferentiated.
  • Kawasaki disease – An inflammatory disease that affects the blood vessels. This can lead to heart complications without proper or delayed treatment.
  • Juvenile scleroderma – Causes the skin to harden.
  • Juvenile dermatomyositis – Causes a skin rash on knuckles and eyelids, and causes muscle weakness. It is an inflammatory disease.
  • Juvenile lupus – Affects the joints, blood, kidneys, skin, and other areas of the body. It is an autoimmune disease.
  • Fibromyalgia – A chronic pain syndrome that is an arthritis-related condition. More common in girls but rarely is diagnosed before puberty.
  • Mixed connective tissue disease – This can include features of the other diseases.

Almost 300,000 children in the United States have some form of juvenile arthritis and 50,000 of those suffer from the most common, juvenile idiopathic arthritis. These diseases present themselves in children as young as 6 months old. Some children may have no symptoms at all and symptoms can vary depending on which type of disease they have.

Some of the more common symptoms include:

  • Joint pains and swelling
  • Stiffness, especially in the morning
  • Rash
  • Fever
  • Weight loss
  • Eye redness, pain, and/or blurred vision
  • Fatigue
  • Irritability

Unfortunately, diagnosing for juvenile arthritis can be difficult. There are no specific tests for JA but doctors can use tests to eliminate other options or even help determine which type of arthritis the child may have. A careful physical exam and a thorough medical history will help with determining a diagnosis. As with most diseases, early identification and treatment are important to deterring future complications.

Cause and Treatment

The cause of juvenile arthritis is still unknown. It is possible that genetics could cause a predisposition for the disease. There is no data to suggest that it could be caused by toxins, foods, or an allergy. There’s no known cure for juvenile arthritis but treatments can help lessen symptoms. Some goals for treatments include reducing swelling and pain, preventing joint damage, and improving joint mobility and strength. There are a variety of options for medication, including IVIg. While it may seem counterintuitive, exercise is actually a vital part of treatment. Diet is another component of maintaining proper nutrition is important to a child’s natural development and to encourage an active lifestyle. Children with juvenile arthritis are still able to lead active lives along with their friends and family. With the care of a trained physician, families can work together to improve a child’s chance of maintaining an improved quality of life, maybe even gaining remission.