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Hot Topic!

Summer 2020

“It’s Hot-Hot-Hot”

If it were cold in July, no one in the North East would be happy. Then again many of us are equally not thrilled when the weather people start to report a “Heat Wave” is about to settle in to the Delaware Valley. But this summer has started and it is “Hot-Hot-Hot”.  So everyone must be aware of the dangers of the summer heat. So here are some useful tips to live by.

Stay Cool

  • Stay in air-conditioned buildings 
  • A fan alone is not enough to cool your home during extreme temperatures
  • Limit outdoor activity, especially during the hottest part of the day
  • Avoid direct sunlight
  • Wear loose, lightweight light-colored clothing
  • Take cool but not cold showers to lower your body temperature
  • Check on at-risk friends, family and neighbors at least twice a day
  • Never leave infants, children, pets or the elderly in a car or truck – even a few minutes is too long

Stay Hydrated

  • Drink more fluids than usual even if you are not exercising
  • Don’t wait until you are thirsty before you drink
  • If your doctor usually limits the amount you drink or you are on water pills, call to ask how much you need to drink during the extreme heat.
  • Drink 2 – 4 cups of water every hour if you are working or exercising outside
  • Avoid alcohol or liquids with sugar
  • Check to be sure your family, friends and neighbors are drinking enough water
  • Make sure pets have water available


Heat Exhaustion Symptoms What to Do

·         Heavy Sweating

·         Weakness

·         Skin cold, pale & clammy

·         Weak pulse

·         Fainting, vomiting

·         Move to cooler location 

·         Lie person down, loosen clothing

·         Use cool, wet cloths on body or a 

bath to lower temperature

·         Sip water if you vomit and if it continues, get medical care

Heat Stroke Symptoms What to Do

High body temperature [above 103 F] 

Hot, red, dry or moist skin

Rapid & strong pulse

Possible unconsciousness


Move person to cooler area 

Lower person’s temperature with cool cloths or bath

Do NOT give any fluids

People who work outdoors are more likely to become dehydrated and are more likely to get heat-related illness.


All activity and get to a cool environment if you feel faint or weak. 

  • Drink from two to four cups of water every hour while working. Don’t wait until you are thirsty to drink.
  • Avoid alcohol or liquids containing large amounts of sugar.
  • Wear and reapply sunscreen as indicated on the package. 
  • Ask if tasks can be scheduled for earlier or later in the day to avoid midday heat.
  • Wear a brimmed hat and loose, lightweight, light-colored clothing.
  • Spend time in air-conditioned buildings during breaks and after work.
  • Encourage co-workers to take breaks to cool off and drink water.
  • Seek medical care immediately if you or a co-worker has symptoms of heat-related illness.
  • For more information, please visit: http://www.cdc.gov/niosh/topics/heatstress/.

Remember your body is about 60% water and you need to keep it that way especially during the summer heat. Hydrate all day long and stay healthy.

Happy Summer!

Dr. Lee Ann

Spring 2020

State of NJ testing guidelines for COVID 19as of April 28, 2020 – Download Here

COVID 19 can cause increased Stress and Anxiety

How can we get through this pandemic?

Watch our podcast on our website regarding anxiety. https://www.pinestreetfamilypractice.com/podcasts

  • Exercise
  • Watch diet
  • Deep breathing
  • Meditate, rest

How can we exercise if we are inside?

  • If you have stairs in your house safely walk up and down, time yourself goal of 5 minutes
  • Walk the perimeter of your house inside or outside at a safe distance, time yourself goal at least 15-20 min a day
  • Get everyone involved, make it fun create a family seek and find within your house
  • Do puzzles either word or pieces helps keep the mind occupied
  • Play board games, this gets the family involved

How can we watch diet, food may be limited?

  • When shopping limit high fat saturated foods and sweets purchases try to plan meals so can included fruits/veggies
  • Make sure you are staying hydrated 6-8 glasses of water a day

Deep breathing

  • Take 3 deep breaths
    • Slowly inhale and control exhale
    • Make sure your chest is moving up during inhales
    • Slowly count to 30 (if you can) when exhaling on the 3rd breath


  • This is difficult and you will need to concentrate and practice
  • Breathe deeply, be in a quiet area and get into a comfortable position
  • You will need to completely relax while staying awake
  • Close your eyes gently
  • Put your thoughts aside empty your mind and focus on your breathing
  • You will need to practice…try 10 minutes a day…you deserve it


  • We need to try and sleep between 6-8 hours a night
  • Try not to listen to social media and news constantly
  • Reduce stimulus 30 minutes before bed no phone or v

Different Therapies

  • Art therapy…try drawing, doodling, or coloring
  • Music therapy…listen to your favorite artist
  • Dance therapy…dance like no one is watching
  • Pet therapy…if you have animals playing and/or petting them can be very relaxing
  • Guided image therapy…close your eyes, go to your happy place, either the beach, the mountains, the park or some place that you feel comfort, your imagination is limitless!

Try one or try them all, Be Safe!!!


How many times a day do we here COVID 19, social distancing, and wash your hands?

Did most people know what a pandemic was before this virus, most likely not.

COVID 19 is on everyone’s mind and should be, can you remember the last time you didn’t think about this pandemic?

This can often cause increased stress and anxiety.  Being prepared, be safe and be cautious, this can help slow the spread.


What do we know about COVID 19?

  • COVID 19 is a virus that is spread through droplets by coughing/sneezing.
  • Common symptoms are coughing, shortness of breath and fever.

How can we help slow the spread?

  • Take precautions
    • Wear face coverings
      • fit snugly but comfortably against the side of the face
      • be secured with ties or ear loops
      • include multiple layers of fabric
      • allow for breathing without restriction
      • be able to be laundered and machine dried without damage or change to shape
    • Wash hands for AT LEAST 20 seconds
    • Clean surfaces
      • High touch surfaces are tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, sinks.
    • Stay inside
    • Keep 6 feet away from people (social distancing) if going outside for necessary essentials
      • Limit going outside see if stores have special hours for senior if you are in that age group

What to do if you are feeling sick:

  • If you think you may be sick, stay home and consult with your healthcare provider, telemedicine options are available at Pine Street Family Practice.
  • Rest, increase fluids to stay hydrated, take Tylenol as needed

If you are very sick get medical attention immediately

If you develop any of these emergency warning signs* for COVID-19 get medical attention immediately:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse

Call 911 if you have a medical emergency: Notify the operator that you have, or think you might have, COVID-19. If possible, put on a cloth face covering before medical help arrives

At Pine Street Family Practice, we care about YOU!

The safety and health of our patients, staff and providers are our top priority while continuing to provide you with quality medical care.

Be safe!

Winter 2020

Eat Smarter in 2020

There are very few of us who don’t want to lose a few pounds. Here is an overview from US New & World Report 2020 rankings. Please remember that “Diets Don’t Work!”. Consistency in an eating habit that you can sustain on a weekly basis over months is the hallmark of successful long-term weight loss and healthy eating. This prevents the yo-yo dieting and then the need for you to continue to lose the same 40 pounds over and over. Read, eat and enjoy 2020.
– Dr. Lee Ann

This is the 10th year US News & World Report has published its “Best Diets” ranking. The full report includes 35 plans, both well recognized and not-so-familiar. Primary care patients looking to make lifestyle changes, lose weight, or give their food choices a jolt have been scrolling through the offerings and the extensive information on each since publication on January 2, 2020.

#1. The Mediterranean Diet. The popular diet is low in red meat, sugar, and saturated fat, high in produce, nuts, grains, olive oil and fish. It was also ranked #1 in Best Plant-based Diets and Best Diabetes Diets and #2 in Best Heart-healthy diets.

#2. The DASH Diet, aka Dietary Approaches to Stop Hypertension, is promoted by the National Heart, Lung, and Blood Institute and was designed to prevent hypertension. The focus is on foods high in nutrients that work against high blood pressure, e.g., potassium, calcium, protein, and fiber. The food plan sets a daily sodium limit at 2300 mg/day with a target of 1500 mg for those who stick to it. DASH was also ranked #1 in Best Diets for Healthy Eating and #2 in Best Diabetes Diets.

#3. The Flexitarian Diet. The Flexitarian approach to eating combines vegetarian food choices with a flexible approach to meat consumption. It suggests adding a food group called “new meat” when meal planning to include non-meat proteins such as eggs, beans, and peas. As a weight-loss plan it maxes at approximately 1500 cals/day. It also tied for 2nd place as Best Plant-based and Best Diabetes Diet and was ranked #2 in Easiest Diets to Follow.

#4. Weight Watchers (aka, WW). The original Weight Watchers program focused on weight loss and has always combined in-person meetings with healthful eating. The new myWW program is the easiest to date to customize with its system of Smart Points and the guiding philosophy is a holistic one focused on healthy eating and exercise. The WW plan of eating scored the highest for Best Overall Weight Loss and Best Fast Weight Loss as well as #1 in Best Commercial Diet Plans.

#5. The Mayo Clinic Diet. This diet was developed to help individuals lose weight by recalibrating eating habits and other lifestyle choices. The Mayo Clinic’s unique food pyramid guides selection and emphasizes fruits, vegetables, and whole grains – foods with low energy density. Following the diet, individuals are expected to lose 6 to 10 lbs. in 2 weeks and continue dropping 1 to 2 lbs. until goal weight is reached. The diet tied for the #2 spot in Best Diabetes Diets.

#5 (tie) The MIND Diet, aka, Mediterranean-DASH Intervention for Neurodegenerative Delay. MIND combines the 2 healthy diets and focuses on choices from each that potentially affect brain health, thus reduce the risk for Alzheimer disease. The food plan, rich in leafy green vegetables, nuts, and berries, was found in a 2015 study to reduce Alzheimer risk by 35% for those who adopted it moderately and 53% for individuals who followed it rigorously. MIND was also ranked #3 in Easiest Diets to Follow.

#5 (tie) The Volumetrics Diet. Conceived by a Penn State nutrition professor, Volumetrics is described as less a structured diet than an approach to eating. It focuses follower’s attention on choosing foods with low energy density–foods that tend to fight hunger. While the plan can be followed prescriptively, individuals are encouraged to apply the basic philosophy throughout the day, replacing high-density foods with low-density options. The Volumetrics Diet tied for the #2 spot in Best Weight-loss Diets.

#8. TLC Diet. The Therapeutic Lifestyle Changes diet was created by the NIH’s National Cholesterol Education Program. The focus is on reducing cholesterol intake to promote heart health. The broad eating guidelines recommend fruits, vegetables, cereals, and pasta; low-fat dairy, skin-off poultry. To lower LDL-C, calorie goals are 2500/day for men and d a 1800/day for women; for weight loss daily calories go down to 1600 for men, 1200 for women. TLC was ranked #4 (tie) in Best Diets for Healthy Eating and #5 in Best Heart-healthy Diets.

#9. The New Nordic Diet. The diet is based on 10 concepts meant to “revolutionize” Nordic cuisine and improve public health, among them include more food from the seas and lakes and from wild landscapes. The regimen’s carbohydrate/protein ratio (2:1) relies on a combination of low-glycemic index and moderately high protein foods. It tied for 3rd place in the Best Plant-based Diets.

#9 (tie) The Ornish Diet. Created in 1977 by physician Dean Ornish, founder of the Preventive Medicine Research Institute, the diet is low in fat, refined carbohydrate, and animal protein–a whole foods, plant-based regimen. The food plan was originally conceived to reverse heart disease and proven to do so in randomized controlled trials. The Ornish philosophy emphasizes exercise, stress management, and relationships as part of a heart-healthy way of life. The diet was ranked #1 in Best Heart-healthy Diets and tied for #3 in Best Plant-based Diets.

#9. The Vegetarian Diet. Among people who prefer a vegetarian food plan, the lacto-ovo approach is the most popular. There are US dietary guidelines that provide a template for a healthy plan including how many meatless calories should be consumed and what types of food those should come from. A gradual approach to this way of eating could include a few meatless meals a week. Vegetarian diets have been associated with lower BMI, LDL-C, and glucose levels as well as lower rates of ischemic heart disease.

November 2019

The Best Skin of Your Life!

Did you know skin is the human body’s largest organ? So, taking exceedingly good care of your largest organ is very important. At Pine Family Practice we want to provide our patients with the best non-invasive options for preventative skin care maintenance/cosmetic improvements. Read on and we’ll take a dive into our skin care treatment options.

Up first is our HydraFacial treatment. This is our favorite way to get glowing! If you have not had a HydraFacial yet, you are surely missing out. In fact, HydraFacial was crowned the most popular beauty treatments of 2019 according to Yelp. So, what exactly is a HydraFacial? What sets HydraFacial apart from other facials is the use of spiral design HydroPeel Tips in conjunction with patented vacuum technology and super serums to create a vortex effect to easily dislodge and remove impurities while simultaneously supplying hydrating solutions onto the skins surface. In other words, it takes out the bad and puts in the good. Say goodbye to blackheads, dead skin cells and clogged pores and say hello to beautiful radiant skin.

HydraFacial provides 3 steps in as little as 30 minutes delivering you instant, long lasting results that you can see and feel.

  • Step 1: Cleanse + Peel: Uncover a new layer of skin with gentle exfoliating and relaxing resurfacing
  • Step 2: Extract + Hydrate: Removes debris from pores with painless suction. Nourish with intense moisturizer that quenches the skin
  • Step 3: Fuse + Protect: Saturate the skin’s surface with antioxidants and peptides to maximize your glow

HydraFacial is for all skin types, ages, and tones and addresses all skin care needs including:

  • fine lines and wrinkles
  • elasticity and firmness
  • even tone and vibrancy
  • skin texture
  • brown spots
  • congested and oily skin
  • enlarged pores
  • dry skin

Treat yourself to a HydraFacial for the best skin of your life!
Gift certificates available for you or your favorite person.
We Recommend a HydraFacial monthly for maximum benefits.

Another amazing skin care treatment option that we offer at Pine Street Family Practice is Exilis Ultra 360. Exilis Ultra 360 targets your skin’s fine lines and wrinkles by safely delivering radio-frequency and ultrasound energy to heat up the skin to stimulate collagen production. What’s even more amazing is Exilis Ultra 360 can be used almost anywhere on the body providing a true head to toe treatment. If you are looking to tighten and tone your body non-invasively with no downtime Exilis Ultra 360 is the easy answer. This treatment like HydraFacial is ideal for anyone! Typically, patients undergo between 4 to 6 treatments scheduled 7-14 days apart. Each treatment of a specific body part usually takes between 15 – 30 minutes. I would describe the treatment as being comparable to a pain-free, hot stone massage. You can easily relax during the procedure as one of our certified technicians will provide you with soothing spa music, aromatherapy and dimmed lighting to maximize your comfort and enjoyment!

Having trouble deciding which one may be better for you? No worries! HydraFacial and Exilis Ultra 360 complement each other producing a more youthful, radiant you. We even provide you with discounted package rates when you purchase the two treatments together because we believe you shouldn’t have to choose. Gift certificates also available!

Mention to our technician that you read our Hot Topic-The Best Skin of Your Life! And receive a free Signature HydraFacial or Exilis maintenance treatment with purchase of a HydraFacial or Exilis treatment.

If you have any questions/concerns or would like to schedule your appointment please give the office a call.


September 2019

Update on Vaping

If you read our prior article on Vaping you understand it is NOT an alternative to quit smoking in fact the most recent information about Vaping is that it is causing unexplained lung illnesses.

In a recent update from the CDC this month September 2019, there have been 6 deaths linked to vaping within ages 18 to 25 and over 450 people experiencing unexplained lung infections. With more than 25 states reporting possible cases of lung illnesses associated with use of e-cigarette products.

While many of the patients, not all, stated recent use of THC-containing products, some described using both THC and nicotine containing products. A smaller group reported using nicotine only.

There has been no evidence of infectious diseases identified in these patients, as a result lung illnesses have been associated with a chemical exposure from vaping. The common factor in these unexplained illnesses has been vaping.

The CDC and FDA are partnering to get to the bottom of these strange illnesses with the recommendation of stopping this habit now.

If you do vape think twice, you are encouraged to monitor for sudden symptoms of cough, shortness of breath, chest pain, nausea, vomiting, abdominal pain, and fever and promptly seek medical attention. E-cigarette products should not be purchased off the street and not be modified by adding THC containing products. E-cigarette products should never be used by youth, young adults, pregnant women, or adults.

Again, if you are interested in quitting smoking, pick a date, develop a plan and ask a provider at your next visit to Pine Street Family Practice.

Here is a hotline number: call 1-800-QUIT-NOW (1-800-784-8669)

Additionally, if you are concerned about your health after vaping or using an e-cigarette product, contact your health care provider, or you can also call your local poison control center at 1-800-222-1222.


Summer 2019


Have you ever heard of Vaping or Juuling? Is Vaping the same as smoking? Is there nicotine in vaping? Is it better to switch from smoking cigarettes to vaping?

All good questions.

You most likely have heard of this if you are a teen or young adult.

E-cigarettes are an electronic device that is used to heat a liquid to produce a mist or vapor of small particles in the air. This liquid has nicotine, chemicals, and other flavorings like cucumber, mango, and fruit medleys, making the product more attractive, especially to adolescents. They come in many different shapes and sizes, having a battery or heating element. The devices can have different shapes and sizes, looking like a pen, a cigarette, a cigar, a pipe or every a USB flash drive. They also have different names like e-cigs, vape pens, e-hookahs, or tank systems, it’s also known by its most popular names of vaping or JUULing. JUUL being a common e-cigarette manufacturer and has been around the longest since 2015. Below are a few pictures of what the devices can look like.

A JUUL device is shaped like a USB drive and has the highest percentage of nicotine, according to the manufacturer 1 JUUL cartridge can contain as much nicotine as 20 cigarettes. Adolescents have been reportedly vaping in bathrooms and classrooms. Adolescents and young adults do not understand that vaping is still delivering nicotine causing the addiction. This chemical can alter a young brain which is still developing to age 25. This can cause problems with attention, learning, mood and impulse control. Marijuana can also be used in these devices. Adults and children have been poisoned by ingesting the liquid aerosol and getting the substances in the eyes or on the skin which can be very harmful. There have been many cases where the batteries in the e-cig have been reported to have caught on fire or explode.

Using e-cigarettes is not a good alternative to smoking, there are similar health risks with this product as with smoking tobacco cigarettes.

E-cigarettes and Vaping are not safer then tobacco cigarettes and should not be started.

E-cigarettes cannot help you stop smoking tobacco cigarettes you just switch addiction.

If you are interested in quitting smoking, pick a date, choose a plan and ask a provider at your next visit at Pine Street Family practice.

Here is a hotline number: call 1-800-QUIT-NOW (1-800-784-8669)

Set a good example be tobacco and smoke free!


Welcome 2019

New Year Resolutions Gone Bust


So, January is gone, the snow is has come and many of our New year resolutions for health have faded. We come out of the gate like gang busters but soon find that we cannot maintain such a frantic pace. One missed gym day turns to two. One piece of pizza becomes three. We are quickly falling back into our old habits. Sometimes we just take on too much at once, feel overwhelmed and quit.

Here is a list of 10 things that we can easily try to lead a healthier life. The good thing is none are overwhelming to try. Would recommend picking a few to try, not all ten at once. Slowly try working your way through the list.

1. Drink Water: When eating a meal water will take up the same amount of space as any liquid, without the empty calories.

2. Don’t Only Drink a meal: Liquid shakes sound healthy but very quickly leave the stomach. This makes our full sensation go away faster.

3. Plan Meals: It is easier to eat healthy if you plan ahead. Waiting to the last minute makes it easy to impulse eat whatever is fastest.

4. Fresh Foods: Avoid eating prepared foods as much as possible. There are usually all kinds of added sodium, preservatives and fat hidden in them.

5. Fruits/Veggies: Have a fruit or vegetable with every meal. Not only are they healthy choices but high in fiber. Fiber gives us a longer sensation of fullness.

6. Food Log: Write down everything that you eat. It’s amazing that when you write it down it makes you think about before you open your mouth again.

7. Small Plates: We are very visual eaters, we tend to fill the plate that we are using to satisfy our brain. Use a smaller plate and it will trick the brain into thinking we are eating more.

8. Cardio 30: Try to get 30 minutes of cardiovascular activity in 3 times a week. Once you are able to do that then try to slowly increase to daily activity.

9. Sleep: Practice good sleep hygiene and get enough sleep. When we are tired our body gets stressed and makes it more difficult to lose weight. Also when we are tired we often will eat whatever to make us feel better.

10. Go Slow: No one says that you need to do everything at one or do it completely the first day. Slowly build up to the desired goal. Focus on one or two things at a time then move on to your next goal when accomplished.

Here’s to a healthy new year not just January!!           Dr. Steve


Winter 2018

 “The Rich Man’s Disease”


How does your blood level measure up to your blood bank account?

Gout is a medical problem that was known hundreds of years ago and also to this day as the “Rich Man’s Disease or the Disease of Kings”.  This is because gout has the reputation of being caused by the overindulgence of rich, fatty, and creamy foods, as well as, red meats and expensive shell fish while washing them all down with extreme volumes of beer and wine.  So why do some people get gout and some not? The theories continue to abound, but genetics appear to have a key role.

The symptoms start usually with a sudden onset of an extremely painful joint that is red, hot and swollen. Most commonly the big toe, but any joint can be affected. It would not be unusual for this problem to awaken one from sleep and have difficulty walking due to the pain. The joint becomes so sensitive, having the bed sheet or the shoe touching the foot is intolerable.

Gout is the result of the body not being able to process the dietary breakdown of purines turning to uric acid, as well as, the metabolism of alcohol and sugary beverages that increase the production of uric acid. This elevation of uric acid in the blood then circulates and settles in the joints causing this painful joint syndrome.

High uric acid levels in the blood are usually > 6mg/dl in women and > 7mg/dl in men.

What are the dietary triggers of Gout?

Alcohol– in large consumption, alcohol is a known trigger, however even moderate amounts may increase the risk in people prone to gout.  Beer is the highest risk and wine appears to be the lowest.

Sugar– sweetened Beverages- high consumption of dietary sweeteners used in common beverages has been known to increase blood uric acid level.  Juices with high fructose corn syrup and soft drinks are also known triggers.  Natural honey sweetened beverages included in many teas also may increase the uric acid level.

Purine Rich Meats– High intake of purine rich meats may increase a gout attack by 5 times the normal.  Red meats- beef, veal, lamb are the highest.  Wild game – turkey and duck should also be limited in the diet. Organ meats, like liver, heart and kidney also have elevated levels of purine and can trigger a gout attack.

Fish and Shellfish– Haddock, anchovies, tuna, herring , codfish and trout are all high purine non shell fish that should be avoided with increased risk or prior diagnosis of gout.  Mussels and scallops are the highest shell fish to trigger gout, but shrimp, crab and lobster should also be limited.

Tomatoes– This fruit, although a food always mislabeled as a vegetable, has now been labeled a “possible trigger” for gout due to the phenolic acid and glutamate in the tomatoes which then may increase uric acid levels.  So over indulgence in tomatoes may also be an avoidable trigger for that chronic gout suffers.

What is the treatment of gout? 

 I don’t have to be a doctor to give this antidote!

Avoid the TRIGGERS!  Alcohol, sugary beverages, red meats, shell fish and some non shell fish, and tomatoes.

For those patients who are unable to comply with dietary treatment the use of colchicine, NSAIDS, prednisone, and allopurinol are the most common treatment options.  Cherry juice, drinking more water to keep the body hydrated, rest of the joint, and weight loss are all touted to help prevent uric acid build up in the blood stream and prevent gout attacks.

So as we approach this holiday season and may be treating ourselves to the Trigger List Foods and Beverages- Beware of the King’s Disease and watch your dietary bank account!  This is not a “No pain no gain” eating plan.  You will pay for your indulgent choices. Choose wisely!

Happy Holidays!

Dr. Lee Ann



We all love when the calendar turns to summer so we can get outside and have fun. Who doesn’t enjoy the sun and the beach. We just need to be prepared for our summer time fun.


First off when the temperature hits the 80-90’s and the humidity rises we need to prepare before going out. Everyone thinks about being well hydrated when exercising or doing yard work. Pre-hydrating when going to do something physically active is important, not only water but sports drinks as well. By the time you start to feel thirsty you are already behind. Symptoms of fatigue, cramping and dizziness are early signs. Headaches, confusion and nausea/vomiting are late signs. Stopping the activity, cooling off and rehydrating are the mainstay of treatment. Symptoms of fatigue and malaise can last for a couple days post heat exhaustion. Heat stroke includes rapid pulse, excessive sweating and passing out. Heat stroke requires intervention with IV fluids to help turn the tide in a hospital setting.

It is graduation and picnic season we need to be vigil for the very young and old. Children and seniors do not tolerate the heat as well because their reserves are less. So it is not out of the ordinary for these groups to suffer heat symptoms at a backyard party. Seniors should be in the shade and drinks readily available for them. Young children have to monitored when playing a lot because of course they do not want to stop to eat or drink something, unless it is ice cream. Keeping an eye on these groups can prevent problems.

Our second big problem in the summer is the sun exposure to our skin. We all want that radiant golden tan but not all of us can attain this. We can get a sever sun burn though. It is important to apply sun screen prior to going out in the sun. We should also re-apply every time that we go into the water. Sunscreen is resistant, there is no such thing as water proof. Reapplication is also recommended after a few hours as it starts to wear off, sweat off or rub off.

Sunburns are not only a problem now but put us at risk for skin damage leading to skin cancer down the road. We pay in our 50-60’s for our beautiful tans in our 20-30’s.

Have a wonderful Summer!! Stay safe stay hydrated and use sunscreen!

Dr Steve




Melt Away the Winter Fat  Get Ready for Summer

Now Available at Pine Street Family Practice

As we move from our warm and cozy homes and bulky clothing of this cold winter it is time to think about warming up and moving into the spring season. What comes next? It is the fun and sun of summer and removing those layers. Many of us can’t wait for the pool and shore months, but this means we need to start to get ready for bathing suit season. Some of you have made New Year’s resolutions and have started your new eating and exercise routines to shed those extra pounds in anticipation of shedding the layers of clothing. Many of us have continued our year round health mantra and would still like to see those few extra inches melt away to complement our hard work and dedication at the gym and eating right. So whether you are on a new mission or continuing on your trek to looking and feeling better Pine Street Family Practice has a way to compliment your goals.

is a safe and in office non-invasive procedure that will help you melt away those annoying inches that just don’t want to budge with the diet and exercise program you have implemented. Coolsculpting works by delivering a controlled cooling to gently and effectively target fat cells to crystallize and then die off and be reabsorbed by your body, while leaving the surface skin unaffected. As the targeted fat cells die and become reabsorbed that specific area of fat then flattens and those inches become reduced to help you achieve the sculpted inch reduction you desire. This process will take 8-12 weeks to see the full improvement you want and will be reassessed in our office at that time. Areas of the body with best results are the abdomen, triceps, front of chest arm fat near the arm pits, back fat, under the chin, outer and inner thighs and the buttocks (banana roll) areas. I know we all have one of these areas that could use some inch reduction!

Pine Street Family Practice has fully trained staff that will do a free in office consultation to evaluate which body areas you are interested in sculpting and help you identify other areas that will be improved with this procedure. Not all fat is “freezeable” fat and not all areas you may want inch reduction will have good results, so a consultation is necessary for you to understand the process and achieve the desired outcome. We have financing options also available to help you make this process more attainable for you.

Go to our Facebook page and see my pictures of the procedure from February 2018 and the progress I have made. Call our office to schedule a free consultation now and continue the process to a healthier and more sculpted you.

Dr. Lee Ann


FALL 2017



Do you know someone who has had Shingles? Chances are you have heard of it but do you really know much about the virus. We are Pine Street Family Practice think it’s important for you to know a little bit about the virus and how you can help protect yourself.


Shingles is a viral infection that can cause a very painful rash. This blistery rash can appear almost anywhere on the body which shows up on one side. The virus’ name is varicella-zoster which is the same virus that causes chicken-pox. After you have chicken pox this virus can lie dormant in the nervous system, until it rears its ugly painful head, at what age – not known, where on the body – can be anywhere, how long does it last – undetermined.


Some signs and symptoms include fluid filled blisters either in a linear pattern or a group that can be red, itchy, tingly, and painful. This rash can be very sensitive to the touch. Although this virus is not life threatening if the rash develops near the eyes this can be very serious and the pain can be debilitating. Some people have complained of fever, fatigue, headaches, and becoming sensitive to light. This virus can be contagious if you come in contact with an open blister.


The shingles virus does not discriminate, male or female, young or old, healthy individuals or people who have compromised immune systems. Complications associated with this virus are vision problems, post herpetic nerve pain, and possible neurological problems, like inflammation of the brain or hearing problems.


There are 2 vaccines that were developed, Zostavax and Shingrix.

*Zostavax was approved for use in 2006, it’s a one dose vaccine recommended for people over the age of 60 with an 65% effective rate.

*Shingrix was approved for use in 2017 and is the preferred alternative. This is a two dose vaccine for people ages 50 and older, with the second dose given anywhere from two to six months after the first dose has been administered. And if you’ve received the Zostavax vaccine already you can also receive the Shingrix vaccine. The most common side effects of the vaccine is a headache, redness, itching and soreness at the injection site.


-Who can get the Shingrix vaccine? Anyone over the age of 50, it’s a 2 dose series.

-Can I get the Shingrix vaccine if I receive the Zostavax already? Yes you can.

-How can I get the vaccine? Call the office we ask that you call your insurance company and give them code 9750 and see if the vaccine is covered. Then call our office and schedule a convenient time.

-Why should I get the Shingrix vaccine? In people ages 50-69 the vaccine was 95% effective in preventing shingles and over 90% effective in preventing the pain associated with the rash. In ages 70 and over the vaccine was almost 90% effective.

As we get older our risk of getting shingles increases.

So why get ShingRix-it will help prevent the after-shingles pain that can last for six weeks to six months and in some people, it can last a lifetime.

Protect yourself today! Call the office for an appointment.



OVER 70? Four Test to Avoid


If you’re over 70, regular screening tests — especially when it comes to cancer — may be a big waste of time, say a growing number of health experts worried about the over testing of those who are in their 70s, 80s and even older. These experts’ concern is that unnecessary screenings could lead to invasive procedures or treatments that leave patients worse off than before, especially among those with serious health problems such as heart disease.


Having a colonoscopy past age 75 may do little to protect you against cancer, reports a new Harvard study of more than 1.3 million Medicare patients ages 70 to 79. Researchers found the cancer risk dropped from about 3 percent to a little more than 2 percent over a span of eight years. At the same time, other studies have shown, the risk of complications from the test increases with age, especially for those in their 80s. The U.S. Preventive Services Task Force (USPSTF), an independent advisory board of medical experts, recommends that screening for colorectal cancer in adults 76 to 85 “be an individual decision,” based on overall health and careful consideration of potential benefits and risks. Obviously, if you’ve had a polyp removed or have a family history of colon cancer, your risk is higher and you should probably be screened. If not, you may be able to finally skip all that lovely laxative prep.


The experts pretty much agree that women should get a mammogram every one to two years until age 75. After 75, however, the evidence for continuing the exams is murky. The USPSTF says there is “insufficient evidence” to conclude yay or nay to mammograms past 74. A large European study of women 70 to 75 showed that screening mammograms may have limited benefits and could lead to overtreatment, putting some women at risk from harmful side effects. For women with several chronic conditions that could affect their life expectancy, the benefits of routine mammograms after 75 are questionable. Those women should discuss with their doctors whether continuing the exams is really necessary.

PSA Test

No medical group recommends a PSA screening for prostate cancer past age 75, yet recent research published in the Journal of the American Medical Association found that 41 percent of men in this age group still have the test, many at the recommendation of their physician. Talk with your doctor, but many men age 76-plus can skip this.

Pap Smear

After age 65, most women with no previous cancer or precancerous lesions are good to go if they’ve had three negative Pap smears to check for cervical cancer in the previous 10 years. Unfortunately, most women have become so accustomed to having an annual Pap smear that they have them even after undergoing a hysterectomy, according to a study. So, ladies, assuming your physician agrees, you can cross this test off your annual to-do list.

Two Test You Should Get

Bone Density Scan

While women should be getting routine bone density scans beginning at 65 (or earlier, depending on their risk factors), men 70 and older also need to get a bone mineral density test to check for osteoporosis. This weakening of the bones is often considered a “silent disease,” because its symptoms can develop unnoticed until a bone fracture occurs. In men, osteoporosis begins later than in women, and progresses more slowly, but the problem is growing among men who are 70-plus, notes the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Indeed, by age 65 or 70, men and women are losing bone mass at about the same rate, making this screening test critical for everyone — men as well as women — over age 70.

Abdominal Aortic Aneurysm Screening

Men 65 to 75 who have been smokers anytime during their lifetimes should have a onetime ultrasound to screen for an abdominal aortic aneurysm (AAA). The aorta, the main artery supplying blood to the body, extends from the chest to the abdomen. Men who have smoked are at higher risk for the aorta to rupture, which is usually fatal, but if an aneurysm is caught before rupturing, it can be successfully repaired by surgery. The evidence is unclear whether routine screening would benefit women ages 65 to 75 who have been smokers in the past, notes the USPSTF, but the panel recommends against AAA screening for women who have never smoked.


WINTER 2016 (2)

Six Things That Raise Your Blood Pressure


American Heart Association News, 02/26/2016

· Salt. The American Heart Association recommends people aim to eat no more than 1,500 mg of sodium per day. That level is associated with lower blood pressure, which reduces the risk of heart disease and stroke. Because the average American’s sodium intake is so excessive, even cutting back to 2,400 mg per day can improve blood pressure and heart health.

· Decongestants. People with high blood pressure should be aware that the use of decongestants may raise blood pressure. Many over–the–counter (OTC) cold and flu preparations contain decongestants. Always read the labels on all OTC medications. Look for warnings for those with high blood pressure and who take blood pressure medications.

· Alcohol. Drinking too much alcohol can raise your blood pressure. Your doctor may advise you to reduce the amount of alcohol you drink. If cutting back on alcohol is hard for you to do on your own, ask your healthcare provider about getting help. The AHA recommends that if you drink, limit it to no more than two drinks per day for men and no more than one drink per day for women.

· Hot Tubs & Saunas. People with high blood pressure should not move back and forth between cold water and hot tubs or saunas. This could cause an increase in blood pressure.

· Weight gain. Maintaining a healthy weight has many health benefits. People who are slowly gaining weight can either gradually increase their level of physical activity (toward the equivalent of 300 minutes a week of moderate–intensity aerobic activity), reduce caloric intake, or both, until their weight is stable. If you are overweight, losing as little as five to 10 pounds may help lower your blood pressure.

· Sitting. New research shows that just a few minutes of light activity for people who sit most of the day can lower blood pressure in those with type 2 diabetes. Taking three–minute walk breaks during an eight–hour day was linked to a 10–point drop in systolic blood pressure.



Is it the Flu or a Cold?


When you wake up sneezing, coughing, achy and feverish how do you know if it is a cold or the flu? It’s important to know the difference between the two because treatments are different. Also secondary health issues can be more serious with one versus the other. For the most part a cold is a milder respiratory illness then the flu. Length of symptoms also varies greatly from a cold to the flu.

Cold symptoms can begin with a sore throat that lasts a couple days. This is often followed by nasal symptoms that can be either runny or congestion. Nonproductive cough is not uncommon. Fever is rare in adults but can be low grade. Children are more likely to have a fever.

Flu symptoms are usually much more severe and come on very quickly. Symptoms can include sore throat, headache, cough and runny nose. Fever is usually high causing body and joint aches.

SYMPTOMS                                         COLD                                       FLU

Fever                                                   Seldom, mild                           Usual, 101-102

Headaches                                          Occasional                              Common

Body aches                                          Slight                                       Usual, often severe

Fatigue                                                            Sometimes                              Usual, up to 2weeks

Congestion                                          Usual                                       Sometimes

Sore throat                                          Common                                 Sometimes

Cough                                                  Mild                                         Moderate/ severe

Complications                                                 Sinus HA, Ear Infection           Bronchitis/Pneumonia

The best treatment for either is prevention. Good hand washing techniques is the most important prevention, along with avoiding touching your face and staying away from those who are visibly sick. For the flu getting an annual vaccine is important. Cold treatments include decongestants, pain/ fever relievers and cough meds. Flu treatments pain/ fever relievers, decongestants, cough meds and antiviral meds.

Cold symptoms can last for up to a week no matter what you do. The first 2-3 days are the worst and when you are the most contagious. Flu symptoms are much more severe and can last 10-14 days. A not uncommon complication of the flu is pneumonia, which can last for 3-4 weeks after the flu. This is much more common in the young, elderly or people with lung problems.

If you have a cold or the flu and symptoms worsen after a few days, it’s time to call the doctor. Other worrisome symptoms include persistent fever for more than 4 days, chest pain, persistent cough, ongoing sore throat or shortness of breath. Seek the advise of a physician if any of the above symptoms occur.



Mosquito Fever Is Among Us


It is spring, it’s wet and the mosquitoes are on their way. As the weather gets warmer and we plan more outdoor activities, it’s important to remember that we are not the only ones becoming more active. Mosquitoes are vectors for disease. This means they can transmit disease from one human or animal to another. Typically, the diseases are caused by viruses or tiny parasites. The virus and mosquito coexist together without harming each other. The virus reproduces itself within the mosquito, and then is passed along when the mosquito bites another person.

The big story in the news lately has been the Zika virus. The most common symptoms of the Zika virus are fever, aches, rash and red eyes. Most of the time the illness is not severe enough for people to seek medical treatment. For this reason, people may not even realize they are infected. The worry with the Zika virus is mainly for pregnant women. The Zika virus can cause a serious birth defect called microcephaly or other fetal brain defects. The most recent increase in outbreaks has been in South America, specifically Brazil. Also reports from Central America and Puerto Rico have occurred. No local mosquitoes have been found to have the Zika virus in the United States. Cases that have been diagnosed in the U.S. were all related to travel exposure. The Zika virus can be detected by a blood test, but the availability is limited. Tests need to be approved by the state CDC. Treatment is all symptomatic; it is aimed at preventing dehydration, controlling fever and aches.

Prevention of transmission is also important. Transmission has been found to occur through sexual contact. Males who have traveled to areas endemic with Zika virus and have a pregnant partner are recommended to use condoms with any sexual activity throughout the entire pregnancy. Men who have traveled to endemic areas should avoid attempting to impregnate their partner for 3 months post exposure. Women who become pregnant after recent travel to endemic areas should consult their physician for testing. So as you can see it’s a good news story but not something most of us in the state of New Jersey will have much exposure to.

What we do need to be more concerned about is West Nile virus, which does occur in the northeast. Again symptoms are flu like in nature, fever, aches, chills, and diarrhea. In less than 1% of the cases people develop encephalitis or meningitis. These patients suffer from severe headache, neck pain, fever and seizures. Treatment usually entails supportive treatment in a hospital setting.

The true goal with any mosquito borne illness is prevention. Avoiding mosquito bites by using repellants that contain DEET is the mainstay. When weather permits, wearing long sleeves and pants when outdoors at night is beneficial. Mosquito proof your home by fixing screens and keeping doors closed. Reduce the # of mosquitoes in your yard by removing standing water. Also notify the state of any issues with dead birds in your area, which can be a sign of West Nile virus. Some local municipalities may participate in applying insecticides.

All in all mosquito borne illnesses are not that common in our area. A little prevention will go a long way. If you are planning on traveling to areas endemic with mosquitoes check the CDC website to see what specific precautions should be taken.





The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck.

The thyroid gland can be described as a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working properly.

Prevalence and Impact of Thyroid Disease
Here are a few statistics about thyroid disease from the American Thyroid Association.

  • More than 12% of the U.S. population will develop a thyroid condition during their lifetime.
  • An estimated 20 million Americans have some form of thyroid disease.
  • Up to 60% of those with thyroid disease are unaware of their condition.
  • Women are 5 to 8 times more likely than men to have thyroid problems.
  • One woman in 8 will develop a thyroid disorder during her lifetime.
  • Most thyroid cancers respond to treatment, although a small percentage can be very aggressive.
  • The causes of thyroid problems are largely unknown.
  • Undiagnosed thyroid disease may put patients at risk for certain serious conditions, such as cardiovascular diseases, osteoporosis, and infertility.
  • Pregnant women with undiagnosed or inadequately treated hypothyroidism have an increased risk of miscarriage, preterm delivery, and severe developmental problems in their children.
  • Most thyroid diseases are life-long conditions that can be managed with medical attention.

Facts about the Thyroid Gland and Thyroid Disease
According to the ATA, the thyroid is a hormone-producing gland that regulates the body’s metabolism—the rate at which the body produces energy from nutrients and oxygen—and affects critical body functions, such as energy level and heart rate.

  • The thyroid gland is located in the middle of the lower neck.
  • Although the thyroid gland is relatively small, it produces a hormone that influences every cell, tissue and organ in the body.
  • Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone.
  • Symptoms include extreme fatigue, depression, forgetfulness, and some weight gain.
  • Hyperthyroidism, another form of thyroid disease, is a condition causing the gland to produce too much thyroid hormone. Symptoms include irritability, nervousness, muscle weakness, unexplained weight loss, sleep disturbances, vision problems and eye irritation.
  • Graves’ disease is a type of hyperthyroidism; it is an autoimmune disorder that is genetic and estimated to affect 1% of the population.

Research Advancements in Thyroid Disease
Research funded by the ATA over the past 40 years has accomplished the following:

  • Mandatory screening of newborns for congenital hypothyroidism, and early treatment that has prevented mental retardation.
  • Cost-effective methods to detect thyroid cancer by screening the 250,000 thyroid nodules developed in Americans each year.
  • Groundbreaking work in brain development and thyroid hormone function.
  • Promising Graves’ disease genetic research that may lead to improved prognosis and new preventive treatments.
  • An experimental drug that may prove useful for treatment and prevention of eye problems associated with Graves’ disease.

For more information, contact the American Thyroid Association.


FALL 2015

We thought our patients would find this article helpful:


5 Important (But Rarely Explained) Medical Terms, and What They Mean

By Jeanne Faulkner

No one wants to seem ignorant when they see their doctor, but no one should be expected to be bilingual either. If your doctor’s medical jargon is incomprehensible, you’re not getting your money’s worth. In fact, not knowing what your doctor is talking about can be downright dangerous.

Here are five common terms that patients hear frequently—but often don’t understand.

1. Blood Pressure. When your doctor says your blood pressure is something over something, what is she talking about? She’s referring to the pressure of the blood in the arteries, the result of the heart muscle’s contractions. Let’s say your blood pressure is 120 over 80, which is read as 120/80. The two numbers reflect the first and last heartbeats heard with a stethoscope after a blood pressure cuff (a sphygmometer) is pumped up to restrict blood flow, then slowly released.

  • The first number (120) is called systolic pressure and it measures the highest pressure as the heart contracts.
  • The second number (80) is called diastolic pressure and it measures the lowest pressure as the heart relaxes.

What should your blood pressure be? If your systolic number is below 120, and your diastolic number is below 80, you have normal blood pressure. Higher numbers can indicate pre-hypertension, or hypertension (high blood pressure).

2. Cholesterol. What if your doctor says you have high cholesterol? Cholesterol is a natural chemical compound produced by the body, a combination of lipid (fat) and steroid. Cholesterol is a building block for cell membranes and hormones like estrogen and testosterone. The liver produces about 80 percent of the body’s cholesterol; the rest comes from diet. When your doctor gives you your cholesterol lab results, you’ll hear three numbers, which are expressed in terms of milligrams (thousandths of a gram) per deciliter (tenths of a liter) of blood (mg/dL).

  • LDL (low-density lipoprotein) cholesterol is known as “bad cholesterol,” because high levels are associated with heart disease. LDL levels lower than 100 md/dL are great; levels from about 130 to 160 mg/dL are borderline, and higher levels boost your risk of heart disease.
  • HDL (high-density lipoprotein) cholesterol is considered “good cholesterol,” because it prevents the hardening of the arteries (atherosclerosis) by taking cholesterol out of the arteries and depositing it in the liver. An HDL level of 60 mg/dL or more is good. For men, levels below 40 mg/dL and for women, below 50/dL, raise your risk of heart disease.
  • Total Cholesterol is the sum total of all cholesterol components in your blood stream. A good total cholesterol level is under 200 mg/dL.

3. Biopsy. If your doctor says you need a biopsy, she wants to remove and examine a tissue sample. Biopsies often help diagnose or rule out cancers, but are also used to identify other conditions. Biopsies may be performed with a needle or a scalpel; they might be minor procedures or require general anesthesia. After a biopsy, your tissue sample will be sent to a laboratory, examined under a microscope, and subjected to any tests your doctor has ordered.

4. CBC and BMP. Your doctor may order these blood tests to help determine your health status. CBC stands for Complete Blood Count, and it measures the amount of several different types of blood cells, including white blood cells (WBCs), red blood cells (RBCs), hemoglobin (HGB), hematocrit (HCT), and platelets in your body.

  • WBC: The normal range is between 4,500 and 10,000 cells/mcL, or cells per microliter (millionth of a liter). A higher count usually indicates infection.
  • RBC, Hgb and Hct values indicate the presence or absence of anemia (a lack of red blood cells). Normal RBC range for men is 4.7 to 6.1 million cells/mcL; for women, normal range is between 4.2 to 5.4 million cells/mcL. Normal Hgb is between 13.8 to 17.2 gm/dL (grams per deciliter, or tenth of a liter) for men, and between 12.1 and 15.1 gm/dL for women. Normal Hct ranges from 40.7 to 50.3% (in men), and from 36.1 to 44.3% (in women).
  • Platelets indicate your blood’s ability to clot. The normal platelet count range is between150,000 – 400,000 platelets per microliter (millionths of a liter).
  • BMP stands for Basic Metabolic Panel, a test for sodium, potassium, calcium, and glucose levels, and measurements of kidney function. Your doctor may order this if you’ve had vomiting or diarrhea, or to screen for other types of diseases, including heart and kidney disease.

5. Body Mass Index (BMI). Your BMI is a measure of your weight in comparison to your height. It’s calculated by plugging your height and weight into a formula.

  • Normal BMI for adults is between 20 and 25.
  • Overweight is 25 to 30.
  • Obese is 30 to 35.
  • Morbidly obese is 35 to 40 or above.

Don’t hesitate to speak up when your doctor speaks medical-ese. Excellent health care is all about communication and getting the information you need.