Attention deficit/hyperactivity disorder (ADHD) is a common behavior disorder in both children and many adults. Patients may have trouble behaving or paying attention due to hyperactivity or impulsiveness. While ADHD can be inherited, the medical community does not currently know what causes some people to have ADHD.

Symptoms

• Daydream often
• Easily distracted
• Fidget frequently
• Forgetful
• Have trouble paying attention
• Interrupt
• Talk often before gathering thoughts

Most children with ADHD will show these symptoms by age 7.

Diagnosis

An evaluation will be done to determine if there are any underlying health concerns, find out what the patient’s life is like, behavioral history, and will observe the patient to see how they behave and interact.

Treatments

ADD and ADHD cannot be cured, but the symptoms can be treated and controlled. Treatment options may include:

• Behavior therapy – Behavior therapy or modification uses consistent rules to help with attention
• Medicine – Stimulant medication may be used in a pill or as a patch.
• Occupational Therapy
• Social skills training
• Special Education support

What is an allergy?

An allergic reaction occurs when a person’s immune system becomes hypersensitive to certain substances, such as food. An allergen can be a multitude of things, and many of them are common in everyday life. Allergies develop when a person’s immune system overreacts to one of these allergens.

Someone might not have an adverse reaction when first in contact or have exposure to an allergen that person is sensitive to. It can take time for the immune system to build up a sensitivity to the substance. The body makes antibodies to attack an allergen when exposed.

Symptoms

Symptoms vary depending on the allergen, but they generally cause inflammation and irritation.

Commons symptoms are:

• Abdominal pain or cramps
• Chest tightness
• Contact swelling
• Cough
• Diarrhea
• Hives
• Itchy eyes and nose
• Rash
• Restlessness
• Runny nose
• Shortness of breath
• Sinus congestion
• Swollen lips
• Swollen tongue
• Swollen or watery eyes
• Vomiting
• Wheezing 

Anaphylaxis symptoms

Anaphylaxis is the most severe form of allergic reaction. It is a medical emergency and can be life-threatening. Symptoms can appear seconds to minutes or even hours after.

Some symptoms include:

• Change in heart rate
• Difficulty breathing
• Dizziness
• Hives
• Loss of consciousness
• Very low blood pressure
• Wheezing
• hives, flushing, and itchiness
• difficulty breathing
• wheezing 

Risk factors

During an allergic reaction, the allergen and an antibody, called immunoglobin E, connect and release chemicals into the body. That reaction triggers the body to respond. A chemical called histamine is released during an allergic reaction, which will cause the airways and blood vessels of the body to tight and cause the sinuses to create more mucus and fluid.

Common allergens

• Eggs
• Fish
• Household chemicals
• Insect stings or bites
• Latex
• Medication
• Metals
• Milk
• Mold
• Peanuts
• Pet fur
• Pollen
• Shellfish
• Soy
• Tree nuts
• Wheat

Tests

Blood tests – Measures the level of antibodies to specific allergens that are present.

Skin prick tests- The skin is pricked with a small amount of a potential allergen. If the skin reacts and becomes itchy, red, or swollen, an allergic reaction may be occurring.

Treatment

Medications

• Antihistamines – Block the reaction from the histamine chemical being released into the body by the immune system.
• Corticosteroids – Reduce inflammation
• Decongestants – Reduce blocked nasal and sinus passages
• Immunotherapy: Can help develop long-term tolerance through gradual and routine exposure using oral tablets or injections.

Anaphylaxis

An auto-injector of a drug called epinephrine can be administered into the body, which will need to be used immediately. This treatment is commonly in the form of an EpiPen.

ASTHMA

What is Asthma?

Asthma is a chronic lung condition that involves the airways. Something triggers the airways to swell and inflamed and become narrow. The muscles tighten, and the airways become too narrow so that air can't move in and out of your lungs.

Risk factors

There are no exact causes, but there may be inherited factors or environmental triggers. Some might include dust, pollen, or smoke, or such conditions such as a respiratory infection or gastroesophageal reflux disease. .

Symptoms

• Cough
• Fatigue
• Shortness of breath
• Tightness in chest
• Wheezing

Call 911 or receive emergency assistance if the following symptoms occur during an asthma flare-up:

• Breathing difficulty
• Lightheadedness or dizziness
• Lips or fingers turn blue
• Walking or talking is difficult

Tests and Treatment

Diagnosis is accomplished by an examination by a physician of:

• Lung function
• Tests to rule our lung disorders 

Tests might include:

• Allergy test – Skin or blood test
• Exercise test
• Imaging test – X-ray or CT scan
• Spirometry – Test used to measure the amount of air being exhaled and how quickly.

There are ways to manage asthma, including avoiding triggers and exercising moderately, but there are also medications that can be prescribed:

Fast-acting medications

• Anticholinergics
• Beta-agonists – Most common quick-relief medications
• Corticosteroids (oral)

Long-term medications

• Beta-agonists (inhaled
• Biolegics
• Bronchodilators
• Corticosteroids (inhaled)
• Cromolyn
• Leukotriene modifiers
• Theophylline

Behavioral health issues are common and can affect anyone at any age. The behavioral health professionals and providers at Care New England are experts and are equipped to support and treat individuals who suffer from one of these conditions.

Some conditions include:

• Anxiety and mood disorders
• Bipolar disorder
• Depression
• Hoarding
• Obsessive-Compulsive disorder
• Psychotic disorders, such as paranoia, psychosis, and schizophrenia

A primary care physician can talk to you and your family about your concerns and refer you to a specialist for further assessment.

Saint Vincent Hospital’s Outpatient Partial Hospitalization Program (PHP) is located at 299 Lincoln Street in Worcester, MA.

What is Chronic Obstructive Pulmonary Disease?

It is a broad range of diseases, that includes emphysema, where air sacs, called alveoli, become:

• Collapsed
• Destroyed
• Narrowed
• Overinflated
• Stretched

The damage cannot be reversed. Holes are created in the tissues of the lower lung.

Risk factors

• Air pollution
• Alpha 1-antirypsin – inherited form of the disease
• Smoking

Symptoms

• Cough
• Rapid breathing
• Mucus or sputum
• Shortness of breath
• Wheezing

Other symptoms might include:

• Anxiety
• Depression
• Fatigue
• Heart difficulties
• Sleep problem
• Weight loss

Diagnosis

An examination is required, but some tests ordered may include:

• Peak flow monitor – measures the speed air can be exhaled out of the lungs
• Spirometry – most common lung function test

Other tests might include a CT scan, x-ray, blood tests, electrocardiogram, or a sputum culture.

Treatment

• Antibiotics for infections
• Avoid environmental factors such as pollution and smoke
• Endobronchial valve device – Minimally invasive system to treat severe emphysema
• Medicine such as bronchodilators
• Nutritional support
• Oxygen therapy
• Pulmonary rehabilitation program
• Surgery to remove the damaged area of the lung
• Vaccines such as the flu or pneumococcal vaccines

What is diabetes?

Diabetes is a condition that can affect anyone, from all walks of life, across all age levels. The condition causes higher than normal blood glucose levels, or blood sugar. Blood sugar is the main source of energy your body uses and is derived from the food you eat. It’s also your brain’s main source of fuel. While the underlying causes of diabetes vary by type, the issue lies with how your body makes – or doesn’t make – insulin to properly process your body’s glucose levels.

Over time, having too much glucose can lead to significant health problems, including heart disease, blindness, kidney failure, and lower-extremity amputations. While there is no cure, there are steps to manage diabetes and lead a healthy, active lifestyle.

Types of diabetes

Type 1 diabetes

In type 1 diabetes, the body does not produce the insulin needed to get glucose (energy) into the bloodstream. Usually diagnosed in children and young adults, type 1 diabetes can appear at any age. With proper care and use of insulin therapy in conjunction with other treatments, those affected can learn to manage the condition and lead long, healthy lives.

Type 2 diabetes

Type 2 diabetes is the most common form of diabetes. With type 2, the body does not make or use insulin properly. While medication may be necessary for some to control their blood sugar levels, others are able to manage through healthy eating and exercise. With nutrition and fitness being a key component to proper management, Care New England’s Wellness Center is here to support you in your journey to improved health and management of type 2 diabetes.

Gestational diabetes

Gestational diabetes develops in some women during pregnancy, and it is similar to type 2 diabetes. During pregnancy, your body makes hormones that make your body resistant to insulin. Most pregnant women make more insulin to keep their blood sugar levels normal. But seven to 14 percent of pregnant women still cannot make enough insulin to keep their blood sugar levels normal during pregnancy, resulting in gestational diabetes.

What is fibromyalgia?

Fibromyalgia is a musculoskeletal disorder where widespread pain is felt. It can be brought on after physical trauma. Many times, there tend to be common pain points in the body for this condition, including the hips, lower and upper back, arms, upper chest, front and back of the neck, and shoulders.

Symptoms

The pain points are very sore, particularly when touched, and often these symptoms occur:

• Bowel conditions, such as diarrhea, constipation, and bloating
• Burning pain
• Depression
• Fatigue
• Headaches
• Numbness or tingling in extremities
• Sleep difficulty
• Stiffness

Diagnosis

There are no tests for the condition, but a physical examination by a provider is required and other tests may be needed to eliminate other health concerns from being the cause of the pain. The symptoms usually are ongoing for at least three months.

Treatment Medication

• Duloxetine
• Milnacipran
• Pregaballin

Other pain medication may be prescribed, and over-the-counter pain medication can be used., including acetaminophen, and nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen.

Lifestyle changes

• Exercise
• Healthy diet
• Sleep

Other therapies such as cognitive behavioral therapy can also be helpful, as well as other alternative treatments, including chiropractic intervention and massage.

What is hypertension?

Blood pressure is the force of blood traveling through an artery. With each heartbeat, blood is pumped from the heart and into the blood vessels. Every time the heart beats, pressure is created inside arteries as the heart contracts and relaxes.

High blood pressure occurs when the force inside the arteries is too high during the contraction or relaxation.

Complications of high blood pressure include: 

• Death
• Heart attack
• Heart failure
• Kidney failure
• Loss of eyesight
• Stroke

Risk Factors:

• Diabetes
• Excessive alcohol consumption
• Family history
• High sodium
• Kidney disease
• Lack of physical activity
• Sleep
• Smoking
• Stimulant drugs
• Stress
• Weight

Symptoms

Very high blood pressure may exhibit:

• Changes in vision
• Chest pain
• Headache

Diagnosis

• Check blood pressure
• Systolic pressure – top number is the pressure inside the artery when the heart contracts
• Diastolic pressure- the bottom number is the pressure inside the artery when the heart is at rest

There are four ratings of blood pressure:

• Normal – 120/80 or less
• Elevated – Systolic 120-129 and diastolic less than 80
• Stage 1 high blood pressure – Systolic is 130-139 or diastolic is 80-89
• Stage 2 high blood pressure – Systolic is 140 or higher or diastolic is 90 or higher

Treatment

Lifestyle changes

• Exercise
• High fiber foods
• Limit calories and fat in food
• Limit salt (sodium) in food
• Limit serving sizes in food
• Quit smoking
• Reduce alcohol consumption
• Reduce stress
• Sleep
• Weight

Medicine

• Alpha-blockers
• Angiotensin-converting enzyme inhibitors
• Angiotensin II receptor blockers
• Beta-blockers
• Calcium channel blockers
• Diuretics

What is cholesterol?

Cholesterol is a fat-like, substance that is found throughout the body. It helps make cell membranes, hormones, and nutrients like vitamin D and perform important functions.

In the blood, cholesterol comes from food and from the liver. There are two types of cholesterol – low-density lipoproteins and high-density lipoproteins.

Low-density lipoproteins cause plaque buildup in arteries, while high-density lipoproteins help to reduce plaque buildup.

Risk factors

• Diabetes
• Family history and genetics
• Lack of exercise
• Obesity
• Poor nutrition and diet
• Smoking

Diagnosis

 High cholesterol is diagnosed through laboratory testing, using a blood draw.

Cholesterol levels are measured in milligrams per deciliter (mg/dL) Total cholesterol levels less than 200 mg/dL are considered ideal for adults. Numbers between 200 and 239 mg/dL are considered borderline high and 240 mg/dL and above is considered high.

LDL cholesterol levels should be less than 100 mg/dL. Levels of 100 to 129 mg/dL is ok, but those with risk factors, such as family history, may need to be watchful and try to lower their LDL. LDL cholesterol of 130 to 159 mg/dL is borderline high, and 160 to 189 mg/dL is high. A reading of 190 mg/dL or higher is considered very high.

Treatment

Lifestyle change

• Increasing intake of certain fish, like salmon
• Increasing physical activity
• Limiting saturated and trans-fats
• Low-sodium diet
• Quit smoking
• Reduce alcohol consumption

Medication

• Statins
• Bile acid sequestrant
• Cholesterol absorption inhibitor
• Cytrate lyase inhibitor
• PCSK9 inhibitor

What is Influenza or the flu?

Influenza is a highly contagious viral disease of the throat and nose, and sometimes the lungs. It is easily transmissible, and its effects can be mild to severe. It can lead to death as it has been linked to several recorded pandemics throughout history.

Risk factors

• Coughing and sneezing causes droplets to be released
• Touching contaminated surfaces where the virus may be contained

Symptoms

• Cough
• Fatigue
• Fever, often around 102° Fahrenheit
• Headache
• Muscle aches
• Runny or stuffy nose
• Sore throat

Diagnosis

The disease can only be determined by tests and a physical examination by a physician

Treatment

• Drink liquids
• No consumption of alcohol
• Rest and sleep

The best way to prevent influenza is by receiving a flu vaccine. It is recommended to receive a flu shot every six months to a year.

What is insomnia?

Insomnia is a common sleep disorder that makes it difficult for someone to fall asleep or they have a restless sleep. This condition can affect everyday function and cause someone to continue to be tired throughout the day.

Insomnia can last for a long period of time or become chronic. It may be associated with other health conditions as well.

Symptoms

• Difficulty sleeping
• Depression or anxiety
• Fatigue
• Lack of focus
• Wake up too early or during the night

Someone should see a medical provider once the condition begins to affect everyday function.

Risk factors

• Eating late at night
• Poor sleep
• Stress
• Travel 

Other causes can include drug use such as alcohol, smoking and caffeine, medication, mental health disorders, other medical conditions like chronic pain, cancer, asthma, overactive thyroid, heart disease, diabetes, and more.

What does the kidney do?

Kidneys are abdominal organs that have some main maintenance functions of the human body:

• Removes waste from the body and extra fluid
• Helps control blood pressure
• Produces red blood cells
• Promotes bone health by producing Vitamin D
• Helps maintain pH levels in the body by balancing acids

When kidneys are not functioning properly toxins begin to build inside the body because of the kidney’s filtering properties.

Symptoms of kidney problems or failure

Some symptoms that the kidneys are not functioning well are:

• Breathlessness
• Breath smells
• Confusion
• Fatigue
• Itchiness
• Lack of appetite
• Muscle cramping
• Poor sleep
• Swollen face and/or feet
• Very dark, brown, or bloody urine

Common kidney diseases or conditions

• Acute and chronic kidney disease
• Fluid and electrolyte abnormalities
• Hematuria (blood in the urine)
• High blood pressure
• Kidney stones
• Proteinuria (protein in the urine)
• Urinary tract infections

Risk factors

• Diabetes
• Family history of kidney problems
• Heart disease
• High blood pressure

Diagnosis

There are a few tests that a physician can use to determine the state of kidney function within an individual: 

• Blood test – determines how well blood is being filtered in the kidneys. It called glomerular filtration rate or GFR. A GFR of 60 or more is healthy, while less than 60 could be a sign of kidney disease. Less than 15 is diagnosed with kidney failure.
• Imaging
• Removing a piece of a kidney to test
• Urine test – tests levels of protein in the urine. The test specifically looks for a protein called albumin, which is released into the kidneys when the kidney is not functioning. A level of 30 mg/g or less is healthy, while anything more can be a sign of kidney disease.

Treatment

A starting point for treating kidney issues is trying to treat the cause of the problem. That may require lifestyle changes or medications to treat for:

• Anemia
• High blood pressure
• Lower cholesterol
• Strengthen bones
• Swelling

For end-stage kidney disease, more advanced and immediate treatment may be needed, which includes:

• Dialysis – dialysis involves either using a thin tube, or catheter, inserted into the abdomen to fill the body with a solution to absorb waste and excess fluid, which then later drains from the body, or using a machine to filter waste from the blood.
• Kidney transplant – a healthy kidney is surgically placed inside the body after removing a damaged one. Medication will then need to be permanently taken in order for the body to not reject the donor kidney.

There are many neurological and nervous system disorders and diseases. Some of these include diseases where the causes are unknown. The types of conditions include:

• Acute spinal cord injury
• Alzheimer's disease and other dementia
• Amyotrophic Lateral Sclerosis (ALS)
• Ataxia
• Bell's palsy
• Brain tumors
• Cerebral aneurysm
• Encephalitis
• Epilepsy and seizures
• Guillain-Barré Syndrome
• Headache
• Head injury and chronic traumatic encephalopathy
• Huntington’s disease
• Hydrocephalus
• Lumbar disk disease, or a herniated disk
• Meningitis
• Multiple sclerosis
• Muscular dystrophy
• Neurocutaneous syndromes
• Parkinson's disease
• Stroke

A primary care physician can talk to you and your family about your concerns and refer you to a specialist for further assessment.

Sexually transmitted diseases can most often occur through direct and unprotected sexual contact. Commonly, symptoms usually include a combination of the following:

• Pain or discomfort during sex or urination
• Sores, bumps, or rashes on or around the vagina, anus, buttocks, thighs, or mouth
• Unusual discharge or bleeding from the genitals
• Itchiness in or around the genital area

These diseases can also be contracted by sharing needles.

Types of STI’s

The most common types are:

Chlamydia – Bacterial infection that causes pain during sex or urination and in the lower abdomen, and colored discharge from the genitals. It can lead to various infections as well as pelvic inflammatory diseases and infertility. Babies born to untreated mothers may develop blindness, eye infections, or pneumonia.

Gonorrhea – Bacterial infection that often does not present symptoms, but those that do include a lighter colored discharge from the genitals, pain during sex or urination, frequent urination, itching around the genitals, and sore throat. It can lead to other infections, infertility, and pelvic inflammatory disease, and it is treated with antibiotics. It can pass from mother to child during childbirth.

Herpes – Officially called the herpes simplex virus, there are two strains of the virus, which commonly are transmitted sexually. It causes cold sore, with are blisters on the genitals or mouth. They heal on their own within a few weeks. It can be passed to a fetus in the womb or to a baby during childbirth, and congenital herpes can be dangerous. There is no cure

Human immunodeficiency virus (HIV) – Immune system becomes damaged or compromised and can lead to contracting other diseases, developing cancer, and possibly to AIDS, a more severe form of the virus if not treated. Symptoms resemble the flu and include aches, chills, fever, headaches, nausea, rashes, sore throat, and swollen lymph nodes. There is no cure yet, but management, starting in the early stages, is effective.

Human papillomavirus, (HPV) – Virus that is passed by skin-to-skin contact, and symptoms usually involve warts on the genitals, mouth or throat, and certain strains can lead to cancers affecting the cervix, rectum, mouth, and vulva. There is no treatment, but infections often clear on their own. There are vaccines for the more dangerous strains.

Lice – Small infects similar to head or body lice and live in the public hair. Symptoms include itching, bumps, low-grade fever, fatigue, and irritability. They are easy to transmit to others through contact and by sharing clothes, bedding, towels, and touching other objects.

Syphilis – Bacterial infection characterized by a sore with later symptoms including rashes, fatigue, fever, headaches, joint pain, hair loss, or weight loss, and it can lead to a loss of sensory functions, mental illness, heart disease, other infections, and possibly death.

Trichomoniasis – Tiny organism that is hard to detect. A smaller percentage of people develop symptoms, which include a genital discharge, itching or burning, painful sex or urination, and frequent urination. It can lead to infections, infertility, and pelvic inflammatory disease, but it is treated with antibiotics.

What is a thyroid disorder?

The thyroid is a gland located in the upper chest or lower part of your neck and is an endocrine gland that produces hormones, which include thyroxine, triiodothyronine, and calcitonin. It helps maintain and control activity within the body, including how the body burns fat and calories. Disorders occur when the gland is not functioning properly.

Disorders include:

• Goiter or toxic nodular goiter – Enlarged thyroid gland. It can cause pain or difficulty breathing, speaking, or swallowing. A toxic nodular goiter can occur when a lump or nodule of the thyroid becomes overactive.
• Graves’ Disease – The most common form of hyperthyroidism, Graves’ disease is an autoimmune disorder involving the thyroid being overstimulated by antibodies. It can be hereditary, and it is commonly most found in young to middle-aged women.
• Hashimoto's Thyroiditis – The most common type of thyroiditis, it may also be called chronic autoimmune thyroiditis. It occurs when the body creates antibodies that attack cells in the thyroid, which causes the gland to be inundated with white blood cells. It scars the thyroid, and it cannot make enough hormones. Risk factors include being female, between 30-60 years of age, heredity, and other autoimmune diseases, such as rheumatoid arthritis, or diabetes.
• Hyperthyroidism – More hormones are created by the thyroid than are needed. The body’s metabolism works at a faster rate, risk factors include over-use of medicine to treat an underactive thyroid, too much iodine in the diet, having a tumor in the pituitary gland, as well as advanced age, being female, pregnancy, past thyroid concerns, family history and other conditions such as diabetes. Symptoms include anxiety, nervousness, sweating abnormally, thinning of skin and hair, heart palpitations, hands shaking, high blood pressure, weight loss, abnormal bowel movements, insomnia confusion, and light sensitivity.
• Hypothyroidism – Not enough hormone is created by the thyroid, and it is the most common thyroid disorder. Risk factors include being female, being older than 60, family history, having past thyroid health problems, having other conditions like diabetes or arthritis, pregnancy, or an iodine deficiency. Symptoms include fatigue, sensitivity to the cold weather, voice changes, slowed speech, swelling, weight gain, dry or coarse hair, carpal tunnel in the hands, slow pulse, joint pain, confusion, and cramping.
• Thyroid Disorders in Women – As the thyroid assists in maintaining the proper bodily function, a woman’s body and health systems are adversely affected if thyroid conditions occur. These include bone health and osteoporosis, emotional and mental health patterns, pregnancy and postpartum health, reproduction, puberty, and menstruation, and menopause.
• Thyroiditis – Swelling or inflammation of the thyroid. This condition can be painless, but many times this condition does involve discomfort. It can be brought on by a virus, bacteria, radiation during treatment, after giving birth, or by drugs such as amiodarone, interferons, and lithium. Heredity can also be a factor. Symptoms include anxiety, irritability, insomnia, rapid heart rate, weight loss, fatigue, sweating or heat intolerance, increased appetite, and shaking or tremors,

Diagnosis

A medical provider will need to perform an exam, and blood tests may be needed, or ultrasound or scan.

Treatment

Treatment depends on the condition, but some may involve:

• Medicine, including beta-blockers
• Radioactive iodine
• Steroids
• Surgery
• Thyroid hormone replacement therapy