What’s that rash? Have you had your shingles vaccine?

shingles vaccineHerpes zoster, or more commonly known as “Shingles” affects almost 1 in every 3 people in the United States in their lifetime.  Anyone who has ever recovered from the chickenpox may develop shingles, even children. However, the risk of shingles increases with age.  Almost half of cases are seen in individuals 60 years and older.  Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox. After a person recovers from VZV the virus stays inactive or dormant in the body and the virus can reactivate years later.

Symptoms of shingles include a very painful rash that develops on one side of the face or body. The rash forms blisters which may burst, and scab over in 7-10 days and clears up within 4 weeks. Before the rash develops you may have pain, itching, burning, or tingling to the area. This can happen anywhere between 1-5 days prior to the rash occurring. Most commonly, the rash occurs in a stripe pattern on one side of the body. It can also cause fever, headaches, chills, upset stomach, and fatigue.

Shingles cannot be passed on from one person to another. HOWEVER – the virus that causes shingles, VZV, can spread to another person with active shingles who has never had chickenpox. In this case, the person may develop chickenpox, but not shingles. The virus is spread through direct contact with fluid from the blisters. A person with active shingles can spread the virus when the rash is in the blister-phase. A person is not infectious before the blisters appear and once the rash has developed crusts. Shingles is less contagious than chickenpox and the risk of a person with shingles spreading the virus is low if the rash is covered.

  • Avoid touching or scratching the rash
  • Wash your hands often to prevent the spread of VZV
  • Until the rash has developed crusts, avoid contact with those who:
    • Are pregnant who have never had chickenpox or the vaccine,
    • Premature or low birth weight infants,
    • Have weakened immune systems (chemotherapy, immunosuppressant medications, HIV)

Treatment for shingles includes antiviral medications, which shorten the length and severity of the illness. Medication must be started as soon as possible after the rash appears. If you, or someone you know thinks they have shingles, contact our office for an evaluation appointment as soon as possible.

You can reduce your risk for developing shingles and long term pain from shingles by vaccination. The Center for Disease Control recommends that individuals age 60 and over get one dose of the shingles vaccination. If you, or someone you know is interested in the shingles vaccination contact our office at 512-336-2777 to schedule a wellness visit so we can discuss the vaccine, along with other vaccinations and screening measures for your age.  Here is more information on the vaccination. (http://www.cdc.gov/vaccines/hcp/adults/downloads/fs-shingles.pdf)

Center for Disease Control. Shingles (Herpes Zoster). http://www.cdc.gov/shingles/index.html (2016).

National Foundation for Infectious Diseases. Shingles (Herpes Zoster). http://www.nfid.org/idinfo/shingles.aspx. (2016)

About the Author: Ashley Hollister, FNP-C is a Nurse Practitioner on the Family Medicine team at Cedar Park Pediatric & Family Medicine. She is currently accepting new patients.


What you need to know about Zika virus:

Zika virus is spread to people primarily through mosquito bites. The most common symptoms of Zika virus disease are:zika

  • Fever
  • Rash
  • Joint pain
  • Conjunctivitis (red eyes)

The illness is usually mild with symptoms lasting from several days to a week and can generally be managed at home with symptomatic treatment alone, similar to the common cold.  Antibiotics do not treat Zika.  Severe disease requiring hospitalization is uncommon.  If you feel your symptoms are severe, we are available with same day appointments to see you and provide guidance.  For an appointment with one of our Family Medicine providers, call 512-336-2777, option 1.

Other online resources on Zika virus:

Author: Cameron T. King, MD


Can Electronic Cigarettes, “E-Cigs”, Really Help Me Quit Smoking?


Are you looking to quit smoking? That’s great news! Giving up smoking is an extremely tough decision to make (and keep), but one that has incomparable health benefits for the short and long term.

There are many ways you can quit smoking that range anywhere from quitting cold turkey, weaning yourself via nicotine patches and gum, to medications prescribed from your family provider. One speculated way of quitting that has gained popularity over the past few years is the use of electronic cigarettes or “e-cigs”. I would like to clear some misconceptions about the use of these products and hopefully provide good information that helps consumers make educated and accurate decisions about their quitting tools.

What are e-cigs?
E-cigs are battery operated, hand held devices that vaporize nicotine and other chemicals for inhalation. They were first introduced into the U.S. market in 2006 and have been gaining acceptance over the past few years. When exhaled, the vapor looks similar to smoke and has gained the nickname of “vaping”.

What is the controversy behind e-cigs?
You may have heard the many arguments behind whether e-cigs can truly help people quit smoking, or whether that is simply a marketing ploy. The producers of e-cigs and those that provide accessories to the product hold fast to the claims that they are “healthier” than traditional cigarettes because “[they] deliver nicotine without the thousands of known and unknown toxicants in tobacco smoke” (Cahn & Siegel, para. 3, 2011). However, a 2014 study revealed higher voltage e-cigs have higher levels of formaldehyde and other toxic carcinogens (American Lung Association (ALA), 2015).

E-cigs are currently not regulated by the Food and Drug Administration (FDA), which means it is unknown how much nicotine or other harmful chemicals are being ingested during use (FDA, 2014). This means e-cig vapor contents can vary across manufacturers, who are not required to disclose what exactly is in the vapor being sold. These chemicals are the same as those found in traditional cigarettes and have been known to be the cause of cancer related to tobacco smoking.

What are my other options then?

Thankfully, there are many other FDA regulated and medically approved options available for smoking cessation. First, talk with your family provider about your intentions. They will be able to discuss with you various alternatives that range from over the counter tools to prescribed medications. Smokefree.gov is an excellent website full of information from reputable sources that includes tips on how to adjust to life without smoking and how to manage withdrawal symptoms.

The first step is making the commitment and the second is making an informed plan of action!

Meredith Long is a Board Certified Family Medicine Nurse Practitioner at Cedar Park Pediatric & Family Medicine. She is currently accepting new patients.

At Cedar Park Pediatric & Family Medicine one of our goals is to provide relevant and accurate medical information for our patients and their families.
Cahn, Z. & Siegel, M. (2011). Electronic cigarettes as a harm reduction strategy for tobacco control: a step forward or a repeat of past mistakes? Journal of Public Health Policy, 32, 16-31. doi: 10.1057/jphp.2010.41.Food and Drug Administration. (2014). Electronic cigarettes. Retrieved from http://www.fda.gov/newsevents/publichealthfocus/ucm172906.htm .

Food and Drug Administration. (n.d.) Ecigarettes. Retrieved from http://smokefree.gov/e-cigarettes

American Lung Association. (2015). American Lung Association Statement on E-Cigarettes. Retrieved from http://www.lung.org/stop-smoking/tobacco-control-advocacy/federal/e-cigarettes.html.

Turkey and ham and pie – OH MY!

TurkeyTrotThe average American gains one to two pounds (or more…) during the holiday season. While this may not seem like much, this weight does accumulate over time.

Here are a few tips to help you have a fun holiday season and stay healthy:

  • Don’t skip meals. Sometimes we skip meals to prepare for a large meal later in the day, however skipping meals can actually lead to over eating later in the day. Instead, have a healthy high fiber breakfast, including whole grains, fruits and vegetables.
  • Use a smaller plate. This can help with portion control. When serving buffet or family style, always start with salad or vegetables first. This can help one eat less calories overall.
  • Eat slowly, savor the meal. Wait at least 10 minutes before serving yourself more food. This will assure that you are still hungry prior to eating more.
  • Get Active! Make plans to participate in a community Turkey Trot before your big meal. It’s a great way to get the family active and earn those extra calories!  Check out the Cedar Park Turkey Day 5K or the Turkey Trot in Austin.

 Wishing everyone a Happy & Healthy holiday!


What you Need to Know about Screening for Cervical Cancer

iStock_000001840964XSmallOne of the primary ways to prevent cervical cancer is by having regular screenings to improve the chances of early detection. But how often do you need to be screened and at what age?

Our clinic follows The American Cancer Society, U.S. Preventative Task Force, and American College of Obstetricians and Gynecologists which recommends a cervical cancer screening (or pap smear) at the age of 21, regardless of sexual activity.

  • Women ages 21-29: Pap smear should be done every 3 years. This exam screens for abnormal cervical cells.
  • Women ages 30-65: Pap smear should be completed every 3 years but co-testing with HPV (human papilloma virus) should be completed once every 5 years.
  • Women over the age of 65: Screenings may stop with an adequate screening history, which includes 3 normal pap smears without a history of hysterectomy due to abnormal pap smear.

You can read more on cervical cancer screening guidelines on the Center for Disease Control website.

HPV Screening:

HPV (human papilloma virus) is very common in women under the age of 30. It is not useful to test women under the age of 30 for HPV because most HPV that is found will never cause long term health risks and your body will fight off the HPV within a few years.

Not all types of HPV can lead to cervical cancer. There are two different types of HPV, one type that places you at a higher risk for developing abnormal cervical cells and a low risk type which can cause other symptoms such as genital warts.

  • Women under the age of 30: HPV co-testing should not be completed.
  • Women ages 30-65: HPV is less common in women over the age of 30 who are at an increased risk for cervical cancer. HPV is also more likely to signal a health problem for these women, who may have had the virus for many years.

You can read more on HPV screening guidelines on the Center for Disease Control website at http://www.cdc.gov/vaccines/vpd-vac/hpv/

*Please keep in mind, guidelines are generalized to a large population and may be applied differently to an individual based on a variety of factors. Talk to your provider about what screening methods and recommendations apply to you.

It’s National Men’s Health Week – Make YOUR health a priority!

three-generationsNational Men’s Health Week is celebrated the week leading up to Father’s Day. We are urging individuals, families, and others to work on raising awareness to promote healthy living and encourage early detection and treatment of diseases among men and boys.

Ladies, this means that you can help too. Encourage everyday actions to promote good physical and mental health. Be a role model on how to live healthy as well.

Health week isn’t only to remind you to have your wellness exam, but to remind you to lead by example….

  • Eat healthy
  • Be physically active
  • Have annual wellness visits
  • Get vaccinated
  • Be smoke-free
  • Prevent injuries
  • Sleep well
  • Manage stress

Remember to exercise – Adults need at least 2.5 hours of moderate intensity aerobic activity such as brisk walking every week, and muscle strengthening two or more days a week. Remember, you don’t have to do it all at once, spread your activity out during the week, or break it into smaller chunks during the day. If you have questions about exercising then ask your primary care provider how you should start. Always remember to listen to your body, and don’t overwork yourself if you are just starting out.

Eat Healthy Eating a variety of fruits and vegetables gives you energy, and are great sources for vitamins, minerals, and other natural substances that help protect you from diseases. Limit the amount of food and drink that are high in calories, sugar, salt, fat, and alcohol. Choose healthier snacks – nuts, apples, grapes, or snacks high in protein.


Tame your stress Sometimes stress can be good (sometimes!). However, it can also be harmful to your health. It can make you feel overwhelmed and out of control. Avoid drugs and alcohol, which can worsen stress. Take charge of your health, and find an outlet that is best for you – running, kickboxing, swimming, yoga, meditating. Take 15 minutes out of each day for yourself – Sit in a quiet room with no TV, cellphone, or children and take a few deep breaths. RELAX!

Wellness Checklist for Men

  1. Cholesterol – High cholesterol is one of the major risk factors for heart disease. Have you had your cholesterol checked this year?
  2. Blood pressure – High blood pressure increases your chance of developing heart or kidney disease, and increases your risk for stroke. If you have high blood pressure, you may need medication to control it.
  3. Colorectal Cancer – Beginning at age 50, through age 75 (depending on other risk factors present that your primary care provider will determine) you need to get tested for colorectal cancer. It is a great primary screening tool.
  4. Prostate Cancer – Starting at the age of 50 (depending on other risk factors present) you may want to talk to your provider about a prostate cancer screening, and if it is the right choice for you.
  5. Sexually Transmitted Diseases – Talk to your provider to see if you are at risk for developing sexually transmitted diseases, and ask about testing.
  6. Diabetes – If you have a family history of diabetes, or are overweight you may be at risk for developing diabetes. Ask your provider about screening tools, and ways to prevent and decrease your risk for diabetes. Diabetes can affect your heart, eyes, feet, nerves, and other body parts.
  7. Tobacco use – If you smoke or use tobacco, talk to your provider about quitting.
  8. Vaccinations – Get up to date on your vaccinations to protect you, your loved ones, and the community. Ask your provider which vaccinations you may need to stay healthy.
  9. Testosterone screening – May be indicated for some, but not all men.

Scheduling an Annual Wellness Visit with your family medicine provider is the best way to start these conversations and starting taking control of your health and wellness.

Ashley Hollister, FNP-C

Sun Safety – Protecting your family in the Texas sun

As wsunburn cartoone enjoy more bright and sunny days, the risk of sunburns and skin damage rises for everyone.   Take these steps now and your skin will thank you in the long-run.

Ultraviolet (UV) rays from the sun or indoor tanning damage the skin. Even a tan is a response to injury, not an indication of good health, as some may perceive. There are many risk factors that can contribute to sunburns, and skin cancer including: family history of skin cancer, sun exposure sun through work and play, history of sunburns (especially early in life), history of indoor tanning, freckles, skin reddens easily or becomes painful in the sun, if you have blue or green eyes, blonde or red hair, and certain types of moles and/or a large number of specific types of moles.

Now that you know your risk factors for UV damage the next step is reducing your risk.sunscreen

Protection from UV rays is important all year round, not just during the summer months. UV rays from the sun can reach the Earth on a cloudy, hazy day as well as bright and sunny days. UV rays also reflect off of surfaces such as water, cement, sand, and snow. The hours between 10:00am and 4:00pm during late Spring and Summer are the most hazardous for UV exposure outdoors in North America.

The Center for Disease Control and Prevention (CDC, 2014) recommends easy options for protection from UV radiation for adults and children.

  • Stay in the shade during peak hours (10:00am to 4:00pm) Plan indoor activities with children during this time unless you can be under an umbrella, seek shade under a tree, or under a pop up tent. An infant’s best defense is sun avoidance.Smiling-Sun-dreamstime_144972-440x372
  • Wear clothing that covers your arms and legs. Long sleeve shirts and pants may not always seem practical in the Texas summer, but a t-shirt, long shorts, a beach cover-up are good choices too. It is wise to double up on protection by applying sunscreen in the shade when possible.
  • Wear a hat that has a brim to protect your eyes, head, ears, and neck. Baseball caps do not protect ears and neck, so you must apply sunscreen in those exposed areas.
  • Wear sunglasses that wrap around and offer both UVA and UVB protection.
  • Use Sunscreen with sun protective factor (SPF) 15 or higher and UVA a/UVB protection. Plan ahead, keep a spare bottle of sunscreen in the car, in your purse, or a child’s backpack. For best protection apply sunscreen generously 30 minutes prior before going outdoors. Don’t forget to protect your ears, nose, lips, and the top of your feet! Always follow the directions on the package. All products do not have the same ingredients. If you or your child’s skin reacts to a product, call your primary care provider and avoid that product.
  • Reapply sunscreen.   Especially if outdoors swimming or exercising. This applies to both water resistant and waterproof products as well.
  • Avoid indoor tanning beds and booths.

Try combining sunscreen with other options such as hats, sunglasses, and shade options to prevent UV damage!