After-Hours Care Appointments

Patient Education Websites*

This website gives easy-to-read, accurate description of conditions, causes, symptoms, and treatments by linking to trusted Web sites for specific information. For instance, someone looking up bone cancer would be linked to the bone cancer page on the National Cancer Institute Web site. Lots of Spanish-language materials available here as well.

Not only gives extensive information about diabetes, its treatments, and ongoing research, but it also offers patients advice on nutrition and meal planning, fitness regimes, and lifestyle changes, and connects them with support groups in their communities. Also check out the ADA-sponsored, interactive nutrition site – My Food Advisor, which allows patients to create meal plans, find recipes, and research foods they can eat.

Offers extensive disease/condition information, and goes a step further with its comprehensive and helpful “Treatment Decisions” section, Q&A section called “Ask a Specialist,” and a plethora of interactive quizzes, self-assessments, and calcustors under “Health Tools.”

Patients can read about their prescriptions or research the various drugs available for their condition. This site provides an easy-to-use drug interactions checker, and an innovative pill identification wizard that allows patients to enter the shape, color, and imprint of their mystery pill and view photographs of potential matches to identify the medication.

Drug Watch is an awareness group that aims to educate the public about prescription drugs, over-the-counter medications, and medical devices that have the potential to cause patients serious harm. The website is continually updated with drug recall news, recent FDA approvals, drug interactions, side effects, and current developments in the medical field.  In addition, Drug Watch patient advocates are work with patients to help them get the treatment and care they deserve.

As well as offering patients information on wellness, diseases, drugs, and other health topics, this site has an extensive searchable medical encyclopedia with cool pictures and diagrams and a medical dictionary that gives speilling and pronunciation tips. It also offers health information in more than 40 languages.

Proves well-organized information on diseases, treatments, procedures, drugs, and current research. What sets this site apart is its use of multimedia formats: check out the very cool interactive tools, video health talks, online health chats, podcasts, and webcasts.

Sponsored by the American Academy of Family Physicians, this site presents broader information on the patient experience, not only offering information on conditions and treatments, but tips for patients on choosing a doctor, understanding medical bills, navigating insurance coverage, and advocating for themselves. Also provides helpful information on children’s health and development issues, from toilet training to dog bites to acne.

The American Heart Association’s patient portal on heart disease supplies information, tools, videos, recipes, exercise tips, and expert advice for patients with heart disease and their families. Patients will dig Heart360, an interactive way to manage their heart health by tracking their medications, blood pressure, weight, exercise, and diet.

Sports Physicals right in your neighborhood

Sports Physicals are offered at a flat rate of $45, unless they are performed in conjunction with child’s well/physical exam visit.

Playing sports is a great way for kids to stay fit, but first you need to know if your kid is fit enough to play. With summer camps, summer sports, and team tryouts just around the corner, now is the perfect time for your child to get a sports physical.

It’s important to have a proper sports physical whether you’re involved in team sports, cheerleading, or just going to summer camp. Many times sports physicals aren’t covered by insurance, so Avance Care is offering a special rate to make it available to as many families as possible.

The ultimate goal of a sports physical simply is to ensure safe participation. In most cases, doctors don’t find anything serious enough to prevent teenagers from participating in an athletic activity. In fact, less than one percent of students have conditions that prevent them from playing sports, and most of these are known in advance. Avance Care recommends a sports physical six weeks prior to the starting date of a new sports season.

Please click here for Wake County Public School System Forms.

High Blood Pressure Treatment Goals

There are many options in the treatment of high blood pressure. Medicines, lifestyle changes, and other interventions are all used in different combinations depending on specific patient characteristics. While the goal of high blood pressure treatment is always to reduce the blood pressure, the specific target numbers differ depending on whether the individual being treated is a “complicated” or “uncomplicated” patient.


The difference between these two types of patients is:

  1. Uncomplicated Patients have no underlying disease causing their high blood pressure and have not developed any other organ problems as a result of their high blood pressure.
  2. Complicated Patients have other existing diseases in addition to their high blood pressure

Goals for Uncomplicated Patients

Treatment for uncomplicated patients is focused on reducing the blood pressure and avoiding long term complications. The specific blood pressure goals are:

  • Systolic Pressure <140
  • Diastolic Pressure <90

So, a blood pressure of 138/87 would be considered within goal range but 138/91 would not.

Goals for Complicated Patients

Complicated patients require treatment of both high blood pressure and other existing diseases. Some common diseases that coexist with high blood pressure include:

  • Diabetes
  • Kidney Disorders
  • Certain Heart Disorders or Diseases

The specific blood pressure goals in complicated patients are:

  • Systolic Pressure <130
  • Diastolic Pressure <85

So, 129/84 would be within the target range but 130/83 would not be.

Monitoring Goals

During treatment, blood pressure must be checked regularly the effectiveness of the current course of therapy. It is common for patients to have their blood pressure checked every 1-6 months depending on:

  • The Aggressiveness of the treatment
  • Past records of success or failure with treatment
  • The blood pressure as recorded over the previous 3 months

Cholesterol Treatment Goals

It is extremely important for everyone — men and women of every age, with or without known heart disease — to have a low LDL cholesterol level. The optimal guideline level of LDL cholesterol is less than 100 mg/dl.

Measure your LDL and other blood lipids

Everyone age 20 and older should have their cholesterol checked at least every five years through a blood test. The guidelines recommend you have a complete “lipoprotein profile” that measures total cholesterol, LDL cholesterol, high-density lipoprotein (HDL, the good cholesterol that may help prevent heart disease), and triglycerides, another type of fat in the blood stream. The test should be performed after fasting.

Low density lipoprotein (LDL cholesterol) goal values:

  • Less than 70 mg/dL for those with heart or blood vessel disease and for other patients at very high risk of heart disease (those with metabolic syndrome)
  • Less than 100 mg/dL for high risk patients (for example: some patients who have diabetes or multiple heart disease risk factors)
  • Less than 130 mg/dL otherwise

 

Total cholesterol (TC) goal values:

  • 75-169 mg/dL for those age 20 and younger
  • 100-199 mg/dL for those over age 21

High density lipoprotein (HDL) goal value:

  • Greater than 45 mg/dl (the higher the better)

 

Triglyceride (TG) goal value:

  • Less than 150 mg/dl

 

Determine your other risk factors for heart disease

If you have already diagnosed coronary heart disease, atherosclerosis, or diabetes, the guidelines would place you into the high risk category, even if you have no symptoms of heart disease.

In addition to high LDL, atherosclerosis or diabetes, other important risk factors for heart disease are:

  • Cigarette smoking
  • High blood pressure (140/90 mm Hg and above or on blood pressure medication)
  • low HDL cholesterol
  • family history of early coronary heart disease
  • age (for men, age 45 or older; for women, age 55 or older)

For people who do not have coronary disease, but who have two or more risk factors, doctors may use a risk-factor chart plus your LDL level to calculate your 10-year risk of developing disease and determine whether intensive cholesterol lowering is warranted.

With this risk-factor information, your doctor will place you in one of four categories of risk for heart disease. The higher your risk, the lower your LDL cholesterol goal will be:

If You Have You Are in Category LDL goal
Heart disease, diabetes, other forms of atherosclerosis and multiple risk factors listed above (and risk score greater than 20%) I. Highest Risk LDL level of less than 100 mg/dl with a therapeutic option of treating to under 70 mg/dL. For very high-risk patients whose LDL levels are already below 100 mg/dL, there is also an option to use drug therapy to reach the less than 70 mg/dL goal.
2 or more risk factors listed above (and risk score 10 – 20%) II. Next Highest Risk LDL level of less than 100mg/dl with option for drug therapy for those high-risk patients whose LDL is 100 to 129 mg/dL
2 or more risk factors (and risk score less than 10%) III. Moderate Risk LDL goal of less than 130 mg/dl
0 or 1 risk factor IV. Low-to-Moderate Risk LDL goal of less than 160 mg/dl

 

Improve your cholesterol numbers

The new guidelines emphasize preventing heart disease in the short- and long-term, and recommend “therapeutic lifestyle changes (TLC)” to lower LDL. These involve:

  • Reducing saturated fat and cholesterol intake
  • Increasing intake of soluble fiber
  • Reducing weight if you are overweight – especially if you have metabolic syndrome (see below)
  • Increasing physical activity – regular physical activity is recommended for everyone.
  • Controlling high blood pressure
  • Quitting smoking

Working with a dietitian or nutritionist is extremely helpful.

Should I take cholesterol-lowering medication?

Drugs to reduce LDL include the “statins,” bile acid sequestrants, nicotinic acid and fibric acid. If your LDL and heart-disease risk are both high, doctors may prescribe medications at the same time as lifestyle changes. For others, medication may be added if six to 12 weeks on the TLC plan fail to adequately reduce LDL. Those who are started on a cholesterol-lowering medication will need to continue lifestyle changes.

Identifying those with metabolic syndrome

A group of specific risk factors, known as the metabolic syndrome, raise your risk for coronary disease at any LDL cholesterol level. If you have three of the following risk factors, you may have metabolic syndrome, and need more rigorous cholesterol lowering:

  • Abdominal obesity (a waistline over 35 inches in women and 40 inches in men)
  • Triglycerides of 150 of higher
  • Low HDL (lower than 40 in men and lower than 50 in women)
  • Blood pressure of 130/85 mm Hg or higher
  • Fasting glucose of 110 mg/dL or higher

Middle-aged men (age 35 – 65) are predisposed to abdominal obesity and the metabolic syndrome. As a result, they carry a relatively high risk for heart disease. For those with high risk, intensive LDL reducing strategies should be followed.

See your doctor!

See your doctor. Ask for a complete lipoprotein profile. With results in hand and with your doctor’s help, determine your risk for heart disease. If your cholesterol levels are not optimal, ask for a referral to a nutritionist, and begin your heart-healthy lifestyle right away.

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*Disclaimer: External websites linked on this page are not part of Avance Care’s website, and are not monitored by our staff and providers. They are not endorsed by our providers, not intending to be used for medical purposes, and are not a substitute for seeing a physician or seeking medical attention.