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Author Archives: Dr. Raymond Kordonowy

Dr. Raymond Kordonowy

About Dr. Raymond Kordonowy

Private Practice Medicine. President of IPALC. Delegate for the FMA,. Member of the National Lipid Association, and Florida Lipid foundation. I have provided CME lectures in the area of cholesterol disorders. Areas of interest : General Internal Medicine are advanced lipid testing/Lipidology, difficult to manage lipid cases, obesity, diet and nutritional assessment, wellness. I am married to Margaret and our two grown boys are Nicholas and Matthew. Hobbies mostly reading, listening to music economics, jogging, bad mandolin playing and upland bird hunting.

Facts About Tetanus and the Shot

When was the last time you had a tetanus vaccine booster? Many people aren’t entirely informed on what a tetanus shot does for the body; however, they may know they need to get this shot if they step on a rusty nail.  As an adult, the tetanus-diphtheria (td) vaccine is recommended for adults every 10 years or after a presumed exposure from a deep wound.  The CDC and FDA deem this shot safe and necessary.

Tetanus shots have been routine since the 1920s, as they are believed to be 100 percent effective in preventing a tetanus infection. What is tetanus? Tetanus, also known as lockjaw, is a disease caused by toxins released if infected with the bacteria Clostridium tetani.  When the bacteria infect the body, a person can experience dysfunction of nerves and resultant muscle spasms in the abdomen, neck stomach, and extremities. A case of tetanus can either be localized (in one spot) in the body or felt all over. True to its name, lockjaw, muscle spasms in the face and neck can cause a person to not be able to open his or her mouth. This is a serious disease; around 30 percent of those who get the tetanus bacteria end up dying from the disease.

Where does the Clostridium bacteria come from? It can be found in dust, dirt and manure. This bacteria can enter a person’s body through a cut or puncture wound, but animal bites, burns, and non-sterile needles can lead to a tetanus infection, as well. Tetanus cannot be passed on from person to person.

A person will experience tetanus symptoms anywhere from three days to weeks after the infection starts. On average, a person will notice symptoms around 8 days after exposure. Early symptoms and signs of tetanus include stiff muscles, difficulty swallowing, spasms, rigid abdominal muscles, sweating, and fever.

The vaccine is the only way to protect oneself from tetanus. Thankfully, due to immunizations, this is a rare disease in the United States.

The vaccine Is known to be safe, and very few people experience any side effects. If side effects do occur, they include: soreness, swelling, and redness around the injection site, and a mild fever. It is believed the potential risks that come with tetanus are far greater and worse than the risks that come from the vaccine. You cannot get tetanus from the vaccine.

If a person gets this disease, he or she will likely have to spend several weeks in the hospital in intensive care, and most likely, will be on a ventilator. Around 50 or less cases occur in the United States each year.

If you cut, scrape, or burn yourself or use a non-sterile needle, you should clean the area, and seek out medical attention. Upon meeting the doctor and reviewing your vaccination history, the doctor will determine if you need a vaccine and tetanus immune globulin to prevent tetanus from entering your nervous system.

For more information on this topic, the best person to talk to is a primary care doctor. Dr. Kordonowy of Internal Medicine, Lipid & Wellness of Fort Myers is a concierge, patient membership physician, and provides direct primary care services. He will be able to administer the tetanus vaccine at his office To book an appointment, click here or call 239-362-3005, ext. 200.

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November 10, 2017
Dr. Raymond Kordonowy

About Dr. Raymond Kordonowy

Private Practice Medicine. President of IPALC. Delegate for the FMA,. Member of the National Lipid Association, and Florida Lipid foundation. I have provided CME lectures in the area of cholesterol disorders. Areas of interest : General Internal Medicine are advanced lipid testing/Lipidology, difficult to manage lipid cases, obesity, diet and nutritional assessment, wellness. I am married to Margaret and our two grown boys are Nicholas and Matthew. Hobbies mostly reading, listening to music economics, jogging, bad mandolin playing and upland bird hunting.

What is an Internist?

An explanation by Dr. Kordonowy

Speaking to patients as well as personal friends, I have become aware that many patients do not understand what an Internal Medicine physician is or does. We are the broadest specialty that diagnoses and manages adult health problems. Surgery is another example of a broad specialty from which various surgical subspecialties arise. We are not interns-an intern is a first year resident. We are also not General Practitioners (GP).

The term Internal Medicine comes from the German name Innere Medizin (prounounced in-‘err-a med-i-tzeen’), popularized in Germany 100 years ago to describe physicians who combined the science of the laboratory with the care of patients. Many early 20th Century American doctors studied medicine in Germany and brought this new field-which married scientific discovery to the healing art-to the US. They adopted the name Internal Medicine. Like some words adopted from other languages, it doesn’t fit any American meaning. This is likely why they’re so much confusion around an Internist. We are one of three specialties in the area known as Primary Care- the other two being Pediatrics and Family Medicine. Primary care physicians can be viewed as personal health care advisers for patients. We function as physicians who guide patients through the complex system of modern health care services. Modern health care services include: preventive services including vaccinations, referring to other specialists, assisting in getting admitted to the hospital, coordinating prescriptions, as well as coordinating home health care and/or durable medical equipment.

On any given day I wear multiple medical “hats”. My first appointment might involve a health physical where I am making sure a patient has had all the proper vaccinations and is getting cancer screening and not developing the most common of adult silent illnesses such as obesity, hypertension or diabetes. In that first room the patient’s complaint of new scaling skin lesions may require that I be a Dermatologist and diagnose and perhaps treat the problem. In the next room a patient may be complaining of cough and sputum changes, which falls in the field of Pulmonary Medicine. My third appointment may involve complaints related to the heart system and thus on goes my Cardiology” hat”. Many times, in a single visit, I may wear 2, 3, or even four different physician “hats”. The above described typical day illustrates why my field is called General Internal Medicine. I see, evaluate and manage many general/common adult health problems.

One description of Internal Medicine that I find resonates the best with patients is when I suggest they view me as the “Pediatrician for Adults”. Sometimes Internists referred themselves as “Doctors for Adults”. Family medicine physicians take care of patients from infancy to the end-of-life and often have surgical training as part of their comprehensive training. Family medicine physicians are even broader in their patient responsibility and skill set. Traditionally, Internists have a much more intensive hospital training background than Family Medicine physicians. Internists focus a full 3 years of their residency taking care of complex adult medical illnesses.

Many subspecialties that people are familiar with come from within the field of Internal Medicine. Examples include: Pulmonary and Critical Care, Endocrinology, Nephrology, Rheumatology, Gastroenterology, Cardiology, Hematology/Oncology, and Infectious Disease. All of the mentioned specialties in the prior list were first trained as General Internists. After taking their Internal Medicine Board exams, they subsequently went on and trained between 2-4 years of additional fellowship training in their particular subspecialty. When I trained in Internal Medicine, I spent at least one-month training side-by-side with a specialist in all the above-mentioned fields. This is typical training for Internal Medicine physicians.

As a patient, if you are thinking you might need a subspecialist such as a cardiologist, I wish for you to understand that your general Internist has extensive prior training as well as medical knowledge in that field. The cardiology subspecialist went on to become more intensely exposed to cardiac conditions and specifically they learned interventional techniques as related to cardiovascular disease diagnosis and management. As an internist, I view the need for the subspecialists as necessary when specific diagnostic procedures or treatment plans that are new or unusual are needed to manage a medical problem. For the common subspecialty conditions an Internist is fully capable of managing the problem. Patients often have more than one medical condition that falls within the very subspecialties. Again, it is best to be managed by a general Internal Medicine physician who is capable of using medications from the various specialties helping patients not take harmful combinations or duplicate medications. This is where the “quarterback “function of your Internist is highlighted.

Doctors refer to the Internist as the “Doctor’s Doctor.” Internists tend to be the “detectives of health” and are known for their diagnostic skills. If a person has a unusual or difficult medical problem that perhaps no one has yet labeled, they are best served by seeing an Internist. As your internist I am your “go to” quarterback doctor. Unless you have suffered an obvious trauma, I recommend you call upon me and my colleagues to evaluate any ailment you may develop.

By starting with an internist, you can be effectively diagnosed and removed through the complex health care system efficiently. I recommend the average patient not self-refer to a specialist based on a physical complaint. Since the human body is very complex we may have various symptoms and complaints related to various diseases or organ systems. If you send yourself to a neurologist when in fact you need a neurosurgeon, you have wasted important time as well as money and physician resources. If your cough happens to be related to a cardiac condition but you assumed it is a lung problem, your referral to a Pulmonary Specialist might result in delayed treatment or proper diagnosis.

Many patients do not understand the wide skill set that Internal Medicine physicians have. Depending upon an Internal Medicine physician’s training and procedural experience, we are often able to manage a large majority of things that are also seen by specialists. As an example, I am very comfortable providing cryotherapy to premalignant and early malignant skin cancers. I provide injections to large joints such as the knee and shoulder and all of us in our group supervise and interpret EKG’s and cardiac stress tests. When it comes to musculoskeletal disorders, our patients are often surprised that we can coordinate diagnostic imaging such as MRI if necessary and appropriate. In most of cases musculoskeletal complaints are best remedied with conservative management such as stretching and/or physical therapy. My  electronic medical record system provides very useful handouts that provide information and illustrations for patients to begin taking care of their problem at home. If our conservative recommendations fail or a person’s pain is so acute that they need more hands-on assistance, we can readily refer them to independent physical or occupational therapists. This approach is a more effective utilization of our health care system and helps reduce the burden on our specialists in the areas of orthopedics and neurosurgery. The price of an Internal Medicine office assessment offers terrific value. An internist can diagnosis and manage a multitude of medical conditions that technically fall into the field of numerous subspecialties but quite frankly don’t require a subspecialist level of expertise to manage most cases. Now incorporating the Direct Primary Care membership model, I recommend you look at the services I and my staff provide to get better idea of what an internal medicine physician is capable of.

Dr. Kordonowy of Internal Medicine, Lipid & Wellness is a concierge, patient membership physician in Fort Myers, and provides direct primary care services. To book an appointment, click here or call 239-362-3005, ext. 200.

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November 3, 2017
Dr. Raymond Kordonowy

About Dr. Raymond Kordonowy

Private Practice Medicine. President of IPALC. Delegate for the FMA,. Member of the National Lipid Association, and Florida Lipid foundation. I have provided CME lectures in the area of cholesterol disorders. Areas of interest : General Internal Medicine are advanced lipid testing/Lipidology, difficult to manage lipid cases, obesity, diet and nutritional assessment, wellness. I am married to Margaret and our two grown boys are Nicholas and Matthew. Hobbies mostly reading, listening to music economics, jogging, bad mandolin playing and upland bird hunting.

Hyperthyroidism vs. Hypothyroidism

Have you ever felt like your metabolism may be off? Do you have difficulty losing weight? Experienced unexplained weight gain?  Hair loss? Chronic fatigue? You may have a thyroid issue. Around 27 million Americans suffer from a thyroid-related illness. Thankfully precise laboratory testing can clarify if there is abnormal function of the thyroid gland. There are different ways your metabolism can be improperly running. If there’s a problem with your metabolism, you most likely will be diagnosed with hypothyroidism or hyperthyroidism. Both hypothyroidism and hyperthyroidism affect the same gland but have opposite effects on the body.

I want to briefly discuss the thyroid gland, which is in the front of your neck. The thyroid secretes hormones that help the body use energy properly while also maintaining the brain, heart, muscles, and other organs. When something is off, the thyroid can become overactive (hyperthyroidism) or underactive (hypothyroidism).  The biggest difference between these two conditions is the thyroid’s hormone output.

With hyperthyroidism, the thyroid gland is making too much of the thyroid hormone whereas it doesn’t make enough for the body in hypothyroidism.

Hyperthyroidism

With hyperthyroidism, a person’s body functions are sped up.  Persons have a faster than normal metabolism. The result includes signs and symptoms of weight loss, heat intolerance, insomnia, difficulty focusing their attention, elevated heart rate and/or palpitations and overactive bowels.

Graves’ disease is a common cause of hyperthyroidism. This disease is an autoimmune disorder that causes the overproduction of thyroid hormones; it’s most commonly occurring in women under 40.

Hypothyroidism

Opposite to hyperthyroidism, hypothyroidism is when the metabolism slows down, along with a person’s intestinal tract and heart rate. Because of these sluggish bodily systems, a person can experience weight gain, slow pulse, constipation, dry skin and hair, fatigue, forgetfulness, depression, brittle nails, and in women decreased menstrual flow.

The most common cause for hypothyroidism is Hashimotos’s disease, which is also an autoimmune disease. In this condition, the immune system produces antibodies that destroy thyroid cells resulting in loss of functioning tissue.

The following health conditions associated with hypothyroidism: diabetes, depression, chronic fatigue syndrome, PMS, iron deficiency, chronic stress, chronic pain, and insulin resistance.

If you are experiencing many of these above symptoms, it’s time to reach out to a doctor before your symptoms get worse. Dr. Kordonowy of Internal Medicine, Lipid & Wellness is a concierge, patient membership physician in Fort Myers, and provides direct primary care services. He will be able to order testing for your thyroid and direct you to the proper treatment depending on the results. To book an appointment, click here or call 239-362-3005, ext. 200.

The post Hyperthyroidism vs. Hypothyroidism appeared first on .

October 30, 2017
Dr. Raymond Kordonowy

About Dr. Raymond Kordonowy

Private Practice Medicine. President of IPALC. Delegate for the FMA,. Member of the National Lipid Association, and Florida Lipid foundation. I have provided CME lectures in the area of cholesterol disorders. Areas of interest : General Internal Medicine are advanced lipid testing/Lipidology, difficult to manage lipid cases, obesity, diet and nutritional assessment, wellness. I am married to Margaret and our two grown boys are Nicholas and Matthew. Hobbies mostly reading, listening to music economics, jogging, bad mandolin playing and upland bird hunting.