Top10MD Blog


 3 months ago    Leave a comments (0)

With kids heading off to camp this summer and families headed to the mountains or camping outdoors ticks can be a problem if not a life-long problem if infected with Lyme Disease or other tick related diseases. “It’s a good idea to take preventive measures against ticks year-round, be extra vigilant during the months of April-September when ticks are most active,” says Dr. Jeffery West Ticks transmit over ten diseases to humans and pets. Some of these diseases can be debilitating for the rest of you or your child’s life; it’s important to seek immediate care. Early recognition and treatment decrease the risk of serious complications later on.

Approximately 300,000 people in the United States are diagnosed with Lyme disease yearly; while only 30,000 of these are estimated to be reported to the CDC by state health departments. Ninety-six percent of Lyme disease cases come from 13 states.


  • Avoid direct contact with ticks
  • Avoid wooded and brushy areas with high grass and leaf litter
  • Walk in the center of trails


  • Use repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours.
  • Always follow product instructions. Parents should apply this product to their children, avoiding hands, eyes, and mouth.
  • Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks and tents with products containing 0.5% permethrin. It remains protective through several washings. Pre-treated clothing is available and may be protective longer.


  • Bathe or shower as soon as possible after coming indoors to wash off and more easily find ticks that are crawling on you.
  • Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.
  • Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs.
  • Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors.
  • If the clothes are damp, additional time may be needed.
  • If the clothes require washing first, use hot water. Cold and medium temperature water will not kill ticks effectively. If the clothes cannot be washed in hot water, tumble dry on low heat for 90 minutes or high heat for 60 minutes. The clothes should be warm and completely dry.


  • Remove the tick as quickly as possible, do not wait for it to detach.
  • Use a fine-tipped tweezers. Grasp the tick as close to the skin as possible, and pull straight up with steady pressure. Then thoroughly clean the bite (and your hands) with rubbing alcohol and soap and water.
  • Kill the tick without touching it and throw it away. If you develop a rash or fever following exposure, see a doctor immediately.


  • Fever/chills: With all tickborne diseases, patients can experience fever at varying degrees and time of onset.
  • Aches and pains: Tickborne disease symptoms include a headache, fatigue, and muscle aches. With Lyme disease, you may also experience joint pain. The severity and time of onset of these symptoms can depend on the disease and the patient’s personal tolerance level.
  • Rash: Lyme disease, southern tick-associated rash illness (STARI), Rocky Mountain spotted fever (RMSF), ehrlichiosis, and tularemia can result in distinctive rashes:
    • In Lyme disease, the rash may appear within 3-30 days, typically before the onset of fever. The Lyme disease rash is the first sign of infection and is usually a circular rash called erythema migrans or EM. This rash occurs in approximately 70-80% of infected persons and begins at the site of a tick bite. It may be warm but is not usually painful. Some patients develop additional EM lesions in other areas of the body several days later.
    • The rash of (STARI) is nearly identical to that of Lyme disease, with a red, expanding “bull’s eye” lesion that develops around the site of a lone star tick bite. Unlike Lyme disease, STARI has not been linked to any arthritic or neurologic symptoms.
    • The rash seen with Rocky Mountain spotted fever (RMSF) varies greatly from person to person in appearance, location, and time of onset. About 10% of individuals with RMSF never develop a rash. Most often, the rash begins 2-5 days after the onset of fever as small, flat, pink, non-itchy spots (macules) on the wrists, forearms, and ankles and spreads to the trunk. It sometimes involves the palms and soles. The red to purple, spotted (petechial) rash of RMSF is usually not seen until the sixth day or later after onset of symptoms and occurs in 35-60% of patients with the infection.
  • In the most common form of tularemia, a skin ulcer appears at the site where the organism entered the body. The ulcer is accompanied by swelling of regional lymph glands, usually in the armpit or groin.
  • 30% of patients and up to 60% of children, ehrlichiosis can cause a rash. The appearance of the rash ranges from macular to maculopapular to petechial and may appear after the onset of fever.

Tickborne diseases can result in mild symptoms treatable at home to severe infections requiring hospitalization. Although easily treated with antibiotics, these diseases can be difficult for physicians to diagnose. However, early recognition and treatment of the infection decrease the risk of serious complications. Seek medical advice immediately if you have been bitten by a tick and experience any of the symptoms described here.


  • Anaplasmosis is transmitted to humans by tick bites primarily from the blacklegged tick.
  • Babesiosis is caused by microscopic parasites that infect red blood cells. Most human cases of babesiosis are caused by Babesia microtiBabesia microti is transmitted by the blacklegged tick.
  • Borrelia mayonii infection has recently been described as a cause of illness in the upper Midwestern United States. It has been found in blacklegged ticks. Borrelia mayonii is a new species and is the only species besides B. burgdorferi known to cause Lyme disease in North America.
  • Borrelia miyamotoi infection has recently been described as a cause of illness in the U.S. It is transmitted by the blacklegged tick and has a range like that of Lyme disease.
  • Colorado tick fever is caused by a virus transmitted by the Rocky Mountain wood tick. It occurs in the Rocky Mountain states at elevations of 4,000 to 10,500 feet.
  • Ehrlichiosis is transmitted to humans by the lone star tick, found primarily in the south central and eastern U.S.
  • Heartland virus infection has been identified in eight patients in Missouri and Tennessee as of March 2014. Studies suggest that Lone Star ticks may transmit the virus. It is unknown if the virus may be found in other areas of the U.S.
  • Lyme disease is transmitted by the blacklegged tick in the northeastern U.S. and upper Midwestern U.S. and the western blacklegged tick along the Pacific coast.
  • Powassan disease is transmitted by the blacklegged tick and the groundhog tick. Cases have been reported primarily from northeastern states and the Great Lakes region.
  • Rickettsia parkeri rickettsiosis is transmitted to humans by the Gulf Coast tick.
  • Rocky Mountain spotted fever (RMSF) is transmitted by the American dog tick, Rocky Mountain wood tick, and the brown dog tick in the U.S. The brown dog tick and other tick species are associated with RMSF in Central and South America.
  • STARI (Southern tick-associated rash illness) is transmitted via bites from the lone star tick, found in the southeastern and eastern U.S.
  • Tickborne relapsing fever (TBRF) is transmitted to humans through the bite of infected soft ticks. TBRF has been reported in 15 states: Arizona, California, Colorado, Idaho, Kansas, Montana, Nevada, New Mexico, Ohio, Oklahoma, Oregon, Texas, Utah, Washington, and Wyoming and is associated with sleeping in rustic cabins and vacation homes.
  • Tularemia is transmitted to humans by the dog tick, the wood tick, and the lone star tick. Tularemia occurs throughout the U.S.
  • 364D rickettsiosis is transmitted to humans by the Pacific Coast tick. This is a new disease that has been found in California.

Dr. Jeffery West is a Rockwall Otolaryngologist specializing in allergies and ENT surgery. Board Certified by the American Board of Otolaryngologists, Dr. West is Medical Director of Lakeside Allergy ENT with offices in Rockwall, Forney, and Wylie Texas. Named Top10MD in 2016 – an honor only 1-in-3 doctors succeeds within the United States. To schedule a consultation with Dr. Jeff West, click on his profile or call his office at 972-398-1131.


IMAGE: Shutterstock


 1 year ago    Leave a comments (0)

It’s that time of year again; it’s time to prepare for physicals and back to school. Physicals are important for monitoring growth and making sure the child is progressing properly. Teachers and coaches have to know if the child has any physical problems or health issues, so they know what actions to take in case of emergencies. There are several places you can get this done.

Places To Get Physicals

  • Pediatrician offices
  • Primary Care Physician
  • Walgreens
  • Clinics

As long as you have one, it does not matter where you get it. They are only good for a year though, so if you know that your physical is about to expire, you should schedule one soon to save yourself the hassle.

What Happens During a Physical?

During the physical, the doctor will check your stomach for any abnormalities. They will also check your reflexes. Blood pressure is important, and if you have asthma, they will assess how well it is being controlled. Physicals differ depending on age. If it is for kindergarten, the doctor will ask you about health concerns and make sure they are eating enough. The kindergarten physical is a tough one because the child has to get a lot of immunizations. If they are behind on immunizations, the doctor will try to catch them up.

For a teenager, the parent, will have to leave the room for some of the questions. The doctors will ask about drugs, alcohol, and sex. Most children will not answer truthfully while the parents are in the room. You were a teenager once; I’m sure you did not want your parents to know some of the things you did. At the age of 15, a child is considered to have autonomy; meaning they can make decisions about their treatment without you. But they have to be 18 and older to sign for vaccines.

Now that summer is almost over, it is already time to prepare for a new year. Do not neglect your school and sports physicals. Make sure you get those things in so that you and your child is prepared for the next school year. Schedule an appointment with a Top10MD Pediatrician today!


 1 year ago    Leave a comments (0)



 2 years ago    Leave a comments (0)

After being considered primitive for decades, IUDs have been rising rapidly among American women in recent years. Strong endorsements from birth-control experts are leading the increase. IUDs are not for every woman, but top women’s health experts are saying they are a good option for most women. This is far different from the old days. Only women who had already given birth were given the option for IUDs, due to the risk of infection. Birth control experts are not balanced on the subject; some argue that the IUD is an under-used option for birth control, while others are still not recommending it. There are two categories of IUDs currently in use, those made of copper and those that emit a progestin hormone.

Intrauterine devices made of copper are effective at preventing pregnancy for 10 years. They are hormone-free making them an option for women who cannot use hormonal contraception. They work by making the intrauterine cavity inhospitable to sperm and hinder the sperm from traveling through the uterus and into the fallopian tubes. The copper IUD can also be used for emergency contraception for up to 5 days following unprotected sex.

With hormonal IUDs, a small amount of progestin, a hormone similar to the natural hormone progesterone, is released into the uterine lining. This hormone thickens cervical mucus and makes it difficult for sperm to enter the cervix. Hormonal IUDs also slow down the growth of the uterine lining, making it inhospitable for fertilized eggs.

As with all birth control options there are pros and cons. The need for a procedure to get this type of birth control allows you to have conversations with your ob-gyn to find what kind of birth control suits your lifestyle. The conversation should also include a run-down of the risks. A decision should ultimately be made between you and your practitioner.
IUD and Birth Control

Pros to IUDs

  • It takes a doctor’s visit to have an IUD implanted, but then your birth control is likely set for years.
  • The device is close to 100% effective.
  • The IUD is also considered one of the most cost-effective forms of birth control when paid for out of pocket. Although it costs several hundred dollars up front, the cost is spread out over years.
  • Under federal rules, insurance companies must cover FDA-approved contraception, which includes the IUD, with no co-pays or additional fees.
  • Periods diminish or disappear with a progestin-releasing IUD, which many women appreciate.
  • The copper IUD offers effective long-term birth control without hormones.
  • Though IUDs work long-term, their birth control effect is reversible: once they’re out, it ends.
  • IUDs are private and cannot be seen or felt.

Possible Side Effects

  • IUDs do not protect against sexually transmitted infections and diseases. An IUD is an effective form of birth control. It is NOT a way to practice safe sex.
  • Though current IUDs have caused nothing like the 1970s debacle of the dangerous Dalkon Shield, some complications do arise. There is a remote risk of embedding and perforations. Some women do experience pain, while others don’t. There are also reports of women expelling the IUD, although it is rare.
  • The progestin-releasing IUD makes periods lessen or disappear, which some women don’t like.
  • While the risk of infection is low, the devices can make existing ones—specifically, chlamydia and gonorrhea—much worse. About one in 100 women report infections within the first 20 days of insertion. The infections can generally be treated with antibiotics. Given that the infections usually arise due to bacteria that crept in during insertion, is it essential to find a skilled practitioner to perform the procedure.
  • The copper Paragard can lead to heavier periods.
  • Also, though their levels are very low, the progestin released by the hormone IUD can affect some women. Some women experience depression and similar symptoms and ultimately switch to the copper IUD. Others have reported acne, headache, and sore breasts.

If you are considering a new form of birth control contact Dallas Top10 OBGYN Dr. Nathan Thomas today.  Dr. Nathan Thomas is a Dallas, Texas Obstetrician and Gynecologist and Board Certified by the American Board of Obstetrics and Gynecology. Dr. Thomas moved to Dallas in 2009 and now one of the most sought after OBGYN’s in Dallas. He follows hundreds of patients yearly all receiving the same quality of care and expertise. Dr. Thomas has been named 2015/2016 Top10MD – an honor only 1-in-3 doctor’s in the United States succeed with this recognition. To schedule your appointment contact Dr. Thomas at 972-566-4555.


 2 years ago    Leave a comments (0)

Are you or your children suffering from red eyes after being in a public pool? Suffering from stinging, nasal irritation or having difficulty breathing after being in the water or breathing the air at swimming pools, particularly indoor pools?

New research indicates that these symptoms are an indication of poor water and indoor air quality at the pool caused by a build-up of irritants, known as chloramines, in the water and air.

Irritants in the air at swimming pools are usually the combined chlorine by-products of disinfection. These by-products are the result of chlorine binding with sweat, urine, and other waste from swimmers.

As the concentration of by-products in the water increases, they move into the surrounding air as well. Breathing air loaded with irritants can cause a variety of symptoms depending on the concentration of irritants in the air and amount of time the air is breathed.

The symptoms of irritant exposure in the air can range from mild symptoms, such as coughing, to severe symptoms, such as wheezing or aggravating asthma. It is also known that routine breathing of irritants may increase sensitivity to other types of irritants such as fungi and bacteria.

The problem can easily be fixed according to the Centers for Disease Control and Prevention (CDC) through a combination of preventive measures:

  • Improving air movement over the pool and increasing the air turnover rate will reduce irritant levels in the air.
  • Open all of the doors and windows in the pool area or to use fans to boost airflow over the pool surface when many swimmers are using the pool. When super chlorinating, do the same.
  • Ensure that the air recycling systems are bringing in enough fresh air.
  • Maintain adequate disinfectant levels and constant monitoring of water quality will help reduce irritant levels by decreasing combined chlorine formation in the water.
  • Adding secondary disinfection systems, such as ultraviolet light or ozone, may reduce combined chlorine levels in the water.
  • In addition, good hygiene is needed. Have swimmers shower before getting in the pool.
  • Promote regular bathroom use to your children prior and during swimming to reduce the amount of urine in the pool. This decreases the formation of irritants.

For the health of pool staff and patrons, remember that all indoor pools need adequate fresh air exchange and all pools need good water quality. This will help make all pools a healthier and more enjoyable place to play and work.

Next time you’re thinking it’s just the chlorine…. Think again.

Keep your children safe this summer.


Source: CDC


 2 years ago    Leave a comments (0)

Keeping your children safe online is getting harder and harder. On April 15, 2015 the Texas Medical Board temporarily suspended, without notice, the Texas Physician-in-Training Permit of Abdussamed Kose, M.D. after determining he poses a continuing threat to public welfare.


The Texas Medical Board panel found that on March 30, 2015, Dr. Kose engaged in a chat online with an individual who represented to Dr. Kose that she was an underage female (Minor). The online discussion between Dr. Kose and Minor turned sexual in nature and led to Dr. Kose travelling to Minor’s home to have sex with her. Unbeknownst to Dr. Kose, Minor was an undercover police officer posing as a minor online during an undercover sting operation to identify individuals using the Internet to meet and solicit minors for sex. When Dr. Kose arrived at Minor’s home, he was arrested for Online Solicitation of a Minor. The temporary suspension will remain in place until the Board takes further action.


Friends this is a 50-year-old doctor who graduated from medical school and was in the middle of a four-year residency at the University of Texas Medical School. All we can say is this boil’s down to CHARACTER. Dr. Kose is obviously lacking character and mentally deranged. How ironic he’s studying to be a psychiatrist….


Children and young people spend a lot of time online though it’s a great way for them to socialize, explore and fun it also subjects them to the risks and dangers online such as inappropriate content, including pornography, ignoring age restrictions, friending or communicating with people they don’t know, grooming and sexual abuse, sharing personal information, and gambling or running up debits. As the National Society for the Prevention of Cruelty to Children Every childhood is worth fighting for.


How To Keep Your Child Safe Onlineonline safety


Talk to your child openly and regularly. Have a family discussion and set boundaries and agree on what’s appropriate and what is not. Explore sites and apps together.


Have The Conversation Early And Often

  • Explore online together
  • Know whom your child is talking to online
  • Set rules and agree to boundaries
  • Make sure that content is age appropriate
  • Use parental controls to filter, restrict, monitor or report content
  • Check they know how to use privacy settings and reporting tools


Ask Your Child If They Know How To

  • Block someone
  • Where reporting functions are
  • How to keep information private


Shelagh McManus an Online Safety Advocate for security software Norton by Symantec said it right If you wouldn’t do it fact to face – Don’t do it online


Top10MD –  America’s Leading Patient Advocacy Service connecting patients to ONLY “10″ doctors in 32 specialties who not only meet Top10MD core standards; but, have impeccable character in the treatment of their patients. Is Your Doctor a Top10MD? 



  • Texas Medical Board
  • The Guardian





 2 years ago    Leave a comments (0)

Have you thought about why you and your family should get the measles shot? Perhaps you should as the United States experienced a record number of measles cases during 2014, with 644 cases from 27 states reported to CDC’s National Center for Immunization and Respiratory Diseases (NCIRD). This is the greatest number of cases since measles elimination was documented in the U.S. in 2000.

From January 1 -March 13, 2015 176 people from 17 states and the District of Columbia were reported to have measles [AZ (7), CA (118), CO (1), DC (2), DE (1), GA (1), IL (15), MI (1), MN (1), NE (2), NJ (2), NY (3), NV (9), PA (1), SD (2) TX (1), UT (2), WA (7)].  The CDC updates this data weekly on Monday’s.


Measles Cases in 2015

Measles Overview

Typically, measles occur during childhood. The measles was formally called rubeola and is a serious and even fateful condition in children and although death rates are continually falling, measles still kill 100,000 people a year, and most of them are under the age of 5. We hear of children acquiring the measles but adults get them too if they have not been vaccinated.

What are the symptoms of measles?

  • Measles starts with a fever that can get very high
  • Rash of tiny, red spots that start at the head and spread to the rest of the body
  • Cough, runny nose, and red eyes
  • Ear infection
  • Diarrhea

How is measles spread?

Measles can be spread as simply as an infected individual sneezing or coughing where moisture from the infected nose and throat come into contact with others whether being inhaled or through touching an infected surface.

Background of the measles vaccination

It is generally assumed that those who were born before 1957 are immune to the measles because the previous outbreaks of it helped people become immune to it prior to the measles vaccination coming out in 1963. Unsure if you were vaccinated? That’s ok, there is a blood test that can be given in order to see if you have certain antibodies that will tell a doctor if you are immune or not.   Don’t want to put up with that hassle? That’s ok, it’s also perfectly fine to have the vaccine again, and it’s affordable.

According to the National Center of Immunization and Respiratory Disease, there was a glitch during the early years of the administration of the vaccine between the years of 1963 and 1967 and it may be possible that someone is not fully immune if they were accidentally given a “killed measles virus vaccine” rather than the “live virus vaccine. Because of this, the center estimates anywhere between 600,000-900,000 individuals received the dead vaccine during that time period.

Protect Yourself!

Secondly, those who have a vitamin A deficiency and don’t get enough of that in their diet are more prone to getting the measles and also have more severe symptoms when they do. An easy way to get more vitamin A in your diet is to eat fish and meats, as well as dark leafy greens, carrots and sweet potatoes to name a few. And lastly, the third way you can become likely to contract the measles is through traveling internationally without getting vaccinated first. So take these precautionary steps to keep yourself healthy, happy and measles-free!

If you believe you or your child have been exposed to the measles contact one of our Pediatricians or Internal Medicine  doctors today.


 3 years ago    Leave a comments (0)

From names, to the color of the nursery and how you’ll raise your little one, parents to be have a lot to think about when a new baby is on the way. One of the most important decisions is choosing a doctor to care for your little guy or gal. Many doctors recommend selecting your pediatrician during mom’s third trimester, as your pediatrician may visit your new baby while you’re still in the hospital after birth. If not, the American Academy of Pediatrics recommends a well visit to your baby’s pediatrician in the 3-5 days following baby’s big arrival. So, your baby and his or her pediatrician will become fast friends! Choosing the right pediatrician is important for your little one’s health and your piece of mind.

When selecting a Pediatrician for your baby to be, these are questions to ask before your commit:

Is the Pediatrician Board Certified?

The American Board of Pediatrics certifies pediatricians to ensure their professional standing and medical knowledge. You can see if a pediatrician is certified by visiting the American Board of Pediatrics web site.
Who covers for the pediatrician when he or she is not available? Some pediatricians work in a group, while others have a solo practice. The important information to determine is who covers for your baby’s doctor when he or she is not available, and after hours? And, are you comfortable with the doctor(s) who may be covering?


Does the Pediatrician’s office have a separate waiting area for sick children?

If you’re taking baby for a well visit, the last thing you want is to be surrounded by kids who aren’t feeling well, coughing – or worse! A separate waiting area for sick kids can help you and your baby stay well.


What are the Pediatrician’s views on various parenting issues? 

From breastfeeding to immunizations and developing sleep patterns, it may be important for you and your pediatrician to share similar philosophies. After all, your pediatrician is someone you will turn to for help and advice on issues that impact your baby’s health and happiness.


What insurance does the Pediatrician accept and do they have any hospital affiliations?

Let’s face it, for most of us, it’s important that our health care providers are “in network” for our insurance to avoid additional co-pays and fees. Determining if your pediatrician is in network, and if the hospital they’re affiliated with is covered by your insurance, may be an important consideration.

These are just a few of the questions you may want to ask a pediatrician to find the right fit for your baby. Many online resources, like BabyCenter, even provide Pediatrician question check lists to guide your interviews with Pediatricians.

A little bit of prep can go a long way when selecting your baby’s doctor. After all, you want the best for your little bundle of joy!


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