The ABCs of CBD By Renee Alwan Percell, MMS, PA-C

About CBD- What is it?

Cannabidiol (CBD) was discovered in 1940. It is a chemical component of the Cannabis sativa (cannabis plant) and constitutes up to 40% of the extracts of the plant. Unlike THC (found in marijuana) it does not have psychoactive properties, which mean it cannot give you a high. Studies have confirmed CBD does not interfere with psychomotor and psychological functions in humans since it is not the part of the plant that creates psychoactive symptoms. In the last decade, there has been a notable increase in the scientific literature on CBD that shows its benefits in anti-inflammatory and neuroprotective effects.  CBD is used for diverse conditions including relieving pain, reducing anxiety and depression, alleviating cancer-related symptoms; Parkinson’s related symptoms, seizures, and multiple sclerosis.

But how does it work?

The Endocannabinoid System (ECS) regulates bodily functions. It helps the body maintain homeostasis or balance. If there is an imbalance in the body, the endocannabinoid system (ECS) will release neurotransmitters to address the problem. There are numerous receptors in the ECS that help the brain, organs, connective tissues, glands, and immune cells function smoothly. CBD1, for example, is a receptor in the brain, spinal cord, peripheral nervous system, and gastrointestinal tract that plays a role in memory, pain, emotion, and hunger. Endocannabinoids are naturally released when insult occurs and bind like lock and key to these receptors to reduce pain. TCH and cannabidiol act like the naturally occurring endocannabinoids and bind to these receptors to produce the same effect- alleviating symptoms. Similar to how our immune system works in our body to react to harm of the body, the ECS also works to keep our body neither deficient nor overloaded.

Can I have some?

When the ECS is functioning normally, a person will enjoy a healthy mental state, without pain, and have proper digestive function. The ECS can become unbalanced, however. In conditions like obesity or diabetes, the ECS will go into overdrive, flooding our system with endocannabinoids to try to combat the problems these diseases cause such as fatigue, trouble sleeping, anxiety. In doing that, inflammation may occur as our systems receptors become overloaded. CBD will work against this overload, relieving symptoms, and restoring balance. For example, if you experience anxiety, CBD bind to receptors and tells your body to calm down.

It is also hypothesized that the body can become endocannabinoid deficient which manifests most commonly as chronic pain through migraines, IBS, fibromyalgia. Data has shown that supplementing with CBD can bring the ECS back to normal functioning levels, relieving pain symptoms.

You should talk with your health care provider if you are interested in trying CBD for guidance on dosing and to discuss your specific concerns. It is also essential to get your CBD from a reputable source. Quality can vary greatly, so going to a trusted supplier is best.  We recommend ECS Therapeutics CBD Oil, available here at the Couri Center Retail Center. If you have questions, schedule a visit with your provider at the Couri Center!

Be Well, Renee Alwan Percell, MMS, PA-C

The Thermography Myth By Renee Alwan Percell, MS, PA-C

The American College of Obstetricians and Gynecologists recommend women have annual screening mammograms starting at age 40 and continue screening through age 75. There are recommendations about further imaging such as breast MRI or sonogram that should be decided case by case depending on your medical history, risk factors and family history. A mammogram is a low dose X-Ray of the breast tissue. A cancerous mass in the breast tissue would appear white on the image. A mammogram is the gold standard for detection of breast cancer. It can often detect cancer before there are any symptoms, resulting in a better outcome for many.

Several women opt for an “alternative” testing method called Thermography. Women are drawn to thermography because there is no radiation exposure, no compression of your breasts, and no real risks associated with the test. Thermography produces an infrared image that shows the patterns of heat and blood flow on or near the surface of the body. It tracks blood flow which has been thought to be sufficient in interpreting precursors to breast cancer. Although thermography is safe, there isn’t any evidence to prove it’s effective. People had looked at thermography as an early detection tool, but there is NO data to support such claims. The FDA approved thermography as an adjunctive (to be used with mammography) tool in the assessment of breast masses in 1982. Since then, there have been several offices, health spas and mobile imaging units that falsely advertise that thermography is an effective stand-alone test that is safer than mammography in detecting breast cancer. The American College of Radiology and the Society of Breast Imaging DO NOT endorse thermography for detecting breast cancer. Recently the FDA sent out a warning against thermography for breast cancer detection. This was a result of several cases reported where women had breast cancer and treatment was delayed due to thermography.

At the Couri Center, we care about breast health and have a variety of options for patients to reduce the risk of breast cancer. Prevent is a personalized, proactive, evidence-based program that will help you understand your future health risks. We can also calculate your lifetime risk for developing breast cancer and give lifestyle modification guidance. These are tools that we offer and recommend you use in addition to your annual screening mammogram so that you can be your healthiest self. If you would like more information on the programs we offer, please call our office to make an appointment. Most importantly, get your mammograms every year!

Be well,

Renee Alwan Percell, MS PA-C

Do I Really Need an Antibiotic? By Renee Alwan Percell, MMS PA-C

 

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As we start the New Year, many of us will make a New Year’s resolution involving our health, diet, or exercise.  One thing we must keep in mind this time of year is healthy habits to avoid the common cold, the flu, sinus infection, and pneumonia.  A healthy habit that many of us forget is when it is appropriate to use an antibiotic for our illnesses.  Everyone plays a critical role in improving antibiotic use and preventing antibiotic-resistant illnesses.  The CDC has started an initiative for health care workers, hospitals and nursing homes to guide providers in evidence-based findings on when an antibiotic is appropriate for treatment.  Working together we can improve and protect the health and well being of everyone.  This is crucial for the well being of generations to come.  We need to be sure the life-saving antibiotics we have today will continue to be useful for years to come.

What are Antibiotics Used for?

We rely on antibiotics to cure life-threatening illness. Antibiotics do not come without risk, however.  Antibiotics can cause diarrhea, GI upset and allergic reactions.  Also, when we take an antibiotic, it kills not only the harmful bacteria but also the good bacteria.  Killing these good bacteria will make you more susceptible to other illness.  This can take your body months to recover, therefore posing a risk to you for getting another illness.

Most importantly, the overuse of antibiotics has created bacteria that are becoming resistant to the antibiotics we have available.  This makes it extremely difficult for some to improve without complications from antibiotic-resistant bacteria.  Over 2 million people are infected with a resistant bacterium where nearly 23,000 people end up dying as a result.

An antibiotic is not necessary for the common cold, bronchitis, the flu, most sinus infections, and sore throats.  Up to 70% of antibiotics given are not needed.  That means that 7 out of 10 of us take an antibiotic for an acute respiratory infection or something similar that we did not really need. That causes a cascade of effects making our bodies weaker in the long run.  Antibiotics are necessary for the treatment of urinary tract infections, pneumonia, and strep throat.

What Can I do to Stay Healthy?

There are many things you can do to stay healthy.  Healthy lifestyle habits of having a good diet, drinking plenty of water, getting enough sleep and exercise regularly will help your body fight off infection when exposed.  Also taking a daily vitamin and probiotic will help to maximize your body’s ability to fight infection.  That doesn’t always work, so when you start feeling like you may be getting a cold, you can begin a supplement like OlivDefense.  This is a supplement we have at the Couri Center that lessens symptoms and limits the duration of your illness.  It promotes immune function and provides antioxidant activity.  Resting and drinking plenty of water when you feel something coming on also makes a big difference in limiting your symptoms.

Stay warm and healthy this winter.

Be well

Renee Alwan Percell, MMS PA-C

 

I Said NO to Incontinence By Renee Alwan Percell, MMS, PA-C

My first job as a physician assistant was at a community health center where I conducted many adult exams. I had several young mothers talk to me about their stress or urge incontinence. I remember thinking, “that will never happen to me”. I thought my pelvic floor muscles were pretty tough. I regularly did yoga and Kegel exercises so I assumed I would not be plagued with leaking urine.

After my 2nd child, I joined a fitness class similar to Cross Fit in an attempt to get my pre-baby shape back. I loved the routine, but every time I had to jump rope, sprint, or jump on a barrel, I would leak a little or sometimes a lot of urine. I was in the company of fellow women who suffered similar symptoms, but I was embarrassed to the point that I stopped the exercise class. I found myself feeling like I needed to empty my bladder right before I knew I’d be doing anything strenuous; playing soccer with my boys, running up the stairs, lifting heavy objects. I just accepted it as part of my daily routine.

Last week I was waiting for my Daily Method class to start and out of habit headed for the restroom where I was met by a long line of women, no doubt also wanting to avoid any incontinence. While standing in line, I realized that now that I completed my Emsella treatments, maybe I didn’t need to be in this line anymore! Sure enough, I made it through class without any incontinence! Now I notice all the things that I would avoid or alter in my day-to-day life to avoid stress incontinence.

If you would like to know more about incontinence, please read Dr. Couri’s recent article where she discussed types of incontinence and Emsella; the latest FDA-cleared treatment.  Emsella is a chair that you sit on for 28 minutes and it strengthens your pelvic floor. In those 28 minutes the chair delivers over 11,000 Kegel exercises through non-invasive electromagnetic stimulation.  The Emsellais indicated for any woman who is looking for a solution to their urinary incontinence.  If you have a pacemaker, heart condition, any metal in your body, are pregnant or have hip replacements, you may not be a candidate for this treatment.

I am so thankful for our Emsella treatments! I can now do activities without thinking about where the restroom is and I can exercise with confidence!  If you would like more information on the Emsella offered exclusively at the Couri Center, I encourage you to go to our website for a listing of FREE educational classes or make an appointment with one of our providers.

Be Well,

Renee Alwan Percell, MMS PA-C

The Integrative Consult: My Experience By Renee Alwan Percell PA-C, MMS

When I started working at the Couri Center I was still struggling to lose those final pounds I had gained from my last pregnancy. I also struggled with painful body aches and joint pain. I was considering going to a Rheumatologist to see if some kind of rheumatism or autoimmune issue was causing my pain.

During my training at the Couri Center, I learned the powerful role integrative health and food sensitivity testing play in our overall well-being. The Couri Center bundles many aspects of integrative health into a program called the TLC™ Integrative Consult. This program sparked my interest, especially since I was not feeling my best. I talked with Leslie, our Registered Dietitian, about my concerns. The first step of the Integrative Consultation involves uncovering the science behind what is going on within the body. This process includes and extensive panel of specialty blood tests, including hormone, inflammation, vitamin and food sensitivity testing, to name a few. To be honest, I wasn’t convinced the labs would provide much information because overall, I considered myself a healthy eater and person.

At my first appointment, we reviewed all my lab results. My food sensitivity testing was a complete shock! Food was my problem! I had suspected that dairy “did not agreed with me,” but other than that, I thought I was fine. It turns out that I have sensitivities to dairy, gluten, yeast and even almonds! Leslie spent one-on-one time with me to help me better understand my labs, what they meant and how I could improve them. She reviewed supplement recommendations that would help improve my labs as well as how to modify my current diet. With all of the personalized information, I felt ready to tackle my sensitivities.

Next, we discussed how a liver detox would help lay the foundation of my new lifestyle. After Leslie reviewed the simple instructions (I get to eat normal food the entire week!), I set a date to start. The first two days were tough, but doable. Once I was finished the seven days, I couldn’t believe how great I felt! I actually woke up in the morning without any aches or pain and I have more energy. I also noticed all my rings were loose on my fingers.

Based on our Registered Dietitian’s guidance, I slowly reintroduced the foods I removed. I quickly became aware of the foods I could have on occasion and the foods I needed to mostly avoid. As life would have it, I often get off track with my diet. Life as a working mother of three is busy and sometimes I just like to indulge in some cheese and bread! I find that I can follow my diet for several months and then inevitably a holiday or social party will throw off my plans. I don’t get down on myself when I fall off track. Instead, I use the guidance I received from my Integrative Consultation and use the Detox Program recommended by the Couri Center every 4 months (seasonally). I have even encouraged my husband to do the elimination diet with me. He agrees that he feels his best afterward. Now we do it together and like all things, it is much easier to be successful when you have a partner to help keep you on track. I easily lost my last few pounds of baby weight, and I have even had friends complete the program with amazing results!

If you are interested in learning more about your health and our TLC™ Integrative Consult, call 692-6838 and make an appointment with Leslie for a free consultation! With summer around the corner, get a jump start on your best YOU!

Be well,

Renee Alwan Percell PA-C

Couri Girl Spring 2018

At the Couri Center, we specialize in women’s health.  With years of advanced medical training and decades of experience, our success is easily measured in volumes of patient praise.  From traditional gynecology & surgical procedures, integrative health programs & aesthetics, take comfort in knowing you can trust the Couri Center with:

  • Well-Woman Exams
  • Urinary Incontinence
  • Menopausal Management
  • Family Planning
  • Contraception
  • Pap Smears
  • Pelvic Ultrasounds
  • Treatment of Heavy Menstrual Bleeding and/or Fibroids
  • Treatment of Abnormal Pap Smears
  • da vinci® Robotic Surgery
  • MonaLisa Touch™ Vaginal Laser
  • harmonié Bioidentical Hormone Replacement Therapy
  • Food Sensitivity Testing
  • Customized Nutritional Supplements
  • TLC™ Integrative Lifestyle Programs
  • Weight Loss Programs
  • Infrared Sauna Therapy
  • Aesthetic Studio:  Laser Hair Removal, Wrinkle/Age Spot Removal, Scar & Stretch Mark Removal, Rosacea & More
  • Injectables:  BOTOX®  & KYBELLA®
  • LATISSE®
  • Pro-Niacin® Skincare by NIA24®

New patients welcome!  Schedule today: 692-6838  

Welcoming NEW Gynecology Patients

 

Welcome to the Couri Center for Gynecology & Integrative Women’s Health.  We are accepting NEW patients and look forward to meeting you!

At the Couri Center we specialize in women’s health.  With years of advanced medical training and decades of experience, our success is easily measured in volumes of patient praise.  From traditional gynecology & surgical procedures to integrative health programs and aesthetics, take comfort in knowing you can trust the Couri Center.

LEARN MORE ABOUT THE COURI CENTER HERE

If you would like to schedule your new gynecology visit with one of our providers, please call 309-692-6838.  To expedite your appointment process, please complete the below forms and return them to us. 

What do I need to bring to my appointment?

To allow us to better serve you, and expedite your check-in process, we have included the below forms for you to fill out at your convenience at home:  Patient Information Form, Gynecologic Questionnaire and Medical Release. Also, please include a copy of the front and back of your insurance card. Please complete and return all forms to:  Couri Center, 6708 North Knoxville Avenue, Suite 1, Peoria, Illinois, 61614 or email to info@couricenter.com.  Unfortunately, if we do not receive these forms two weeks prior to your appointment, we will ask you to reschedule. We take pride in providing the utmost in compassionate and comprehensive gynecologic care and your paperwork helps us do just that right from the start.

Thank you so much, we look forward to meeting you!

Regards,

The Couri Center for Gynecology

If you are a NEW PATIENT: Please plan on arriving 15 minutes early.

Please complete the below (3) forms as follows:

A.  Print all (3) forms and fill in by hand. Then either:

  1. Mail to our office.  Or
  2. Scan completed documents and email to info@couricenter.com.

OR

B. Complete forms online as .pdf:

  1. Please open each form and save it on your computer, preferably add your last name to the file name while saving
  2. Open the saved documents and complete each fill in form
  3. Save completed documents.
  4. Email completed documents as attachments to:  info@couricenter.com

 

Dense Breast Tissue & Mammograms By Renee Alwan Percell, PA-C

Breast cancer is the most commonly diagnosed cancer in women and second leading cause of cancer death in American women, according to The American College of Obstetricians and Gynecologists. Mammogram screenings should begin for the general population at age 40. Regular mammograms can find breast changes that could be cancer years before physical symptoms develop. Women should become familiar with how their breasts normally look and feel and report any changes to their health care provider.

After your mammogram is complete the radiologist will look at the images and describe it on the final report. Breast tissue will look different depending on what type of tissue you typically have. Women can have almost entirely fatty tissue, scattered fibroglandular densities or heterogeneously dense tissue. Forty percent of women ages 40 and older have dense breasts. You are more likely to have dense breasts if you are younger/ premenopausal.

Dense breast tissue is common and is not abnormal. Dense breast tissue can affect you in two ways. It increases the chance that breast cancer may go undetected. Dense breast tissue and cancer both appear white on a mammogram. It also increases your risk of breast cancer. The reason why it increases your risks is unclear. At this time, experts do not agree with what tests should be performed to further evaluate the dense tissue. However, women with heterogeneously dense tissue should consider breast a sonogram or MRI, especially if they have other risk factors for breast cancer such as the BRCA 1 or BRCA2 gene mutation, first-degree relative with breast cancer, and/or radiation therapy to chest between ages of 10 and 30 years.

In the United States, law requires health care providers in some states to inform women when mammograms show they have dense breasts. Illinois is one of the few states that currently mandate insurance reimbursement for supplemental screening exams for women with dense breasts. At the Couri Center, we are committed to your health and providing you with the information you need to make the best decision for you. When we receive your mammogram report, if the radiologist notes “dense breast tissue”, we will notify you. We recommend you join our portal system so we can send you information via email. It takes only minutes to register!

 

Be Well,

Renee Alwan Percell, MMS PA-C

 

 

Top Questions Answered: HPV Vaccination By Renee Alwan Percell, MMS, PA-C

 

In 2006, a vaccination was made available that prevents cancer. It’s remarkable when you think about it like that. Wouldn’t you want to prevent cancer? This vaccination was the Quadraivalent HPV Vaccination that protects young adults against HPV Types 6, 11, 16, and 18. In 2014 the vaccination was updated to the 9-Valent HPV Vaccination that protects against 9 genotypes of the virus.

So what is HPV? HPV is a virus that is transmitted through sexual contact. Most HPV infections go away by themselves within 2 years. But sometimes the HPV infection will last longer and can cause certain cancers and other diseases. HPV is a virus that can cause cancer of the cervix, vagina, vulva, penis, throat and tongue. It is also a cause of genital warts. One in four people have HPV but it often doesn’t have any symptoms. Since there are no obvious signs of infection, it is easily spread and may only take one sexual encounter to become infected.

Does this vaccine really work? According to the CDC, clinical trials show that the vaccine provides close to 100% protection against cervical pre-cancers and genital warts. There has been a 64% reduction in HPV type infections among teen girls since the vaccine came out in 2006. The 9-Valent Vaccine has been shown to reduce cervical, vulvar, and vaginal cancer as well as penile cancers and warts at a greater than 99% rate.

Is the HPV vaccination safe? The United Sates currently has the safest, most effective vaccine supply in history. The CDC and FDA closely monitor any associated side effects/adverse events through the Vaccine Adverse Event Reporting System. All of the HPV vaccinations went through safety testing and clinical trials. There have been more than 60 million doses of HPV vaccine distributed since 2006 and there is no data to suggest that there are any severe adverse reactions linked to the vaccination. There are potential side effects but they are minimal and the same as many other vaccinations. The most common side effects are redness, swelling around the area and soreness that is temporary and will pass on their own without any treatment. Brief fainting can happen after any medical procedure including vaccinations. Your provider administering the vaccine may recommend staying 15 minutes after administration to prevent fainting.

Who should get the HPV vaccination? The recommendation is for girls and boys at the age of 11-12 as part of the adolescent immunization platform to help reduce the incidences of HPV infection. This group is more likely to complete the vaccination series versus an older teen thereby giving the child full protection against HPV. The vaccination is most effective in those who have not been sexually active, although the vaccination is recommended regardless of prior exposure to HPV. It can be started at age 9 and through age 26. It is recommended to have two doses at least six months apart.

What are you going to do? I’ve been asked by many fellow mothers about this vaccination. My children are younger so I hadn’t thought about it from a mother’s perspective until now. When I see statics like: 50% of new HPV infections occur in 15-24 year olds, my conclusion is that I will vaccinate my boys and daughter at the recommended age. The evidence based medicine is solid and supports the recommendation.

 

Renee Alwan Percell, MMS, PA-C

 

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Her First Gynecology Visit By Renee Alwan Percell, MMS, PA-C

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As girls grow into teens, it is important that they receive appropriate medical care. We recommend that the first gynecology visit occur during adolescence to discuss menstrual health and to assess for contraceptive needs. If there are no medical issues, she can wait until she is 18-21 for this initial appointment. Seeing a provider for her first gynecology exam can make a girl feel nervous or embarrassed, so it is important to explain what to expect the first visit. This visit is an opportunity to build trust and counsel patients and parents about healthy behavior as well as dispel any myths and fears that may be present.

During this visit, we will gather information about the following:

  • Personal past medical history- has she had any surgeries or any other major illness or disease?
  • Menstrual cycle- is her cycle regular/irregular? Does she experience cramps?
  • Family history- is there anyone in the family who has had breast cancer or any other kind of cancer? Any other pertinent family history?
  • Social history- is there any history of smoking or drug/alcohol use? Is she sexually active or thinking about becoming sexually active in the near future?
  • Preventative health- we will discuss healthy lifestyle habits such as diet, exercise, and stress reduction. We will also discuss STD prevention- if applicable. I will spend time explaining how the body works and answer any questions she may have.
  • Treatment- if she has dysmenorrhea (painful periods) or irregular menses, we will discuss treatment options.

The exam for this visit will consist of:

  • Listening to the heart, lungs, and examination of the thyroid gland.
  • A pelvic exam is not necessary unless the patient is sexually active and medical history provided suggests an exam is necessary.
  • Lab tests may be performed depending on necessity. The American College of Obstetrics and Gynecology recommends that all women ages 25 and younger be screened for STDs, if sexually active. This can be done through a urine examination or through a culture swab during a vaginal exam.

Our goal is to establish healthy behavior habits to carry on into adulthood. If you have any questions about the initial visit you can contact the Couri Center and we would be happy to help you.

Be well.

Renee Alwan Percell, MMS, PA-C