We Are Members of Privia Medical Group

As of October 26, 2020, we are proud members of Privia Medical Group!

We Now Have TeleVisits!

While we are all doing our part to help lessen the length of the Covid-19 pandemic by practicing social distancing, it doesn’t mean you have to sacrifice getting the quality healthcare you deserve.

We are happy to announce that Healthy Steps Internal Medicine now has TeleVisits! Telemedicine is a secure way to keep your appointments with your medical provider and it is covered by most insurances like a regular office visit. It is even covered by Medicare.

Whether you had a scheduled appointment that you cancelled to err on the side of caution, or we cancelled out of concern for your well being; LAPSES in care may be detrimental to your overall health. Additionally, Telemedicine is an excellent platform if you have any URGENT medical concerns (that are not emergencies).
Please call the office at 301-593-6072 to schedule your TeleVisit. If you are currently a patient you also have the option, through your secure patient portal, to request routine Virtual Visits.

At Healthy Steps, your health and safety are our top concern.We are pleased to be able to offer you this safe and secure method to stay on top of your health issues and make it easier for you to achieve and maintain optimal health.

A Note To Our Patients

Dear Healthy Steps Patient,

We have had many questions from our patients about the Coronavirus and our plans during this worldwide crisis. At Healthy Steps Internal Medicine, the health and welfare of our patients is our top priority.

For this reason we have put in place several new practices that will help us decrease our patients’ likelihood of exposure to potentially contagious persons.
If you are experiencing the following symptoms, we are asking that you STAY HOME and call the office for further instructions:

  • High fever
  • Dry cough
  • Difficulty breathing

A healthcare professional will return your call as soon as possible. You will then be advised on your best course of action.

If you are having difficulty breathing, and your symptoms are concerning, or your fever is not well controlled with over the counter medications, please do not hesitate to go to your local ER. Please call ahead and notify them that you are coming so they can guide you per their ER protocol. These measures are in accordance with the CDC and local health department guidelines.

If you have traveled to a country that is considered high risk for transmitting the disease, please follow the CDC guidelines for self isolation. However, since we now know the chances for community spread (transmission not related to foreign travel) is high and on the rise, we are asking that all persons who have these symptoms follow the above guidelines.

Due to limited availability of test kits, this office is not currently equipped to test for the Coronavirus.

Since much emphasis has been placed on social distancing we are actively working on implementing Telehealth in our practice. Our hope is to initiate this ASAP so that we will have seamless transition for optimal care. We will keep you updated on this as it becomes available.

A link to a UChicagoMedicine article is below. Though there are MULTIPLE articles about COVID-19 we found this comprehensive and straightforward. The CDC website is also an excellent source of information and will have the most updated changes.

https://www.uchicagomedicine.org/forefront/prevention-and-screening-articles/wuhan-coronavirus

https://www.cdc.gov/coronavirus/2019-ncov/index.html

We appreciate your patience, cooperation and understanding. As we all stay calm and use common sense measures, we will be able to deal with this virus together.

Husna R. Baksh, MD and Staff
Healthy Steps Internal Medicine

Desperate Times, Desperate Measures: Actually, Common Sense Measures

If you have known allergy exacerbations of cough, runny stuffy nose, itchy eyes etc., due to this season of allergens, I would strongly recommend that you start an antihistamine every day to prevent those symptoms which can radically worsen.

In these uncertain times these symptoms might have you wondering if you’ve contracted the Coronavirus by an incidental contact. You really don’t want to spend your time in a doctor’s office or an emergency room being vigorously evaluated for Covid-19 just because you did not take a simple medication which would help control your airway inflammation.

So!! Please start using an anti-histamine and any other airway anti-inflammatory medication such as nasal steroids, Benadryl, Claritin, Allegra etc. etc. Of course, please use all medications wisely. Don’t drive or use heavy equipment if certain of these medications cause you extreme drowsiness. We don’t want you to have an accident that sends you to the ER, defeating the main goal! If alcohol is in your daily diet and there can possibly be competition in the liver for attention of these two medications (yes I am referring to alcohol as a medication), these are considerations you should keep in mind as well.

GORGEOUS DAYS AHEAD: TAKE YOUR AIRWAY INFLAMMATION MEDICATION DILIGENTLY so you can ENJOY these beautiful days outdoors and not in an ER.

Valentine’s Day Heart Health

In 2014, frustrated by the inability to convince patients to protect their heart, I learned about the cardiopulmonary exercise (bike) test. Athletes do this test to determine their ability to use oxygen (VO2Max). By focusing on improving their VO2Max, they are able to improve their overall health to achieve the WIN!

VO2Max tells us how well our bodies use oxygen. It helps us “stabilize” not just heart health – but emotional and intellectual health as well. Studies have shown that the higher the VO2Max, the lower the risk of death and disability from ALL causes of illness and death. We’re not just talking about heart disease – we’re talking about cancer, diabetes, HIV, hypertension, addictions, intellectual and emotional health, and more! It got me thinking: Why not offer this simple test to maximize our patients’ heart AND overall health? Since then, we have used the bike test as a tool to help patients protect their hearts….their life engine!

So today, I encourage everyone to take a bike test. It may be the most important moment of your life as you strive to delay or prevent heart disease. In this 21st century, heart disease should not be the #1 cause of death or disability for men and women.

At Healthy Steps, we pay close attention to heart health every second of every minute. Taking care of your heart is the BEST Valentine’s gift you can give! The benefits of this test are far reaching and will improve health – not just for yourself, but for the folks who treasure you and who you love.

HAPPY VALENTINES DAY!!

CRYSTAL BALL CARE

Despite my burnout (ALMOST EVERY work day FOR THE Last 5 years), there is continued re-energizing once I see the amazing crystal ball results, CRYSTAL BALL. Did I say CRYSTAL BALL RESULTS? YES! of the innovative work we do at HEALTHY STEPS.

I have been wracking my brain to figure out how to spread the SIMPLICITY yet EFFECTIVENESS of this work on a widespread level but, other than the successes at the community lectures I’ve scrounged time to do, I have not been able to share the positive outcomes of our CRYSTAL BALL evaluations. The goal of these evaluations: LONG LIFE/QUALITY OF LIFE. In the stories which follow the names have been changed to protect the innocent…

Here is TODAY’S EXCITEMENT:

Dr. Jan comes from New York to see us. She teaches at a well known university in NY but makes it back to Maryland on a regular basis to be with family and “keep my favorite doc.” Prior to seeing us she went through an exhaustive set of EXPENSIVE tests to evaluate constant FATIGUE and BRAIN FOG. AFTER 2 years of negotiation, education and discussion she FINALLY conceded to do the bike test. She completed it yesterday. Today I decoded the results.

She has ASTHMA and a blood pressure RISE TO STROKE levels during exercise.
NO OTHER TEST DONE BY HER SPECIALISTS, gave her this critical info. Her VO2 max (ability to use oxygen) is 86 %. (this is NOT out of 100% … the highest value we have had is 173% from a female triathlete).

The fix is simple: Evaluate airway inflammation (which exists in 80-90% of patients because we KNOW what to look for) we recommend natural/holistic as well as conventional treatments to Decrease airway inflammation TO IMPROVE OXYGEN UPTAKE. We evaluate her for FOOD and ENVIRONMENTAL causes of airway inflammation through our allergy testing. Further, we check for anemia which affects OXYGEN TRANSPORT (because the red blood cells “carry” the oxygen throughout the body). Additionally, we check for cholesterol which affects OXYGEN DELIVERY (at the level of the blood vessel) to the ENTIRE BODY.

If any (or all) of these 3 simple pathways are affected what do we have? FATIGUE AND BRAIN FOG. Hmmmmm….Guess what!? NONE of her EXPENSIVE TESTING, with her multiple specialists over the last 2 years, gave her this LIFE CHANGING information. Once we fine tune the areas of concern (OXYGEN UPTAKE, TRANSPORT and/or DELIVERY) this will positively affect her life profoundly. Howwwww do I know this?.. This has been 5 years of studying EACH patient, EACH day and the resultant clinical innovative work to achieve PERSONALIZED CARE.

To Be Continued….!!

ALLERGY SEASON: ACHOOOOO!~!

As you walk around and hear everybody sneezing, nasally congested and coughing, INCLUDING YOURSELF!,Please don’t say, “It’s JUST my allergies.”
Because what I, Husna R. Baksh, M.D, hear is: AIRWAY INFLAMMATION (EXACERBATION) and DECREASED Oxygenation which MAY lead to:

1. fatigue
2. feverish feeling
3. sleepy all day
4. not spending quality time with SELF, FRIENDS and FAMILY
5. decreased physical, emotional and intellectual motivation/FUNCTION

AND IF AIRWAY INFLAMMATION stays around chronically, when I hear sneezing I think:

1. imbalance
2. increased risk of falls
3. decreased hearing
4. decreased social interaction
5. decreased JOY!

SO, PLEASE BE SEEN BY YOUR DOCTOR, OR OTHER PROVIDER, for treatment.
Tune in next time for clarification of above.

Should I still be wearing sunscreen in the Fall?

During the summer time, most of us try to protect our skin by wearing sunscreen, especially while on vacation or at the beach or pool. However, our use of sunscreen sharply decreases once we’re back home and Fall weather has kicked in. The problem? We still need sunscreen even in colder weather! Yes the leaves are turning colors and we’re replacing our bathing suits for sweaters but the truth is, the sun is still there every day.

Sunscreen can help protect our skin from the damaging UVA and UVB rays we are exposed to while being out in the sun. But did you know we are still exposed to those same rays even when the temperatures get cooler?

UVA rays are the cause of premature aging, wrinkling and sun damage. These rays are present year-round at the same intensity. That means that you are exposing yourself to the same damaging rays in the Fall as you are in the Summer.

EVERYONE NEEDS SUNSCREEN

While some skin types are slightly more protected than others, the harmful UVA/UVB rays can still affect everyone.

What about sunscreen use if I’m indoors?

Guess what? Those rays that cause wrinkling – they can go through glass! So if you spend 8 hours a day sitting at your desk next to your beautiful view, you’re also spending 8 hours a day exposing your skin the harmful UVA rays.

WHAT’S THE BEST SUNSCREEN

Working in skincare, I think this is the question I get asked the most. And my answer is always: The best sunscreen is the one that you’ll wear! We all have different skin and skincare concerns. And sunscreen is definitely not one size fits all. Some people prefer a sunscreen catered for oily skin, while some need a sunscreen for gentle skin. It doesn’t matter what the brand is, how much it cost or if you bought it at a department store or convenience store. The most important part is that it’s SPF 30 (or higher) and you incorporate it into your every day morning skincare routine. It won’t do your skin any good if you have a beautiful jar of sunscreen sitting on your counter. It needs to be on your skin doing it’s job!

So enjoy the crisper weather, all the pumpkin spiced lattes and football games the Fall brings us – but DON’T forget your sunscreen!

Is Laser Hair Removal Worth It?

IS LASER HAIR REMOVAL WORTH IT?

Our short answer: YES!

Have you ever considered laser hair removal? Are you curious to how it works? Or more importantly, have you wondered if it was actually worth the money?

I’m here to answer all those questions and more!

It all starts with a consultation. At Healthy Steps, all our aesthetic consultations are FREE. During this time, we review what areas you want treated and evaluate whether you’re a candidate or not. Almost any area on the body can be treated and our lasers are safe for all skin types!

How does Laser Hair Removal Work?

Laser hair removal works by destroying the root of the hair follicle. The energy from the laser is absorbed by the melanin in the hair follicle. Once the hair follicle is destroyed, the hair no longer grows back. Multiple treatments are needed to achieve long-lasting results. This is because of the hair growth cycle. There are 3 stages of the hair growth cycle: anagen, catagen and telogen.

In any given area, hair strands can be found in any of the 3 stages. For example, if we look at the hair strands in the underarm at any given time, we can find 1 strand

in catagen phase, 1 strand in telogen phase and 1 strand in anagen phase. In other words, not all hairs in the same area are in the same phase of the hair growth cycle.

Why does the hair cycle matter?

Laser hair removal treatments only work for hair strands that are in the anagen phase. Therefore, it’s important to know that to get successful results, most patients will require an average of 4 to 6 treatments generally spaced a month apart.

The treatment is fast and easy, with minimal to no discomfort.

How much does it cost?

The cost of the treatment is completely dependent on the area being treated. The larger the area, the higher the cost of treatment. Research found that the cost of shaving over a 20-year period cost on average $3,500. The cost of waxing over a 20-year period was on average $15,600! Both shaving and waxing are temporary solutions to hair removal. With laser hair removal, you are getting permanent hair reduction – never worry about shaving or waxing again!

How do I get started?

It all starts with a consultation! Call Healthy Steps Laser Skincare at 301-346-8868 to schedule your free consultation and get started on our hair removal journey!

Heroes Know When To Call For Help

It has been awhile since I’ve posted a blog. Patient care and an increasingly busy schedule has left me with little time to communicate all of the ideas I have regarding over-all health and wellness. In the past two weeks, however, 2 similar events occurred and I feel obligated to make this post. All of you Heroic girls and women out there who are actively trying to bring PEACE and JUSTICE into this increasingly hostile world: PLEASE THINK ABOUT YOUR PHYSICAL AND EMOTIONAL HEALTH before you walk into a group to break up a fight. In the past week we saw two women whose lives will forever be changed because of their heroism. One 29 year old found herself attacked when she tried to save someone from being attacked by three teen women. She lost some of her teeth, but is amazingly and thankfully still alive. In a separate incident, a 58 year old woman became a victim of a different group of girls when she attempted to stop them from stealing. My message to everyone is clear and definitive: If you see an injustice or crime, PLEASE CALL 911 or SECURITY. Do not put yourself in harm’s way. In situations like this, the heroic thing to do is to call for assistance. Remember, your family and friends are counting on you to be around to be their hero. Don’t become a victim while saving someone else.

Medication and the Elderly

Recently, I met an outstanding example of a geriatric patient. While shadowing Dr. Baksh at her office the other day, I learned about issues that are especially important to geriatric medicine, including the importance of reviewing medications and managing co-morbidities during treatment.

Brittnie, one of Dr. Baksh’s clinical assistants, went over each medication with this patient to discuss how it might interact with the patient’s medical conditions and other medications. Three crucial issues are whether a patient tolerates a given medication, whether the patient’s blood work shows adverse side effects, and whether the patient needs a refill. Dr. Baksh mentioned recently that without medications, elderly patients would probably be at much greater risk of life-threatening emergencies. Medications help manage disorders that occur as a patient ages.

The patient also had blood work to check up on her general health. In addition, she had been monitoring her blood pressure and blood sugar at home. Some elderly patients may have no health issues, but many illnesses increase in incidence as patients age. For example, age is a risk factor for cancer because in older patients cells have had more time to undergo genetic changes that lead to cancer. Another example is osteoarthritis, which is almost ubiquitous in older patients. Elderly patients also may have more comorbidities, necessitating various simultaneous treatments.

The patient shared many wonderful stories during her visit. An aide helps her at home every day. The aide’s company disbanded, but the aide still comes to the patient’s home and assists her.
In short, I learned a lot about geriatric medicine, a topic of importance today as the population of the country becomes older.

The Heart and Aesthetics

Growing up, my father taught us Arabic prayers and both of our parents taught us hard work and discipline. My earliest heroes were Martin Luther King, Jr , John F. Kennedy and Ghandi. I was determined to follow a non violent life. I had other heroes: Billie Jean King, Maya Angelou and Gloria Steinem. They lived and spoke the virtues of feminism. I passionately supported equality in all forms and realized the critical need for non-objectification and zero judgment.

When I was 10 years old I resolved I would never wear make-up, never dye my hair, and never be fake about anything, because the world is full of dishonesty. I vowed to always be simple since, in my mind, “dressed up folks never will understand poor folks and material pursuits will not bring me closer to family or to God.” I was determined to become a physician and to learn how to take care of people in the way I wished my grandmother had received care. She had died slowly, after a physically and emotionally crippling life, knowing that there was no cure for her painful and progressively deforming rheumatoid arthritis.

One decade old and I had set a massive challenge for myself.

Much has changed over 40-plus years of adventures and growth. I have prevailed through the physical, emotional and intellectual challenges of medical school, residency and working as a physician for many years. I now wear make up. My early heroes remain important to me but I have added new ones so that I may always strive to become a better person. I haven’t dyed my hair (YET!!!) . However, I still work to develop relationships emphasizing non-objectification, zero judgement and building trust.

On a daily basis, if not hourly, challenges arrive. Through each challenge and clinical revelation I work to develop my own style of care to help patients achieve their optimal health.
One of these clinical revelations was the dreadful realization regarding cardiovascular disease; the number one cause of death and disability. Despite our recurring recommendations patients continued to decline or stop treatment on a scale that was incomprehensible for this number one killer. My own father’s demise from cardiovascular disease was the last straw that impassioned me to search actively for ways to help folks understand what is happening inside their bodies and WHY we make the recommendations we make to prevent heart disease. As fate would have it, after dad’s passing I was introduced to, what we lovingly call, our “crystal ball.” The “crystal ball,” or, the bicycle stress test, looks at EACH PERSON’S ability to use oxygen and has helped me speak clearly and simply with our patients… leading them to many “Aha” moments surrounding our care recommendations. It is personalized medicine at its finest.

We were on a roll helping our patients understand medication recommendations. We had nutritionists and emotional health providers to whom we referred our patients with weight loss challenges. We had dance classes, dances and self defense workshops to inspire people to move. The piece missing from this professional network was a bariatric presence for folks who were overweight and, as a result, had diabetes, high blood pressure, and high cholesterol but simply could not lose weight. —

Throughout the years, studying aspects of health beyond what we do as physicians, it has been no secret that, if there is a way for folks to bypass “Western” medical care and look for alternative forms of improving their health, they will do so. Look at the billion dollar market in vitamins, herbs, acupuncture, massage, reflexology etc. We wholeheartedly support holistic care at Healthy Steps. That is a reason many folks COME to us. We collaborate, educate and negotiate around health care decisions.

One year ago I received a surprise visit from an aesthetic representative. I planned a brief hello and a quick return to my mountain of clinical and administrative tasks. Instead, intrigued by his words, we actively shared information for almost an hour. As he spoke I began to visualize the possibility of a non surgical bariatric program. After going through the pros and cons, the biggest con being the price of start up, I made the financial jump. After all, if my patients were intent on doing this they would pursue Aesthetics with others and they would be left to their own devices to make the right decision. Though financially a steep jump it would be a further convenience for our patients and we could guide them with their overall health in mind. They could pursue aesthetic care and, my hope; Healthy Steps could have a “reward” system for them to focus on the overall benefits of weight loss and healthy living….. IF IF IF they wanted or chose to do so.

Since the onset of this component of our trend to veer off the beaten path the feedback has been either overwhelmingly positive or overwhelmingly negative.

The NEGATIVE:

“Why would you bring such a treatment which leads to objectification of women into your practice? This is the one place people should feel free to be who they are and confident that they are not judged.”

My hope is that it is clear this move is not to objectify, judge or force anyone to do anything they are not interested in doing. As well, these opportunities, to “reward” themselves externally while we fine tune their internal health, are for both men and women.

“Why would you bring in a procedure that is not covered by insurance?”

My goal is to give our patients choices in how they would like to pursue their quality of life. It is important to do labs, educate and present a treatment plan for patient consideration. However, why NOT be a practice which offers more choice and thinks “outside the box”? There are multiple choices that patients, as consumers, make everyday which don’t involve insurance. At the risk of being viewed negatively we wanted patients to have those choices through a reliable source.

The POSITIVE: “We trust you because of the many ways you have taken care of our health and the health of our family. Thank you so much for bringing this procedure into a place where we feel safe and know that you are considering our overall quality of life. I will speak to Gloria (Aesthetic Director) to find out if the procedure (I’m interested in) is right for me.”

My hope in writing this has been to share with our patients, and any persons considering joining our practice, the evolution of a vision, since childhood, which continues to evolve. This note is to inform anyone interested in being informed of our intent; not to objectify and judge but to give a choice to our patients who wish to have the choice. If you want to be proactive about your heart health, and improve your ability to use oxygen optimally, then jump into our Prevention of Cardiovascular Disease program. If you feel special putting on make up, dyeing your hair, body sculpting, decreasing skin blemishes/ wrinkles or getting rid of what you perceive to be excess body hair, then explore our Aesthetic program. These are options that we provide, along with our usual detailed and thorough medical care, to help you achieve your overall quality of life.

– Husna R. Baksh, M.D.

Internal Medicine: A Lot Like Being A Detective

Hello! My name is Olivia Bankole. I am a rising junior at the University of Maryland-College Park studying family science, interested in pursuing medicine. I am shadowing Dr. Baksh for this summer.

I’ve been enlightened by my shadowing experience at Healthy Steps Internal Medicine with Dr. Baksh. The first thing that intrigued me is the realization that medicine is far beyond just the patient and the physician interaction. There are amazing assistants that play a major role in the care of the patient. Behind Dr. Baksh, there is a great team informing her of the patients’ information and making sure that all goes smoothly. This may seem like an evident detail to many, but to me, it opened up my eyes to the fact that medicine is a truly team effort. When all players (i.e. assistants, providers) work together, it will be reflected in how the patient is cared for.

There are no words to explain how awesome internal medicine is! It is such a fascinating, complex, and an inviting field of medicine. As Dr. Baksh said, it takes a lot of “detective work”, with a great attention to details. The field of internal medicine is very much analytical. Dr. Baksh had many patients who had an array of symptoms. Going into detective mode, Dr. Baksh investigated each symptom and asked the patients specific questions that could lead to deciphering a possible diagnosis. While shadowing, I was also informed of the role of cardiovascular disease (CVD) and the implications it can bring along. It is well known that cardiovascular disease is the leading cause of death in the United States. Because it is a silent killer, many patients slowly accumulate a variety of health issues. While these health issues may not flash as a sign of CVD, they often are. With many of the patients’, Dr. Baksh thoroughly informed them of the bike test and the SLEEP study. Because of her knowledge about the role of cardiovascular health and its implications on other areas of our health, especially with those patients with difficult diagnoses, Dr. Baksh proposed that they participate in these tests in order to zoom in on the possible factors of their symptoms and prevent any case of CVD.

This shadowing experience has definitely made internal medicine an area of interest for me as I work my way into the field of medicine. Dr. Baksh’s loving and open relationship with her patient, her ability to connect with patients from all walks of life, and her ability to investigate her patients’ symptoms gives me an understanding of the kind of physician I want to be.

Allergies: Pervasive and Potentially Dangerous

Shadowing a doctor is a very interesting and engaging task full of information. As I observed Dr. Baksh, I noticed the attention to detail she has for the symptoms her patients present during the visit as well as their previous health history and daily activities. I learned that it is important to perform thorough labs and analysis in order to pinpoint the smaller yet very important factors that can affect our health such as cholesterol counts.

During the visits of patients presenting with allergy issues, special labs were addressed in order to find the triggers causing the allergies. These labs examined possible allergens on a micro level to a greater scale looking at things such as dust and the foods we consume in our diet.

After finding the problem allergens, suggestions were made to the patient on how they could manage or avoid them. During the consult, Dr. Baksh explained to a patient how a special prescription could be administered to give their body the antibodies it needs to fight off the allergens. I also learned that allergies may not present themselves in an obvious way at an early age but, instead, become a problem as an adult or at an older age in life when chronic upper airway inflammation may affect hearing or even balance! After shadowing today, I learned that the relationship between a doctor and their patient becomes very open and intimate. Knowing as much information as possible about the patient is needed for finding the best treatment.

PATIENT CARE WITH DR BAKSH: MULTIPLE OBSERVATIONS DURING 4 HOURS

Kelly Hurtado is a University of Maryland Undergraduate student who is considering going to medical school. She followed providers in our office in Silver Spring, MD. Below is a summary of 4 hours of her experience.

My visit at Healthy Steps Internal Medicine helped me understand what signs to look out for if a patient is experiencing infection. Certain signs and symptoms are: redness, tenderness, swelling, or pus in the involved area. To decrease inflammation, it is better to apply warm water and keep the area elevated. If there are signs of an abscess then a surgeon is consulted. In a diabetic this is even more critical since infection can destabilize their total system.

I learned that in diabetic patients, action must be taken as soon possible to prevent infection from worsening because the infection can spread through to their bone. A foot ulcer or open sore can easily be infected and can travel to the bone if not caught early by a visit to a medical professional. When bone is infected the area will need amputation. The reason amputation is done is to surgically remove the area before the infection spreads to more bone or to the blood system. It is also to regain as much quality of life as possible by taking away infection which is “eating up healthy tissue” and destabilizing the patient.
I also learned the importance of the Mallampati score as well as what actions need to be done for high blood pressure. For diabetics and any type of patient, maintaining an optimal airway is important in order to receive the adequate amount of oxygen for the body. This should be looked at closely because no air for a certain time can lead to progressive fatigue, increased weight, increased blood pressure, increased risk of heart disease which can, ultimately, be life threatening. The Mallampati score is Class I-IV as noted below.

This is one of the physical findings Dr Baksh and the providers at Healthy Steps look for when a person has hypertension, diabetes, anxiety, depression and certain other physical and emotional concerns. As you can imagine: a smaller passageway (often affected by inflammation due to allergies NOT treated on a daily basis) can lead to decreased UPTAKE of oxygen…especially when someone is sleeping. Decreased oxygenation has been associated with various physical AND emotional illnesses. Looking for, finding and clearly discussing such findings with their patients is what makes Healthy Steps unique in their patient care interaction.

Medications: The Good and The Bad

Lesley “Uchechi” Azike is a University of Maryland college student who shadowed at our practice this semester. These are some of her observations.

Today’s experience with Dr. Baksh was more than simply learning about medications and their effects on patients. Rather I witnessed the doctor-patient interaction in the healthcare setting. It was truly a beautiful experience to see the patient have so much trust and confidence for Dr. Baksh. She expressed everything that she was going through freely knowing that she was confiding in someone in whom she trusted and who had her best interest at heart. I think that it is so powerful and important to foster healthy relationships with the patients because it not only makes the job of the physician easier, but it allows them the opportunity to do their job and provide optimal care. The patient was so pleased with the care that Dr Baksh and the Healthy Steps staff has provided, that she even brought a gift to express her gratitude.

In addition to the above observation, we also discussed the importance of educating the patient about medication side effects in order to properly treat the patient. This elder patient requested antibiotics so she could use them if her symptoms were ever to return. Dr. Baksh emphasized to her that, if she had a history of recurrent urinary tract infections, she could provide her with a prescription. However, though she recently THOUGHT she had an infection , “Your urine culture was negative.” Dr. Baksh mentioned how antibiotics are like chemotherapy…replete with side effects, some life threatening. This means physicians and healthcare providers would not have the patient’s best interest at heart “if we nonchalantly prescribe antibiotics (or other medications) without factual data, such as a positive urine culture in this patients case. Overall, it was yet another day filled with meaningful lessons.