Ensuring Safe Play: The Importance of Preparticipation Sports Physicals

by Lindsey Rux, FNP-C

Organized sports have held a special spot in my heart from a young girl playing three sports, through my years playing college basketball. This lifelong love of athletics built my special interest in helping young athletes safely prepare for play. With over half of the child/adolescent population in the United States participating in organized sports, pre-participation physical evaluations (sports physicals) are essential in the safety and proper clearance of this population. In addition to sports-related clearance, a sports physical is a wonderful way to update the child’s preventative care all in one office visit.

At Gagon Family Medicine, we strive to provide the best care and safety for all athletes and encourage all young athletes to receive a preparticipation physical evaluation (sports physical) to determine medical eligibility for sports. We follow the recommendations for sports physicals created by a diverse task force including the American Academy of Family Physicians, American Academy of Pediatrics, American Medical Society for Sports Medicine, American Orthopedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine.

Key recommendations include:

  • Determine general physical and psychological health.
  • Evaluate for life-threatening or disabling conditions, including risk of sudden cardiac arrest.
  • Structured physical examination focusing on cardiovascular, musculoskeletal, and neurologic systems.
  • Screening for depression, anxiety, and attention-deficit/hyperactivity disorders.
  • Exams should take place in a medical office rather than a group setting.

The first part of the sports physical involves the parent and child filling out a medical history form that encompasses general physical/mental health questions, immunizations, social history, heart, and bone/joint health. This ensures that the health care provider understands all medical history for all body systems and can review any previous injuries (such as bone/joint injuries, concussions).

Concussion screening is essential in the clearance of an athlete thus we screen all athletes with a Standard Assessment of Concussion form. This form helps provide a baseline screening score so that if a concussion does occur, we can repeat this test to better understand the degree of concussion and develop the proper treatment plan.

Once the history form and concussion screening are both completed the medical provider will review all history, screenings, and vitals with parent/athlete. The physical exam portion of a sports physical includes the following: appearance, eyes/ears/nose/throat, lymph nodes, heart, lungs, abdomen, skin, neurological and musculoskeletal systems.

Because we find this part of an athlete’s care so important, we donate $25 per sports physical back to the sports team of your choice.

Schedule your child’s preparticipation sports exam today!

Insights to Hormone Replacement Therapy– Lindsey Rux- FNP-C

Insights to Hormone Replacement Therapy by Lindsey Rux, FNP-C, with Gagon Family Medicine & Urgent Care

Lindsey Rux, FP-CHormone replacement therapy (HRT) has been a staple treatment for menopausal symptoms for years. What many people do not understand is there is always some risk when we introduce hormones into the body, especially after menopause. The average age for menopause in women is between ages 45-55 years old, but age of onset does vary person to person. Through this period, women can experience disruptive and frustrating symptoms and HRT has been used for many years to help manage those menopausal symptoms.

  • When looking at benefit versus risk of HRT, benefits outweigh the risks for women who are under the age of 60 or less than 10 years from menopause. This does not include those who are already at high risk for adverse outcomes such as those with significant personal or family history. Evidence has found that out of those specifications there is an increased risk of adverse outcomes such as increase coronary heart disease, stroke, venous thromboembolism (blood clots) and breast cancer. Thus, because of these risks, at any age most experts are recommending use of hormone replacement therapy for 5 years or less.
  • In relation to breast cancer, evidence does show some supporting data of being an “absolute risk” between hormone replacement therapy and breast cancer. Absolute risk is your risk of developing the disease over a period of time. Although percentages are quite low in ages 50-59 without other risk factors, this is something that is taken into consideration when starting treatment like HRT for menopausal symptoms.
  • An even safer option for women taking HRT is not taking estrogen alone (unopposed estrogen) and instead, combining it with progesterone. As many of you may have noticed, some primary care providers are prescribing HRT this way to help decrease your overall risk for adverse outcomes.
  • Primary care providers recommend staying up to date on mammogram screenings as well as routine yearly exams to better understand cardiovascular and breast cancer risk.


In conclusion, if you are on HRT or are considering if HRT is right for you or would like more information on alternatives, please contact your primary care provider .



Colorectal Cancer Screening

What Is Colorectal Cancer?
Colorectal cancer is cancer that occurs in the colon or rectum. Sometimes it is called colon cancer. The colon is the large intestine or large bowel. The rectum is the passageway that connects the colon to the anus.

Screening Saves Lives
Colorectal cancer is the second leading cancer killer in the United States, but it doesn’t have to be. If you are 50 or older, getting a colorectal cancer screening test could save your life. Here’s how:

• Colorectal cancer usually starts from precancerous polyps in the colon or rectum. A polyp is a growth that shouldn’t be there.
• Over time, some polyps can turn into cancer.
• Screening tests can find precancerous polyps, so they can be removed before they turn into cancer.
• Screening tests also can find colorectal cancer early, when treatment works best.

Who Gets Colorectal Cancer?
• Both men and women can get it.
• It is most often found in people 50 or older.
• The risk increases with age.

Are You at Increased Risk?
Your risk for colorectal cancer may be higher than average if:
• You or a close relative have had colorectal polyps or colorectal cancer.
• You have inflammatory bowel disease, Crohn’s disease, or ulcerative colitis.
• You have a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer.

People at increased risk for colorectal cancer may need earlier or more frequent tests than other people. Talk to your doctor about when to begin screening, which test is right for you, and how often you should be tested.

Colorectal Cancer Can Start With No Symptoms
Precancerous polyps and early-stage colorectal cancer don’t always cause symptoms, especially at first. This means that someone could have polyps or colorectal cancer and not know it. That is why having a screening test is so important.

What Are the Symptoms?
Some people with colorectal polyps or colorectal cancer do have symptoms. They may include:
• Blood in or on your stool (bowel movement).
• Stomach pain, aches, or cramps that don’t go away.
• Losing weight and you don’t know why.

If you have any of these symptoms, talk to your doctor. They may be caused by something other than cancer. However, the only way to know is to see your doctor.

Types of Screening Tests
The U.S. Preventive Services Task Force recommends that adults aged 50–75 be screened for colorectal cancer. The decision to be screened after age 75 should be made on an individual basis. If you are aged 76-85, ask your doctor if you should be screened.
Several different screening tests can be used to find polyps or colorectal cancer. They include:

Stool Tests
Guaiac-based Fecal Occult Blood Test (gFOBT): uses the chemical guaiac to detect blood in stool. At home you use a stick or brush to obtain a small amount of stool. You return the test to the doctor or a lab, where stool samples are checked for blood.

Fecal Immunochemical Test (FIT): uses antibodies to detect blood in the stool. You receive a test kit from your health care provider. This test is done the same way as gFOBT.
FIT-DNA Test (or Stool DNA test): combines the FIT with a test to detect altered DNA in stool. You collect an entire bowel movement and send it to a lab to be checked for cancer cells.

How Often: gFOBT Once a year. FIT Once a year. FIT-DNA once every one or three years.

Flexible Sigmoidoscopy
For this test, the doctor puts a short, thin, flexible, lighted tube into your rectum. The doctor checks for polyps or cancer inside the rectum and lower third of the colon.
How Often: Every five years, or every 10 years with a FIT every year.

Similar to flexible sigmoidoscopy, except the doctor uses a longer, thin, flexible, lighted tube to check for polyps or cancer inside the rectum and the entire colon. During the test, the doctor can find and remove most polyps and some cancers. Colonoscopy also is used as a follow-up test if anything unusual is found during one of the other screening tests.

How Often: Every 10 years.

CT Colonography (Virtual Colonoscopy)
Computed tomography (CT) colonography, also called a virtual colonoscopy, uses X-rays and computers to produce images of the entire colon. The images are displayed on a computer screen for the doctor to analyze.

How Often: Every five years.

Which Test is Right for You?
There is no single “best test” for any person. Each test has advantages and disadvantages. Talk to your doctor about which test or tests are right for you and how often you should be screened.

Free or Low-Cost Screening
Colorectal cancer screening tests may be covered by your health insurance policy without a deductible or co-pay. Where feasible, CDC’s Colorectal Cancer Control Program grantees provides free or low-cost screenings to eligible men and women. To find out more visit www.cdc.gov/cancer/crccp/contact.htm.

The Bottom Line
If you’re 50 or older, talk with your doctor about getting screened. For more information, visit www.cdc.gov/screenforlife or call 1-800-CDC-INFO (1-800-232-4636). For TTY, call 1-888-232-6348.

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