World Alzheimer’s Month: 10 Signs Every Adult Should Know

According to Alzheimer’s Disease International, every three seconds someone in the world develops dementia, “a collective name for progressive degenerative brain syndromes which affect memory, thinking, behavior and emotion.”

Alzheimer’s disease and vascular dementia account for nine out of ten cases of dementia. Symptoms may include:

  • Memory loss
  • Personality and mood changes
  • Difficulty in performing daily, routine tasks
  • Difficulty in using words or comprehending others

While there is no cure for Alzheimer’s, we may be able to improve outcomes by making earlier diagnosis and providing patients and their families with better support and information.

Recognize Alzheimer’s Warning Signs

This September, in recognition of World Alzheimer’s Month, internal medicine doctors at St. Thomas Medical Group are encouraging Nashvillians to learn the ten warning signs of Alzheimer’s (via Alzheimer’s Association).

  1. Memory loss disrupting daily life. It’s not uncommon to forget names or appointments as you age, but routinely forgetting information or asking for the same information on a repeat basis could be a sign of Alzheimer’s.
  2. Difficulty in planning or problem-solving. Occasional errors are normal at any age, of course. But individuals in the early stages of Alzheimer’s may exhibit greater difficulty concentrating on problems. Working through challenges could take longer than in the past.
  3. Difficulty completing familiar tasks. Driving, budgeting, or remember rules to a game could be challenging for individuals with Alzheimer’s.
  4. Time/place confusion. Not understanding where you are or how you got there could be a sign of dementia.
  5. Difficulty judging distance or color/contrast. Difficulty judging spatial relationships can make tasks like driving risky and difficult.
  6. Losing words (speaking or writing). Stopping mid-sentence or using odd word choice can be a sign of Alzheimer’s.
  7. Misplacing items. It’s not uncommon for individuals with Alzheimer’s to place items in unusual spots. In some cases, this can lead to the individual accusing others of stealing.
  8. Poor judgement. Affected individuals may lose their ability to exercise good judgement or make sound decisions.
  9. Withdrawal from work or social life. From time to time, we all need a break from the demands of work, family, and friends. But for individuals with Alzheimer’s, the step back may be more pronounced and longer lasting.
  10. Mood and personality changes. Many patients with Alzheimer’s may exhibit confusion, suspicion, depression or other new behaviors.

Find an Internal Medicine Doctor in Nashville

For more information about Alzheimer’s diagnosis and care, contact St. Thomas Medical Group. Call +1 (615) 297-2700.

Should I Get My Thyroid Checked Out?

What is the thyroid?

The thyroid is a tiny gland at the base of the neck that has an incredible amount of control over many of the body’s functions. The thyroid is critical in regulating hormones that affect everything from metabolism to body temperature to heart rate. When the thyroid is functioning as normal, we give it very little thought. In people with under- or overactive thyroids, however, symptoms can be quite uncomfortable.

What are the symptoms produced by hyperthyroidism?

Hyperthyroidism is a condition in which the thyroid produces too much thyroxine (the “thyroid hormone”). This can cause a number of symptoms, including:

  • Rapid weight loss
  • Rapid heartbeat
  • Sweating
  • Tremor in the hands and fingers
  • Fatigue
  • Muscle weakness
  • Increased heat sensitivity
  • Sweating
  • Increased appetite
  • Anxiety, irritability, nervousness
  • Swelling at the base of the neck
  • …and others

If you experience any of these symptoms – especially rapid heartbeat and/or unexplained weight loss – be sure to see your primary care provider in Nashville for an evaluation. While these signs and symptoms are certainly not exclusive to hyperthyroidism, they can be indicators of a serious thyroid condition.

What are the symptoms produced by hypothyroidism?

While some people struggle with an overactive thyroid, others are troubled by a thyroid gland that doesn’t produce enough thyroxine. Women over the age of 60 are most likely to experience hypothyroidism, though anyone can develop this condition. The good news is, once diagnosed, hypothyroidism can oftentimes be managed easily through the prescription of a synthetic thyroid hormone.

Symptoms of hypothyroidism may include:

  • Pain, stiffness or swelling in the joints
  • Achy, tender or stiff muscles
  • Depression
  • Weight gain
  • Fatigue
  • Constipation
  • Dry skin
  • Increased cold sensitivity
  • Hoarseness

How can I get care for thyroid issues?

If you are experiencing any of the symptoms described here, see your primary care doctor for an evaluation. If you don’t have a primary care doctor in Nashville, contact St. Thomas Medical Group to schedule an appointment. Your physician may be able to provide a diagnosis and treatment through oral medication.

When is thyroid surgery recommended?

Thyroid surgery may be recommended for patients with nodules on the thyroid. (Note that there is not necessarily a correlation between the presence of nodules and hormone levels or thyroid function.) At St. Thomas Medical Group, surgical treatment is performed by surgeons at Nashville ENT and Allergy Clinic; all physicians are certified by the American Board of Otolaryngology/Head and Neck Surgery.

During the procedure, which is typically done using a minimally invasive approach, a small incision is made for removing the nodules. Patients typically go home that day. Downtime from the surgery is as little as a few days.

For more information about thyroid care, contact Nashville ENT and Allergy Clinic at St. Thomas Medical Group. Call +1 (615) 386-9089.

3 Ways to Get Care for Chronic Fatigue

We all experience seasons of our lives that are marked by fatigue and exhaustion. But for people with chronic fatigue syndrome (CFS), sleep deprivation and difficulty with thinking and concentrating isn’t just a phase that lasts a couple weeks or months. Chronic fatigue syndrome is an illness that can have serious effects on many of the body’s systems for six months or more.

In patients with CFS, there is no primary illness or condition causing the fatigue. The fatigue is a force of its own, requiring, in some cases, a battery of medical tests as providers rule out other potential illnesses.

What Is Chronic Fatigue Syndrome?

Many patients describe their experience as being akin to the flu. Symptoms of CFS may include:

  • Joint/muscle pain
  • Difficulty concentrating
  • Memory loss
  • Headaches
  • Digestive problems
  • Chills
  • Night sweats

CFS can affect patients mentally, as well. Mood swings, anxiety, depression, and panic attacks are not uncommon among individuals with chronic fatigue syndrome.

If faced with CFS, what can you do? While there is no “cure” for CFS, there are some strategies you can discuss with your doctor about implementing into your daily routine.

#1 Improve Quality of Sleep

Avoiding caffeine and alcohol altogether can be a good first step toward improving your chances of getting quality sleep. Try to establish a regular nighttime routine that lets your body know it’s time to go to bed. Avoid screens for at least 90 minutes prior to bedtime.

#2 Get Vitamin D

Vitamin D deficiency is widespread, affecting patients with CFS, as well as the general population. This deficiency makes it difficult for your body to absorb calcium. The deficiency can be responsible for bone pain, muscle pain, fatigue, and difficulty thinking. While you can get vitamin D through sun exposure, talk to your doctor about taking a vitamin D supplement, which allows you to know the actual amount of Vitamin D that’s getting into your system.

#3 Graded Exercise Therapy

Graded exercise therapy has patients start exercising with slow stretching and gentle movements. Intensity and duration of exercise is increased gradually over time as the body becomes accustomed to the movements. Graded exercise therapy has been shown to reduce fatigue in patients with CFS.

See an Internal Medicine Doctor In Nashville

Meet our internal medicine providers at St. Thomas Medical Group. For scheduling information, please call +1 (615) 297-2700. You can also request an appointment online.

5 Great Places to Grab a Healthy Meal In Nashville

Summer is winding down and our attention is being pulled back in the direction of work and school. Shopping, errands, and busyness begin to take over our routines… leaving little time for meal prep and healthy eating. It’s easy to just order that pizza or pop a frozen meal into the microwave, right?!

When we get busy our bodies need healthy food more than ever. Extra stresses on the schedule can weaken the immune system and increase our risk for illness… just when illness is the last thing we have time for!

Eating Healthy Doesn’t Have to Be Hard

If you know you’re going out for a meal, consider one of these Nashville favorites, which serve up delicious healthy food that doesn’t taste like “health food.” These restaurants rely on whole foods, seasonal ingredients, and creative cooking techniques as they pioneer some of Nashville’s healthiest meals…

#1 Vui’s Kitchen

With locations in Germantown and Berry Hill, Vui’s Kitchen serve up delicious Vietnamese food that exclusively features whole food ingredients. Plenty of fresh herbs and no MSG makes Vui’s an easy choice. Try their signature bánh mì sandwich or a bowl of pho!

#2 Sunflower Cafe

Just a four-minute walk from Vui’s in Berry Hill, Sunflower Cafe is a Nashville classic known for its all-vegetarian menu, which includes gourmet veggie burgers and vegan barbecue. Gluten-free diners will find plenty of options at Sunflower Cafe, which focuses on fresh, local and organic ingredients. Dine in or grab a to-go order for the family. (Don’t miss their Thai Ginger Tofu, a daily chef special!)

#3 Epice

If you’re looking for something a little more upscale, pop into Epice in 12 South. Classic Lebanese dishes in a contemporary environment make Epice a treat for the body and senses.

#4 AVO

Less than three miles from our St. Thomas Medical Group offices, AVO prides itself in sourcing “the finest plant-based ingredients” around town. The restaurant specializes in both raw and cooked vegan meals that feature seasonal ingredients. The seasonal drink menu is built around local, gluten-free, and reduced gluten beers, and organic, biodynamic, and kosher wine.”

#5 The Wild Cow

From AVO, cut across town and over the river to East Nashville for some diverse vegan and vegetarian fare at The Wild Cow. Don’t miss their famous Buffalo Beans & Greens, featuring a sautéed garlicky kale with pinto beans!

Let’s Partner Together In Your Health. Find a Nashville Doctor Near You.

Primary care physicians at St. Thomas Medical Group partner with patients throughout Nashville in working toward better health. To learn more about how you can develop personal health goals and take charge of your health with a primary care doctor, schedule an appointment at St. Thomas Medical Group. You can schedule online or by calling +1 (615) 301-7040.

What Happens In a Metro Nashville Sports Physical Exam?

Can you believe summer vacation is already over? It’s back to school for kids throughout metro Nashville. As you check off back-to-school supplies and clothes, have you remembered those sports physicals?

Completion of Metro’s “Preparticipation Physical Evaluation” form is required for any students wishing to participate in school sports. The examination and form, which Metro Nashville Public Schools makes available here, is a fairly straightforward process. But, if you have any questions or concerns, we’ve put together this post to walk you through the exam step-by-step. Here’s how it works at St. Thomas Medical Group

Step 1: History Form

Prior to seeing your physician, you and your child will fill out the History Form. This is a basic pre-appointment form that asks questions about medicines and allergies, heart health, family history, bones and joints, and any potential medical issues. Questions, for example, range from “Have you ever had a stress fracture?” to “Do you have headaches with exercise?” etc.

The purpose of this form is to give the healthcare provider some basic background information about your student prior to the exam. This is an important time to list any events in one’s health history that could require further review or discussion with a healthcare provider.

If your student has special needs, there is a supplemental history form that will provide you with an opportunity to list these conditions.

Step 2: Physical Examination Form

Next up: the physical examination form. The physical examination will include a review of several health indicators, such as pulse, lung function, vision function, etc. Evaluations of the musculoskeletal system (from the neck down to the toes) will give the provider a chance to potentially detect any abnormalities in function.

In concluding the exam, the health care provider will (1) clear the student for all sports without restriction, (2) clear for sports without restriction but with recommendations for further evaluation or treatment, or (3) not provide immediate clearance.

Step 3: Clearance Form

Upon discharge, the student and parent will be provided with a clearance form that summarizes the exam findings. This form can be used in lieu of the physical exam form and health history form; it may be an appropriate alternative for any circumstances in which HIPAA concerns are an issue.

Step 4: Consent for Athletic Participation & Medical Care

Finally, the parent or legal guardian of the student athlete will fill out a form detailing allergies, medications, insurance information, and emergency contact information. This form acknowledges legal responsibilities and protocols in the event of injury.

Schedule a Student Athlete Sports Physical In Nashville

Don’t delay in scheduling your student’s sports physical. You can schedule an appointment in Nashville with a St. Thomas Medical Group provider by calling +1 (615) 301-7040. You can also make your appointment online (both new and returning patients).

Training Tips to Help You Get In Shape for One of Nashville’s 5K Races

Whether you hit the pavement first thing every morning or you’ve never put on a pair of running shoes in your life… participating in one of Nashville’s summer 5K races is a fun way to challenge yourself and get some exercise.

A great activity for all levels, 5K races (5 kilometers, 3.1 miles) are happening all over town this summer. If you’re thinking about signing up for a 5K, check out these tips from providers at St. Thomas Medical Group!

Get In Shape for a Nashville 5K

  • Join a community of runners! “But I’m not a runner,” you say. Great! You don’t have to be. East Nasty, an East Nashville running community, offers a “Potato to Tomato” training program for the East Nashville Tomato 5K. Fleet Feet Sports offers 12-week training programs to help new and experienced runners train for 5Ks and other races. These programs cater to all levels of experience, offering different pace groups. The community aspect can help motivate you to stay on-track and committed to completing your goal.
  • Take time to warm up. Always take a few minutes to warm up before your run. A good stretch and warm-up routine can get your blood flowing, reducing risk of injury and setting you up for a more enjoyable and efficient run.
  • Mix up the running and walking. If you’re new to running, cut yourself from slack and mix things up. Consider walking on some of your training days. On other training days mix up your activity with both running and walking. For example, you might run for 15 seconds and then walk for 45 seconds. This approach may reduce the risk of injury and stress on your body.
  • Re-evaluate your diet. Once you start exercising, you might find that your diet affects you differently. You might feel fatigued or low on energy after a run. Talk to your doctor about your diet. Consider adding in protein and healthy energy-rich snacks that will replenish those depleted resources.
  • Drink lots of water. It’s hot out there! Don’t forget to hydrate before setting out for your run. Drink 8 to 16 ounces of water about an hour or two before. Have a few more sips 15 or 30 minutes before setting out.
  • Consult a Nashville doctor. Finally, if physical activity is a new priority in your life, you may want to talk to a primary care physician about new exercise habits. If you have any concerns about developing healthy new exercise habits, you may find an exam and conversation with a doctor to be immensely helpful in setting you off in the right direction.

Trusted Physician Care That Helps You Prepare!

For many people, committing to participate in a 5K is no small undertaking! If you’re looking to make some new exercise habits, talk to a trusted primary care physician in Nashville at St. Thomas Medical Group. You can schedule an appointment online or by calling +1 (615) 301-7040.

What’s Covered In a Well-Woman Visit?

Did you know that your health insurance plan covers you for one completely free wellness exam per year? According to, a well-woman visit can include 16 specific preventive services for women and another 12 preventive services for pregnant women or women who may become pregnant… things like shots, disease screening, education and counseling.

It’s Really Free?

Yes! If you have Medicare or a health insurance plan obtained through the Health Insurance Marketplace, you are entitled to one free wellness exam per year from a doctor or provider in your plan’s network.

You Don’t Have to Be Sick to See a Doctor.

Our internal medicine providers at St. Thomas Medical Group are here for you when you get sick. But we also love seeing you when you’re healthy! Why? By getting the chance to visit with you when you’re healthy, we can build a relationship and establish a knowledge of your “baseline wellness.” That way, if you do get sick in the future, we have better context and knowledge about you. We may know something about your family history or personal medical history that could allow us to provide better, more accurate care. A well-woman visit is a great opportunity for establishing that “baseline wellness” with your doctor.

So, What Happens In the Well-Woman Visit?

We’ll use this appointment to look at your overall health and wellness. During this time we’ll document your health habits and history, perform a physical exam, and talk with you about your health goals.

#1 Health Habits & History

First we’ll open up with a discussion about your health and history. Things like…

  • Medical history and family health history
  • Sexual health and sexual partners
  • Eating habits and physical activity
  • Use of alcohol, tobacco, and other drugs
  • Mental health history, including depression
  • Relationships and safety

#2 Physical Exam

Then, we’ll move to the physical exam portion of the well-woman visit, which may include:

  • Measuring your height and weight
  • Calculating your body mass index (BMI) to see if you are at a healthy weight
  • Checking your blood pressure
  • Taking your temperature
  • Doing a clinical breast exam (feeling your breasts and under your arms for lumps or other changes)
  • Doing a pelvic exam
  • Pap smear (if it is due for your regular interval)
  • Birth control and contraception management


#3 Health Goals

Finally, we’ll talk about your health goals. If you want to lose weight or quit smoking, we can work together to develop a plan that will help you achieve that goal. We can also talk about what screenings or follow-up services might be appropriate for you. This is your chance to take action with your health!

How Can I Prepare for My Well-Woman Exam?

You can make the most of this appointment by coming prepared with a list of questions. Go ahead and write them down as you may not remember all of your questions during the appointment! Ready to schedule? Make your appointment online, or call +1 (615) 297-2700.

Nashville Allergies Are Here! 3 Ways to Fight Back!



“Uggh… why, Nashville?”

No, it’s not the traffic at this time of year that has Nashvillians grumbling. (Okay, who are we kidding? It’s always the traffic.) It’s that special time of the year when pollen is out in full force and allergies are taking over our sinuses. When allergies have got a hold of your eyes, nose, and throat, it’s hard to focus on anything else.

So What Are Allergies?

Those symptoms we call “allergies” are a reaction produced by the immune system’s hypersensitivity to substances like pollen, dust and pet dander (“allergens”). When exposed to those allergens, the body releases histamine in the blood and tissues, bringing on the all-too-familiar symptoms like sneezing, watery eyes, nasal congestion and drainage, headaches, and even gastrointestinal or skin reactions. This is known as an Ig-E Mediated Allergy.

There’s another type of allergy doctors assess: Non-Ig-E Mediated Allergy, which is triggered by things in the environment that do not depend on Ig-E – things like smoke, chemicals, and cold moist weather.

Ok, How Can I Stop My Allergies?

First, you have to know what’s causing the symptoms of your allergies. The Nashville allergy specialists at St. Thomas Medical Group may evaluate the cause(s) of symptoms by obtaining a medical history; performing an ear, nose and throat exam; ordering a sinus CT scan (in some cases); and ordering an allergy test. Allergy testing can be done directly through the skin or as a blood test.

Once the evaluation is complete, the allergy specialist may be able to provide a diagnosis, which informs treatment. Generally speaking, there are three ways to treat allergies:

  1. Medication Therapy. Antihistamines and nasal sprays are some of the common drugs used to manage allergy symptoms. If you’ve bought over-the-counter versions before in the past with mediocre results, don’t assume that’s just “how it is.” Prescription versions of these medications have helped many patients. Furthermore, once you’ve been properly diagnosed, your allergy specialist may be able to prescribe you a different medication that’s more appropriate for your specific allergen triggers.
  2. Avoidance Therapy. As a part of your care, your allergy specialist will help you develop strategies for limiting your exposure to the allergens that trigger your symptoms.
  3. Desensitizing Immunotherapy (IT). Finally, some patients may qualify for immunotherapy (IT) – “allergy injections.” Immunotherapy may be administered in the form of weekly injections in your doctor’s office or orally (taken under the tongue) twice a week at home. There are different options, benefits and risks associated with both. However, IT has brought about relief for many patients suffering from Nashville allergies!

Sniffly, Runny or Stuffy? Visit the Nashville ENT & Allergy Clinic!

Advanced care for Nashville allergies is possible at Nashville ENT & Allergy Clinic. We are committed to professional specialty care using a collaborative team approach and state-of-the-art electronic information and medical technology – all conveniently housed under one roof. To schedule an appointment with one of our physicians (all certified by the American Board of Otolaryngology/Head and Neck Surgery), call +1 (615) 386-9089 or send us a message.

Do You Know the RIGHT Way to Use Sunscreen?

Squeeze it, smear it, and go?

Turns out, there’s a little more to proper sunscreen use, says the American Academy of Dermatology. As we get into some of Nashville’s hottest temperatures, a quick refresh of proper sunscreen use can help you and your family stay safe while outside.

Why Use Sunscreen?

  • 1 in 5 people in the US will develop skin cancer.
  • Using sunscreen is one of the most effective things you can do in reducing your risk for skin cancer.
  • Sunscreen can help reduce premature aging of the skin.

How to Use Sunscreen

The Nashville doctors at St. Thomas Medical Group offer the following sunscreen recommendations…

  • Use a broad spectrum sunscreen. “Broad spectrum” (you’ll see this printed on the front of the bottle) means the product offers protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. UVA rays can cause premature skin aging (such as wrinkling); UVB rays cause the visible sunburn we’ve all experienced. You need protection from both, and only a broad spectrum sunscreen can provide it.
  • Choose a sunscreen that’s labeled SPF 30 or higher. SPF stands for “sun protection factor.” The number represents how much longer the product allows you to be exposed to the sun’s rays without getting burned. So, if your skin would normally burn in just 10 minutes of exposure, you would actually last 300 minutes (10 x 30), or 5 hours. Take that recommendation with a grain of salt, though. With water, sweat, and activity, sunscreen is more likely to be removed from the skin before it offers a full afternoon of protection!
  • That being the case, reapply sunscreen regularly. A general rule of thumb is to reapply every two hours. If swimming or sweating, then reapply immediately.
  • Also, the Nashville doctors at St. Thomas Medical Group recommend a water resistant sunscreen. Even if you don’t plan on going for a dip, water resistant sunscreens can offer extended protection in the heat of the summer when sunscreen is quickly carried away from the skin through sweat.
  • Not sure how much to use? One ounce (enough to fill a shot glass) is a standard recommendation from the American Academy of Dermatology for covering the average body. You can adjust depending on your size and the amount of skin exposed. Most people tend to apply too little sunscreen.
  • Apply sunscreen approximately 15 minutes before going outside. This allows time for the sunscreen to offer the protection you need!
  • Finally, make sure to use a lip balm with SPF protection. Any skin exposed to sun needs protection, and only sunscreen can do the job!

Find a Doctor Near You In Nashville

Have more questions about caring for your family? Schedule an appointment online with a Children & Adult provider at St. Thomas Medical Group. Or, you can schedule your next appointment by calling +1 (615) 301-7040.

5 Ways to Get a Better Night’s Sleep… Starting Tonight!

According to a health survey for the Centers for Disease Control and Prevention, “About 7–19 percent of adults in the United States reported not getting enough rest or sleep every day” (source). Four out of 10 adults report accidentally falling asleep during the day at least once a month. Some 50-70 million Americans have chronic sleep disorders.

By all accounts, the United States faces a sleep crisis. Patients throughout the Nashville area turn to Dr. Jon Tumen at St. Thomas Medical Group. Dr. Tumen is triple board-certified in Internal Medicine, Pulmonology Diseases and Clinical Polysomnography/Sleep Disorders Medicine.

Why Does Sleep Health Matter?

The quantity and quality of sleep we get each night has a tremendous impact on all aspects of our lives, from physical health and safety to emotional well-being. Poor quality sleep can lead to…

  • Road accidents. Driving while drowsy can be as dangerous as driving while under the influence of alcohol.
  • Increased risk of chronic health conditions. Sleep deprivation is associated with increased risk for a number of chronic health conditions, including heart disease, high blood pressure, diabetes, and more. Failure to get adequate sleep can also increase your risk for heart attack, stroke, and heart failure.
  • Depression. Studies have found a strong link between insomnia and depression/anxiety.
  • Memory loss. Our bodies use sleep to reset. During sleep, the brain consolidates memory, transferring short-term memory into long-term memory storage. Failure to get enough sleep can prevent this process, causing long-term memory problems.
  • Weight gain. Several studies have found a correlation between obesity and lack of quality sleep.

Failure to get a recommended seven to eight hours of sleep per night can result in many adverse outcomes. If you’re having trouble meeting your sleep requirements, talking to a sleep specialist may help.

How Can a Sleep Doctor Help?

Sleep specialists like Dr. Tumen are able to help many Nashvillians struggling with sleep through polysomnography, a type of sleep study used to diagnose sleep disorders. This test allows a physician to record your sleep patterns and make recommendations for improving sleep health.

What You Can Do For Yourself TONIGHT

While polysomnography may be recommended for ongoing sleep health problems, you may be able to get a better rest tonight by trying some of these tips recommended by sleep doctors:

  1. Avoid caffeine – not just at night – but for the entire day, as caffeine can have long-lasting effects.
  2. Keep the bedroom quiet and cool.
  3. Get in the habit of going to bed and waking up at the same time each day.
  4. Avoid screens in the hour before bed. The artificial light can make it difficult to go to sleep.
  5. Avoid nicotine and alcohol in the hours leading up to bed time.

See a Nashville Sleep Doctor Near You

For more information about how a Nashville sleep doctor can help you, call the office of Dr. Jon Tumen at +1 (615) 964-5864. You can also request an appointment online.