Family Care

Newborn to Adolescent Care

At Maria Cole Family Practice, we provide advice, reassurance, and in the face of often differing opinions from the family, help with decisions regarding the care of your baby.

Newborn and Infant Care

Congratulations on the arrival of your new baby (or babies)! If this is your first, you may be apprehensive – but remember that your most valuable resource is your own common sense. At Maria Cole Family Practice, we provide advice, reassurance, and in the face of often differing opinions from the family, help with decisions regarding the care of your baby.

Newborn Healthcare: After Home Discharge

To schedule this first visit with your provider, call us at (432) 580-7320 during office hours. let the staff member know that you need to schedule a hospital follow up for a newborn baby and you will be scheduled for an appointment for 2 weeks after discharge.

Newborn Health Questions? Our Providers Will Listen & Answer

Throughout your years as a parent, remember that children of all ages have their own individual personalities and behavior patterns. Babies enter this world with their own unique temperament and comparing your infant’s development with that of other like-aged children can be concerning as easily as it can be reassuring. We can help you get the answers and information you need to have peace of mind that comes with knowing your baby is receiving the right medical care. As questions arise, please know that at Maria Cole Family Practice, we look forward to discussing them with you. We can help you wade through what may feel like piles of information to find the right solution for your newborn, family and circumstances we can quickly answer your questions and point you to helpful patient resources and information.

Physical Exams & Yearly Pediatric Health Care

Maria Cole Family Practice recommends that our patients visit us each year for an annual physical exam or “check-up.” Our annual exam visits are a wonderful opportunity for our providers and nurses to perform a complete physical examination. Our caring providers will conduct each part of the exam with warmth and understanding, making each visit as comfortable as possible.

 

The Benefits of Annual Physical Exams for Children

During your annual exam, we check and discuss your child’s health, growth, and development. It is also a time for us to:

  • Update your family medical history
  • Review your child’s medical history & current immunization status
  • Provide your family with age-appropriate safety information & health education
  • Perform a screening of your child’s growth, emotional, & social development
  • Check your child’s blood pressure, vision, & hearing

Occasionally, we may perform laboratory screening for cholesterol and anemia, along with other tests depending on your child’s individual risk factors for a given health problem. For older children and teen physical exams, these visits are a good chance for us to check on educational successes and goals, and to perform necessary sports physicals required for participation. When you bring your child for a yearly check-up, please let us know if you have had your child’s hearing or vision screened by a specialist so that we will not duplicate these important services. As you can tell from the list above, these visits are comprehensive, and we take this part of our job incredibly seriously. When performing our annual exams, our Practice follows the recommendations of the American Academy of Pediatrics’ “Bright Futures” program.

 

Care for Longterm of Special Health Needs

Because of the time involved, yearly annual exam visits may not be the best time to address chronic health issues such as asthma, diabetes, or ADHD in great depth. However, we always make every effort to identify all significant health issues during check-ups, renew all prescriptions, and give you follow-up recommendations. If there is a need, and time is available during the health care visit, to address a significant medical issue (ADHD, asthma, chronic headache, obesity, etc) in detail, or if the visit includes any special screening or laboratory testing that is medically necessary, extra charges may incur. If your child has special needs, please let the scheduler know prior to making your next appointment.

Teen / Adolescent PEs and Health Care

Maria Cole Family Practice takes great pride in the care we offer adolescents. Our providers and clinical staff strive to provide confidential and developmentally appropriate medical care to all ages. We provide excellent health care for teens and adolescents, which includes the stages of early adolescence (11-13), middle adolescence (13-17) and late adolescence (17-21). We offer comprehensive annual physical exams that will meet school, sports, and college requirements.

 

Annual Physical Exams

We recommend for adolescent patients to meet with us annual for a routine physical exam. This exam helps us keep up and check on good health and appropriate development.Your primary care provider conducts the physical, so it is always someone that you and your adolescent know and trust. Each of our providers will make the visit as relaxed and comfortable as possible. Our physical exams consist of the following elements: 1. Brief interview with adolescent and parents (if present) 2. Expanded interview and physical exam with adolescent only laboratory tests as indicated 3. Wrap up session with adolescent and parent. The interview itself focuses on home, school, education, activities, friendships, diet, nutrition, sexual health and development, and mental health. If concerns arise with specific academic, emotional, physical, and social issues in the physical exam and evaluation, a follow-up appointment is recommended to continue appropriate assessment and management.

Treatment

Our nurse practitioners are prepared to identify, assess, provide medical testing, and offer treatment or refer to a specialist if necessary:

  • Minor Illnesses such as small fever, ear aches, coughing, cold, rash, flu, coughs, colds, strep throat, infections.
  • Endocrine Problems such as abnormal growth and development, thyroid disease or gynecomastia.
  • Cardiovascular Problems such as hypertension or heart murmurs.
  • Dermatologic Disorder such as acne or other skin conditions.
  • Neurologic Disorders such as headaches, syncope, vertigo, or seizures.
  • Urologic Disorders such as urinary tract infections, enuresis, hematuria, or proteinuria.
  • Infectious Diseases such as mononucleosis, hepatitis, or sexually transmitted diseases (STDs).
  • Orthopedic Issues such as scoliosis, back pain, or knee pain. We also provide sports medicine guidance.
  • Other Medical Issues such as fatigue, recurrent abdominal pain, chest pain, or sleep problems.
  • Acute Minor Injuries/Lacerations such as ear piercings or other piercings.
  • Nutrition/Weight Issues such as weight gain and weight loss, supplements, weight training, anorexia, and bulimia.
  • Mental Health Screenings for depression, anxiety, attention deficit disorder (ADD), attention deficit hyperactive disorder (ADHD), eating disorders, and substance use or abuse.
  • School Problems such as attention deficit disorder (ADD), learning disability, or school failure.
  • Adolescent Female Health Care such as pelvic examinations, sexually transmitted disease (STD) screening and treatment, pregnancy testing, counseling in contraceptive practices, abnormal periods, and breast disorders.
  • Adolescent Male Health Care such as scrotal disorders and sexually transmitted disease (STD) screening and treatment.

Men’s Health

Our Men’s Health services include physicals, screening tests, prostate exams, and testosterone.

Physicals

Regular health check-ups are important for men. Even in the absence of symptoms, we recommend routine, yearly physicals for males of all ages.

 

We Offer Complete Physicals that Include:
Why Screening Tests Are Important

Getting the right screening test at the right time is one of the most important things a man can do for his health. Screenings find diseases early, before you have symptoms, when they’re easier to treat.

 

9 Tests Men Should Not Ignore:

1. Prostate Cancer

Have a discussion with our practitioners about the benefits and risks of a prostate cancer screening to make an informed decision about testing. After age 50, most men should consider yearly prostate screenings. High risk men should consider testing at age 45. If you have more than one first-degree relative diagnosed with prostate cancer before the age of 65, consider screening at age 40. Prostate screenings can include the PSA (prostate-specific antigen) blood test and DRE (digital rectal exam).

2. Testicular Cancer

The American Cancer Society recommends that testicular exams be incorporated into every male patient’s annual physical exam.

3. Colorectal Cancer

The USPSTF says most patients should begin colorectal cancer screening with a colonoscopy at age 50 and undergo the test every 10 years, usually until the age of 75

4. Skin Cancer

Talk with our practitioners about suspicious-looking skin. A biopsy can determine whether you have skin cancer and, if so, what type of skin cancer you have.

5. High Blood Pressure

The American Heart Association (AHA) recommends patients have their blood pressure taken at least once each year starting at age 20

6. Cholesterol Levels

The AHA recommends testing cholesterol and triglycerides levels every 4 to 6 years

7. Type 2 Diabetes

Screening for diabetes should occur at least every three years starting at age 45.

8. Eye Health

Eye and vision examinations are an important part of preventive health care. Individuals may be unaware of eye and vision problems because sometimes there are no obvious signs or symptoms. In order to maintain good vision, an early diagnosis and treatment of eye and vision problems is necessary.

Prostate Exams

Most prostate cancer starts in the gland cells in the prostate. Men often do not have symptoms in early, which is why prostate cancer is known as a silent killer. In the United States prostate cancer is the most common form of cancer among men besides skin cancer. Prostate cancer is a leading cause of cancer deaths among men. Detecting prostate cancer early is critical to survival. If the cancer is detected before it spreads, patients have a nearly 100 percent chance of survival after five years. Survival rates have increased over the past 25 years with early diagnosis and treatment improvements.

Statistics
  • One in seven men will be diagnosed with prostate cancer in his lifetime.
  • One in 38 men will die from the disease, making it the second most common
  • cause of cancer death in men.
  • In 2015, 220,800 new cases of prostate cancer will be diagnosed in the United
  • States, with 27,540 deaths.
  • In Texas, it is estimated that 13,363 new cases of prostate cancer will be
  • diagnosed in 2015, and 1,919 men will die from the disease.
Risk Factors

• Age: 60 percent of all prostate cancer cases diagnosed are in men age 65 and older.
• Family History: Men with close relatives (father or brother) who have had prostate cancer are twice as likely to develop the disease.
• Race: The highest rate of prostate cancer in the United States is in African Americans.
• Genetic Factors: A small percentage of cases have an increased risk caused by a gene mutation on BRCA-1 or BRCA-2 or having Lynch syndrome.
• Diet: Men who’s diets contain a high amount of red meat and dairy with few fruits and vegetables have a higher risk of developing prostate cancer.

Symptoms

The following may be symptoms of prostate cancer but could also be linked to other health issues. If these symptoms are present, men are encouraged to consult their physician for proper testing:
• Interrupted or weak urine flow
• Difficulty regulating urination
• A burning sensation or painful urination
• Blood in urine or semen
• Stiffness or pain in ribs, upper thighs, spine, hips, or other bones
• Painful ejaculation
• Urinating frequently, especially at night
• Difficulty having an erection
• Numbness or weakness in feet or legs

Prevention

• Cut down red meat and dairy products in your diet.
• Eat plenty of fruits and vegetables daily. Some vegetables that are rich in substances and may help prevent prostate cancer are tomatoes, soybeans, cauliflower, and broccoli.
• Eating soy products may reduce risk of prostate cancer.
• Exercising regularly may decrease the risk of prostate cancer.
• Obesity can further complicate prostate cancer so try to maintain a healthy body weight.

Screening

Have a discussion with your physician the benefits and risks of a prostate cancer screening to make an informed decision about testing. After age 50, most men should consider yearly prostate screenings. High risk men should consider testing at age 45. If you have more than one first-degree relative diagnosed with prostate cancer before the age of 65, consider screening at age 40. Prostate screenings can include the PSA (prostate-specific antigen) blood test and DRE (digital rectal exam).

Treatment Options

Depending on how advanced the cancer is and whether it has spread to other body parts treatment options vary. The physician determines the most appropriate treatment for each patient. Treatment may include surveillance, surgery, radiation therapy, proton therapy, hormone therapy, chemotherapy, vaccine treatment, bone-directed treatment, and cryotherapy.
Sources: American Cancer SocietyNational Cancer InstituteProstate Cancer Foundation, and Texas Cancer Registry

Testosterone

Testosterone is the sex hormone that develops boys into men. Testosterone is important during puberty and the development of male physical features. This hormone maintains men’s muscle strength and mass, a deeper voice, and facial and body hair. Testosterone levels can affect men’s sex drive, erections, mood, muscle mass and bone density. For men testosterone is also needed to produce sperm.

What is Low Testosterone? (Low T)

Some men have low levels of testosterone. This is called hypogonadism, or low-T. The level of a man’s testosterone usually decreases with age. About 4 out of 10 men over the age of 45 have low testosterone. It is seen in about 2 out of 10 men over 60, 3 out of 10 men over 70, and 3 out of 10 men over 80 years old.

*Urology Care Foundation

What are the Signs of Low T in Men?

There are non-sexual and sexual signs of low testosterone.

Non-Sexual Signs

  • Increase in body fat
  • Lower energy levels
  • Reduced muscle mass
  • Depression
  • Anemia (low iron)
  • Calcium loss from bone

Sexual Signs

  • Low sex drive
  • Poor erections (weaker and fewer)
  • Wanting sex less often
What are Risk Factors for Low T?

Certain health problems can also tend to cause low testosterone. Some of these are:

  • High blood pressure (about 40 out of 100 also have low testosterone)
  • High cholesterol (about 40 out of 100 also have low testosterone)
  • Diabetes (about 50 out of 100 also have low testosterone)
  • Overweight (about 50 out of 100 also have low testosterone)
  • HIV (about 30 out of 100 also have low testosterone)
  • AIDS (about 50 out of 100 also have low testosterone)
  • Long-term opioid use (almost 75 out of 100 also have low testosterone)
How is Low T Diagnosed?

A blood test is used to find low testosterone levels. In general, if you hormone levels is below 300 ng/DL a diagnosis of low testosterone is made.  A PSA (prostate specific antigen) blood test may also be done to check for prostate cancer signs. Your health care provider may also test to measure the red blood cells in your body (hematocrit). A hematocrit is checked to keep record of your red blood cell count, because it can go up if you take testosterone.

Testosterone Replacement Therapy

There are many choices for raising testosterone levels. However, not everyone chooses treatment. Testosterone replacement therapy (TRT) can be given using:

  • Biote
  • Skin gel
  • Shots
  • Patches

The most common type of treatment is skin gel. This is used by about 70 out of 100 patients. After a shower, the gel is rubbed onto your shoulders or upper arms. About 10% of patients use shots, and 17% of patients use patches. About 3% of patients use testosterone in other forms, such as patches or pellets placed in the body. Pills are not approved for use in the U.S.
Taking testosterone for non-medical reasons is not recommended. Body building, aging prevention, and performance enhancement are examples of non-medical reasons. Men should not take TRT if their testosterone levels have not been tested or they have normal testosterone levels. TRT use will not help your health problems if you have normal testosterone levels. TRT can also decrease your sperm count and fertility, so keep this in mind if you are trying to father a child.

A doctor who specializes in diagnosing low-T should examine you carefully before you take TRT. Your health provider should not prescribe TRT without taking an extensive health history and giving you a physical exam and blood tests. Other health problems can have some of the same symptoms for low-T so other causes of symptoms need to be ruled out before testosterone is prescribed.

Your doctor should talk to you about possible side effects before you start TRT. Side effects can include:

  • Acne (pimples)
  • Breast soreness or swelling
  • A high red blood cell count
  • Swelling of the ankles or feet
  • Smaller testicles
  • Infertility

You should have regular check-ups if your doctor prescribes TRT. Follow-up visits with blood tests for testosterone level, PSA and hematocrit should be scheduled. Depending on your health history, your doctor may want to follow up with other tests as well.
Talk about the risks and benefits of taking testosterone replacement therapy with your doctor. Do not take TRT if you do not have low levels of testosterone. You need to be aware of the possible benefits, side effects and risks before you start taking TRT. Today’s science does not offer final answers about whether taking TRT will increase your risk of prostate cancer or heart disease.

What Can I Expect After Treatment?

Testosterone replacement has been shown to:

  • Improve energy
  • Improve sex drive
  • Increase muscle mass
  • Lower body fat
  • Help sleep
  • Improve erections
  • Raise energy level
  • Improve mood

Testosterone treatment may also lower the risk for broken bones by increasing bone mineral density. Jus like in other chronic conditions, testosterone treatment is a life-long therapy. Stopping treatment will result in low levels.
Sources: Urology Health Foundation

Statistics
  • One in seven men will be diagnosed with prostate cancer in his lifetime.
  • One in 38 men will die from the disease, making it the second most common cause of cancer death in men.
  • In 2015, 220,800 new cases of prostate cancer will be diagnosed in the United States, with 27,540 deaths.
  • In Texas, it is estimated that 13,363 new cases of prostate cancer will be diagnosed in 2015, and 1,919 men will die from the disease.
Risk Factors
  • Age: 60 percent of all prostate cancer cases diagnosed are in men age 65 and older.
  • Family History: Men with close relatives (father or brother) who have had prostate cancer are twice as likely to develop the disease.
  • Race: The highest rate of prostate cancer in the United States is in African Americans.
  • Genetic Factors: A small percentage of cases have an increased risk caused by a gene mutation on BRCA-1 or BRCA-2 or having Lynch syndrome.
  • Diet: Men who’s diets contain a high amount of red meat and dairy with few fruits and vegetables have a higher risk of developing prostate cancer.
Symptoms

The following may be symptoms of prostate cancer but could also be linked to other health issues. If these symptoms are present, men are encouraged to consult their physician for proper testing:

  • Interrupted or weak urine flow
  • Difficulty regulating urination
  • A burning sensation or painful urination
  • Blood in urine or semen
  • Stiffness or pain in ribs, upper thighs, spine, hips, or other bones
  • Painful ejaculation
  • Urinating frequently, especially at night
  • Difficulty having an erection
  • Numbness or weakness in feet or legs
Prevention
  • Cut down red meat and dairy products in your diet.
  • Eat plenty of fruits and vegetables daily. Some vegetables that are rich in substances and may help prevent prostate cancer are tomatoes, soybeans, cauliflower, and broccoli.
  • Eating soy products may reduce risk of prostate cancer.
  • Exercising regularly may decrease the risk of prostate cancer.
  • Obesity can further complicate prostate cancer so try to maintain a healthy body weight.
Screening

Have a discussion with your physician the benefits and risks of a prostate cancer screening to make an informed decision about testing. After age 50, most men should consider yearly prostate screenings. High risk men should consider testing at age 45. If you have more than one first-degree relative diagnosed with prostate cancer before the age of 65, consider screening at age 40. Prostate screenings can include the PSA (prostate-specific antigen) blood test and DRE (digital rectal exam).

Treatment Options

Depending on how advanced the cancer is and whether it has spread to other body parts treatment options vary. The physician determines the most appropriate treatment for each patient. Treatment may include surveillance, surgery, radiation therapy, proton therapy, hormone therapy, chemotherapy, vaccine treatment, bone-directed treatment, and cryotherapy.
Sources: American Cancer SocietyNational Cancer InstituteProstate Cancer Foundation, and Texas Cancer Registry

Women’s Health

Our Women’s Health services include gynecologic services, saliva testing, screening tests, and weight health

Women’s Health Services
We practice a full range of services:
  • Gynecologic services
    • Physicals including pap smears, breast and pelvic exams
    • Family planning and contraception
    • Cancer screening
    • Visits such abnormal bleeding, painful periods, hormones, PCOS
  • Saliva Testing
    • Saliva Testing is used to measure specific hormones to identify imbalances and monitor levels during individualized hormone replacement therapies.
Top Ten Women’s Health Issues

1. Blood Pressure

The American Heart Association (AHA) recommends patients have their blood pressure taken at least once each year starting at age 20

2. Breast Cancer

3. Cervical Cancer

4. Cholesterol

5. Colon & Rectal Cancer

6. Dental Health

7. Diabetes

8. Eye Health

9. Osteoporosis

10. Weight Issues

Breast Cancer

Recommendations from The American Cancer Society for women without breast cancer symptoms that may actually have breast cancer:

          • Women should get a mammogram every year once hitting the age of 40 and continue to do so every year to insure good health.
          • Mammograms are associated with many benefits such as finding cancer in its earliest stage. Sometimes mammograms do miss certain cancers in different situations, but it is rare.
          • Age shouldn’t be a sole reason to stop getting a mammogram yearly, but if you are suffering severe health problems then it is not recommended to get a mammogram. Some health problems that could potentially hold back a woman from getting her yearly mammogram would include congestive heart failure, chronic obstructed pulmonary disease, dementia and end-stage renal disease.
          • Women who are in their 20’s and 30’s should have a clinical breast exam (CBE) as part of their regular checkup with their doctor about every 3 years. Then when hitting 40 a women should have a CBE every year by an expert.
          • Sometimes having the CBE before the mammogram is beneficial. It gives her the chance to talk with her nurse or doctor about her breast and to talk about her family’s history when it comes to breast cancer.
          • Women who are in their 20’s are very unlikely to have breast cancer, but with age the chances do increase. Any symptoms or lumps should be reported to a health care professional right away.
Cervical Cancer

Cervical Cancer is easily treated if detected in time which is easily done through a regular pap smear. Cervical screening is used to uncover changed cells in the cervix that could lead to cancer. Cervical screening is quick and painless. Women must lie on the examination table where the skilled professional will use a speculum to open the vagina. This mechanism gives a lucid view of the cervix.

Who should have a screening & how frequent?

At age 21 women should start having a cervical cancer screening. Depending on your age and your health history will determine how often you should have a cervical screening. You can stop having a screening at age 65 if you do not have a history of cervical cancer in your family along with having at least three negative pap smears in a row. If your screening results are irregular another pap test will be taken, an HPV test, or a more in depth examination called a colposcopy biopsy.

Are screenings always accurate?

Just like with anything else screening results may not always be 100% accurate.  When cells are normal, but the screening shows the cells are irregular it is called a “false-positive” result. Vice versa, if cells are actually harmful and the screening shows they are normal we call this a “false-negative” result. To help put a stop to these “false-positive” and “false-negative” results avoid douching, sexual intercourse, and using vaginal hygiene products 2 days before your test. If it is your times of month, you should also avoid having your cervical cancer screening until it is over.

Cholesterol

The AHA suggests testing cholesterol levels every 4 to 6 years.

Dental Health

Regular dental checkups are a vital part of preventive health care. During your exam the dental hygienist and or dentist will clean your teeth, floss and check for any cavities or gum disease. A dental exam may also include x-rays and checking for any other oral abnormalities. The dentist or hygienist will more than likely discuss lifestyle factors, proper brushing and flossing techniques.

Diabetes

Screening for diabetes should start at age 45 and occur every three years.

Eye Health

Individuals may be clueless of eye and vision problems because there aren’t always signs or symptoms. In order to maintain superior vision, a yearly eye examination is needed.

Osteoporosis

This is a disease dealing with the bones. People who have osteoporosis have fragile bones that break effortlessly. Broken bones can have a negative impact on your daily life. Osteoporosis affects all bones in the body. Breaks are more common in the vertebrate, wrist, hip and spine. Signs of osteoporosis include, but are not limited to: bend in the back, height loss, back trouble, and hunched posture. There are many things that can increase your chance of getting osteoporosis. Some factors you can manage while some you cannot manage.

Factors you can’t manage:

  • Getting older
  • Menopause
  • Having a thin slim body (127 pounds or lighter)
  • Family history
  • Your race
  • Long term use of certain medicines that increase the likelihood you develop osteoporosis

Factors you can manage:

  • Smoking
  • Drinking too much alcohol
  • A diet low in calcium
  • Not getting enough exercise
How Can I Discover if I Have Weak Bones?

There are tests that can be performed to determine your bone density. One particular test that can be done is called dual-energy x-ray absorptiometry (DXA). Talk with your doctor about different options and tests to determine what kind of bones you have. If you are 65 years old or older you should have tests done to figure out if you have osteoporosis. Bone density testing is recommend to those 65 years of age and older. If you have history in your family of osteoporosis you may want to consider having a bone density test done sooner.

How can I Prevent Weak Bones?

  • Get enough calcium in your diet
  • Get plenty of vitamin D each day
  • Exercise
  • Eat a healthy balanced diet
  • Don’t smoke
  • Drink alcohol in moderations
  • Maintain a healthy weight
  • Make changes in your home to live in a safe environment
Weight Health

Obesity is a growing problem in the United States. Gaining weight with age is a difficulty women are struggling with. And, at sooner ages than anticipated.

Menopause, hormones, not enough fiber, not eating enough, stress, sleep deprivation, depression, medications, and diseases or illnesses can be some of the causes of weight gain in woman.

Schedule an appointment to discuss your weight loss options with one our nurse practitioners.

Contact Us

Whether you need to schedule an appointment, reschedule an appointment, or sign up for our patient portal, we would love to help you.