Internal and Family Medicine for Adults

Littleton Internal Medicine Associates is a medical practice that specializes in internal medicine and family medicine for adults (ages 18 and up).

Everyone deserves compassionate healthcare and a caring physician who will listen to them. We view our patients as a whole person seeking total wellness. We treat patients with respect, compassion and as unique individuals. We demand of ourselves and our entire team, the highest professional and ethical standards to earn our patient’s trust and confidence.

Littleton Internal Medicine Associates understands building a strong relationship with your personal doctor is very important for your long term healthcare. Our dedication and professionalism have made us successful and have made Littleton Internal Medicine Associates one of the largest and fastest growing primary care medical practices in our area.

LIMA Testing

A bone density test is called a DXA or DEXA scan. This is not the same as a bone scan. A bone density test uses a small amount of x-ray to measure the amount of mineral in the bones of your lower back, hip or sometimes the forearm.

A bone density test tells you if you have normal bone density, low bone density (osteopenia) or osteoporosis. It is the only test that can diagnose osteoporosis. The lower your bone density, the greater your risk of breaking a bone.

For instructions on bone density testing and to fill out the necessary paperwork, please visit our Patient Forms or click on the title above.

An echocardiogram (cardiac ultrasound) is an ultrasound examination of the heart using sound waves. It will give information about the size of the heart chambers, the thickness of the walls of the heart, how the heart is contracting and detect abnormalities in the structure or function of the heart valves.

The test is done by placing a small transducer on your chest. The test is painless and takes less than a half-hour to complete. Before the test is done, you will be asked to undress to the waist and put on a gown so that it opens in the front. Then you will be asked to lie comfortably on the bed on your left side.

First, three paper disks (electrodes) will be placed on your chest; these are then attached to a cable and are used to give a picture of the electrical activity of your heart. Next the transducer, which has conductive jelly applied to it, will be placed on your chest. The transducer is moved to various areas so different views of the heart can be recorded. The echocardiogram is recorded in digital format and then transmitted to a cardiologist for interpretation.

To learn more about the procedure, go to Patient Forms or click on the title above.

Cartoid NIVA

Carotid ultrasound (also called carotid doppler or NIVA) is a painless test that uses high-frequency sound waves to create pictures of the insides of the two large arteries in your neck. These arteries, called carotid arteries, supply your brain with oxygen-rich blood.

Carotid ultrasound shows whether a substance called plaque has narrowed your carotid arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Plaque builds up on the insides of your arteries as you age. This condition is called carotid artery disease.

A carotid ultrasound can show whether plaque buildup has narrowed one or both of your carotid arteries and reduced blood flow to your brain. If plaque has narrowed your carotid arteries, you may be at risk of having a stroke. That risk depends on how much of your artery is blocked and how much blood flow is restricted.

Carotid Intima-Media Thickness Test (CIMT)

The carotid intima-media thickness test (CIMT) is a measure used to diagnose the extent of carotid atherosclerotic vascular disease. The test measures the thickness of the inner two layers of the carotid artery-the intima and media-and alerts physicians to any thickening when patients are still asymptomatic. Early detection may indicate the need for a more aggressive approach to managing the risk factors associated with heart disease and stroke.

Aging is a contributing factor to increased carotid intima-media thickness. Other risk factors include high lipoprotein levels, high blood pressure, smoking, diabetes, obesity and a sedentary lifestyle.

Physicians use CIMT testing to determine the “age” of the carotid arteries. Knowing that patients may not be experiencing the symptoms of artherosclerosis, there still may be subtle changes in artery thickness. Armed with this information, physicians may develop an aggressive medical approach by prescribing medications such blood pressure and cholesterol lowering agents and aspirin, and patients may be encouraged make lifestyle and dietary improvements.

Abdominal Aortic Aneurysm (AAA) Ultrasound Test

An abdominal aortic aneurysm (AAA) is a weakened, bulging spot in your abdominal aorta, the artery that runs through the middle of your abdomen and supplies blood to the lower half of your body.

An abdominal ultrasound to screen for an AAA is recommended for men ages 65 to 75 who are current or former cigarette smokers. Having an abdominal ultrasound to screen for an aortic aneurysm isn’t specifically recommended for men who have never smoked, nor women, unless your doctor suspects you may have an aneurysm.

A typical ultrasound exam is painless and takes about 20 minutes to complete. You may be asked to change into a hospital gown for the procedure.

Your abdominal ultrasound will be performed by a specially trained technician (sonographer). During the exam, you lie on your back on an examination table and a small amount of warm gel is applied to your abdomen. The gel helps eliminate the formation of air pockets between your skin and the instrument, called a transducer, the technician uses to see your aorta. The sonographer presses the transducer against your skin over your abdomen, moving from one area to another. The transducer sends images to a computer screen that the technician monitors. The technician monitors blood flow through your abdominal aorta to check for an aneurysm.

Stress echocardiography is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to your body. It is mainly used to detect a decrease in blood flow to the heart from narrowing in the coronary arteries.

A resting echocardiogram will be done first. While you lie on your left side with your left arm out, a small device called a transducer is held against your chest. A special gel is used to help the ultrasound waves get to your heart.

Most people will walk on a treadmill. Slowly (about every 3 minutes), you will be asked to walk faster and on an incline. It is like being asked to walk fast or jog up a hill.

In most cases, you will need to walk for around 5 to 15 minutes, depending on your level of fitness and your age. Your doctor will ask you to stop:
• When your heart is beating at the target rate
• When you are too tired to continue
• If you are having chest pain or a change in your blood pressure that worries the provider administering the test.

Your blood pressure and heart rhythm (ECG) will be monitored throughout the procedure.

More echocardiogram images will be taken while your heart rate is increasing, or when it reaches its peak. The images will show whether any parts of the heart muscle do not work as well when your heart rate increases. This is a sign that part of the heart may not be getting enough blood or oxygen because of narrowed or blocked arteries.

To prepare for a Stress ECHO procedure, visit Patient Forms-Stress ECHO Patient Instructions or click on the “Stress ECHO” title above.