Inova General Internal Medicine Group, (IGIMG) is committed to providing our patients with high quality, comprehensive, patient-centered care with the goal of optimizing health and well-being. Our team of providers and support staff cares about our patients and strives to offer every one the access and control they need over their healthcare experience, in a warm and friendly environment. Telemedicine services are offered to patients (new or established) who are physically located at the time of the virtual visit in Virginia. Book an appointment online or call our office to schedule.

Inova General Internal Medicine encourages all of our patients to contact us if they need a same day appointment or have an urgent acute illness. We see all walk in patients as soon as a medical practitioner is available to see them, but there may be a wait. Be assured that we will see you as soon as possible. We are available during our regular business hours to see you for an appointment or advise you about your care.

We are fortunate to have Nora Jansen Shank on our staff to provide nutrition therapy and fitness counseling to all our patients. Nora is a registered dietitian with more than 20 years of experience. She has specialized certification in obesity management and has a rare combination of high-level acute care clinical knowledge and outpatient chronic disease management. She previously grew outpatient practices in several organizations and is looking forward to improving health outcomes at Inova Primary Care. Her patients benefit from her combination of kind counseling and metabolic analysis that have helped them lose over 3000+ pounds together. 

During the initial 30-minute consultation, Nora will work with you to determine what your health goals are and develop an individualized plan to help you begin your journey on accomplishing your goals. Follow-up appointments are 15-30 minutes in length. It is recommended to have a weekly or every other week follow up appointments when first getting started to help reinforce the changes you will be making and to discuss how to handle obstacles that will arise along the way.

Billing: This provider accepts major insurance plans – please check with your insurance carrier.

A routine physical is a preventive health exam designed to catch problems before they catch up with you, and help keep you in good health. This routine exam also helps you maintain a relationship with our practice, as well as allowing us to better coordinate care with you and other providers, ensure your health information is updated, and provide refills if necessary.

The preventive health exam takes more time than a regular appointment, in order to:

  • Go over your medical background, including any chronic medical problems, medications, and relevant family medical history

  • Check for new issues via physical examinations –

    • Routine preventive lab testing and disease screening may be done, if warranted

    • Baselines are established so we can compare your past results to those in later appointments and exams, and identify any important changes

Important Note: Your preventive exam is different than a regular appointment. We cannot sufficiently address your preventive health needs if also asked to address treatment of chronic or acute issues such as a cold, injury, etc. Please schedule a separate appointment for these needs.

Men

Depending on your age, we may also check your prostate, do a hernia and testicular exam, and check for evidence of sexually transmitted infections. 

Recommended preventive screenings, counseling and immunizations for men

Women

We do a breast and pelvic exam with Pap smear, if you do not have a gynecologist. We may also check for sexually transmitted infections. 

Recommended preventive screenings, counseling and immunizations for women

Your Provider

Your provider will flag signs of a potential problem and discuss them with you. A follow-up office visit may be recommended to review any abnormal findings. Otherwise, we will convey your results to you through MyChart.

Login to MyChart

We use Audiometry to test hearing. 

Travel Immunizations and Wellness Preparation

We are pleased to offer medical visits for patients planning to travel internationally. COVID-19 Testing for travel is not available. During your visit, our staff will review the necessary interventions prior to your travel, as well as general health and safety guidelines pertinent to each country you are planning to visit. Appropriate vaccinations and medication prescriptions are generally provided at the time of your visit.

Payment for travel immunization services is required at the time of your visit. Be aware that most insurance plans do not cover the cost of travel immunizations or the travel visit fee.

Read on for some general traveler’s advice on common travel-related ailments.

Advice for Travelers

Altitude sickness can be caused by rapid ascent to altitudes over 9000 feet. Symptoms include headaches, loss of appetite, and trouble sleeping, but can lead to more severe issues.

Things to do:

  • Do a gradual ascent. If you are mountain climbing or hiking, take a 1 to 2 day break at an appropriate altitude during your ascent.
  • Drink extra fluids.
  • Do not overexert yourself.
  • Avoid sedatives, codeine and alcohol.
  • Under specific conditions, there are medications that can be considered. Talk to your healthcare provider about this.

Many travelers experience motion sickness when traveling by airplane, boat or automobile. This may be avoided simply by choosing your seat carefully. There are also effective medications available.

Things to do:

  • In a car, the driver’s seat or front window seat is the best place to sit.
  • On a bus, sit near the front window.
  • On a plane, sit over the wings or wheels (where it’s more stable).
  • On a boat, get a mid-ship cabin close to the waterline.

Jet lag is a common complaint of travelers who travel across more than 3 time zones. Your body runs on an internal biological clock, and it takes time to adjust to new time zones. Symptoms of jet lag include fatigue, insomnia, headaches, and decreased appetite.

Things to do:

  • Break up your trip if possible by 1 day of rest for every 6 time zones crossed.
  • Avoid caffeine, excessive alcohol and heavy meals.
  • Schedule important meetings, etc. at least 24 hours after arrival.
  • Alter your sleep habits 1 week prior to departure if possible.

Most traveler’s diarrhea does not need medical attention and is usually a self-limiting illness that can last several days. Taking a daily antibiotic to prevent diarrhea is NOT generally recommended, except for individuals with certain medical risks. However, your provider may give you a prescription for an antibiotic to use in case certain symptoms develop.

Things to do:

  • Avoid raw vegetables and fruit that you do not peel yourself. Avoid non-pasteurized dairy products, cooked foods not served hot, and tap water (including ice).
  • If you do develop mild diarrhea, drink plenty of fluids, take an over-the-counter medication such as Imodium, initially 4 mg and then 2 mg after each loose stool, maximum of 16 mg per day for adults. Imodium should not be used if a fever or bloody diarrhea are present.
  • If you develop a fever or bloody stools, consult your healthcare provider, or other local health care clinic if still abroad.
  • If diarrhea is moderate to severe and persistent, an antibiotic such as ciprofloxacin, levofloxacin, norfloxacin or ofloxacin may be needed, especially if associated with fever or bloody diarrhea.

Respiratory infections, such as cold symptoms or bronchitis, are the most common traveler’s disease other than gastro-intestinal (GI) illness.

Things to do:

  • Travelers should wash their hands frequently with soap and water, or use an alcohol-based hand rub.
  • Eat only poultry products that are well cooked.
  • In countries with documented outbreaks of avian influenza, avoid live poultry markets, farms, and other contact with sick or dead poultry, and surfaces that may be contaminated by poultry feces.
  • Avoid visiting live animal markets in China.
  • Seek medical attention if you develop difficulties with breathing, a persistent cough, or cough associated with a fever.

Remaining still for long periods of time (especially with air travel) increases the risk of lower extremity deep vein thrombosis (DVT), or a blood clot. Risk factors for DVT are a past history or family history of DVT, obesity, malignancy, or known clotting disorder. Symptoms may include leg swelling on only one side, or calf pain/redness.

Things to do:

  • Walk around every 1-2 hours while on an airplane.
  • Exercise while sitting – flex and extend ankles and knees.
  • Drink extra fluids
  • Avoid alcohol
  • Wear compression stockings

Travel to some areas, especially tropical climates, increases your risks of contact with a variety of insects capable of transmitting infectious diseases. The most well-known disease carriers are mosquitoes, which can transmit a variety of diseases.

Things to do:

  • Apply an insecticide in liquid or spray form, permethrin (Duranon, Permanone, etc.) on clothing, tents, sleeping bags, etc. for protection.
  • Use DEET on exposed skin in combination with the permethrin for increased protection. Reapply DEET after swimming or excessive sweating.
  • Use permethrin-impregnated mosquito nets while sleeping in rooms that are not screened or air-conditioned.
  • Limit outdoor activity between dusk and dawn to reduce the risk of malaria and Japanese encephalitis.