PG Direct Care, 1100 Pine Avenue Ste. 3B, Sheridan, WY (2026)

10/05/2026

Does your heart ever feel like it’s racing, pounding, fluttering, or skipping a beat?

Those sensations are called heart palpitations. Palpitations are a symptom — not a diagnosis — and there are many possible reasons they can happen.

Sometimes the trigger is fairly simple: stress or anxiety, exercise, caffeine, ni****ne, alcohol, dehydration, fever, or certain medications. Other times, palpitations can be related to thyroid problems, anemia, electrolyte changes, or an abnormal heart rhythm.

One thing that can really help during a healthcare visit is paying attention to the details:

How did it feel — racing, pounding, fluttering, or skipping?
How long did it last?
What were you doing when it started?
Did you recently increase caffeine or start a new medication?
What was your pulse or heart rate, if you were able to check it?
Did you have dizziness, chest discomfort, or shortness of breath with it?

Palpitations that are new, happening more often, getting worse, or lasting longer than usual are worth discussing with a healthcare professional.

🚨 There are also times when palpitations should not wait.

If a racing or irregular heartbeat happens along with chest pain or pressure, fainting, severe shortness of breath, or severe dizziness, seek emergency medical attention.

💡 The takeaway:
Don’t just remember that your heart “felt funny.” The timing, sensation, duration, triggers, and accompanying symptoms can provide valuable clues about what is happening.

💙💚 PG Direct Care

📱 Text 307-218-3417 for more information to get started with personalized care.

PGDirectCare.com

10/05/2026

A quick personal update for everyone planning to attend the Wyoming Health Fairs blood draw event at Living Water Community Church in Kemmerer, Wyoming on Tuesday, October 6.

I won’t be able to be there physically that day, but I still want to make sure I’m available to support you. I’ll be available **virtually throughout the day on Tuesday, October 6** for one-on-one consultations.

For that day only, I’ll be offering:

Focused Health Visit — $25
Have a specific health concern? We can evaluate the issue, answer your questions, and discuss appropriate next steps.

Lab Review Consultation — $25
Already have lab results you’d like help understanding? I can review them with you, explain what they may mean, answer your questions, and discuss appropriate follow-up.

Lab Order Support — $25
Need lab work but aren’t sure what may be appropriate? We can discuss your concerns and help determine which labs may be clinically indicated. Lab charges through Wyoming Health Fairs are separate from the PG Direct Care consultation fee.

Even though I can’t be there in person on Tuesday, October 6, I still want you to have access to me and the opportunity to ask questions about your health.

We are also planning to be back in person for the Wyoming Health Fairs event on Tuesday, November 3.

To schedule an October 6 virtual consultation, text 307-218-3417.

Thank you for continuing to trust PG Direct Care with your health. I look forward to connecting with you!

Nicholas Green, APRN, FNP-C
PG Direct Care
Your Care. Anywhere. When You Need It.

10/01/2026

A positive urine test does NOT always mean you have a UTI.

This is one of those healthcare topics that surprises a lot of people.

Bacteria can sometimes be found in the urine without actually causing a urinary tract infection. This is called asymptomatic bacteriuria—and for most people without urinary symptoms, antibiotics are not needed.

Why does that matter?

Because antibiotics aren’t harmless. Using them when they aren’t necessary can cause side effects and contribute to antibiotic resistance, making future infections harder to treat.

When evaluating a possible UTI, the symptoms matter just as much as the urine test.

Burning or pain with urination, increased frequency or urgency, lower abdominal discomfort, and sometimes blood in the urine can fit with a bladder infection. A urinalysis can provide additional clues, while a urine culture can help identify the bacteria and determine which antibiotics may work when treatment is actually needed.

There are important exceptions. Pregnancy and certain urologic procedures are situations where bacteria in the urine may need treatment even when typical UTI symptoms aren’t present.

And urinary symptoms accompanied by fever, chills, nausea or vomiting, or pain in the back or side can be signs of a kidney infection and deserve prompt medical evaluation.

💡 The bigger lesson?

Treat the person, not just the urine test.

Good medicine isn’t always about prescribing another medication. Sometimes it’s recognizing when treatment is necessary—and when it isn’t.

💙💚 PG Direct Care

📱 Text us at 307-218-3417 to learn more and get started with personalized care.

PGDirectCare.com

09/30/2026

Need care after hours but don’t want the surprise bill?

That’s exactly why PG After Hours exists.

Sometimes you just need a simple, straightforward option for care in the evening or on the weekend — without wondering what the final bill will be.

What is DPC?

Direct Primary Care (DPC) is a simpler, more transparent healthcare model that gives patients direct access to their provider.
It is not insurance — and that’s exactly why many people appreciate it.

Why can this save money?

With traditional insurance, many people are still dealing with:

* Rising deductibles
* Copays
* Unexpected out-of-pocket costs
* Expensive urgent care or ER visits for concerns that may not require that level of care

With PG After Hours, we are not currently accepting insurance, but we do offer a simple one-time self-pay visit for $65.

That means:

✅ Transparent pricing
✅ No copay for your one-time self-pay visit
✅ No waiting to find out what insurance did or didn’t cover
✅ A lower-cost option for many common after-hours concerns

PG After Hours is a great fit for:

* Sudden illnesses
* Minor infections
* Medication questions
* Evening and weekend care needs

Hours

Mon–Fri: 9 AM – 12 Midnight
Saturday: 12 PM – 9 PM
Sunday: 1 PM – 5 PM

If you’ve been frustrated by rising deductibles and the cost of using insurance for every little thing, this may be a simpler option when you need care after hours.

Text us at 307-218-3417 to learn more and get started.
PGDirectCare.com

09/30/2026

“It’s over the counter, so it must be pretty harmless… right?”

Not always.

Ibuprofen and naproxen are NSAIDs—nonsteroidal anti-inflammatory drugs. They can be very useful for pain, inflammation, headaches, arthritis, and injuries, but being available without a prescription does not mean they are risk-free.

NSAIDs can irritate the stomach and increase the risk of ulcers or gastrointestinal bleeding. That risk is higher in people with a history of ulcers or bleeding, older adults, people taking blood thinners or steroids, and those taking more than one NSAID-containing product.

They can also affect the kidneys. This becomes especially important during dehydration, vomiting, diarrhea, poor fluid intake, or in people who already have kidney disease. NIDDK specifically notes that medicines such as ibuprofen and naproxen can contribute to acute kidney injury when someone is dehydrated or has low blood pressure.

There is a cardiovascular side too. Non-aspirin NSAIDs carry warnings about an increased risk of heart attack and stroke, and the risk can rise with higher doses or longer use.

A few simple habits can make OTC pain medicine safer:

✅ Use the lowest effective dose for the shortest amount of time needed.
✅ Avoid taking two different NSAID products at the same time unless your healthcare professional specifically recommends it.
✅ Read the labels on cold, headache, and combination medicines—some already contain an NSAID.
✅ Ask before using NSAIDs regularly if you have kidney disease, high blood pressure, heart disease, a history of stomach bleeding, take blood thinners, or are pregnant.
✅ Seek medical attention for warning signs such as vomiting blood, black or bloody stools, chest pain, shortness of breath, sudden weakness, or slurred speech.

One good question to ask at your next visit:

“Is the pain medicine I use regularly still the safest choice for me?”

Sometimes a medication review is just as important as adding a new medication.

💚 PG Direct Care

Text 307-218-3417 to learn more and get started with personalized care.

PGDirectCare.com

09/30/2026

Turning 45? Colon cancer screening belongs on your health checklist.

One misconception I hear often is:

“I’m not ready for a colonoscopy, so I’ll just wait.”

For many adults at average risk, that does not have to be the only option.

Most average-risk adults ages 45–75 should be screened for colorectal cancer. Screening matters because it can find precancerous polyps before they become cancer, and it can also find cancer earlier—when treatment may be more effective.

Depending on your situation, screening options may include:

✅ FIT every year — an at-home stool test that checks for hidden blood.

✅ Stool DNA + FIT every 1–3 years — another at-home option that looks for blood plus certain DNA changes.

✅ Colonoscopy every 10 years — allows the colon to be examined directly and polyps can sometimes be removed during the same procedure.

One very important point:

An abnormal stool-based screening test still needs follow-up with a colonoscopy. Completing that follow-up is part of completing the screening process.

And these schedules are meant for average-risk adults. Your plan may be different if you have a history of colon polyps or colorectal cancer, inflammatory bowel disease, a strong family history, or a hereditary colorectal cancer syndrome.

For adults ages 76–85, the decision to continue screening is more individualized and depends on overall health, previous screening, and personal preferences.

A good question for your next visit:

“Which colorectal cancer screening option is best for me?”

Preventive care works best when the plan is one you can actually complete. 💚💙

PG Direct Care

Text 307-218-3417 to learn more and get started with personalized care.

PGDirectCare.com

09/28/2026

Before you trust your home blood-pressure number… check your technique.

A home blood-pressure cuff can be extremely helpful, but small setup mistakes can make a reading look higher or lower than it really is.

For a more accurate check:

✅ Avoid caffeine, smoking, and exercise for about 30 minutes beforehand.
✅ Empty your bladder.
✅ Sit quietly for 5 minutes before measuring.
✅ Keep your back supported and both feet flat on the floor.
✅ Keep your legs uncrossed.
✅ Rest your arm on a surface so the cuff is at heart level.
✅ Put the cuff on bare skin, not over clothing.
✅ Stay still and avoid talking or using your phone while the cuff is running.
✅ Take 2 readings about 1 minute apart and write them down.

One blood-pressure reading is only a snapshot.

What is often more useful is seeing a pattern over several readings taken with good technique. Keeping a short home log can give you and your healthcare professional much better information than one isolated number.

And don’t forget the cuff itself: an automatic upper-arm monitor with the correct cuff size is generally preferred for home monitoring. A cuff that does not fit correctly can give you an inaccurate result.

If your blood pressure is over 180/120, repeat the measurement after a few minutes. If it remains that high and you are having concerning symptoms such as chest pain, shortness of breath, weakness, vision changes, or other neurologic symptoms, seek emergency care.

A simple question for your next visit:

“Am I checking my blood pressure the right way at home?”

Sometimes improving the measurement is the first step toward understanding the number. 💚💙

PG Direct Care

Text 307-218-3417 to learn more and get started with personalized care.

PGDirectCare.com

09/26/2026

What if the first sign of hearing loss isn’t “I can’t hear”?

What if it sounds more like:

“Why is every conversation so exhausting?”

Hearing is not just an ear function. Your brain is constantly processing sound, separating speech from background noise, filling in missing information, and trying to make sense of what you hear.

When hearing becomes less clear, the brain may have to work harder to keep up.

That can show up in surprisingly ordinary ways: turning the television up higher than everyone else, struggling to follow conversations in restaurants, asking people to repeat themselves, missing words over the phone, or slowly beginning to avoid group conversations because keeping up has become tiring.

And the conversation goes beyond communication.

Research has linked hearing loss in older adults with social isolation, falls, and faster cognitive decline. That does not mean hearing loss guarantees dementia—but it does mean hearing health may deserve more attention as part of overall healthy aging.

An NIH-funded randomized trial found something especially interesting: hearing aids did not slow cognitive decline across the entire study population, but among participants already at higher risk for cognitive decline, the hearing intervention was associated with a substantially slower rate of decline. Researchers are still studying the long-term connection.

That is why I would not frame hearing aids as a “dementia prevention treatment.”

I would frame hearing care as something much more grounded:

Better communication. Better connection. Better awareness of what is happening around you. And potentially another piece of the healthy-aging puzzle.

If you or someone you care about is constantly turning up the volume, struggling in noisy rooms, asking people to repeat themselves, or withdrawing from conversations, consider having hearing checked rather than simply writing it off as “getting older.”

A useful question for your next visit may be:

“Could my hearing be affecting more than just my hearing?”

💚 PG Direct Care

Text us at 307-218-3417 to learn more and get started with personalized care.

PGDirectCare.com

09/25/2026

You can be iron deficient without being anemic.

That surprises a lot of people.

Someone may feel exhausted, notice that workouts suddenly feel harder, struggle with restless legs, or experience increased hair shedding — yet their CBC comes back “normal.”

The reason is simple: hemoglobin and iron stores are not the same thing.

Hemoglobin helps tell us whether anemia has developed.

Ferritin helps us understand how much iron the body has stored.

Iron stores can begin falling before hemoglobin drops enough to show anemia on a CBC.

That’s why the conversation sometimes needs to go beyond:

“Your blood count looks fine.”

Depending on symptoms and history, additional testing such as ferritin, iron, TIBC, and transferrin saturation may provide a much clearer picture.

And finding low iron is only part of the story.

The next question should be:

Why is the iron low?

Heavy menstrual bleeding is common, but frequent blood donation, pregnancy or the postpartum period, gastrointestinal blood loss, low dietary intake, and problems absorbing iron can also contribute.

One important caution: don’t automatically start high-dose iron just because you’re tired. Fatigue has many causes, excess iron can be harmful, and ferritin itself can be affected by inflammation.

A better question for your next visit may be:

“Could my iron stores be low even if I’m not anemic?”

Sometimes the lab result that says “normal” isn’t the end of the conversation.

💚 PG Direct Care

Text us at 307-218-3417 to learn more and get started with personalized care.

PGDirectCare.com

09/24/2026

Your kidney bloodwork can look normal… and still miss an early warning sign.

Most people think kidney health is measured by one number on a blood test.

But there are really two different questions worth asking:

How well are my kidneys filtering?
That’s what eGFR helps estimate.

Is the kidney filter leaking protein?
That’s what a urine albumin-to-creatinine ratio, or uACR, helps detect.

And that second question matters because albumin can begin leaking into the urine before eGFR becomes obviously abnormal.

That means someone can have reassuring blood kidney numbers while still showing an early sign of kidney damage.

A uACR below 30 mg/g is generally considered the normal or goal range.

A result of 30 mg/g or higher may indicate albuminuria, but one abnormal result usually needs follow-up rather than being treated as a diagnosis by itself.

If elevated urine albumin persists for 3 months or longer, it may support a diagnosis of chronic kidney disease.

This is especially worth discussing if you have:
diabetes, high blood pressure, cardiovascular disease, a history of kidney problems, or other kidney-risk factors.

So instead of only asking:

“How is my kidney function?”

Consider asking:

“Have we checked both my eGFR and my urine albumin?”

Sometimes the earliest warning sign is not in the bloodwork at all.

💚 PG Direct Care

Text us at 307-218-3417 to learn more and get started with personalized care.

PGDirectCare.com

PG Direct Care

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