Emailed 2/6/2025

---

To My Patients, 

Hope all is well. 

The famous groundhog, Punxsutawney Phil, saw his shadow, predicting six more weeks of winter. I suppose we'll be seeing more animal footprints in our backyard, and ski lovers will be happy. 

Colorado is expecting more cold weather, and we'll be visiting the crew for a few days this month. 

Please note that the office will be closed on Thursday, February 13th. As usual, Janine and I will be available to take messages while we're away. Dr. Sarfraz will be covering in case of any urgent needs. 

Please give us a call at 203-853-1919 if you need an appointment!

When there's a little free time, there are always puzzles, Sudoku, exercise, tennis, and time with friends. Sandy's favorites are the 1,000-piece puzzles. One we recently finished was a patchwork of squares, each containing a meaningful saying. Feel free to take a look at the photos. 



A special kudos to our son Michael for completing the Disney marathon last month-repeating the feat he accomplished exactly 20 years ago! 

Congratulations to our son Jeffrey on his new position as Chief Information and Innovation Officer at Firefighters First Credit Union. 

The office has been busy, with a steadily increasing demand for online telemedicine visits. While many cases still require in-person visits, a growing number of medical concerns-especially in general office medicine and its specialties, including mine-can now be effectively addressed online. 

Several factors are driving this trend:

• Convenience - No travel time, minimal (if any) waiting time, and reduced exposure to waiting room environments.
• Chronic Disease Management - Telemedicine allows for easier check-ins for conditions such as diabetes, hypertension, heart disease, and asthma, which require frequent monitoring.
• Advancements in Home Monitoring - The increasing availability of home test kits (e.g., COVID, influenza A, strep throat, urinary tract infections) and monitoring devices like continuous glucose monitors (CGMs), pulse oximeters, continuous oxygen monitors, and smartwatches that track sleep patterns. 

Many of these kits and devices are available over the counter from retailers such as Amazon and Walmart, while some, like CGMs, still require a prescription. 

Telemedicine is becoming more efficient and useful-and this is just the beginning. 

A Message to Insurance Providers & Policymakers: Pay attention and address the health needs of our people! 

Longevity: Living Longer, Living Healthier 
Longevity is on most of our minds-the goal is to live as long as possible while maintaining optimal health. 

Global life expectancy has increased dramatically due to advances in sanitation, nutrition, and healthcare access (though the U.S. lags behind in many ways-perhaps a topic for another letter). 

However, there is a genetic limit to aging, with the longest known human lifespan recorded at 122 years. Perhaps the Jewish blessing, "May you live to 120," originates from this natural limitation. 

As physicians, our role is to help extend life to its fullest genetic potential. I take this responsibility seriously. The motto "We help you live a longer, healthier life" has been with me since the founding of the old Health Extenders facility. 

The Future of Longevity Research 
A vast amount of research is now focused on breaking the genetic barrier to longevity.

• Some studies advocate dietary changes such as caloric restriction or intermittent fasting.
• Others explore removing "zombie cells"-cells that have stopped dividing but continue releasing inflammatory substances.
• Another area of focus is telomere extension. Telomeres are protective caps on the ends of our chromosomes, and when they degrade, cells lose function and die.

And the list goes on. 

There is no universal longevity prescription - every individual has unique genetics and medical conditions. Longevity strategies must be personalized. 

Please give us a call at 203-853-1919 if you need an appointment!

We're here to answer your questions. 


Igal Staw, Ph.D., M.D.
www.drstaw.com
Dr. Staw on Facebook 

A Great Vacation and Info on Microplastics

 

Emailed12/22/2024

To My Patients, 

Just back from our vacation. 

This time it was a driving vacation, mainly through Southern France and San Sebastian in Spain. All courtesy our daughter, Laurie. 

Some of the highlights (in addition to the great wines of Provence and Bourdeau) were the many thousands of flamingos at Camargue national park (at their "courting season"), the nighttime drone show in San Sebastian, Spain, and the 300-foot climb up the Sand Dune du Pilat on the coast, west of Bordeaux. 

The office has been very busy, patients trying to get exams done before the end of the year. 

Many patients have their insurance changed or modified at the beginning of the new year. Please make sure we have your updated insurance information when you come to the office or have a telehealth call. 

A special request: Traffic is becoming increasingly heavier. Some patients are unavoidably late for their appointments, which may increase waiting time for on-time patients. I try to minimize waiting time. Please try to anticipate excess traffic; looking at Waze may be helpful. Thanks for thinking of this issue. 

Interesting medical notes: 

It's not only probiotics, it's also prebiotics. Our bodies are full of bugs, most of them in the gut. The constitute our Human Microbiome, made of trillions of microorganisms such as bacteria, fungi and viruses. About 80% of the cells in our body are not human cells, they are part of the human microbiome. These microorganisms carry an enormous load of genetic material that affects our health, frequently more so than our own genetic makeup. 

No wonder we must live in peace with our microbiome. 

Prebiotics are live microorganisms that, when consumed in adequate amounts, keep our microbiome happy. They are present in fermented foods such as yogurt, Kefir, kimchi, miso and sauerkraut, and many others. They must remain alive when consumed to be beneficial. Keep them refrigerated to prolog their life. Cooking will destroy them. 

Frequently, probiotic supplements must be used to support general good health, strengthen the immune system, or help with digestive problems (irritable bowel syndrome and others). They usually come in capsule form. Each capsule should contain at least 20 billion (yes, billions) organisms and should have several, different organisms; the more, the better. 

Please give us a call at 203-853-1919 if you need an appointment!

What about microplastics? We live in a world of plastics. Plastics production was 28 million metric tons in 1980, that's about 240 pounds a year per person, man, woman, and child! Production in 2019 was three times as high, and it continues to grow. About 40% of plastics are single-use plastic, used for packaging, food containers, cups and plates, and beverage straws. 

In addition to pollution, there are health risks. Recent studies show that very small plastic particles, microparticles, accumulate in our bodies. They were found in the common plaques that develop in the coronary arteries, and are considered a significant risk for the development of coronary heart disease, which end in a heart attack. 

Cookware that can shed consumable microplastics include nonstick cookware (coated with PTFE - polytetrafluoroethylene), plastic utensils and cutting boards, and plastic cookware and containers. 

Foamed-plastic products also shred microplastic particles, especially processed with CFCs (chlorofluorocarbon). This includes foamed packing material, drinking cups and foamed plates. 

What should you do, what should you watch for? The list is long, here are some important points:

• Cookware. Choose stainless steel, cast iron, ceramic or glass. 
• Plastic tableware. Try to avoid single-use plastic such as knives, forks, plates, and cups. Use silverware and ceramic plates when possible.
• Heating cookware. Don't heat food in plastic containers, even if it states "microwave safe."
• Recycle Plastics. Recycle damaged, scratched plastic. They may shed microplastics.
• Fish. Prefer non-farmed fish; there likely contain fewer microplastics.

And the list goes on. It may not be possible to eliminate consumption of microplastics, but we must try to minimize our exposure to these dangerous particles. 

Need more detail? Email e at istaw@drstaw.com. 

Until I see you again, stay well. 

Sandy and I wish all of you and your families a great holiday season and a happy, healthy, and peaceful New Year. 


Igal Staw, Ph.D., M.D.
www.drstaw.com
Dr. Staw on Facebook 

Thank you for your messages & Itinerary change

 To My Patients, 

Emailed 10/10/2023

In view of the horrendous, barbaric attack against Israel, which began on Saturday, 10/7/2023, we postponed our trip to Israel to a safer time. We will spend our planned time away from the office with our family in the US. 

We’ll be back in the office on Tuesday the 24th resuming our regular schedule. 

As usual, Janine will handle the phone, and I'll be able to receive email messages. If necessary, Janine knows how to find me, and Dr. Sarfraz will cover me in urgent cases. 

Sandy and I received numerous calls, emails and texts from patients and friends inquiring about our safety, and that of our family and friends in Israel. As of the time of this writing, everyone is OK and accounted for. Sandy and I thank you for your concern. 

Please give us a call at 203-853-1919 if you need an appointment, or if you have any questions. 

Stay well, 

Igal Staw, Ph.D., M.D.

Office hours and some happy news

 

To My Patients, 

emailed to patients 10/1/2023

Hope all is well. 

It's been a while since the last "letter to patients," of mid-May. A lot has transpired. Our trip to Israel with our daughter in late May was great, our older granddaughter and her boyfriend where there at the same time - kept us going... 

The Colorado crew stayed at our house for about three weeks in June-July, lots of happy noise. We'll be celebrating their son David's, Bar-Mitzvah in Jerusalem in October, traveling with them and more family around the country (see below for time away from the office). 

This spring-summer season wasn't ideal for the garden. The vegetables and flowers were late, but the trumpet flower still managed to show up with its majestic colors, and the spider was able to weave its crafty net. 


Time in Israel: 

Sandy and I will be away for almost 2 weeks, in Israel, beginning Tuesday October 10th (after shorter office hours), until Monday October 23rd. We'll be back in the office on Tuesday, October 25th. 

As usual, Janine will handle the phone, I'll be able to receive email messages. If necessary, Janine knows how to find me, and Dr. Sarfraz will cover me in urgent cases. 

Please give us a call at 203-853-1919 if you need an appointment

Some Administrative "Stuff": 

Telemedicine: Telemedicine continues, but there are changes that may affect you. During the COVID emergency, which officially ended 5/11/2023, HIPPA privacy regulations were not enforced, they could be enforced now. For telemedicine, we are now using an application called Doxy.me, which is HIPPA compliant - it's very easy to use; you'll get a text invitation on your smart phone, click the enclosed link and the telemed session is on. Other communication formats can be used, even if not HIPAA approved, if you agree to it. 

Telemed has been a very effective tool for many patients who could not, or did not have to, come into the office to be examined. I hope that the authorities (and insurance carriers) do not limit its use but, rather, encourage its use and rapid development of telemedicine to a greater capability. 

As of now, both commercial insurance and Medicare/Medicaid have been covering telemed face-to-face visits. Medicare appears to be committed to covering it through 2024, but I hope forever. 

Hours and communication: The office continues to be busy, but that has not diminished the attention paid to each patient's needs. The office continues to be a solo practice, not hampered by the many levels of large company administration. We continue to keep the usual Tuesday, Thursday AM office hours, but have extended them as the need arises. 

We try to answer the phone during daytime hours no matter where we are. If, for some reason, we do not pick up the phone, please be sure to leave a message so we can address your issues. Voice messages generally reach me also by email, which I check regularly. In addition, you can always reach me directly by email at istaw@drstaw.com. 

The COVID world: 

COVID: The US COVID emergency is officially over. But I'm not sure the COVID virus was notified. While the death rates have been declining gradually in the last few months, the last few weeks saw an uptick, with 1005, 944 and 614 in the last 1, 2, and 3 three weeks, respectively, as reported by the CDC (the same is seen nearly world-wide). While the cases are generally milder than what was seen with the delta strain (it's an XBB strain now), would still be careful to avoid exposure. Please report immediately if you, or someone with whom you've been in close contact, develop suspicious symptoms - especially if tested COVID positive at home. And don't forget to be vaccinated with the newly updated COVID vaccine, which was released a few days ago. 

The non-COVID world: 

Protein: There's no need to emphasize the body's need for an adequate dietary intake of protein. The protein we eat is broken down in the stomach to amino acids and then absorbed into the body through the small intestine. They are the building blocks of body structure and function, such as cell wall and its nucleus and enzymes. There are 20 amino acids used by the body, which can synthesize 11 of them on its own. But 9 amino acid are essential, the body cannot produce them on its own, they have to be available in our diet. 

Whole protein vegetables contain all essential AA's; the main ones are legumes (lentil, beans, chickpeas); tofu (it's soy-based); nuts and seeds, and whole grains (quinoa, brown rice, whole wheat - watch the last two if you have diabetes). 

In protein deficiency states, supplements will do. The good ones include casein and/or whey protein (they are dairy based). 

Need more information? You know how to reach me. 

Keto Diet: We get questions about the keto diet almost daily, mostly about its use for weight loss and weight management. So, what is it, and does it have any medical benefits? 

The keto diet is a low-carb, high-fat diet. It changes the way the body uses food to generate energy. Generally, most of the energy we use is derived from carbohydrates which turn into sugar in the body. When carbs are restricted, as in the keto diet, the body begins to use fat, in the form of keto acids, as its fuel. 

There are some advantages and caveats. The keto diet can bring about weight loss, mostly by extracting body fat and turning it into keto acids and by reducing appetite. It can be useful in certain medical conditions, including intractable seizures, better control of type II diabetes (it's the common type). Recent studies suggest that the keto diet slows down age-related mental deterioration. 

And there are caveats. The diet emphasizes fats. If not careful, one may be using a large quantity of saturated fats, usually found in high quantities in red meats and most processed meats. This may lead to an increase in cholesterol, with its heart disease risk, plus other medical risks. The diet is low in fiber and may cause digestive symptoms. 

I believe that most people on keto diet should minimize the consumption of saturated-fat foods and consider the use of a Medium-Chain Triglycerides (MCT) supplement. 

If you are on a keto diet, or are considering it, talk to me (don't get me wrong, I'm not pushing the diet). 

Periodic Health Evaluation: Most, if not all, insurance companies cover periodic physical exams or "periodic health check," at low, or no copay. Some even require it for continuation of care. In my view, expressed regularly, that is the gateway to better health, it's the time to assess your overall health, identify any health risks before they turn into disease, and eliminate or control them to the extent possible. Take advantage of it, and get an appointment! 

Vaccinations: Three vaccines you should consider getting very soon:

• COVID (the recently approved one, BXX, now it's the only authorized one), get it as soon as available in your area.
• RSV (Respiratory Syncytial Virus)
• Flu - mid October would be fine

Are you protected against shingles, pneumonia, or hepatitis B? Unsure? - talk to us. 

Please give us a call at 203-853-1919 if you need an appointment

Until next time, stay well, 


Igal Staw, Ph.D., M.D.
www.drstaw.com
istaw@drstaw.com

Internal and Respiratory Medicine | 2000 Post Road, Suite 202, Fairfield, CT 06824

Office Hours and Spring Notes

 

To My Patients,

emailed 5-9-2023

Hope all is well. It seems that spring has finally arrived.
The office has been very busy, and we opened extra hours on an as- needed basis.

The Covid emergency is officially over on May 11th. I'm not sure yet that the COVID 19 virus knows about it! It's still causing 1000-2000 deaths a week, and if you extrapolate this to the entire year, this represents the 9th most common cause of death in the US. At its peak, COVID was the 3rd and 4th most common cause of death in the two preceding years.

COVID-protecting masks are now optional in our office. However, we do require that you wear a mask if you were not fully COVID vaccinated, and also if you have certain COVID-related symptoms, regardless of your vaccination status.

We still request that you call the office as soon as you arrive in the parking lot, in attempt to minimize or avoid waiting in the waiting room.

More about the changes that the end of the COVID emergency will bring about, including changes to telemedicine - in the next letter.

Sandy and I will be away for almost 2 weeks, in Israel, beginning Wednesday May 17, back in the office on Thursday, June 1.

As usual, Janine will handle the phone, I'll be able to receive email messages. If necessary, Janine knows how to find me, and Dr. Sarfraz will cover me in urgent cases.

Please give us a call at 203-853-1919 if you need an appointment A couple of notes for spring:

Allergy: The allergy season is upon us. There are several things you can do before you have to make a trip to the office:

Flonase (fluticasone) and Benadryl (or a non-sedating antihistamine such as Claritin, Zyrtec) are over the counter and can be tried for nasal congestion and general allergy-related symptoms.

Astepro (azelastine) is a nasal spray antihistamine that recently became available over the counter.

If you have allergy-related asthma, don't forget to use your inhaler as instructed. These are prescription medications. If you're using them seasonally, make sure they are accessible.

Tick bite: The deer are out there, and so are the ticks. The most common tick- borne disease is Lyme Disease. But there are others, such as Ehrlichiosis and Babesiosis, and the treatment could be different from that of Lyme. It's therefore important to bring the tick, especially if the tick is blood-engorged, to the local Health Department for identification. And don't forget to let us know you've been bitten by a tick as early as possible after you realize it.

Keep your mind sharp: Spring is the greatest time to do so. Spend some time outdoors, exercise (nothing wrong with walking outdoors), eat well (which for most people is the Mediterranean Diet), and get enough sleep. You'll be surprised to see the mind-body connection.

Please give us a call at 203-853-1919 if you need an appointment Until next time, stay well,

Igal Staw, Ph.D., M.D.

www.drstaw.com Dr. Staw on Facebook 

istaw@drstaw.com