To My Patients,
Hope all is well. It was crazy weather over the past few weeks - cold, warm, who knows! Stayed home, a good opportunity to get some paperwork done and do some writing.
Despite the recent cold weather, it's almost time to set vegetable and flower seeds for the spring. It would be nice to awaken the Canna plant from its winter sleep soon, it bloomed so beautifully last year.
Some things to know:
Please remember that we now send most of our billing statements by email rather than through the regular mail (saving some trees...).
Medication refill and new prescriptions
As of the beginning of the year many insurance companies made changes to their formulary ("allowable medications") and frequently require pre-certification and/or a change to what they consider an equivalent drug. Frequently you'll hear the pharmacist say, "all your doctor has to do is call the insurance company." Easier said than done. It causes unnecessary delays in filling new prescriptions, and, too often, denials. We do our best to overcome the imposed obstacles.
End of COVID emergency
The government announced that it intends to end the COVID public health national emergencies on May 11, 2023. This will most likely mean a loss of coverage, or a reduced coverage, for people who need to be tested or treated for COVID. The burden of coverage will shift from the government (that's who's fully paying for it now), to the insurance companies, who may then shift a portion of the cost to the insured, you.
I believe that this will cause unnecessary delays in COVID diagnosis and treatment and may put an additional burden on the emergency rooms, thereby increasing medical spending.
Telemedicine continues full speed. But the end of the COVID emergency may bring with it a change in telemedicine insurance coverage. I hope the those in charge have enough sense to continue, and expand, telemedicine coverage, and to make it attractive for industry to develop more-sophisticated home monitoring systems. If done, this could help bring the cost of medicine down, and make many areas of medicine more readily available to the patient.
Now, some real medicine:
Connecticut is one of 22 states with no known recent COVID deaths (none in approximately 5 months in Connecticut!). But the disease is still with us, we're dealing with it on an almost-daily basis. Prevention and treatment are working better now, aided by the decreased virulence of the most recent COVID variants.
Approximately 70% of Americans are fully vaccinated against COVID. An impressive number, but not enough for herd immunity. We can't let our guard down, or the disease will spread again. Remain cautious.
What about fatty liver?
As the name implies, a fatty liver is a condition in which our liver cells accumulate an excessive amount of fat. Experts claim that almost 40% of American adults have a fatty liver. If ignored, it can progress to fatty liver disease, which can be very dangerous. Having no symptoms in the beginning, it's really an American silent epidemic.
There are two types, AFLD and NAFLD (alcoholic and non-alcoholic liver disease, respectively).
The treatment of alcohol-related liver disease, in its early stages, is rather intuitive - but it's not always easy to get off the stuff. I won't elaborate.
According to the Cleveland Clinic, nonalcoholic fatty liver affects approximately 37% of American adults (it's the most common chronic liver disease worldwide). It can progress to an inflammatory liver disease and fibrosis, then cirrhosis. In some cases, it can give rise to liver cancer.
People at highest risk for NAFLD are the obese, and those with type 2 diabetes (the common type). Other risk factors include sleep apnea, hypothyroidism, and genetic factors.
Diagnosis is usually fairly easy (abdominal ultrasound, blood tests for liver function) but, in most cases, treatment is mostly up to you - it's the "good life therapy" of minimizing alcohol consumption, weight loss, and a rigorous routine of exercise. The Mediterranean Diet is very helpful.
Treatment of NAFLD should be followed medically in the office, with advanced disease followed by a specialist.
Need a copy of the Mediterranean Diet (as a diet lifestyle)? Let me know, you'll get it by email.
The vaccine is routinely recommended for people over the age of 65, and for people over the age of 19 who have certain chronic diseases or may otherwise be susceptible to the development of pneumococcal pneumonia. The guidelines were updated recently and made much simpler to follow. The vaccination my consist of either one or two shots, depending on past vaccinations, and may have to be given 8 weeks or one year apart, depending on the type of vaccine used.
If you have any questions about this important vaccine, please contact the office or send me an email.
Until next time, stay well,
Igal Staw, Ph.D., M.D.
2000 Post Road, Fairfield CT 06824