To My Patients,
emailed July3, 2026
I Hope all is well - as always, please feel free to share this newsletter with family and friends...
Summer is upon us, now in full force. I hope you are well and staying comfortable. Despite the heat, the garden is flowering. Like a human being, it needs love, attention, and steady care.
We have some happy family news. Our grandson Benjamin and Emily were married, and Laurie became a fourth-time grandmother to Ronen in early May. Our Colorado crew - Jeffrey, Amy, and their two children - are here for the traditional two to three summer weeks in Westport.
As for me, I recovered rapidly from rotator cuff surgery and was back in the office, with a sling, after only a one-week absence. Thank you for the many kind wishes.
I want to wish everyone a very happy and safe 4th of July holiday.
Please give us a call at 203-853-1919 if you need an appointment!
Administrative Notes:
The office continues to be busy during our usual Tuesday and Thursday morning hours, and even more so with telemedicine, especially during the usual after-work and early-evening hours.
Prior Authorization
Insurance requests for prior authorization are constantly increasing, and denials are becoming part of the norm. Where possible, we keep appealing until the medication is either approved or we have reached a true dead end. It is hard to imagine how time-consuming this process has become.
Insurance and Address
Please make sure that we have your current insurance information and address. This is particularly important; inaccurate information may result in medication delays, insurance denials, or reimbursement problems. You can update us by email at istaw@drstaw.com.
On the Medical Side:
Longevity Revisited
Life expectancy in the United States has improved again and is now about 79 years overall - about 76.5 years for men and 81.4 years for women. That is encouraging, but Americans still live several years less, on average, than people in many other wealthy Western countries.
Some have argued that this difference is mostly due to the diversity of the U.S. population, but that explanation does not fully hold up. The gap is seen broadly and appears to be strongly related to preventable and modifiable risk factors.
So why do Americans not live as long as they should? The answer is not one single disease or one single cause. Much of the problem appears to come from conditions that gradually damage health over many years: excess weight, poor diet, lack of physical activity, smoking, excessive alcohol use, diabetes, high blood pressure, high cholesterol, chronic stress, poor sleep, and delayed preventive care.
These are not easy problems to fix, but they are areas where steady, practical changes can make a real difference. That is the heart of longevity medicine: not chasing miracle cures, but reducing the risks that slowly shorten life and quality of life.
What this means in practical terms:
- Keep weight, blood pressure, blood sugar, and cholesterol in the best range possible.
- Make food choices that emphasize vegetables, legumes, fruit, nuts, whole grains when tolerated, fish, olive oil, and other Mediterranean-style foods.
- Preserve muscle and balance with regular walking, resistance exercise, and stretching appropriate to your ability, especially after midlife.
- Do not ignore sleep, stress, smoking, alcohol, dental care, hearing, vision, and routine preventive visits.
- Small changes, repeated consistently, usually matter more than dramatic short-term efforts.
A useful perspective: According to international life-expectancy rankings, the United States is not near the top. Countries and regions such as Hong Kong, Japan, South Korea, Switzerland, and others tend to do better. According to recent data, the United States ranks around 62nd among about 220 nations. The lesson is not that we can copy another country perfectly, but that prevention, healthier daily habits, and early attention to risk factors can add years of healthier life.
Our own calculations estimate that faulty lifestyles account for about 47 percent of premature death in the United States. This has not changed significantly in over 30 years. It is prime time for improvement!
Zepbound, Foundayo, Wegovy, and the New Medicare GLP-1 Bridge Program
Many patients have asked about Zepbound (tirzepatide), Wegovy (semaglutide), and the newer GLP-1 medicines for weight loss. Zepbound is a once-weekly injectable medication that affects appetite, fullness, and glucose-related hormone pathways. Foundayo (orforglipron) is the new once-daily oral weight-loss tablet.
These medications are not meant to be cosmetic medications. They are intended to treat obesity and to improve obesity-related health risks, including diabetes risk, blood pressure, fatty liver risk, joint strain, sleep apnea risk, and overall metabolic health.
A new Medicare pilot program began July 1, 2026. Under this program, some Medicare Part D and Medicare Advantage patients may qualify for treatment of obesity with selected GLP-1 medications, reportedly with a fixed monthly copay of about $50. The program is temporary and is expected to run through December 31, 2027 unless extended or changed.
Eligibility is not automatic. Prior authorization is required, and coverage depends on documentation of weight status, related medical conditions, and use of the medication together with lifestyle treatment, including diet and exercise. Some patients who already qualify for a GLP-1 medication through another Medicare indication, such as diabetes or certain cardiovascular indications, may need to follow a different coverage pathway.
The benefits can be significant, but there is no free lunch. Side effects may include nausea, reflux, constipation, diarrhea, decreased appetite, dehydration, gallbladder problems, and, rarely, pancreatitis. In older adults, rapid weight loss can also mean loss of muscle and bone unless protein intake and resistance exercise are emphasized. Steady, relatively slow weight loss, accompanied by appropriate muscle-sparing exercise, is usually the safer goal.
I look at these medications as part of a long-term metabolic plan, not as a short-term diet. The proper question is not, "Can I lose weight quickly?" The better question is, "Can we reduce health risk, preserve muscle, improve function, and maintain the benefit safely?"
Summer Poison Ivy: Prevention and Early Treatment
Summer also brings poison ivy. The rash is caused by urushiol, an oily resin found in poison ivy, poison oak, and poison sumac. The rash itself is not contagious, and fluid from blisters doesn’t spread poison ivy. Spread comes from residual urushiol oil on skin, fingernails, clothing, shoes, garden tools, gloves, pets, or outdoor furniture.
If exposed, wash the skin as soon as possible with cool water, soap or a poison-ivy cleanser, and gentle friction. Wash under fingernails. Wash contaminated clothing, gloves, shoes, tools, and outdoor gear. Dogs and cats may carry the oil on their fur even if they do not get a rash themselves.
Tecnu is a post-exposure cleanser designed to help remove urushiol oil from skin and sometimes from tools, clothing, and pet fur. It is most useful soon after exposure, before the oil has had time to bind firmly to the skin.
Zanfel is a wash/scrub product for poison ivy, oak, and sumac. Some patients report symptom relief even after the rash has started, probably by helping remove residual irritant from the skin surface. My own experience with Zanfel has been very good.
Neither product is a guaranteed cure, and neither replaces medical treatment when the reaction is severe. Plain soap and water are still valuable, especially if used early.
Please call the office if the rash is on the face, around the eyes, or in the genital area; if there is extensive blistering; if the rash is rapidly spreading; if there are signs of infection such as pus, increasing pain, fever, or expanding redness; or if itching is severe enough to prevent sleep. Some cases require a prescription-strength topical steroid or an oral steroid course.
Important to know: never burn poison ivy. Smoke can carry the irritating oil and may cause serious eye, skin, or respiratory reactions.
Closing Thought:
Good health usually comes from ordinary steps done consistently: prevention, early attention to small problems, better sleep, better nutrition, movement, strength, and thoughtful use of medications when they are truly helpful.
Please give us a call at 203-853-1919 if you need an appointment!
Have a great holiday weekend, family get-together, fireworks and all else (and don’t go overboard with those hot dogs).
Stay well and Happy Birthday USA!
Igal Staw, Ph.D., M.D.
www.drstaw.com
istaw@drstaw.com
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