More about Insurance and Post-Holiday Hours

To My Patients, 

Emailed before Thanksgiving 2019

Hope all is well. Ready for the Thanksgiving holiday, and the winter after that? Enjoy your Thanksgiving meal, eat well, but eat smart too! 


→ A Couple of Announcements

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Communicating with our office.
During off hours, when we don't answer the phone personally, you can always leave a message. Your voice message reaches me by email. I can also be reached directly by email at istaw@drstaw.com. 

An exciting weak with the grandchildren.
We'll be away the week after Thanksgiving, in Disney (Orlando) with our younger son and daughter in law and, of course, with the "young ones," - their first Disney visit. 

We'll be back in the office on Monday morning 12/9/2019. During that time, Janine will be in the office part of the time, and I will still be available by email. 

If you need anything before, we leave, or have upcoming medication renewals, please let me know as soon as possible. 

Medical insurance.
We now participate in the following insurance plans:

• Medicare, including most Medicare Advantage plans 
• Aetna 
• ConnectiCare 
• United Health Care 
• And the most recent addition: Anthem and its affiliated plans (e.g. Empire Blue Cross)

→ A Touch of Medicine

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Shingles.
The Shingrix immunization vaccine (a 2-shot sequence, spaced at least two months apart) is recommended for people over the age of 50 (even if you took the "old" injection more than 4-5 years ago). The vaccine is much more effective than the old one, and is particularly important for the elderly, who are much more susceptible to shingles and its complication with advancing age. Highly recommended. 

Alzheimer's revisited.
Approximately 5.8 million Americans have Alzheimer's disease, the vast majority over 65 years old, but the disease may take many years to develop, with only minor symptoms that may not arouse any suspicion. 

A common question asked by patients is "Do you think I'm developing Alzheimer's?" Some are scared just of the thought of Alzheimer's, especially if it affects someone close to them. The answer is not always easy and may not be reliable without extensive testing. Since there's no cure at this time, it may be more important to do what you can to prevent or delay the onset of the disease. 

Some of the main risks of developing Alzheimer's, and related forms of dementia, include: Genetics (relatively rare!), smoking, diets high in saturated fats, excess alcohol intake, sedentary lifestyle, and lack of social interaction. 

What are some of the recommendations to decrease the chances of developing premature Alzheimer's/dementia?

• Tobacco: If you do - don't
• Exercise. If you don't - do. Exercise regularly (a good regimen is 150 minutes a week, 30 minutes 5 times a week).
• Eat a "Healthy diet," e.g. Mediterranean, low saturated fat, low in "fast carb's" (low sugar, white flour products).
• Be socially active: friends, family, or other social networks (and I don't mean the internet).
• Keep your brain active. Puzzles, word games. Challenge your brain.
• For diabetics: Keep your blood sugar under control. It's not only the fasting sugar, not only the A1C, but it's important to keep the blood sugar from spiking after meals.
• For people with high blood pressure: Keep it under control to minimize cerebrovascular complications.
• Coffee. Believe it or not, "reasonable" amount of coffee (even decaf) may help (usually no more than 4-5 cups a day).
• Cholesterol. If not within acceptable limits, Statin drugs may help.
• Supplements (Gingko Biloba and others): None has been proven in controlled studies to be effective. However, some non-controlled observations seem to show that MCT oils (medium-chain triglycerides) may help in treatment and prevention.
• For people with a genetic predisposition to dementia: the recommendations are still valid!

If you have any questions, feel free to call the office or contact me by email. If you're concerned about having diabetes or you think you may be a prediabetic (especially it there's a family history of diabetes), don't wait, call, it's an easy test. 

So, like in many other medical conditions, we're back to the issue of lifestyle, and maybe medication... 

Confusing? Need to know what is the right move for you? Don't hesitate to ask next time I see you, or email. 

Stay well and have a great Thanksgiving, 

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

Some Announcements and More Insurance Information

To My Patients, Hope all is well. Are you preparing to "winterize?" That snow and ice will be here before you know it! → A Couple of Announcements We will be away for a few days, Wednesday 10/30 through Tuesday 11/5/19, back in the office on Wednesday 11/6. We'll be visiting our son and his family in Denver. The "little ones" (not so little anymore) are anxious to surprise us with their Halloween costumes. Janine will be in the office during most of the time. At others times, please leave a voice message or send me an email at istaw@drstaw.com and we'll get back to you as soon as possible. Our practice now participates in the following insurance plans:       - Medicare (including some Medicare Advantage plans)       - Aetna       - ConnectiCare       - UnitedHealth Care (includes Oxford) It's time to make that appointment you've been putting off, give us a call today! → Diabetes and Pre-Diabetes, Here We Go Again It is estimated that 30.3 million Americans (close to 10%) have diabetes; one fourth of them don't even know it. In addition, an additional 70 million (24% of the population) are prediabetics, and almost three fourths of those will develop diabetes. If you were to break down the percentages by age groups, seniors over 65 years old fare the worst. I need not tell you about the potentially devastating health risks and consequences of diabetes, but I must emphasize, again and again, that good control of diabetes will markedly decrease the chance of complications. Good control is not limited to just having a normal fasting blood sugar and an acceptable A1C. Good control also implies a normal blood sugar "spike" after meals, and it implies controlling other associated risk factors such as hypertension, hyperlipidemia, overweight, sedentary lifestyle, and a general state of inflammation in the body. There is no "one answer fits all" to the control of diabetes; the answer has to be tailored to the individual patient. I spend much of my time in the office doing just that. Prediabetics generally have no specific symptoms. The diagnosis becomes apparent at time of routine blood work, usually during a periodic physical exam or insurance-related blood work. New onset diabetes frequently presents itself as unexplained thirst, frequent urination and weight loss, together with a general feeling of "not well." It's usually prediabetes that's gone unchecked for too long; I'm sure you'd prefer not to be there. If you have any questions, feel free to call the office or contact me by email. If you're concerned about having diabetes or you think you may be a prediabetic (especially it there's a family history of diabetes), don't wait, call, it's an easy test. → Flu vaccine 2019 It's time to get the flu shot. Judging from this year's Australian experience, the flu season will hit the US earlier and perhaps harder than last year - and last year was a particularly bad flu year (79,000 deaths by CDC estimates!). Make sure you get the quadrivalent vaccine (the one with four antiviral components), not the trivalent one. According to the CDC, if you have the "common" egg allergy (itching, hives), you can still get the flu shot just like everyone else. But if you have more severe symptoms than hives, the flu shot should be administered only in a medical setting that can handle complications. You can get the flu shot in most pharmacies, just let us know you got it, for the record. We DO have a small quantity of flu vaccine in the office for those who prefer to get it here - let us know if you want it before our supply runs out. → What About "Dr. Google?" Almost everyone browses the net for medical information, nothing wrong with that. The more information you have about a medical issue, the better it is. But the information has to be reliable; the net has a lot of good information, but it also has an enormous amount of misinformation, and sometimes this is outright dangerous. Look for medical information on trusted sites, like those listed below. Be suspicious of information not based on scientific studies, those based on individual or anecdotal experiences, and on lengthy infomercial-types meant to sell worthless products. In doubt? I'll help you decide. Some acceptable sites for medical information include: Johns Hopkins https://www.hopkinsmedicine.org/patient_care/conditions_treatments.html Harvard https://www.health.harvard.edu/ Mayo Clinic https://www.mayoclinic.org/diseases-conditions Medscape https://www.medscape.com Take care of yourself and stay well and stay well, Igal Staw, Ph.D., M.D. www.drstaw.com

Medicare and Anthem are Back

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To My Patients,  Summer is coming to an end soon; hope you had a chance to take some time off. The gardening season had a late start this year, but things are in full bloom now. Earlier this summer, we had our youngest grandchildren and our daughter in law (the Colorado gang) with us for 5 weeks - it's too quiet around our house now...  → To Our Medicare and Anthem (Blue Cross/Blue Shield) Patients We are now participating in both Medicare and Anthem insurance! We also continue to participate in ConnectiCare.  I will continue to concentrate on disease prevention, early detection, and the identification of health risk factors. The idea is, as it has been, to reduce or eliminate those risk factors in order to reduce the chance of developing major disease.  → Vaping 2019, Is It Safe? Not a day goes by without someone asking me about vaping or e-cigarettes.  When e-cigarettes first became popular, more than 10 years ago, I thought it was a good idea. People who smoke would switch to e-cigarettes in an attempt to quit smoking, or at least in an attempt to reduce the carcinogens they were inhaling from regular cigarettes.  But the idea was hijacked. Now it's not just e-cigarettes, it's a vaping epidemic, and much of it is dangerous, and it's a big business.  Vaping is no longer "just an attempt to stop smoking." The amount of nicotine inhaled can be much higher than regular cigarettes, carcinogenic formaldehyde could be inhaled if the device is malfunctioning, toxic flavorings (containing diacetyl) have been linked to a serious lung disease (bronchiolitis obliterans).  But most importantly, vaping has been taken up by non-smoking young children, down to the primary school level. Their lungs and brains are still developing, and they are much more vulnerable to vaping effects than adults. Major adverse behavioral changes in teenagers have already been documented, and it appears that these changes carry into adulthood, and could be permanent. Vaping is a gateway to nicotine addiction and to the introduction of other harmful substances (particularly high potency marijuana-THC), especially at a young age.  So, what's the verdict?  I still think that, if you are an adult smoker who wishes to use e-cigarettes to wean off regular cigarettes, it's a useful tool if used as directed.  If your kids are using it, educate them. Do all you can to help them stop and make sure you don't enable them (sometimes without recognizing it). Remember that e-cigarettes come in small packages and can easily be hidden from sight.  He who has health has hope, and he who has hope has everything - Arabian proverb.  Stay well,  Igal Staw, Ph.D., M.D. istaw@drstaw.com

To My Patients,

(emailed 12/11/2018) 

Hope all is well. It seems that winter is inching in, and with it the usual December parties and family times. Take advantage of what you can, For Sandy and me, there will also be some fun and relaxation time. 

We'll be out of the office from Tuesday, December 18, until Monday Morning, December 31 (yes, we'll be there New Year's Eve from 8:30-2:00). In our absence, Janine will be in the office during the usual hours and Dr. Sarfraz will cover me. If you need anything before we leave, please me know as soon as you can (call right away!). 

For the curious ones, we'll be visiting with our daughter, Laurie, and her children in Chamonix, France. 

I have some suggestions and caveats: 

→ Food

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Do you find yourself at a gathering, eating just because it's there and just because that's the thing to do? It does take a lot of will power, but all you have to do is "slow down." You can easily decrease calorie intake by 50%, and you'll have so much less to worry about. You can also "bank calories." If you think that you'll be caught in an overeating situation, cut down on your usual portion sizes for a day or two before the event. You'll thank yourself later for doing so. 


→ Physical Activity

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There's no need to stop exercising just because it's cold outside. You don't even have to go to the gym! Jogging in place, light or moderate weight lifting and stretching can all be done at home with minimal or no equipment. Need more detail/information? Just contact me, and I'll tell you everything you want to know! 

Want to see an oldie but goodie home exercise program? It's the program that got exercise going in the US, started by the Royal Canadian Mounted Police more than 50 years ago. Spend 12 minutes on the link, you'll be amazed. 


→ Flu Shot

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Have you gotten yours yet (no excuses please)? Your chances of getting the flu and its serious side effects will be reduced, same for those who are close to you. For those worried about flu vaccine safety because of the preservative thimerosal, it will please you to know the single-vial vaccine, does not contain thimerosal. That's what we use. Regardless, always check the label. There's still time to get your vaccine, don't wait until it's gone! 


→ Winter Asthma?

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Inhaling very cold air may increase asthma symptoms and actually cause an asthma attack in susceptible persons. To play it safe in cold weather, cover your mouth with a scarf (or ski-mask). This will warm the air you inhale and lessen the chance of exacerbation. If you're on asthma medication, continue to take it unless instructed otherwise. 

Sandy, Janine and I wish you a very happy holiday. 

Stay well, 


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

To My Patients

We've Got Flu Shots, and a Little Bit on Turmeric

(Emailed 10/29/2018)

Hope all is well. I haven't written to you in a while, so I decided it's time for a communications reboot! 

With summer over and the cooler weather setting in, don't forget that it's "allowed" to exercise indoors; don't let the cooler weather become an excuse for sedentary life - walk and move - no matter where, it's good for you! 

I am not the only one to have had cataract surgery at our house recently. Sandy had her second eye done earlier this week, and we can now see each other (no comments, please...). 

Now, what's medically important these days? 

→ Have you gotten your flu shot yet?

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Now is the right time. All person's over the age of 6 months (with very few exceptions, such as certain immune issues or life-threatening egg allergy) should be vaccinated yearly. If you are older than 65 years, the CDC recommends that you get the "enhanced" vaccine. There are several types of flu vaccine but any one of them is acceptable. I prefer the quadrivalent over the trivalent. 

Most pharmacies now administer the flu vaccine, but you can get it in our office too!Give us a call and we'll be happy to set up your flu shot. 


→ What should you do if you get the flu, or even think that you're getting the flu?

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Several medications are available to treat the flu, the most familiar of which is Tamiflu. But remember, this is not a substitute for the flu vaccine and, to be effective, it has to be taken within the first 48 hours of the onset of symptoms. 

If you have, or think you have, flu symptoms, call immediately! 


→ A little about organic food

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A recent article in the respectable JAMA Internal Medicine suggests (but does not yet definitely prove) that eating organic foods such as fruits, vegetables and dairy products, decreases the risk of certain cancers (mainly postmenopausal breast cancer, non-Hodgkin lymphoma and other lymphomas). The higher proportion of organic food in your diet, the greater the benefit. 


→ What about turmeric/curcumin?

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I get questions about the use of turmeric supplements, the dried powdered root of the Curcuma plant, almost daily. It is used in Ayurveda, the East Indian Medicine, to treat arthritis and abdominal issues such as indigestion, ulcerative colitis and some potentially precancerous colonic ulcers. Some research even suggests a cognitive benefit. Its most important component is curcumin, which acts as an anti-oxidant and anti-inflammatory agent. It's not a cure-all but may help especially when combined with conventional medical therapy. Turmeric/curcumin can interfere with other supplements or prescribed medication (most importantly blood thinners) and is best absorbed when taken together with fatty food (not the "bad fat," of course) and, believe it or not, black pepper. If the preparation is made with a "bioavailability enhancer" then it can be taken alone. 

Any questions, please feel free to call or email. More about food and supplements in the next letter. 

Stay well, 


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