Still Offering Virtual Visits & more Topics - emailed 4/19/2020

To My Patients,

Much has already been said about COVID 19, which is still with us, so I'm not going to add much to the conversation today. It is time to start thinking beyond COVID too!

I have been keeping the office closed (except for very few, exceptional, cases), and doing all I can to answer our patients' needs through telemedicine (FaceTime for iPhones, Zoom for Android-based phones). Telemedicine is still in full swing, if you'd like an appointment, just give us a call at 203-853-1919 - The process is so easy!

The few patients who tested positive for the COVID 19 virus where symptomatic but not very sick; they were treated and did very well.


As We Look Beyond COVID 19:


Weight Gain.
Many of our patients are doing work from home, and are now not up to their usual physical activity. Their main complaint is weight gain. It's not easy to control noshing while at home. A little bit of willpower will do, but activity will do even more. There are many home exercise programs that do not require special equipment and, as I mentioned in a previous email, the Royal Canadian Air Force Program is still one of the best.

Worried about Alzheimer's Disease?
There is no known cure for Alzheimer's disease, but there are lots of over the counter preparations touted to be helpful (the majority worthless), and many healthy life styles that may help in prevention; see my brief review in a previous letter, available on my blog.

Recently, researchers at Rush Institute for Healthy Aging found that diets rich in specific flavonols were associated with a 48% lower incidence of Alzheimer's. The richest sources of these flavonols are common foods, mainly Kale, beans, spinach, apples, tomato sauce and olive oil. And some tea doesn't hurt either. Isn't this what we thought all these years? Yes. But it's nice to know!

Hypertension.
High blood pressure is a known risk for the development of premature heart attacks, strokes and kidney failure. It turns out that having your blood pressure checked at the doctor's office is not enough. If you have, or are suspected of having high blood pressure, it's very important that you check your own blood pressure at home. Some home devices are notoriously inaccurate (and I don't trust readings at the supermarket either...), but others are good, automatic, and keep records (I don't want to make waves by mentioning names here...). Regardless of what you get, the BP machine should be checked against a Mercury sphygmomanometer like the one we use at our office. Need a recommendation or calibration? Contact me.

But that's not the entire story. Blood pressure can fluctuate widely throughout the day. This may sound unintuitive, but BP may be highest when you wake up in the morning (sometimes referred to as "the morning surge"), and then may change with mood and activity.

All of this is very important information which is not available from a simple BP measurement at the doctor's office.

So, when BP is a potential problem, make sure you have a reliable BP machine. Check your blood pressure at different times of the day and under different situations. Above all, discuss your finding in person (or maybe Facetime) with your choice of physician so you don't carry the risks associated with high BP.

Until next time, keep safe distance and stay well, and until we're COVID-safe, see you on the phone!

Igal Staw, Ph.D., M.D.
www.drstaw.com
www.twitter.com/drstaw

Corona Update - Virtual Visits are Working - emailed 3/23/2020

To My Patients,  Hope you're well, keeping your distance, and avoiding contact with objects that could be contaminated by COVID 19.  Staying at home can be so boring...  Send me your ideas and pictures of the projects that keep you busy; with your permission, I'll share them with the rest of our patients!  Telemedicine Is Here! Virtual Office Visits via Video are Now Available Just Call 203-853-1919 or email istaw@drstaw.com to Set Up an Appointment!  We have minimized our office hours to the bare necessities, seeing some patients only when absolutely safe and necessary.  All the rest is done on the phone (I actually use my iMac most of the time), using FaceTime for those who have an iPhone, and using Zoom (click here for the Android app) for those who have an Android-based phone.  If you have an iPhone, there's nothing special for you to do, I just call you and turn on the FaceTime option.  If you have an Android phone, please download the Zoom app. When I call you, you'll receive an email invitation on your phone to "join the meeting." Accept it by clicking the link on the email invite. It's easy!  Please note: Insurance companies, including Medicare, will cover the cost of the telemedicine call; no copay. This will last at least until early May.  Another note: You can now use telemedicine for any medical issue, not just Corona virus issues.  Please continue to follow the general guidelines for corona precautions. But in addition, I urge you to get tested as soon as any symptoms appear, or if there's a suspicion of contact with an infected person or material. You may want to leave your mail or even grocery foods untouched in a safe place for two days before opening. Use gloves when necessary and change them frequently.  Above all: follow your sense of best, safe behavior!!!  Looking forward to seeing you in person, not just on the phone - as soon as the "storm is over."  Igal Staw, Ph.D., M.D. www.drstaw.com www.twitter.com/drstaw Dr. Staw on Facebook

COVID Update and Virtual Visits - emailed 3/20/2020

To My Patients,  The temperatures outside are rising and spring is here, but COVID 19 is still with us. As a primary care and pulmonary physician with many respiratory patients, I'm taking the present situation very seriously.  In an attempt to prevent the spread of disease, I've decided to temporarily reduce office hours.  Instead, we'll conduct "virtual visits" by smart phone - remember to smile, we'll be seeing each other on the phone. Here is what you need to do:  Call the usual telephone number, 203-853-1919. We'll tell you how to proceed. When you leave a message, don't forget to leave your telephone number. we'll respond as soon as possible.  Contact me by my personal email (as many of you have been doing all along) - istaw@drstaw.com.  If it's imperative that you need to be seen, we'll make special arrangements for that when we speak with you.  Routine medications will be refilled as usual, but in certain cases we'll do a virtual visit before renewal. Above all, adhere to the official guidelines, avoid potentially harmful contacts, and keep social and reasonable distance.  If you develop a fever, cough, shortness of breath or any other "suspicious" symptoms, call immediately - don't wait.  If you need a breath of spring air, walking outdoors is good. Just keep your distance. If it's still too chilly, exercise indoors; the Royal Canadian Air Force Exercise Plan (developed in the 1950's) is an excellent way to do it, you can find it on the net.  Stay well and away from crowds. See you on the phone,  Igal Staw, Ph.D., M.D. www.drstaw.com www.twitter.com/drstaw Dr. Staw on Facebook

More Coronavirus Info - emailed 3/8/2020

To My Patients,  Welcome to daylight savings time (hope you remembered...). We're back in the office from Denver, had great weather, enjoyed the family!  The Coronavirus calls are coming in daily; some are worried, others just looking for information.  As mentioned in last week's letter (now on my blog drstaw.com), and I re-state it here, follow the CDC guidelines as stated on their website.  We are taking special precautions in the office (in addition to the usual measures): Our patients will bypass the waiting room. Call before you get into the office; you can do it from your car in the parking lot, and we'll give you instructions: 203-853-1919.  We will not "overlap" patients, so that patients are separated from each other in both office space and time. But equally important is that you stay in the best health you can.  Make sure that: You've had your flu vaccine and, where indicated, the pneumonia vaccine.  Every acute respiratory illness is looked at.  Any chronic medical condition you have is optimally treated. This includes conditions such as asthma, COPD, diabetes, heart disease, hypertension (and many others), and many others.  If you're on immune suppressing medications (e.g., certain biologicals, long term cortisone therapy, chemotherapy), be even more vigilant.  Get enough sleep and do what you can to reduce stress, your immune system will thank you for it. If you have any questions or concerns about prevention or health optimization, call 203-853-1919 or email istaw@drstaw.com.  Please be reminded that we now participate in more insurance plans, including: Anthem/Blue Cross (including Emblem)  United Health (including Oxford)  ConnectiCare  Aetna  Medicare/Medicaid (including most Advantage programs)  There is no reason to panic, but there's all the reason to avoid risky behavior.  Stay well!  Igal Staw, Ph.D., M.D. www.drstaw.com www.twitter.com/drstaw Dr. Staw on Facebook

To My Patients - emailed 3/1/2020

Greetings from sunny Highlands Ranch, Colorado. The skies are really blue, the snow crested mountains are great, and all is well with the younger generation.  I keep getting questions about the Coronavirus. While there's no US epidemic at this time, precautions are in order. There's no need to repeat here what has been recommended by the CDC on their website.  However, at the office we may need to go beyond the usual recommendations, but certainly not to panic.  If you feel that there is a chance, even a very small one - or you're not sure - that you may have been at risk for exposure to the Coronavirus, then: Make sure you follow the CDC guidelines.  Call about 30 minutes before arriving at the office (even from the parking lot), so we can take appropriate measures and give you additional instructions. Above all, don't panic; call or email if you have any questions, we're back in the office on Wednesday (but feel free to call us sooner).  Stay well!  Igal Staw, Ph.D., M.D. www.drstaw.com www.twitter.com/drstaw Dr. Staw on Facebook