To My Patients,

Emailed 8/16/2020

Hope all is well. COVID-19 is still with us, but life must go on. I don't expect any miracles, but a good COVID 19 vaccine will go a long way toward easing the problem - we'll be sure to keep you updated on any new recommendations when they are available.

** Office Visits - Virtual and In-Person
We are still on "COVID schedule." We see patients (who are not COVID-suspects) on Tuesdays, and usually also during part of Thursdays. The rest of patient-care time is spent doing virtual visits using FaceTime or Zoom.

Medicare announced that they will continue to support virtual visits and phone follow-ups until the end of September. Most insurance companies have followed suit.

Please give us a call if you need a virtual or in-office visit, we don't want separation to be the cause of any unnecessary illness - (203) 853-1919.

I hope that insurance carriers, including Medicare, will come to their senses and realize that virtual visits, as an aid to, and sometimes a replacement of, the traditional office visit does work. There is no doubt in my mind that, done correctly, this can help reduce the cost of medical care, and in many cases improve the quality of medical care.

** More Insurance Accepted
Good news for our ConnectiCare patients who are on the Access or Exchange program (that's the Affordable Care Act side of ConnectiCare insurance). We now participate in that program. All you are responsible for is the copay, deductible and, in rare cases, uncovered services.

** Back to Medicine
While staying home much more of the time these days, I hope you didn't fall into the trap of reduced exercise, consuming more unhealthy foods than you should, and gaining weight. There's so much you can do for yourself even if you feel bored staying home. As I have mentioned in the past, the Canadian Royal Mounted Police exercises have stood the test of time, and much of it can be done at home. The internet is loaded with appropriate demo's and instructions.

But for some people there could be a different reason for weight gain, and that is the medication you may be taking. Examples include some antidepressants, epilepsy and blood pressure medications, steroid hormones (e.g. prednisone), birth control pills and insulin. Don't just stop taking any of these medications, but knowing about this potential side effect may motivate you to do more to control excess weight, and to discuss the possibility of a medication change with your physician.

** Back to COVID
While some people in our patient community did contract the disease, many were mildly symptomatic. None required hospitalization, and we haven't lost anyone. I hope you're watching yourselves carefully, and help maintain the good statistics. If you have any questions, feel free to call!

Until next time, stay safe and stay well!

Igal Staw, Ph.D., M.D. 

To My Patients

Emailed 7/19/2020

Hope all is safe and well.

COVID 19 is still with us; it has changed everyone's life, and I believe that it will continue to make a life-changing impact for years after its defeat.

It has also changed the way medicine is practiced throughout the US and the world and, of course, in our practice.

We have been doing telemedicine, or virtual office visits for close to 4 months, seeing non-COVID patients in the office as the need arose.

Beginning this Tuesday, July 14, we will begin to see patients on a more regular basis on Tuesdays, staying in the office as long as necessary. We may soon add another day. Janine will be with us during open days.

We expect that most visits will be for complete physical exams with emphasis on health maintenance and the reduction of health risks.

Needless to say, you always want to be is in the best health you can be, but especially so at the time of the pandemic.

To reduce your risk of COVID exposure, whenever possible we'll draw blood in the office; you will not have to go to the lab for blood testing.

At this time, we will not be able to see in our office patients suspected of active COVID 19 infection.

Safety above all. At appointment time, don't come directly to the office. Call us from the parking lot, to make sure that the exam room is ready for you. You'll be reminded to come through our back entrance, bypassing the waiting room and not contact with other patients. The number to call is 203-853-1919 (our regular office number).

Virtual visits will continue as before. They are by paid for by Medicare and commercial insurance (usually minus the copay and deductibles).

As of the time of this letter, telemedicine is expected to continue through September 2020.

Until I see you in the office or on the phone, keep a safe distance, stay safe and stay well!

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

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