House Calls

House Calls Started This Year

House calls are meant for patients who are temporarily or permanently home bound, or for other good reasons can't make it into the office.

To schedule a house call: Tel (203) 853-1919; email istaw@drstaw.com

Tuesday, October 5, 2010

Avoid those extra winter pounds

Winter is approaching, and the natural tendency for many of us was to stay indoors. For many of us, lack of activity and overeating follows, and the result is those frustrating extra winter pounds.

Weight gain is not only a medical issue. Sure, there is an increase chance of diabetes, high blood pressure, accelerated heart disease, joint pain, and many other medical conditions. But also important are the social, financial and psychological aspects of overweight. Thin and fit is still the general desire of most people. Some of us would become depressed over gaining weight and the inability to lose it, and others would feel that they lost a promotion opportunity because of it. Very few of us would enjoy buying a new, larger wardrobe, or the inability to fit into our summer vacation clothing.

So what are you going to do about it?

Losing weight is a full time job; you have to be aware of your goal at all times. Some of us can do it without much help. Decrease food portions, decrease fat intake, increase exercise --- the usual steps --- works. For others, professional help is a must.
Professional weight loss focuses on the entire person and his/her needs, and includes:

Establishing realistic goals. The ultimate goal of weight loss has to be a target weight that can be both achieved and maintained. This target weight may not be immediately identifiable, but becomes apparent as you work with your health care provider.

Portion control. Both the portion size and content of the food you consume need to be controlled and monitored. Accurate record keeping, while tedious, is extremely important. Your ability to keep records is a good indicator of how successful you'll be in controlling your weight.

Increase in exercise. Exercise helps burn excess calories, but don't count on exercise alone to reach your target weight. Cardiovascular exercise is best, but stretching and muscle strengthening are very important. Exercise at least four days a week, don't be a weekend hero. Special testing before taking on a rigorous exercise program is advisable, talk to your doctor.

Use of appetite suppressants when appropriate. The days of fen-phen long gone, but other medications are available. Stay away from over-the-counter preparations and "miracle drugs," they can be harmful, and, at best, you'll waste your money.

Use of meal replacement. Low calorie meal replacements have been available in super markets for several years. Others, of much higher quality, are available through some physician offices, including ours (e.g., HMR products). These products help in portion control and record keeping, and may keep you from binging.

Treatment of depression. Depression is frequently a cause of weight gain, and if it exists, it must be addressed.
What about weight loss spas? Many of them are very good, effective while you're there. But when you're back at home, you may still need to consult your health care professional.

When addressed correctly, overweight is manageable. And when you need professional assistance, go with those who will focus on your overall medical needs, not just weight loss. We're here to help!

Saturday, September 18, 2010

Our Medically Supervised Weight Loss Program

The terms overweight and obese often trigger anxiety and frustration. Weight is a part of our personal self image, and an integral part of our well being. When weight is not under control, distress occurs, and poor health may soon follow. Americans have begun placing a great deal of importance on the "ideal weight" and many have gone to extremes to achieve it.

 Our three decades of experience in weight management have shown that there is no single formula that fits everyone's needs. Weight loss programs have to be individualized; they must be designed to meet your individual needs. Genetics and personal habits must be taken into account in order to form a personal program that will help you achieve your desired goal.
We start our weight loss program with a thorough medical evaluation of your needs and your weight gain triggers. It includes a measurement of your daily caloric requirements and body fat analysis with the use of specialized equipment.
 

  Weight control is achieved through several methods, sometimes alone and often in combination, depending on your needs. A suitable program may include:

  • Ways to achieve portion control
  • Meal replacement options
  • Appetite suppression
  • Exercise capacity measurement and exercise prescription
  • Stress management
  • Chinese and herbal medicine methods

 Whether your reason is medical, cosmetic, or both, we can help you lose weight safely and maintain your weight loss over the long run!

  To find your Body Mass Index (BMI), look at the BMI calculator on the left hand column.

Thursday, September 16, 2010

Your weight - setting realistic goals



Have you been repeatedly frustrated with your weight management efforts because you were not able to reach or maintain your goal weight? You may have been setting unrealistic goals for yourself, based on an “ideal of slimness” that comes from society.

Popular magazines and commercial diet programs still show you pages upon pages of beautiful, ultrathin models, many of which have been carefully touched up to make the models appear even thinner than real life. You may be comparing yourself not only to a model, but to an unreal model.

And then there is the Barbie doll. Barbie has the features of an anorexic person, but she still is a child’s role model. Her message is “if you get the body, you can get the guy.” Junior high and high school girls have described the ideal girl as 5’7”, 110 pounds, size 5, long blond hair and blue eyes. TV still shows the slim as the ones that are popular, successful and happy.

The ads keep you aware of how far from their ideal you are, and promote the feeling of failure. It is not surprising that we set goals that are not reachable or maintainable. Nor are they desirable.
The flip side of the drive to become slim is the continuing expansion of the fast food and the sweets industry. Advertising associated with this drive are directed at your emotions. They make it hard to resist unhealthy foods, and they confuse people. You feel guilty if you eat the advertised food, and deprived if you don't.

How can you develop realistic goals? Here are practical considerations:

• Slimness is not the only goal. Other health issues are just as important, including the maintenance of normal cholesterol, blood pressure and glucose levels, smoking cessation, stress management, and regular exercise.

• Your personal weight history and physical activity history should be taken into account. If you are a forty-year old woman who weighed 100 pounds when you were running track in high school, then 100 pounds might not be a realistic goal now.

• Metabolism slows with age. If you continue to consume the same amount of food as you become older, there will be a gradual weight gain throughout adult life. Frequently, you can compensate for this decrease in metabolism by increasing your physical activity.

• Metabolism slows with weight loss. When you are thinner, you require fewer calories to maintain your weight. Again, an increase in physical activity may help significantly.

• The ideal body weight, frequently determined from Life Insurance tables, is neither a good measure of your body fat, nor the best measure of the medical risk of obesity. Body mass index (calculable from your height and weight), the waist hip ratio, and body fat measurement by electrolipoanalysis, are much better ways by which to assess your appropriate weight.

When setting weight goals for yourself, remember this: don't compare yourself with someone else. You are an individual and your body likely behaves differently from someone else's body. When losing weight, make sure you exercise regularly. Feeling good and obtaining the benefits of healthy lifestyle changes is the real goal.

Thursday, July 1, 2010

How do we handle emergency calls?



I hope you're having a great summer. I am trying to make the best of the warm weather by getting outside and exercising as much as possible. I hope you the same

I would like to make you aware of an important change in the way we now handle off-hour telephone calls.

As of June 21st, we stopped using our antiquated answering service. Instead, you can now leave a detailed voice message which will be retrieved directly by our office staff. This skips the answering service, and decreases the chance of miscommunication.

All emergency calls are forwarded to me directly, and are acted upon by me personally, or by the covering physician.

All non-emergency calls will be handled during the next working session. If you would like a response by email, leave your email address with your voice message.

This change has already shown a major improvement in our ability to accommodate your needs. Regardless, it's always more effective to call during working hours.

Please remember that before renewing any "routine" medications, each chart has to be reviewed. Charts are not always available electronically, so medications can not be renewed during off-hours.

In life-threatening situations, always call 911 first!!!


Tuesday, June 22, 2010

Continuing medical education and then some…



First the serious stuff: Just back from taking the Continuing Medical Education courses at the Javits Center in Manhattan.

Two and a half days attending lectures on important topics in the management of conditions which concern so many of us, such as diabetes, heart disease, COPD, sleep disorders, high cholesterol, low back pain, and the metabolic syndrome.

It doesn't matter how much you know, there's always something new you bring back with you from these courses.

And the patients benefit from it.

And now to the ridiculous: You must already know some of the restrictions placed on pharmaceutical companies promotional "giveaways" to physicians. They used to give away trips, tickets to Broadway shows, and engage in other promotional activities which are now considered unethical (don't get me wrong, I'm not taking sides or expressing my opinion here).

At the Javits center meetings, some drug manufacturers were allowed to offer minor refreshments such as coffee and nuts. At several stands, the following sign (or a version of it) was posted: Due to State regulations, we can not serve complimentary beverages to health care providers licensed in the state of Minnesota…

Don't the legislators and regulators have something better to do?

Twitter / Dr. Staw