Are you looking for health insurance for your domestic partner?

Posted on March 25, 2012 by drlesliegreenberg

flickr.com/photos/ wheelz24/ 4291783906

Kansan Kathleen Sebelius, the US Department of Health and Human Services Secretary announced that the Health Plan Finder tool on www.healthcare.gov now allows for users to search for insurance plans that include coverage for domestic partners.

On this site, consumers can compare health plans and employers of a small business can also search for employee coverage.  The website breaks it into categories to help you choose the best option based on enrollment, out-of-pocket expenses, and specific benefits.

Some states have passed same-sex marriage laws and insurance companies are just a few steps behind.

Hope this helps.

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FDA links reflux medicine to severe diarrhea

Posted on March 22, 2012 by drlesliegreenberg

flickr.com/photos /ouistitis/ 6052645034

The U.S. Food and Drug Administration recently issued a drug safety warning  discussing the link between an anti-reflux medication and watery stools.  The warning suggests that medicines in the proton pump inhibitor family (like omeprazole and nexium) may increase the risk of Clostridium difficile-associated diarrhea.

“C. diff” diarrhea is characterized by

  • watery stool
  • abdominal pain and
  •  fever.

Ways to reduce the risk of developing this diarrhea may be to limit the dosage and the amount of time that a PPI is used.    Notify your doctor if you experience the above symptoms that do not resolve.

For more information visit http://www.aafp.org/news-now/health-of-the-public/20120214cdad-ppis.html

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Have you had a gastric bypass? Feeling tired? Here is one consideration…

Posted on March 19, 2012 by drlesliegreenberg

Obesity is an epidemic in America.  Gastric bypass is becoming a mainstream treatment for obesity.  Gastric bypass makes the stomach smaller, making the patient feel fuller with less food, and thereby helping the patient curb caloric intake.  After gastric bypass surgery, the patient is at risk for iron deficiency anemia.

Anemia means that the red blood cell (the cells that carry oxygen and make you feel more energized) count is low.  Iron-deficiency anemia means the reason for the anemia is that the body does not have enough iron in it to make those red blood cells properly.

One study of 300 patients sent to a hematology office showed that ¼ of the iron deficiency anemia patients were due to gastric bypass (with heavy menstrual bleeding as reason #1).

flickr.com/photos/ 46145831@N00/ 53229035

One symptom of iron-deficiency anemia is “pica.”  This is a desire to eat non-nutritive things: leaves, ice, and toilet paper.  So, be aware of your post-surgical risks and let your doctor know of your cravings.

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Do you need an advanced directive? Do you know what this is?

Posted on March 15, 2012 by drlesliegreenberg

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Two answers:  Yes, you do need one.  And, read on… to find out what’s an advanced directive.

An advanced directive is a legal document that spells out how YOU want to be cared for if you are unable to make those decisions.  Some examples of advanced directives are a

  • living will (a list of treatments you’d like if needed) and
  • durable power of attorney (WHO you designate to make those medical decisions for you).

Here in Wichita, Kansas, Health Ethics leads seminars discussing the intricacies of each of the documents free of charge.  You can also get information at www.caringinfo.org  or http://familydoctor.org/003.xml .

I tell my patients when I turned 30 (and was expecting our first child), my husband and I had “the talk.”  We discussed what we each want done– if we were unable to make those decisions ourselves.  It made it easier, I think, because we’re in good health.  This was just one piece of the puzzle in becoming parents for us.

Be specific with your wishes.  Do you want CPR?  Do you want to be on a ventilator?  If so, for how long?  If your heart stops, would you like medication in your vein to try to jump-start your heart?  If you are mentally incapacitated indefinitely, would you like to live in a nursing home where others care for your daily needs?

Try to emphasize to your durable power of attorney what is most important to you in a variety of situations.  You need ONE durable power of attorney.  If you have more than one, they may disagree with your wishes. . . and, in those cases, usually the patient has more treatment (more invasive, more long-term care) done which may leave you in a situation you planned to NOT have.

Once the advanced directive is completed and signed, it can be changed or canceled at any time.  Please discuss your wishes with your doctor and family.

Start the conversation.

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Eczema: “asthma of the skin”

Posted on March 11, 2012 by drlesliegreenberg

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I recently heard a dermatologist describe eczema as “asthma of the skin.” Great analogy. The importance of this is that eczema is a long-term problem. Our goal should be to control this scaly, itchy skin so that the patient and their family lead a life with normal activities. When eczema is not well controlled, the patient itches which can disrupt (patient and parent’s) sleep, increased time spent on skin care and physician/hospital visits.

Eczema, like asthma, has symptoms that will wax and wane, triggers that worsen eczema, and may be passed down from the parents. Some suggestions are to use nondetergent cleansers instead of soap: Cetaphil or Dove. Pat skin dry after bathing so as to not rough up the skin. Put a rich cream on the skin twice a day: once after bathing and one other time during the day. Lather them up with lotion and let it soak in. A dilute bleach bath once a week can help decrease bacterial load on the skin and thereby decrease skin infections. 1/8 cup to a full bath is all that’s needed: more bleach won’t be helpful.

Hope this helps.

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Are you a night owl? There’s a supplement that may help reset your “clock.”

Posted on March 9, 2012 by drlesliegreenberg

flickr.com/ photos/ mellyjean/ 3251173391

Researchers have found that melatonin taken in a specific manner and dose may help induce sleep to reset your circadian rhythm.  Night owls are people who, if left to their own body rhythm, would sleep from … let’s say… 5 AM to noon.

We spontaneously increase our melatonin 2 hours before our regular bedtime.  Those night owls may have their melatonin surge at 3 am.

It has been found that gently increasing melatonin, given as 0.5 to 1.0 mg 4 hours before the desired sleep time may help increase the body’s melatonin (at a more appropriate time) and help that individual fall asleep sooner.

Please see your physician to confirm that there are not any other confounding issues causing altered sleep patterns.

Hope this helps.

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Confirmation that colonoscopies are worthwhile

Posted on March 2, 2012 by drlesliegreenberg

flickr.com/photos/jpmatth/ 415218709Medicare study confirms colonoscopy’s benefit.  Medicare watches their pennies—I appreciate that.  Medicare assisted this study of 50,000 older adults which revealed colonoscopies were associated with a significant 73% reduction in right-sided colon cancer and 54% decrease of left-sided colon cancer, compared to those who were not screened.

Screening colonoscopies suggested start age is 50 years old and, if there are no polyps, should be repeated every 10 years.  If there are polyps found, they should be biopsied or taken out completely at the time of colonoscopy.  Depending on what type of cells are found by the pathologists (doctors who look at cells all day), a colonoscopy may need to be performed sooner than 10 years–the date to be determined by the type of cells found in the polyp.

Bowel prep, anyone?

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Shingles vaccine rebate!

Posted on February 28, 2012 by drlesliegreenberg

The shingles vaccine, Zostavax, can have a pricey out-of-pocket co-pay.  The vaccine maker is offering up to $140 to reimburse the patient for that out-of-pocket payment.

If you are older than 60, have had chicken pox, and have NOT been vaccinated with the shingles vaccine…please follow this link from the vaccine manufacturer.

http://rebate4zostavax.com/

Hope this helps.

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Harmful supplement ingredient, DMAA.

Posted on February 23, 2012 by drlesliegreenberg

nytimes.com/ imagepages/ 2012/02/03/business/DIET.html

Here is an interesting article about DMAA, a supplement that some take before workouts.  Read on . . .

http://www.nytimes.com/2012/02/03/business/army-studies-workout-supplements-after-2-deaths.html?_r=1&ref=health

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Bullying.

Posted on February 20, 2012 by drlesliegreenberg

flickr.com/ photos /nogood/ 5777516360

I recently read a physician commentary on bullying.  This was juxtaposed to a discussion with a friend (a bright, articulate, loyal, well-liked woman) who is being bullied by another adult woman.   Here are some well researched thoughts about bullying—the individual’s age is immaterial.

Bullying today is a form of social cruelty.  It may not be violent, but the Massachusetts Aggression Reduction Center found that repetitive seemingly minor “gateway behaviors” were the most frequent victim reports.  These can be rude, insolent acts like eye rolling, snickering, whispering in front of others.  These “gateway behaviors” (when not corrected) may normalize disrespect or even reward it.  These minor acts can be toxic.  When this occurs online, it may be in the form of forwarding comments or personal information or bashing the individual.

What can you do?  As a parent, consider your or your child’s social lives online.  Be clear about the absolute necessity to watch what one says, whatever the format (in person or online), and to always remain civil to others.  Be aware.  When upset or in distress, people are more likely to text others to garner social support.  This can quickly escalate the situation.  Do not try to resolve a disagreement or settle an argument by texting, emailing or instant messaging.

Want more information?  http://www.bridgew.edu/marc/bully_downloads.cfm

“Where, after all, do universal human rights begin? In small places, close to home – so close and so small that they cannot be seen on any maps of the world. Yet they are the world of the individual person; the neighborhood he lives in; the school or college she attends; the factory, farm, or office where he works. Such are the places where every man, woman, and child seeks equal justice, equal opportunity, equal dignity without discrimination. Unless these rights have meaning there, they have little meaning anywhere. Without concerted citizen action to uphold them close to home, we shall look in vain for progress in the larger world.”

Eleanor Roosevelt

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