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FROM THE DOC
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That is the best thing I can tell a patient.
"You are boring"
My Dad used to say there is nothing more troubling for a patient than to be a 'good case' or an 'interesting case'.
Much better to be boring, of no interest, and to just trundle along in general good health.
So....if you hear me say your boring....let it bring a smile to your face.
Words of Wisdom
Dr. Victor McKusick was chief of medicine at Johns Hopkins for many years and was the chief when I was there. An amazing teacher and researcher, he was a pioneer in the field of genetics, developing the first comprehensive book of genetic defects in humans; the basis for the human genome project.
His font of knowledge was endless, but I can recall two quotes that he repeated on the wards. These stuck with me:
"Brevity is the soul of wit". The lesson: Keep your writing short. Thus, the short email responses I'm known for and the 'boring' essay above.
"Wash your hands before you see the patient; they'll appreciate that. Wash your hands after you see the patient; you'll appreciate that." The lesson: I think it's obvious.
Stay well,
Dr. Lakin
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| VOL 13 / Issue: #4 |
Autumn/ 2017 |
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Words of Wisdom. . . . .
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Tomorrow is a Mystery...
Everyday is a gift, that's why we call it the present!
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Be Ready For the Flu Season & Schedule Your Flu Vaccine With us!
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It's that time again!
Dr Lakin highly recommends to get your flu vaccine in late September, through October/November to have full coverage for our Arizona flu season.
Our Flu Vaccine Clinics are on Wednesdays, 1 - 2:30pm, starting September 20, 2017, through the months of October and November.
Please call to schedule your flu vaccine today!
480.614.5800
Influenza (flu) is a contagious respiratory illness caused by
influenza viruses. It can cause mild to severe illness. Serious outcomes of flu infection can result in hospitalization or death. Some people, such as older people, young children, and people with
certain health conditions
, are at high risk for serious flu complications.
Also the best way to prevent the flu is by getting
vaccinated each year.
The
upcoming season's flu vaccine will protect against the influenza viruses that research indicates will be most common during the season. This includes an influenza A (H1N1) virus, an influenza A (H3N2) virus, and one or two influenza B viruses, depending on the flu vaccine.
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DR. LAKIN'S NEW SECURE PATIENT PORTAL
'MyHealthRecord.com'
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Dr. Lakin and staff are very excited to announce we have upgraded our secure patient portal!
We changed vendors, and our new secure portal,
MyHealthRecord.com, is easier to use and easier for us to respond to your requests.
At your convenience
- View your health record from any Internet-enabled device
- Exchange secure messages with Dr. Lakin or our staff
- Request and manage appointments
Anytime access
- Lab orders
- Test results
- Upcoming appointments
- New Document and articles from Dr Lakin
To access our new patient portal, MyHealthRecord.com, you are required to complete a short questionnaire. This is a very simple process.... quick and easy. If you need assistance, we are always here to help.
Call us for your invitation email!
It will give you all the information you need to use our secure portal, MyHealthRecord.com, for your medical care!
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Four Things You Might Not Know About Fall Allergies. . . . . .
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 As most allergy sufferers will tell you, allergy symptoms can always be bothersome, turning any time of year into sneezing season. A runny nose, itchy eyes and scratchy throat can arise as the days get shorter and the leaves begin to change.
The fall can be especially difficult for people who are sensitive to mold and ragweed pollen. But these seasonal elements aren't the only triggers that can make symptoms worse this time of year. There are also a few lesser known triggers.
Here are four things you might not know about fall allergies:
* Hay Fever?
- Hay fever, a term from a bygone era, actually has nothing to do with hay. Instead, it's a general term used to describe the symptoms of late summer allergies. Ragweed is a common cause of hay fever, which is also known as allergic rhinitis. The plant usually begins to pollenate in mid-August and may continue to be a problem until a hard freeze, depending on where you live. See us for prescription medications to control symptoms or to see if allergy shots may be your best option with an allergy specialist.
* Lingering Warm Weather
While most people enjoy Indian summer, unseasonably warm temperatures can make rhinitis symptoms last longer. Mold spores can also be released when humidity is high, or the weather is dry and windy. Be sure to begin taking medications before your symptoms start.
* Pesky Leaves
- Some folks might find it difficult to keep up with raking leaves throughout the autumn. But for allergy sufferers, raking presents its own problem. It can stir agitating pollen and mold into the air, causing allergy and asthma symptoms. Those with allergies should wear an NIOSH rated N95mask when raking leaves, mowing the lawn and gardening.
* School Allergens
- It's not only seasonal pollen and mold that triggers allergies this time of year. Kids are often exposed to classroom irritants and allergy triggers. These can include chalk dust and classroom pets. Students with food allergies may also be exposed to allergens in the lunch room. Kids with exercise-induced bronchoconstriction (EIB) may experience attacks during recess or gym class. Help your child understand what can trigger their allergies and asthma, and how they can avoid symptoms. Be sure to notify teachers and the school nurse of any emergency medications, such as quick relief inhalers and epinephrine.
No matter the season, it's important for those who think they may be suffering from allergies or asthma to seek medical help. We can help you develop a treatment plan, which can include both medication and avoidance techniques.
Having your allergies properly identified and treated will help you and your family enjoy the season!
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We Love Your Pets. . . . .
But Please Keep Them Comfortable At Home!
**We do welcome Service Animals specifically trained to aid a person with a disability.
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Under the ADA and Arizona law, your service animal must meet these conditions:
- Not pose a direct threat to health and safety, can't be aggressive, bark or snap at other patients
- Be housebroken and positioned off all furniture
- Be in your control at all times
- Not pose an undue burden on the office or fundamentally alter the nature of the our healthcare practice
**Sorry, but 'Emotional support' or 'Hospitality' pets are not considered 'Service Animals' under ADA and Arizona law and should be left at home.
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 Haven't heard of a coffee nap? Say hello to an evidence-backed tool that can help you be more productive and sleep more.
Despite our best intentions, some days result in nothing getting done. We've all had them, productivity levels are at rock bottom, the desire to sleep is overwhelming and minutes feel like hours.
Whether you're an entrepreneur or a working professional, it's in your best interest to find ways to be more productive. You'll get more off your plate and feel a sense of accomplishment and pride. But what steps can you take to actually be more productive and even get more sleep as a result?
The solution could lie in a cup of coffee!
What Is a Coffee Nap?
Coffee naps are literally what they sound like. You drink a caffeinated beverage and then take a quick 30-minute nap. This is considered the ideal nap length because caffeine reaches a peak level in your blood after 30 minutes. You'll get a quick nap, and when you wake up, you'll feel refreshed and alert due to the caffeine kicking into your system.
Should you take a coffee nap?
That answer is completely up to you. But if you're looking for a science-backed way to sleep more and be more productive, a coffee nap may be the boost you need.
For more information,
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New Medicare ID Cards in 2018
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Medicare currently uses a Social Security based ID number to identify people with Medicare and administer the program. On April 1, 2018 Medicare will begin the process of discontinuing Social Security numbers for identification and will begin sending new Medicare cards to Medicare recipients with new ID numbers.
Your new Medicare ID number will replace the Social Security number that is currently on all Medicare ID cards. Your new Medicare number will be specific to you and should be protected as personally identifiable information but must be provided to your medical doctors so your medical claims can be billed. The ID number on your new Medicare card will be different than your current ID number, randomly generated, and have uppercase letters that are "non-intelligent," which means they don't have any hidden or special meaning.
Moving to new Medicare numbers and issuing new Medicare cards requires a lot of change to the current system and it is a change that will be nationwide and gradual beginning no earlier than April 1, 2018 and running through December 31, 2019. This means your new Medicare card can arrive anytime within this time frame. Release of the new ID cards will be timed and controlled by Medicare. Your old Medicare cards should not be discarded but can be filed safely away.
Your new Medicare card will not change your Medicare benefits and patients with Medicare should start giving the new Medicare cards to their health care providers as soon as they arrive. It is important to know the transition period for Medicare providers also begins on April 1, 2018 and will run through December 31, 2019. This means Medicare providers have until January 1, 2020 to begin exclusively billing with the new Medicare ID numbers. Some Medicare providers will begin using the new ID numbers as soon as April 1, 2018, others will be closer to the December 31, 2019 deadline. This decision is made on a case by case basis and is perfectly acceptable under the terms of the Medicare program. A provider may require you provide your "old" Medicare card in order to submit your claim, as long services were provided prior to the December 31, 2019 deadline this is also acceptable.
If you have questions, please contact Veronica, our Billing Supervisor.
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Doctor's Visits:
Why Checkups Are Vital. . . . . .
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 Annual Physicals 101:
When you were little, your parents probably made sure you had an annual checkup with your doctor. But as you've grown older, you may have gotten out of this habit.
Health professionals stress that these regular exams are important to help identify risk factors and problems before they become serious. If diseases are caught early, treatments are usually much more effective. Ultimately, having a regular doctor's visit will help you live a long and
healthy life.
It is also very important for you to play an active role to get the most out of your doctor's visit. Before your exam, review and update your family health history, be prepared to ask if you're due for any general screenings or vaccinations, and come up with a list of questions if you have particular health concerns.
During your actual doctor's visit, don't be shy about getting your questions answered. Also, if the doctor gives you advice about specific health issues, don't hesitate to take notes. Time is often limited during these exams, but by coming prepared you're sure to get the most out of your checkup.
Have you scheduled your physical for 2017 yet?
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Same Game, Different Year. . . .
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The time is fast approaching for you to review, renew or change your health insurance plan. Open enrollment starts Nov 1, 2017 and continues through Dec 15, 2017. In 2018, the open enrollment period has been shortened from 3 months, as it was during the last two years, to a mere 45 days. It's important to act prudently in choosing a plan once open enrollment starts.
One of the most important considerations in considering a plan is prescription drug coverage. Each year, prescription coverage - formulary vs non-formulary drugs - changes, and yours will likely change in 2018.
Companies that handle prescriptions for your insurance company are the "Prescription Benefit Managers" or PBMs for short. Some of the biggest include Express Scripts, CVS-Caremark and OptumRx.
In best light, PBMs play a pivotal role in getting the drugs you need at an affordable price. They negotiate on behalf of insurers and customers. PBM's handle pharmacy benefits for more than 50 percent of patients with pharmacy benefits. However, it's PBMs 'evil-twin' you encounter for approval of a medication - whether it's new or is one you've had a history of success. If your medication loses favor, becomes non-formulary, then the PBM expects you'll find a comparable. The largest PBM's are removing more than 80 prescription drugs from their formularies at the end of 2017 while adding back almost 20 currently excluded drugs in 2018.
What actions you should take:
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Read, we mean READ, the information your insurance mails to you before open enrollment. Most likely, there will be changes to your plan's drug formulary. Pay close attention to two key words: "formulary" and "tiers." Medications that were acceptable in the past may be jumped to a higher tier (higher co-pay) and/or have become non-formulary. Do not expect special consideration. An exception requires you try/fail formulary alternates or a more lengthy PA review process with a less certain favorable outcome. Read in advance: are your current Rx's covered, if not, switch or pay more.
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Pharmacy Benefits: Review what your health insurance plan covers. Every plan is different. Some plans have a combined medical and pharmacy benefit deductible, while many others have a separate deductible for prescription drugs. If most of your medical expenses are due to prescription drugs, consider a plan that offers the lowest prescription drug deductible possible.
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What type of medications do you take regularly? The hardest medications to gain payment approval are the big four: hormone, insomnia, mood and pain (HIMP). And as luck would have it, they are also the most frequently prescribed drugs. The last three are always troublesome because "medical necessity" for their sustained use can be hard to prove. Pain medications, opioids, now face growing opposition by media, FDA, politicians, etc. Expect increased denials/ limitations/legislation on many classic pain meds like never before. Speak with Dr. Lakin about his recommendations for this developing situation.
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What's in your wallet? This question deserves asking every year. It's important. Remember to update your insurance AND prescription drug plan with us annually. If a prescription is denied by your pharmacy or insurance we can address the matter but only if what we have on file is what you have on your card. As many patients already know, prior approval for prescriptions, both renewals and new, have become more frequent, problematic and time-consuming in recent years.
It's the same game, different year.
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These 10 Foods Affect Your Risk of Heart Disease the Most. . . . .
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 Just 10 foods account for nearly half of all heart disease deaths in the U.S., researchers reported Tuesday.
If people ate less salt and meat and ate more nuts, fruits and vegetables, they could greatly lower their own risk of heart disease, the researchers at Tufts Friedman School of Nutrition Science and Policy found.
It comes together in a handy list of what to eat more of and what to eat less of.
What to eat more of:
- Nuts
- Seafood rich in omega-3 fatty acids
- Vegetables
- Fruits
- Whole grains
- Polyunsaturated fats (such as soybean oil, corn oil, walnuts and flaxseed oil)
What to eat less of:
- Sodium
- Processed meats
- Sugar-sweetened beverages
- Red meat (such as steak or pork chops)
They left out monounsaturated fats such as olive oil, vitamin D, magnesium, calcium, antioxidant vitamins, dairy products, cocoa, coffee, and tea because they could not find enough evidence to assign a specific value to their benefits.
The American Heart Association has for decades stressed that food is a major factor in preventing America's No. 1 cause of death. And many studies have shown that Americans eat far too much meat, cheese, processed grains, sugar and salt.
Studies also
back the health effects of a daily handful of nuts, eating more vegetables, fruits and whole grains, as well as the omega-3 fatty acids found in some fish, walnuts, leafy greens and flaxseed.
Diets rich in vegetables, fruit, vegetable oils, and whole grains also
lower the risk of cancer, Alzheimer's disease and diabetes.
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How NOT To Die From Sitting All Day!
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If "
sitting is the new smoking," you can make it even worse by parking your body for more than 30 minutes at a time.
People who experience such long bouts of uninterrupted sitting and who stay sedentary for much of their waking time - 12.5 hours or more a day - have the highest risk of death from any cause, a new study finds.
But there's one thing you can do to reduce the harm: Move every 30 minutes for at least one minute, said lead author Keith Diaz, an associate research scientist at Columbia University Medical Center.
"People need to be mindful and try to take a break every half hour if they can," Diaz told TODAY. "When our bodies are not moving, they just stop working like they're supposed to."
The findings, published this week in the
Annals of Internal Medicine, come after Diaz and his team analyzed data from almost 8,000 people who took part in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study.
The participants, who were all 45 or older, wore a device that measured how much they moved during the day. Overall, it found they spent 77 percent of their waking hours
sitting or being otherwise inactive - the equivalent to being sedentary more than 12 hours out of a 16-hour waking day. It seems astonishing, but Diaz wasn't surprised.
"Look, U.S. adults are just extremely sedentary," he said. "Particularly... middle- and older-aged adults. We know as we age, we become more and more sedentary."
The
sheer amount of sitting around was associated with a higher risk of death, but so was the pattern of inactivity: Staying still for an hour or 90 minutes at a time made things worse, the researchers note. If you spend your day like that, it doesn't matter whether you squeeze in a workout in the morning or at night, Diaz said.
"You need to still be mindful about moving throughout your day and not just think that 'Because I exercised today, I'm done,' he noted. "Sitting in these long bouts, regardless of whether you exercised or not, still increases your risk of death."
If you have to sit, being sedentary in shorter bouts - less than 30 minutes - was "the least harmful pattern," the researchers say.
Your best bet: Movement breaks
* You may want to set your phone or favorite fitness gadget to beep every 30 minutes to remind you that it's time to move: "It's easy to forget how much you've been sitting when you just become engrossed in an activity," Diaz noted. Apple CEO Tim Cook
once said he has such alerts set up to make sure he takes a break.
* Engage in any movement that will get your heart pumping for at least a minute. Diaz suggested
walking because it's an easy, simple activity to do in most any setting. You can also opt of jumping jacks, calisthenics at your desk or whatever works for you. "The longer, the better, and the more intense you can take your break, the better," he said.
* Get up: Standing desks are popular, but there's not enough evidence to suggest standing is any better of an alternative than sitting, Diaz noted.
Fidgeting may be helpful, but it's not entirely clear how much at this point, he added, so his best recommendation is to just take a stroll.
- By A. Pawlowski, Today
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Insights By Steve: Check it Out!
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Think About It!
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Insight By Steve (Author)
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"Learn from yesterday. Live for today. Hope for tomorrow." - Albert Einstein
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Want To Give The 'Gift of Health' To a Special Friend?
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Looking for a great Holiday gift for someone that needs a physical examination?
We have a suggestion!
Dr Lakin is offering a screening 'Physical Examination Gift Card.'
Please contact Nan for more details!
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We Need Your Help!
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 Keeping you on your correct medication is as important to us as it is to you. With your help, we can be more efficient and be sure you are getting your refill requests on time and to your correct pharmacy.
Tips:
1. If you need a refill, be sure to call your pharmacy FIRST, not our office. They will know if you have more refills, and if not, they will call/fax/electronically message us with your request. Then we will contact you if there is a question or concern.
2. Remember to call your pharmacy in plenty of time so you do not run out of your medications. Sometimes we need up to 48 hours to complete a request and we do not want this to be a hardship for you.
3. Register and use our SECURE PATIENT PORTAL for refill requests. We monitor this continually and again will contact you if there is a problem.
4. Remember we do not refill pain or routine medications on Fridays or weekends and all pain medications must be picked up at our office. We cannot mail or any medications outside our office. Please plan ahead and make arrangements!
We are always here to help you and appreciate the opportunity to care for your healthcare needs!
Yours in good health,
Dr. Lakin & Staff
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Cinnamon-Spiced Beef Stroganoff
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A few pinches of pantry spices jazz up the traditional sour-cream gravy. This cozy weeknight dish dances on the line between comfort food and curry.
Ingredients
- 1 pound
boneless beef sirloin steak
- 3/4 teaspoon
salt
- 3/4 teaspoon
ground cinnamon
- 1/4 teaspoon
ground coriander
- 1/8-1/4 teaspoon
cayenne pepper
- Dash
ground cloves
- 3 tablespoons
butter
- 1 tablespoon
all-purpose flour
- 1 cup
lower-sodium beef broth
- 1/4 cup
sour cream
- 1 teaspoon
Dijon-style mustard
- 1/4 teaspoon
freshly ground black pepper
- 2 tablespoons
olive oil
- 1/2 cup
finely chopped shallots or finely chopped white onion (1 medium)
- 1 clove
garlic, minced
- 4 cups
sliced mushrooms (9 ounces)
- Cooked and buttered wide egg noodles
Directions
- If you like, partially freeze beef for easier slicing. Trim fat from meat and thinly slice across the grain into bite-size strips. Pat meat strips dry with paper towel; transfer to a large bowl. Add 1/2 teaspoon of the salt, the cinnamon, coriander, cayenne pepper and cloves. Toss to coat evenly. Set aside.
- In a small heavy saucepan, melt 1 tablespoon of the butter. Stir in flour until smooth. Cook over medium heat, stirring constantly, about 2 minutes or until the mixture is light brown. Whisking constantly, add broth. Bring to boiling; reduce heat. Simmer, uncovered, for 3 minutes, whisking occasionally. Reduce heat to low; stir in sour cream, mustard, the remaining 1/4 teaspoon salt and the 1/4 teaspoon pepper (do not boil). Cover and set aside.
- In a heavy 12-inch skillet, heat 1 tablespoon of the oil and 1 tablespoon of the remaining butter over medium-high heat. Cook meat, half at a time, in the oil mixture for 1 to 2 minutes or until meat browns on all sides but is still pink inside. Using a slotted spoon, remove meat from pan to a medium bowl. Set aside.
- Add the remaining 1 tablespoon of oil and 1 tablespoon of butter to the same skillet; heat until hot but not smoking. Add shallots and garlic. Cook and stir for 3 minutes. Add mushrooms. Cook, stirring occasionally, for 8 to 10 minutes until liquid evaporates, mushrooms are browned and shallots are soft and golden. Return meat with its juices to skillet. Stir to combine and heat through. Pour sauce over meat mixture. Serve over noodles.
Nutrition Facts
(Cinnamon-Spiced Beef Stroganoff)
Servings Per Recipe 6, calcium (mg) 40, fiber (g) 2, Cobalamin (Vit. B12) (µg) 2, Potassium (mg) 577, sodium (mg) 490, iron (mg) 3, sugar (g) 3, Mark as Free Exchange () 0, pro. (g) 29, vit. C (mg) 3, cal. (kcal) 356, vit. A (IU) 243, Riboflavin (mg) 0, Fat, total (g) 18, Thiamin (mg) 0, carb. (g) 20, sat. fat (g) 7, Pyridoxine (Vit. B6) (mg) 1, chol. (mg) 98, Niacin (mg) 10, Polyunsaturated fat (g) 1, Folate (µg) 73, Monounsaturated fat (g) 7, Trans fatty acid (g) 0
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Have a safe and healthy Autumn!
Dr. Douglas Lakin & Staff
Paradise Valley Medical Clinic PC
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