|
Join Our List
 |
|
FROM THE DOC
|
 |
'I Don't Know'
The other day a patient came to me with a small growth on their arm. A small nodule of tissue had developed under the skin of their forearm..but it was noticeable.... no mistaking its presence. They were not sure how long it had been there exactly, although they were sure it was months, not years.
Had it grown? No.... not appreciably, but then again, perhaps a little, they could not be certain.
Was it painful? No...not really?
One day...they just noticed it was there and after a few months they thought it worthwhile to come in and make sure it was nothing to be concerned about.
I looked it.... I felt it...I moved it around...and then I answered:
My answer to what this was: I don't know.... but not to worry.
That seems like a paradoxical response ...how can you not know what something is, but at the same time know it is not something to worry about?
It's really straightforward:
1. It is small and not growing at a rapid pace
2. It's really not bothering the patient (although once noticed, the patient had sensed it more than previously when it was not at all apparent to their mind.)
3. On examination it feels benign (knowing that comes from some experience)
4. Statistically, these types of growth are nearly always benign
My advice:
A: Not to worry
B: Observe it..If no significant change in the coming months...we will let it be.
C. Any major changes (doubling in size...not 'I think it's growing') and we'll reconsider the issue
From experience, training, and reading.... I know that there are numerous benign growths that we might find it we took this out and looked at it under the microscope, but 99+% would make no difference to know about, so the practical solution is to do as the Beatles said: 'Let it Be.'
Ralph Kramden, from 'The Honeymooners', once explained the Internists creed to Alice.
In his typical style, he was explaining to Alice how he, Ralph, was the king...and she, Alice was 'Nothing'.
Ralph: 'I'm the king...and you are nothing, Alice. That's right.... I'm the king.... and you are nothing.'
Alice: 'That's right Ralph...you're the king of nothing!'
That is one thing I am the master of...I know when something is nothing. Although this may sound like nothing.... it's really quite something!
One of my most common answers to patients query about symptoms is: 'I don't know.'
I've often said, this is what the Internist is the king of!
What are we looking for? That is a broad and impossible question to answer, but in reading the paper, watching the news, in art, in our houses of worship, and in our family and relationships, I think one of our great desires if for authenticity.... a sense of honesty that is.
Yours in good health,
- Dr. Lakin
|
|
|
| VOL 14 / Issue: #4 |
Autumn/ 2018 |
|
October is Breast Cancer Awareness Month
|
Far too many women, 1 in 8 to be precise, are diagnosed with breast cancer. Thanks to earlier detection - through screening and increased awareness - and better treatments, a woman's risk of dying from breast cancer has
dropped almost 40 percent between 1989 and 2015, saving 322,000 lives.
Reductions in the unnecessary use of menopause hormone therapy have also spared nearly 200,000 women a breast cancer diagnosis they otherwise would have received. However, there's much more to be done. Breast cancer is still the second leading cause of cancer death in women. Only lung cancer kills more women each year.
Furthermore, a large racial gap in mortality remains. African-American women have a 39 percent higher death rates compared to whites. While, African-American women have a lower incidence of acquiring the disease than white women, certain social and economic disadvantages experienced more by ethnic groups are a leading cause to the problem. Some of these disparities include: limited health care coverage, expensive treatment costs, lack of access to screening, lifestyle choices (e.g. diet and activity), lack of access to quality medical care.
In recent years, advocacy has risen for these issues. Advocates are working towards more equal breast cancer resources and care for all communities. Aside from certain inequalities surrounding the subject, science and research has supported that
preventative measures can help reduce one's risk for breast cancer, catch the cancer earlier, and increase survival rates. Doctors also encourage routine
self-breast exams. Screenings combined with
healthy lifestyle choices are potential contributors towards reducing the risk of breast cancer.
It is through research and advocacy that we will get to the underlying causes of breast cancer. Only then can we devise true prevention strategies.
October is Breast Cancer Awareness Month and while there are many superficial awareness campaigns, we encourage people to seek out & support organizations that are looking for the root causes of breast cancer. For more information click
HERE
|
|
Dr. Lakin's Recommendations:
Get Your Flu Vaccine At Our Office Now!
|
 Flu infections in The Valley generally begin right around Christmas, but it can come earlier, so it's worthwhile getting your flu shot as a preventive, and getting it at the proper time.
The end of September through November is the ideal time for the flu shot as it takes a few weeks for the shot to become effective, and the duration of the shot is not completely the same in every person (3-4 months or longer).....so having it properly timed is a good start.
Second, you need to know which flu shot to get. There are many options out there, surprisingly, and although they all are effective, some offer different advantages.
For the 65 and over set, the high-dose flu shot is recommended. This is TRIVALENT (3 flu strains....2-Type A (most important) & 1 Type B). The high dose provides a boosted immunity in the older crowd, resulting in better protection
For the under 65 set, the standard dose TRIVALENT or the FLUBLOK QUADRIVALENT is desired. We are doing the FLUBLOCK QUADRIVALENT as it has two advantges:
1. NO EGG (Egg allergies are not an excuse people..there are no egg in the production of the genetically produced vaccine.)
2. QUADRIVALENT means (2-Type A & 2 Type B) which gives a broader coverage if Type B is prevalent in the coming season
 Dr Lakin's Flu Vaccine Clinics are on Wednesdays, 1 - 2:30pm, through October 24th...
If you can't come on Wednesdays, call us and we will work you in!
Please schedule your flu vaccine today! 480.614.5800
|
|
Would You Like to be 'Paged' for Your Appointment?
|
With the flu season on its way, we want to keep you as healthy as possible.
So we are bringing back the option to wait outside the office for your appointment and be 'paged' when it is your time.
Yes, now you have the option to wait outside the office; in the main lobby or even in your car! When it is time for your appointment, we will page you so you can avoid close contact with other possible environmental infections.
Simply check in at our front desk, then we will give you a pager to keep in touch. It is that easy!
Stay healthy my friends!
|
Don't Curse the Cold: Shivering May Help Burn Body Fat
|
|
Shivering may be as good as exercise to help you drop a few pounds, a new study finds.
Shivering's weight-loss upside is linked to a hormone produced by the body's muscles, according to research from the National Institutes of Health published Tuesday in the journal Cell Metabolism. When a body trembles from the cold it releases irisin, also known as the "exercise hormone," which stimulates fat tissue to produce heat so the body can maintain its core temperature. Irisin was first discovered two years ago and is a kind of messenger hormone relaying beneficial information to body tissues. Increases in irisin turns the body's white fat into the more metabolically active brown fat, which helps the body burn more calories. It also may make the body more sensitive to glucose.
The researchers wanted to find out if shivering could produce the same effects on irisin as exercise, explains lead author Dr. Francesco S. Celi, chair of the division of endocrinology and metabolism at Virginia Commonwealth University, who has been studying "adaptive thermogenesis," basically how our bodies react to temperature changes. "From an evolutionary perspective, shivering is the last resort to maintain core temperature."
Ten healthy volunteers of normal weight and good health participated in three different experiments designed to measure irisin levels. First, participants exercised at maximal aerobic capacity on a stationary bike. Researchers then measured their energy expenditures. Blood samples were also taken. To induce shivering, participants were put under cooling blankets set to slightly more than 53 degrees Fahrenheit. The researchers found that irisin levels produced through exercise were comparable to shivering.
To help confirm their results, the researchers tested the effects of irisin on cultures of adipose, or fat, tissue cultures. They found that irisin did help stimulate production of specific proteins linked to brown fat, essentially making the white fat cultures more similar to that of the more metabolically active brown fat.
Although the researchers are not saying we should dump our parkas for t-shirts when it's 12 degrees outside, they do think there is something to be said for finding ways to burn more energy.
|
|
New Medicare Cards
Are Here Now!
|
|
You may have heard that the CMS started mailing new Medicare cards to everyone with Medicare. Hang tight -
mailing takes some time across the country, and you might get your card at a different time than friends or neighbors in your state.
In the meantime, keep using your current Medicare card until your new one arrives.
They have got 3 ways for you to find out when you should expect your new Medicare card in the mail:
- Check out the map on Medicare.gov/NewCard. Keep coming back to check the status of card mailings in your state. Once card mailings begin in your state, it'll take at least a month to finish.
- Keep an eye on your email. We'll send you an email update when new Medicare cards start mailing in your state.
- Log in to your MyMedicare.gov account to see if your new card has mailed. Don't have an account yet? Sign up now at MyMedicare.gov - it's a free, secure, and easy way to access all your Medicare information in one place.
- And most importantly..... bring your new Medicare into our office so we have the new updated information!
|
Note From Our Biller:
Medicare Open Enrollment
|
|
The annual Medicare Open Enrollment period began October 15, 2018 and runs through December 7, 2018.
Changes made during this open enrollment period will take effect on January 1, 2019. During the annual open enrollment period you can make changes to your Part B and Part D Medicare coverage.
If you do not want to make changes to your coverage for the coming year and your current plan is available for 2019 you do not need to do anything during open enrollment. Please be aware, if you keep your current plan your benefits and premium(s) could change. Even if you are confident that you want to keep your current coverage I strongly recommend you contact your insurance carrier to confirm your rates and benefits. It is important to make sure you understand any changes that may apply, and that you have double checked to make sure your current plan is still the best available option for you before you lock yourself in for 2019.
As in years past, Dr. Lakin has chosen to work only with Original Medicare; he does not accept Medicare Advantage.
Many insurance solicitations state Medicare Advantage is the same as Medicare or if your physician takes Original Medicare they will accept Medicare Advantage, this is not always true. We do understand each patient must make a choice that aligns with their health, coverage needs and budget in mind, should you choose to transition to a Medicare Advantage plan we will do all we can to assist you in locating a new primary care physician for 2019.
For online assistance in choosing a Medicare based plan you can go to
https://www.medicare.gov
and use their open enrollment tool. This site can be trusted and is provided by Medicare for beneficiaries to find health and drug plans, compare coverage options and estimate your premium costs. After using this tool I strongly recommend making a follow up call with the insurance company to ensure the information provided online is accurate and up to date. If you are researching Part D plans it will be beneficial to have a current list of your medications and doses for the best results.
It is important to remember all insurance is designed for the just in case factor. Some beneficiaries choose to cover all the possible scenarios that may come up in a year; others pick their coverage based on what they know to be true about their health right now. Each individual is different and insurance coverage is a personal choice. I am happy to offer guidance if you have questions about your options but please know I can't pick a plan for you.
Medicare Part A
is your hospital insurance plan. It covers nursing care and hospital stays, although not doctors' fees. They also cover some home health services, skilled nursing care after a hospital stay and hospice care. Medicare Part B pays for a portion of your doctor visits, some home health care, medical equipment, outpatient procedures, rehabilitation therapy, laboratory tests, X-rays, mental health and ambulance services. Part B is optional and requires that you pay a monthly premium to Medicare and there is a deductible that must be reached before Part B begins paying for services. Medicare Part D helps you pay for prescription drugs. Part D is optional. If you enroll in a Part D plan, you will pay a monthly premium and sometimes a deductible, as well as copayments for your drugs. Each Part D plan varies in the cost of premiums, the price of drugs and its list of covered drugs or "formulary" under the plan.
There are many options available to you; the easiest way to feel successful is to start researching your options early. I am happy to offer any guidance but please note I will always recommend you contact the insurance plans directly before finalizing your choices. I can be reached via the main office phone number (480) 614-5800 or by e-mail
v[email protected]
.
This is a busy time of year for all of our patients so kindly allow adequate time for a response.
Thank you,
Veronica
PVMC Billing Supervisor
|
|
What's Happening When You Feel Dizzy?
|
Whether it's when you first stand up to get out of bed in the morning - or after a long day outdoors in the heat, it is likely that you've felt dizzy at one point or another. Dizziness is an
odd sensation; it can make you feel as if the room is spinning and quickly cause you to lose your balance and fall down. As you get older, feeling dizzy can actually become a big health concern since you're more likely to become dizzy as you age and have a greater potential to suffer significant injuries from a fall-especially if no one is around to help you up.
So what exactly happens when you get dizzy? What causes this sensation, and how can you stop it? Let's take a look at some key facts to help you understand dizziness and keep the room from spinning.
Possible Causes of Dizziness
Sometimes, dizziness is nothing more than a
passing sensation that only lasts for a moment. When you move your head quickly, inner ear fluid pushes against receptor cells that help you stay balanced. Even once you've stopped moving, the fluid keeps pushing against these cells, so you feel like you're moving even when you aren't. If you try to walk a straight line in this state, chances are you'll fall right down. But what is happening when you feel dizzy for more than just a few seconds? There's actually a
number of different causes that could be behind your loss of balance, and it's important to know which culprit to blame. Sometimes dizziness can indicate very serious conditions, so you should pay attention to any accompanying symptoms.
Inner Ear Problems - Because the inner ear is responsible for giving us a sense of balance, it is not surprising that problems with the inner ear can lead to dizziness. Issues like vertigo, which affects the inner ear, may be one of the first guesses your doctor makes when you complain of dizziness, but you can rest assured that the cure is relatively simple. In many cases, physical therapy and balance exercises can reduce the problem and eliminate the disruption of dizziness in your life.
Nutritional Deficiencies - If you have ever been
dehydrated or skipped a meal, you might know just how terrible you can feel when your body is lacking the water and nutrients it needs. These issues may be chronic if you follow a diet that does not provide you with the nutrition you need or you fail to drink enough water each day.
Migraines - Among the many disruptive symptoms of migraines is dizziness, which would likely be accompanied by the typical aura, light and sound sensitivity, and severe
headache that a migraine can cause.
Anxiety - Interestingly,
anxiety disorders have been linked to dizziness, indicating that the sensation may really be all in your head. If you suffer from frequent anxiety, you might find that high-pressure situations lead to increased visual stimulation sensitivity, which can translate to feeling like the room is spinning. If you experience dizziness in your 20s or 30s, anxiety is a very likely cause.
Low Blood Pressure - Along with helping maintain balance, the inner ear plays a role in regulating blood flow throughout the body, depending on the position your body is in. If you have low blood pressure, your body may not be able to regulate as effectively, causing you to lose your sense of balance, particularly when you stand up, participate in rigorous activities, or bend down.
Anemia - Anemia is characterized by low levels of iron in the blood, which tends to cause fatigue and the feeling of being drained of energy. When you are overly fatigued, dizziness becomes much more likely.
Stroke - You might be familiar with the most common signs of stroke-blurred vision, impaired speech, and loss of muscle control-but you may not realize that dizziness can be a symptom as well, especially in women. When dizziness comes on suddenly and is accompanied by the other signs of stroke, it's time to head to the ER immediately.
When you think dizziness is the sign of an urgent condition, don't hesitate in seeking emergency care. Otherwise, Call Dr Lakin to identify what's making you dizzy so you can get back to balancing your daily routine.
- Body Odd, Health & Wellness
Back To Top
|
|
Introducing Genetic Testing By Myriad, Available In Our Office Now. . . . .
|
The Myriad Hereditary Cancer test is a 28-gene panel that identifies an elevated risk for eight hereditary cancers:
Genetic screening is now a practical tool that we can use to help in the management of your health and the health of your family. It is recommended by the USPTF (United States Preventive Services Task Force.) This has implications for you, but also for your family, and I think it is worthwhile to consider.
We are at the beginning stages of applying this science in the clinical setting, so it is of limited scope of application. I want to help determine if it can be applied to your particular family history. This questionnaire is meant to do just that.
- Determine if you are at risk for cancers that run in the family
- Determine if genetic testing, at it's current state of development, is applicable to your situation
- Have the testing done to determine the best monitoring strategy, as well as helping guide you and your family in future testing and monitoring.
You will notice that this questionnaire has a specific focus on certain cancers, as that is the state of practical application of current genetic testing.
We are using a 24-gene panel from Myriad labs, the inventors of the BRCA test, which was the first large-scale genetic test validated for breast cancer family history.
For now, only a select group of patients can benefit. In the future, genetic testing will become commonplace and perhaps done routinely for everyone.
Answer the following questions and we will determine if you can benefit from this testing right now.
As for the cost, insurance coverage, and privacy issues related to such testing, this will be answered prior to running the test, so feel free to provide this information to initially see if you can benefit.
The process:
Complete this questionnaire
Submit a specimen of saliva (spit test).....this will be the material that is genetically tested.
Myriad labs will contact you to review cost, insurance, and privacy issues before any testing is performed.
Once completed, you will receive a detailed report and we can review it together to determine the best strategy for monitoring your health on an ongoing basis, as well as having specific advice for monitoring of your family members.
In the future, should additional testing become available that is valid to do, your current information will be used in such an analysis.
** Click HERE for more information and to take the Myriad Genetic test
to see if you are at risk.
If you think you are at risk and would like more information, please contact our office to schedule an appointment with Dr Lakin.
'Knowledge is Power!'
Back To Top
|
Why Do Paper Cuts Hurt So Much?
|
Your skin is an amazing organ that works hard to keep the body protected from the environment while holding all of your internal organs and muscle tissue in a nice, presentable package. Even when you are not aware of it, your skin-which would stretch out to about 22 square feet and weigh in around 8 pounds if it were not on your body-is always
regenerating with new cells, fighting off bacterial intruders, and regulating your body temperature. So how is it that an organ with such amazing capabilities can let you feel so much pain when you sustain an injury as small as a paper cut? Read on to learn how the skin works and why paper cuts are so uniquely painful compared to other cuts and nicks.
How the Skin Works
You may find it surprising that the epidermis, the visible, outermost layer of your skin, is almost entirely made up of dead skin cells. As the dead skin cells on the surface slough off, room is made for the new cells that are formed in the layers below the epidermis. Through this process of regeneration, your skin essentially replaces itself every 35 days. It is also through this cell replacement that your skin heals injuries that occur on the outermost layers.
*
What goes on beneath the surface? Beneath the epidermis, you have the dermis, which is packed full of collagen for structure, hair follicles and sweat glands for protection, and tons of nerve endings to detect sensations of hot, cold, pain, and itchiness. When you sustain a cut that bleeds, you have penetrated to the dermis, meaning that you have probably felt the pain of agitated nerve endings.
*
How is skin different in different parts of the body? The
layered structure of the skin is the same throughout the body, but the exact contents of these layers and their thickness will vary depending on location. The bottoms of the feet, for example, contain the body's thickest skin to protect you from anything sharp you may step on. The skin of your hands and fingertips is fairly thick too, but it contains far more nerve endings that fire off pain signals much more intensely than other parts of the body. Because paper cuts are most common on the hands, they tend to be associated with significant pain thanks to the tightly packed nerve fibers of the palms and fingers.
The sensitivity of your hands is only
part of the equation
when it comes to the seemingly disproportionate amount of pain that comes from a paper cut. If you cut your finger with an object such as a knife, it may still hurt less than a cut caused by a measly piece of paper. That's because a knife is a straight edge that will make a relatively clean cut, while paper can bend and move in ways that cause a jagged cut with more damage on the surface of the skin. The shallowness of paper cuts also works to your disadvantage. Paper cuts tend to bleed very little or not at all, so there will be no blood clot that forms to protect the skin underneath. This means that nerves around the cut are more readily exposed to irritants, causing the cut to hurt longer. Now that you know a little more about how the skin works, you can care for yours.
Back To Top
|
|
Why Is Lip Balm So Addictive?
|
In the cold, dry winter weather, you may not ever think of leaving home without lip balm to soothe your chapped skin. However, if you find yourself compulsively applying the stuff and leaving a greasy residue on all of your drinking glasses, you may be addicted to your chapstick. Lip balm addiction is a far cry from substance abuse, but it can be a problem that leads to skin irritation and unwanted blemishes around your mouth. Plus, it can take a toll on your wallet if you opt for some higher-end designer varieties.
The cycle of over-applying When you apply lip balm, the soothing sensation of softness may entice you to put on more. What happens when you continuously apply, or apply more than you need at once, is a decrease in the skin's sensitivity to the active ingredients. This means that you will need more and more of the balm to relieve chapping. As you continue to slather your lips with your favorite balm, your skin becomes deprived of oxygen and your pores get clogged, leading to consequences like dermatitis. Can you really become addicted? Not entirely, but you may need to
replace the ritual with a different habit to keep you busy. Best and worst balms Lip balms are not all created equal. In terms of what will be the most soothing, simple Vaseline or Aquaphor are the best choices.
These products have the shortest lists of ingredients, so there are fewer potential irritants. If you do like a more traditional balm, Blistex Lip Medex is a highly rated and timeless solution that offers a cooling sensation along with dry skin relief. A few other balms that scored high ratings from
TotalBeauty.com include Clinique Superbalm Lip Treatment and LaRocca Shield Multi-Active Lip Balm, but these came with significantly higher price tags. Some of the least favored options come from L'Oreal and Nivea with varieties boasting shimmer and color in addition to chapped lip relief. As it turns out, these multi-purpose products do not work well for those looking primarily for softer, smoother skin.
Other dry skin remedies You should avoid relying on lip balm alone to soothe chapped lips, since there are other ways to moisturize the skin with whole-body benefits.
Use of an indoor humidifier will keep more moisture in the air so that your skin does not have a persistent chapped, dry, flaky quality.
Covering your skin when you venture outdoors with a scarf or hooded jacket will also be helpful. One habit you should definitely avoid is licking your lips, since this will only lead to further irritation.
|
|
Falling for Fall - Tips to Prevent Fall-Related Injuries at Home
|
Fall is arriving, which means it's time to open our hearts to pumpkin spice lattes and pull our favorite sweaters out of the closet. It's also the perfect time to highlight one of the most common causes of emergency room visits throughout any season-falls around the house. Tripping and falling may seem like no big deal, but every day falls account for broken bones,
sprains, bruises, and a wide range of orthopedic injuries that could keep you off your feet for weeks or even months. Falls can even lead to traumatic brain injuries or fatalities, so they aren't a threat you should ignore.
Seniors are the most
at-risk group for serious injuries resulting from falls, but anyone can benefit from implementing some fall-prevention guidelines around the house. Let's take a closer look at what you can do to avoid these all too common injuries.
Know Why Falls Happen
Falls are often preventable. Many fall-related injuries occur right at home, because it's easy to forget about common tripping hazards like slippery floors, living room clutter, or loose rugs. Most falls are the result of tripping or slipping on physical obstacles. Taking precautions around the house will make it less likely that falls take place and many safeguards can also serve as a visual reminder to slow down and take your time when you're going from one room to another.
Make Your Home Safer
Some
simple changes around the house can make a big difference for preventing injuries. Use the following steps to make upgrades around your own house, and, if you have an elderly relative living on their own, help make these changes in their house as well:
* Add handrails and floor traction
- Anywhere that slipping is more likely, a handrail can be helpful. Add a handle to assist in getting out of the shower or up from the toilet. Make sure all stairs are equipped with handrails as well. On the floors, reduce slipperiness by adding traction with no-slip runners in hallways, a non-skid bathmat in the shower, and carpet mats in the kitchen that are tacked down with non-slip backing.
*
Install floor lighting - Low lighting can be responsible for falls during late night fridge runs or an early morning trip to the bathroom. To make walkways more visible, install motion sensor triggered lighting that points at the floor along the hallways and in your bedroom. This will allow you to see where you're going without feeling blinded by overhead lights when you've just woken up.
* Keep it tidy - Any parent can attest that clutter is a major tripping hazard at home. Toys, clothes, backpacks, and anything else left on the floor can quickly cause a fall. Keep clutter to a minimum by adding plenty of shelving, storage bins, and clothing racks. You can also set house rules that everything has to be put away at certain times, so you can ensure a clear path to anywhere in the house.
*
Maintain outdoor walkways - It's not just indoor areas that pose a risk for falls. In fact, the cool temperatures of autumn may remind you that overnight frost and snow are on the way, which can mean slippery sidewalks. When pathways are icy, use salt or kitty litter for traction and walk on the grass, if possible. At all times of the year, make sure that landscaping is not overgrown and keep a clear path around your house with pavers, concrete, or gravel walkways.
Improve Your Balance
Maintaining your environment is great for fall prevention, but you can do even more by working on your balance. Particularly if you have osteoporosis or any muscular weakness or balance issues, you should work to build strength with some
simple everyday exercises. For example, you can stand on your toes or on just one foot for one minute at a time, slowly working to increase your time and stay balanced with your eyes closed or without holding onto anything with your hand for added stability. Regular walks are also helpful for keeping up lower body and core strength, and weight lifting and yoga can help you tone up even more to keep you lighter on your feet.
|
DR. LAKIN'S NEW SECURE PATIENT PORTAL
'MyHealthRecord.com'
|
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!
Back To Top
|
TOM'S TRAVELS:
Lots of Ambiance in Two Classic Southern Cities. . . . . . .
|
For a ten day domestic travel adventure we selected Charleston, SC and Savannah, GA this past spring. Although close in geographic location each city has a unique feel and charm to it.
Charleston is a peninsula city whereas Savannah lies along a river and is characterized by verdant squares spaced equally with residences surrounding them. Both cities have a free transit system of which we made extensive use, leaving our rental car parked.
 Charleston eating highlights included my sampling of shrimp and grits with different sauces as well as a pickled shrimp salad with peanuts. Our bed and breakfast was atmospheric and included an afternoon Happy Hour to relax and meet other visitors. Pastel colored houses abound along the harbor and mansions you can tour such as the Calhoun House transport you to another era. A vibrant community of students from the College of Charleston is evident throughout the city. Another option is to take the harbor cruise to view Fort Sumpter, which played an important role in Civil War battles, as well as to escape the humid weather noticeable to us desert dwellers. As French teachers we were amazed to find headstones in cemeteries with inscriptions in French regarding early founders buried there.
 Our ground floor room in Charleston was a real contrast to our climb at the Savannah bed and breakfast where it took seventeen steps to reach the front door followed by twenty steps to reach our room. Although help was available we chose to tote our own bags but I would recommend letting someone else get sweaty! River Street teems with tourists and you can cruise the river on the Georgia Queen for views along with a southern buffet lunch.
Savannah School of Design is  well known and has classrooms all over the city along with an art museum. I would rank the art museums in Savannah over those in Charleston and the fountains in the squares are all photo worthy.  We toured a Jewish synagogue, the third oldest in the US, whose rare Gothic architecture rivals the great cathedrals of Europe. Speaking of statuary, the Bonaventure Cemetery is worthy of a stroll to admire the elegant tombs, and the statue on the cover of the novel Midnight in the Garden of Good and Evil had to be moved from the cemetery to a museum due to excessive foot traffic that was harming the shrubbery. If visiting these two cities be prepared for humidity and outstanding southern cooking that can add a few pounds! 
I would be happy to share travel info with you at my email:
|
| Book Reviews By Pat. . . . . . |
 |
|
|
Pat |
T
he Stress Cure
-
How to Resolve Stress, Build Resilience and Boost Your Energy)
- By Patrick Holford & Susannah Lawson
Patrick Holford, author of 'The Stress Cure" written with Susannah Lawson, offers a positive and effective approach when dealing with stress - a daily occurrence in our lives and almost a consistent factor unless we approach it positively.
Reading "The Stress Cure" and applying its principles in a positive manner shows the reader how to take control of the stress by:
- Accepting its presence in our lives
- Reacting to it by utilizing options suggested by the author
- Applying options in a positive manner
Time well spent!
If you follow and apply suggested principles and cope with stress in a positive manner, this book is for you.
Holford emphasizes and presents useful information, but application of its principles is up to the reader. The results can be worth the principle effort. A degree of control is found and an easing of its 'pressure' in our lives in the form of stress-reducing experiences.
Well-written and well-presented! The information is helpful to improving our well-being in a busy, stress-filled world.
|
|
Rx Prior Auth News From Jeff
|
Prescription Prior Authorization Update - Autumn 2018 (PA's Today)
There's a war going on out there. War has been declared on opioid abuse. America historically, like many other countries, has had a rocky relationship with opioid medications for hundreds of years and most noticeably with morphine during and after the American Civil War in the late 1800's.
In the 1990's, a resurgence of use and abuse occurred and grew with the introduction of new, stronger and more "convenient" forms of opioids most notably oxycontin, hydrocodone, methadone and fentanyl among others. Often marketed and prescribed to overuse for patients' young and old for a variety of ills from post-surgical pain, to sports injuries to dental work - opioids flowed freely for years.
No more. Public outcry has grown louder in the past decade warning against and demanding to stem the generous prescribing of these habit-forming drugs. It is harder to obtain a prescription for this class of drugs and strict quantity limits are in place. It's a pain for those with chronic conditions accustomed to using opioid-based medications to manage their situation and achieve a level of personal comfort.
A new wave of restrictions and quantity limits on all pain medications are being implemented. Both new and existing pain medication prescriptions have gotten more restrictive, including the monitoring of those who prescribe, dispense and take opioids. This situation promises to only get stricter and more invasive. Coincidentally, these medications are becoming more expensive to purchase as a result, adding insult to injury to many who refill this class of prescriptions regularly.
In essence, to conform to these new regulations, any "pain" associated with a condition must fit into a narrower window. According to new CDC dictums: "Opioids are not first line or routine therapy for chronic pain." Ouch! Instead, to initiate or continue an opioid prescription, pain must stem from a very severe diagnosis such as life-threatening cancer, palliative, end of life (hospice) or other serious malady.
For those newly prescribed an opioid medication, a seven-day course of therapy is all that's permissible. As well, immediate-release (IR) drugs are being favored over the longer-acting extended-release (ER/CR) varieties. Insurers and pharmacies are enforcing this stance. They fear retribution by the DEA if they don't screen and reign in the amount of opioids they allow or dispense. All controlled substances are, or will eventually be, tracked electronically nationwide via a prescription drug monitoring program (PDMP). All who handle opioids face closer scrutiny and may answer for activity outside the established "norm."
For all healthcare professionals, the process to convince an insurance company to exceed their formulary quantity is also more difficult and time-consuming. The new status quo restricts doctors to an accepted morphine equivalent dose, equivalent or quotient (MED , MME or MEQ); this is the sum total of morphine contained in all of a patient's current pain medications and if that total exceeds an acceptable dose-amount than your prescription, new or refill, may be denied. This number is different depending on the strength of the opioid prescribed.
In light of the current and ongoing restrictions, the CDC recommends some safer and more acceptable alternatives to chronic pain therapy:
- Non-opioid drugs: NSAIDs, topicals, anti-anxiety, steroids, muscle relaxants, epidurals.
- Non-drug treatments: Exercise, physical therapy, acupuncture, yoga, massage, herbs, hypnotherapy, chiropractic, biofeedback.
- New frontiers: Medical marijuana, stem cell therapy, trigger-point massage, bio-genetics and others might offer solutions for pain control as they continue to evolve in research.
- Speak with the doctor to address your individual situation and consider his recommendations.
We will continue to support our patients' medical prescription needs. If a therapy makes sense, opioid or non-opioid, we will continue to pursue the most reasonable and best results on your behalf. We may be at war with a strong foe but we can hold our own by also being strong, understanding and flexible.
|
|
4 Steps to Avoid Binge Eating
|
Binge eating is a frequently overlooked eating disorder in the United States, and, unfortunately, it is also one of the most common.
Binge eating disorder, or BED, is characterized by sessions of eating large amounts of food in the absence of hunger, often within an isolated environment. With frequent episodes of extreme overeating, individuals with BED may be more susceptible to diabetes, GERD, sleep apnea, heart problems, and many other health issues. If you are struggling with binge eating, there are steps you can take.
1. Be open about your eating habits.
Binge eating disorder often goes undiagnosed, because people feel shame about their eating habits and may have psychological issues tied to their relationship with food. However, opening up to a professional can help you overcome those challenges and maintain a healthier relationship with food while improving your overall body image. Talking to a therapist may also present the opportunity to try medications to help manage the urge to binge eat and provide support as you take on other steps to keep binge eating at bay.
2. Don't skip meals.
Controlling binge eating means controlling how often you eat and how much you eat with each meal. Sticking to a regular schedule of meals helps regulate hunger stimulating hormones in the body and keep down the urge to overeat.
3. Keep your kitchen cleansed.
It is easy to have an episode of binging if your fridge and cabinets are fully stocked with food. Take the time to fully clean out your kitchen (and any other areas where snacks might be stashed) and restock with healthy ingredients and foods that require some prep time, so it's harder to just go to the kitchen and start eating.
4. Practice mindfulness.
Mindfulness is the process of connecting with your body by becoming more aware of how you are thinking and feeling within a given moment. Meditation can help you practice mindfulness, as can meditative activities like yoga, and this might help you better manage your hunger and recognize when your motivation to eat is not triggered by hunger.
|
|
Doctor's Visits:
Why Checkups Are Vital. . . . . .
|
 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 2018 yet?
|
|
Easy Autumn Recipe:
Garlic Herbed Beef Tenderloin
|
Ingredients
- 1 beef tenderloin roast (3 pounds
- 2 teaspoons olive oil
- 2 garlic cloves, minced
- 1-1/2 teaspoons dried basil
-
- 1-1/2 teaspoons dried rosemary, crushed
- 1 teaspoon salt
- 1 teaspoon pepper
Directions
- Tie tenderloin at 2-in. intervals with kitchen string. Combine oil and garlic; brush over meat. Combine the basil, rosemary, salt and pepper; sprinkle evenly over meat. Place on a rack in a shallow roasting pan.
- Bake, uncovered, at 425° for 40-50 minutes or until meat reaches desired doneness (for medium-rare, a thermometer should read 135°; medium, 140°; medium-well, 145°). Let stand for 10 minutes before slicing.
Nutrition Facts 3 ounces cooked beef:
198 calories, 10g fat (4g saturated fat), 78mg cholesterol, 249mg sodium, 1g carbohydrate (0 sugars, 0 fiber), 25g protein.
Diabetic Exchanges: 3 lean meat.
- By
Caroline Stanko
|
|
Insights By Steve: Check it Out!
|
|
|
|
Insight By Steve (Author)
|
"Five Foods That Fight Sunburn"
.... and more news you can use!
Back To Top
|
|
We Need Your Help!
|
 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
|
|
|
Have a Safe & Healthy
Autumn!
Dr. Douglas Lakin & Staff
Paradise Valley Medical Clinic PC
|
|
|
