Cori Then and Now…Transformation Tuesday

Cori is an avid football fan and is loyal to our Kansas City Chiefs.  Last spring she set out on a transformation that has changed her life.

Not only does she look fantastic but she feels healthier and happier with her progress. She is a mother of three active children and is excited to be setting a good example for them by being healthier and taking care of herself.

Cori’s encouragement for others is to be prepared for hard work.  The results will not be instant and expect setbacks.  It really is about making small steps towards a bigger goal.

How did she do it?  Hard work.  Nothing compensates for hard work.  She began running and really watching her diet.  Her diet focus was not only about healthier choices but also portion control.   Cori has completed two half-marathons and has plans for more.

Go Cori and Go Chiefs!

 

Ann Riggs, DO

Patient-Driven Affordable Healthcare

When our model hits home–the proof is in the pudding.

 

Pudding Proof

I recently had the opportunity to experience the pitfalls of my own commercial health
insurance.  I tell patients all the time “the proof is in the pudding.”  Well it was my turn to see how this pudding really was in the health insurance world.

 

 

Recurrent Strep

This past fall my daughter was hit with yet another bout of strep throat.  She has fought it throughout her young life.  At the age of seven I made the call to consult with one of my favorite ENT docs.  It was an easy decision that she would do better if we proceeded with tonsillectomy and adenoidectomy.

 

High Deductible

I, like so many of my patients, have a high deductible plan that I have married with an HSA(Health Savings Account).  I knew the bulk if not all of the cost of the procedure would be my responsibility.  I did not hesitate to ask for cash pricing.

Insurance Negotiated Pricing vs Cash Pricing

Pricing for any surgical procedure needs to include the following fees:

1.  Surgeon’s Fee
2.  Anesthesiologist’s Fee
3.  Surgical Facility’s Fee

INSURANCE NEGOTIATED PRICING:  

Surgeon	$372.51
Anesthesiologist + Facility	$2624.00
Total Cost	$2996.51

CASH PRICING: 

Surgeon	$402.50
Anesthesiologist	$578.00
Facility	$879.83
Total Cost	$1860.33

FINAL PRICING AND SAVINGS:

I was actually able to pay the insurance negotiated pricing for the surgeon and the cash pricing for the anesthesiologist and the facility.  My final pricing was $1830.34 for the entire procedure.  And there lies the proof in the pudding:

Almost $1200 in Savings

Happy Healthy Kid at Great Cost Savings by Paying Cash

Bear was Free!

Ann Riggs, DO

Patient-Driven Affordable Healthcare

 

Poison Ivy Prevention–Are you ready to ditch the itch?

Leaves of three, let them be!! Hairy vine, no friend of mine!! Raggy rope, don’t be a dope!! Berries white, run in fright!! Growing up in the midwest, most of us are well informed of this itchy summer issue. We know to avoid the plant, wear protective clothing, and wash the oil off as soon as exposed.

 

As a young child I was never allergic and spent most of my summers exploring the woods, marveling at the wonders of nature. When I developed a rhus (poison ivy, poison oak, poison sumac) allergy as a young adult, it seriously impacted my enjoyment of the summer!!

Five years ago I heard of a pharmacy in Warsaw, Missouri offering a poison ivy prevention treatment. My husband and I had recently purchased a farm with extensive poison ivy actively growing. I had spent the last 3 summers requiring multiple steroid injections for poison ivy so both of us decided to give this a try.

And it WORKED!! Each year it works even better. Some people get complete immunity. I have never been that lucky but have significant less skin eruption with direct contact of the plant and no spread. I have not required steroid treatment for 4 years now and might get one small blister in the area of direct skin contact with the plant.

This is a homeopathic treatment and does not impact medications or supplements. Poison Ivy Oral Solution is designed to work as a preventative to help protect against getting poison ivy. The cost for members is $40 and the cost for non-members is $60 at Direct Medical Care.  This solution is held in the mouth for 30 seconds and then swallowed. Poison Ivy Solution is best taken between meals. Mint flavored foods or mouthwashes must be avoided 30 minutes to one hour before and after administration. The first dose of the medication should be administered in a physician’s office, the other’s may be taken at home. Patients taking the Poison Ivy Solution during the plant’s active growth phase (late spring and summer) should keep away from the plant until all three vials have been taken.

First dose monitoring in the doctor’s office is related to the active ingredient in the solution. It contains a dilution of the resin of the plant Rhus Toxicdendron. I have not seen a case of allergy to the solution, but it is theoretically possible.

The treatment success I have experienced is part of the reason I pursued integrative medicine. It opened my eyes to the possibilities of alternative treatments. I typically order my own solution in March and will be putting an order in soon.

Are you ready to ditch the itch?

Beckie Moore, Integrative Family Nurse Practitioner

 

 

 

 

 

 

 

Baby Boomers Beware

The Scare

The recent commercial promoting screening for hepatitis C in the Baby Boomers has scared many of my patients and their friends. Scare tactics usually work for a desired action, but is this really necessary?  I would argue it is not.

Hepatitis C Commercial

The Facts

Hepatitis C is a virus that is transmitted by blood exposure.  It is estimated that almost 3.2 million people in the United States have the virus.

The hepatitis C virus can cause liver damage, can cause cancer, and can cause death because of the liver damage or cancer.  You can also have the virus and never develop symptoms.

Risks for acquiring hepatitis C:

tattoos, blood transfusions, organ recipients, accidental needle sticks, IV drug use, and sexual intercourse

 

 

 

My Thoughts

Pharmaceutical companies that have a vested interest in the drugs used to treat hepatitis C have a lot to profit with increased diagnosis.  With increased screening, we get increased diagnosis which leads to increased usage of medications which leads to huge monetary gains for the pharmaceutical companies.  While we do not include hepatitis testing in our routine labs we do recommend annual evaluation of liver enzymes which indirectly looks for the presence of hepatitis C.

And while I have certainly lost patients from a variety of disease processes, I have never had a patient die from hepatitis C…don’t be scared regarding this issue, talk to your doctor.

 

Ann Riggs, DO

 

Patient-Driven Affordable Healthcare

 

More Frazzled Than Dazzled?

Whether you are traveling or hosting the holidays, this time of year brings with it an abundance of stress. Finding the perfect gifts and dealing with difficult family members can, for some, overshadow the reason for the season. Oh, and everyday life keeps on ticking as well.

What can we do to slow down, relax, remain healthy and enjoy??

Try this simple breathing exercise. It’s called the 4-7-8 breath and can actually alter our nervous system. It is calming and relaxing, it is free and it is easy!

First, exhale completely, blow all that stress and frustration OUT.

Second, inhale through your nose to the mental count of 4.

Third, hold your breath for a mental count of 7.

Next, exhale through your mouth to a mental count of 8.

Lastly, repeat this sequence for a total of 4 breath cycles.

I recommend starting and ending your day with this breathing exercise and adding it in any time you feel stressed throughout your day.

This is quick, anyone can do it and it has research proven health/relaxation benefits.

This simple breathing technique can help us erase some of the stress in our busy lives.

The power of the breath! Is it really that easy? Try it and find out. Prepare to be Dazzled!!

—Beckie Moore, Integrative Family Nurse Practitioner

Patient-Driven Affordable Healthcare

Magnificent Magnesium

Role of Magnesium

 

Magnesium is #12 on the Periodic Table and is a mineral that plays a role in many bodily functions. There are over 300 reactions in your body that depend on this vital mineral.

 

Magnesium Deficiency

It is estimated that 80% of individuals would benefit from magnesium supplementation. Magnesium is not checked on routine lab evaluations.  Common signs of possible magnesium deficiency are below:

Magnesium Sources

Dietary sources:

• dark leafy greens
• nuts
• seeds
• fish
• beans
• whole grains
• avocados
• yogurt
• bananas
• dried fruit
• dark chocolate

Magnesium supplements:

There are so many forms of magnesium salts used for repletion and supplementation.

• Magnesium Ascorbate
• Magnesium Aspartate
• Magnesium Bicarbonate
• Magnesium Carbonate
• Magnesium Chloride
• Magnesium Citrate
• Magnesium Fumarate
• Magnesium Gluconate
• Magnesium Glutamate
• Magnesium Glycinate
• Magnesium Hydroxide
• Magnesium Lactate
• Magnesium Lysinate
• Magnesium Malate
• Magnesium Orotate
• Magnesium Oxide

Which is best???  And to be honest until writing this blog I had never considered the differences.  In my research, I now recommend one of the following:

Magnesium Citrate–induces more gastrointestinal side effects for individuals that may suffer from constipation

Magnesium Glycinate–induces less gastrointestinal side effects for individuals that do not have any constipation issues

Magnesium Oxide–most available, affordable and side effect profile more neutral

 

Ann Riggs, DO

Patient-Driven Affordable Healthcare

 

 

 

 

**disclaimer:  noted misspellings/grammatical errors in graphics but felt graphics value outweighed the errors.

 

Beckie Moore, APRN Brings “More” to DMC

Direct Medical Care Introduces Beckie Moore, APRN

Beckie Moore, APRN was born in Wichita, Kansas and raised in Platte County, Missouri. After 12 years in Platte City, Missouri, she and her family settled just north of Dearborn, Missouri, where she enjoys her time away from patient care on her farm.  Beckie graduated valedictorian from North Platte High School in 1983.  She has been an RN since 1987.  Beckie went on to earn her Master’s degree in nursing from the University of Missouri, Kansas City in 1999.  As a Family Nurse Practitioner in the Northland for over a decade, Beckie noticed patients interested in and seeking alternative options that were not taught in her traditional western medicine education.  Seeking answers and education for herself, she discovered that the University of Arizona offered a two year medical fellowship in Integrative Medicine. Beckie completed her fellowship in 2016. She hopes to compliment patient care with her new knowledge base. Her passion is treating root causes of illnesses and promoting wellness at every turn.

The Calorie Creep

But Doctor I am not eating that much…

While there are always exceptions rarely does one become overweight by not eating.

The balancing act of  creating a calorie deficit is key for weight loss.  Please see my prior blog post regarding the fundamentals of weight loss:

Calories Consumed < Calories Expended= Weight Loss

It can be one misstep in your day that will sabotage all your good efforts.  Stealing the term introduced to me by an inspiring patient, I would like to bring “the calorie creep” to life in the pictures below:

Keep in mind it does not have to be junk food that can be your calorie creep–avoid the creep in whatever form!

Ann Riggs, DO

Patient-Driven Affordable Healthcare

 

Sneezing, Runny Nose, Itchy Eyes are Here

ALLERGY SYMPTOMS

• Cough
• Runny nose
• Sneezing
• Itchy nose
• Sore throat
• Watery eyes
• Puffey eyes
• Itchy eyes
• Asthma flares
• Difficulty breathing

TIMOTHY GRASS ALLERGIES

One of the most common allergens is grasses and specifically timothy grass.  We are seeing these right now. While preventive treatment is ideal, treatment is currently focused on relieving the symptoms. There is a new option for allergy sufferers of common grasses for future seasons.  The middle of freezing temperatures is when the grasses are dormant.  It is that time that preventive treatment needs to start.

The newest option to treat for the timothy grass allergen is Grastek.   This is immunotherapy in a pill. For those that have endured the weekly shots this is a novel, relatively painless approach to immunotherapy that can be done in the comfort of your own home.

Grastek covers Timothy grasses but also has cross coverage to other grasses.

It should be started for seasonal care 12 weeks ahead of pollen and throughout the season or taken consecutively for 3 years.

Click on the following link for more information on administration of Grastek.

RAGWEED ALLERGIES

Another common allergen that is on the horizon is ragweed.  Fortunately, our timing of discussing this form of treatment is ideal.  The same manufacturer of Grastek has developed a similar treatment for ragweed with the prescription drug Ragwitek.

Ragwitek like Grastek should be taken 12 weeks before the allergen season.  In this geographic area the typical ragweed season begins about August 15.  That gives an estimated start date of the medication in mid-May.

Ragwitek is taken similarly to Grastek with pre-seasonal and seasonal administration or continuous administration for 3 years.

TRADITIONAL ALLERGY CARE

Many other treatments remain the mainstay for allergy treatment: 

Oral Medications:

Antihistamines

• Cetirizine–Zyrtec
• Diphenhydramine–Benadryl
• Fexofenadine–Allegra
• Loratadine–Claritin, Alavert

Decongestants

• Phenylephrine
• Pseudoephedrine

Leukotriene Antagonist

• Montelukast Sodium–Singulair

Nasal/Ocular Medications:

Steroids

• Flonase
• Nasacort
• Nasonex
• Qnasl
• Rhinocort

Antihistamines

• Astelin
• Pataday
• Patanase
• Pazeo
• Zaditor

Decongestants

• Ephedrine
• Oxymetazoline–Afrin, Sinex
• Phenylephrine

Cromolyn

• Nasalcrom

Anticholinergics

• Ipratropium Bromide–Atrovent

Nasal Irrigation

• Navage
• NeilMed
• Neti-Pot

Avoidance:

While avoidance can be difficult here are some pointers that may help:

• Stay indoors when the pollen count is high especially between 5AM to 10 AM when pollen counts are highest
• Wear a mask when mowing or avoid mowing altogether
• Choose grasses for your lawn that produce less pollen–dichondra and irish moss are some examples
• Mow frequently to keep grass short
• Keep windows closed
• Avoid attic fans
• Bathe pets frequently
• Do not dry clothes outdoors
• Minimize alcohol intake as it leads to dehydration and increased sensitivity to allergens

Another topic to come…How do I know what I am allergic to?

Ann Riggs, DO

Patient-Driven Affordable Healthcare

Richer in More Ways than One…

Smoking Cessation

No better time to discuss smoking cessation than when we are at the new year and resolutions are starting to fade while the freezing temperatures outside continue. I tell my patients that are contemplating smoking cessation that if successful they will be richer in more ways than one.   The health benefits of smoking cessation are clear.  The often overlooked benefits of smoking cessation are the return of significant time and money.

 

Health Benefits

• decrease in bronchitis, COPD
• decrease in blood pressure
• decrease in heart rate
• decrease in ALL cancers
• decrease in diabetes
• decrease in osteoporosis
• decrease in rheumatoid arthritis
• decrease in erectile dysfunction for men
• decrease in ectopic pregnancies, miscarriages, small birth weight in pregnancy
• decrease in second hand smoke decreases sudden infant death syndrome, ear infections, respiratory illnesses, and asthma

 

Non-Health Benefits

We never seem to have enough of either time or money and smoking cessation recaptures both.

• Money
• Time
• Time=Money

 

 

The actual cost savings can be calculated here.  The following depicts the savings realized when smoking 1 pack per day with a cost of $5.70 per pack:The amount of time spent smoking is estimated at 6 minutes and 20 seconds per cigarette. Calculations for smoking 1 pack per day equates to over 2 hours per day.  

If you extrapolate the value of your time then your costs rise exponentially.

Smoking Cessation Aids

So you are ready but want some help.  There are over-the-counter, prescription, and alternative options to help you be more successful.

Over-the-counter options:

• Nicotine patches
  
• Nicotine gum
• Nicotine lozenges

 

 

Prescription options:

• Nicotine inhalers
• Nicotine nasal sprays
• Bupropion is a common anti-depressant medication that was once marketed as Zyban. This medication can diminish the cravings and withdrawal symptoms from the nicotine.
• Chantix is for smoking cessation only and can diminish the cravings and withdrawal while also blocking nicotine effects from smoking.

Alternative options:

• E-cigarettes–long term safety has been unclear but recent studies identify significant concerns on safety and effectiveness
• Hypnosis
• Acupuncture
• Support groups

No better time than the present to kick the habit as you will be richer in more ways than one!

Ann Riggs, DO

Patient-Driven Affordable Healthcare