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So far ndiaz has created 46 blog entries.

Mondays with your MD – Just Tired or Fatigue?

2022-07-24T01:59:47+00:00July 23rd, 2022|Adults, Family Practice, Health Care|

Why am I always tired? How tired is too tired?

Today we are exploring the difference between “being tired” and fatigue which often underlies a more serious medical problem.
Tiredness happens to everyone – it’s an expected feeling after certain activities or at the end of the day. Usually, a good night’s sleep solves the problem.
Fatigue is a daily lack of energy – unusual or excessive whole-body tiredness not relieved by sleep. Fatigue can prevent a person from functioning normally and affects a person’s quality of life.

woman sleeping at desk

What are the most common causes of fatigue?

Lifestyle Factors

Taking an honest inventory of things that might be responsible for your fatigue is often the first step toward relief.

Evaluating the following can have an enormous impact on levels of fatigue:

  • Exercise
  • Nutrition
  • Alcohol use
  • Medications
  • Routines

Modifications can often dramatically impact levels of fatigue.

Medical Factors

Underlying Medical Conditions that commonly cause Fatigue:

  • Anemia: iron deficiency anemia is a common blood disorder that makes it hard for your blood to move oxygen to your organs.
  • Thyroid problem: this small butterfly-shaped gland that sits in your neck regulates your metabolism and energy levels. When thyroid gland out of whack, you’re out of whack.
  • Depression: untreated and undiagnosed depression can rob your brain of the chemicals needed to work its best causing low energy levels and fatigue.
  • Infections, Sleep Apnea, Heart Disease are common problems that can manifest the symptom of fatigue as well.

Recap

Many physical and mental illnesses, as well as lifestyle factors, can cause your fatigue, and that can make it hard to diagnose. In some cases, it might be something simple and easy to fix, like having caffeine at bedtime. But other causes, like heart disease or COPD, are serious, and you may need to start long-term treatment right away.
Your doctor can help you sift through your health issues, as well as diet, exercise, and other lifestyle habits, on order to zero in on the cause and help you on the road to recovery.

Mondays with your MD – Urinary Tract Infections: Separating Fact from Fiction

2022-07-17T13:40:09+00:00July 17th, 2022|Adults, Families, Family Practice, Health Care, Urgent Care|

Urinary Tract Infections

Urinary tract infections, or UTIs, are extremely common, especially in women. Dealing with them is no fun and often requires frequent trips to the bathroom, pain when urinating, and soreness in the lower abdomen, back or sides. Many turn to at-home remedies to tackle discomfort or try to change risky behaviors to avoid a repeat infection.

Unfortunately, there are plenty of myths out there about UTIs that can make recognizing the causes and finding effective relief difficult.

Separating Fact From Fiction

Myth #1: Taking AZO for my UTI is “Good Enough”

Although AZO may provide symptomatic relief, it can often mask underlying symptoms and delay seeking appropriate medical care.  In addition, it can cause discoloration of urine making the infection more difficult to detect on examination.

Myth #2: Tampons Cause UTIs

Some women think tampons make them more prone to developing UTIs since tampons are placed inside the body, while other feminine hygiene products are kept outside of the body. However, tampon use may be even more effective at preventing UTIs than pads. Tampons can keep the area dryer, leaving less of a chance for bacteria to flourish and cutting down on the risk of infection.

Myth #3: Cranberry Juice Will Cure My UTI

The cranberry juice cure is one of the most commonly believed myths about treating UTIs. However, don’t for a minute think that a bottle of cranberry juice can replace a visit to your doctor or proper medication. It turns out cranberry juice isn’t nearly as effective as many people think.

Though some studies have demonstrated potential ability to prevent (not treat) symptomatic UTIs, there isn’t sufficient data to support routinely recommending it.

Myth #4: Only Women Get UTIs

Women definitely get UTIs more often than men. This is because the urethra, the duct that carries urine out of the body, is shorter in women, allowing bacteria to more easily reach the bladder. However, this is still a myth, as men can and do get UTIs. UTIs are more common in men who have not been circumcised and suffer from other medical issues including incontinence, prostate cancer or urinary tract stones.

Myth #5: Sex Causes UTIs

This one is both a myth and a fact. The real myth lies in the belief that only sexually active women get UTIs. Sex can definitely play a role, though, as bacteria near the vagina can inadvertently get into the urethra during sexual contact. Urinating after sex is CRUCIAL because it will allow your body to flush out vaginal bacteria that tends to get pushed into the urethra during sex.

Does this mean that abstinence is a sure-fire way to protect yourself from UTIs? Think again. In fact, women are most at risk for getting UTIs while pregnant or experiencing menopause or perimenopause. This is due to the change of hormones in the urinary tract during these times.

Talk to your doctor about UTI symptoms and appropriate treatment.

Mondays with your MD – Telemedicine: Back to the Future

2022-07-11T13:33:18+00:00July 11th, 2022|Adults, Direct Primary Care, Family Practice, Health Care, Telemedicine|

Reminiscent of a time where patients could receive medical advice by simply calling their doctor on the phone….telemedicine, popularized with the pandemic, has always been a structured integral part of Direct Primary Care (DPC). Virtual care has been shown to increase access to health care and lead to improved health outcomes when utilized correctly.

Telemedicine

Telemedicine allows for an ongoing dialogue between patients and physicians about shared health goals and decision-making. This improves adherence to the medical plan of care by providing a platform for a collaborative approach to health, where chronic conditions can be managed.

Telemedicine provides flexibility for scheduling and eliminates barriers between physicians and patients. Follow up appointments are made easier by removing travel times, childcare concerns, and time off work.

Virtual consultations can prevent unnecessary in-person referrals to specialists and lead to shorter waiting times to see specialists.

Telemedicine has always been a structured integral part of (DPC). When patients have an urgent care need or a follow up concern from previous visits, DPC physicians are able to quickly troubleshoot those problems with patients and determine the best course of action for each individual.

Mondays with your MD – Women’s Rights to Reproductive Health Care in 2022

2022-07-03T18:04:48+00:00July 3rd, 2022|Adults, Family Practice, Health Care, Pregnancy, Public Health|

I am grateful today that I live in Illinois, but I do not believe access to health care should depend on where a woman is residing within the US. The disruption to appropriate health care for women has caused chaos in caring for women who are pregnant, and ultimately will lead to preventable deaths of women that will affect the entire nation for generations.

People misunderstand the far-reaching consequences of the ruling by believing abortion to be a simple elective decision to terminate a “normal” pregnancy. This ruling, in fact, threatens the fundamental health care rights of women. It demonstrates HOW IMPORTANT the physician-patient relationship is and why neither government nor insurance companies have any place making health-care decisions.

Reverting to state level laws from early 1900s, immediately following this ruling, has put numerous physicians in an impossible situation wondering how to legally provide appropriate care for their patients. In Utah, for example, the law describes the delivery of anything except a dead fetus as an abortion. Women who are severely infected or hemorrhaging as a complication of pregnancy, with a fetus that has a heartbeat but cannot survive outside of the uterus, have routinely been treated by terminating pregnancy as the standard of care… until now. With the change in law, instead of terminating the fetus and sparing the life of the woman, there will be an additional preventable loss of life. The lives of women will be lost.

In some states, immediately following the ruling, physicians were asked to contact the legal department prior to caring for patients appropriately….this simple delay in care can cost the life of a woman who is hemorrhaging from an ectopic non-viable pregnancy in an emergency care situation.

The supreme court decision eliminates equitable and safe access to medical care and will ultimately lead to higher maternal mortality rates in the US. There is absolutely no space for third parties, government bodies nor insurance companies, in the delivery of health care. These decisions must be made DIRECTLY between patients and their physicians.

“The American Medical Association is deeply disturbed by the U.S. Supreme Court’s decision to overturn nearly a half century of precedent protecting patients’ right to critical reproductive healthcare—representing an egregious allowance of government intrusion into the medical examination room, a direct attack on the practice of medicine and the patient-physician relationship, and a brazen violation of patients’; rights to evidence-based reproductive health services. States that end legal abortion will not end abortion—they will end safe abortion, risking devastating consequences, including patients’ lives….

We will always have physicians’ backs and defend the practice of medicine, we will fight to protect the patient-physician relationship, and we will oppose any law or regulation that compromises or criminalizes patient access to safe, evidence-based medical care, including abortion. As the health of millions of patients hangs in the balance, this is a fight we will not give up.”

Mondays with your MD: Formula Shortage

2022-06-25T21:22:11+00:00June 25th, 2022|Families, Family Medicine, Public Health|

Formula Shortage

Recently I had a patient reach out to let me know she was unable to locate the formula she routinely provided to her baby. She let me know she was considering feeding her baby with breastmilk from a friend and was concerned about allergens in some of the other formula products.

Nothing is as important to families as the health and safety of their babies. The formula shortage has left many anxious about how to feed them. My guess is that many are thinking about a similar solution. I thought I would share a few recommendations from the American Academy of Pediatrics.

RECOMMENDATIONS

  • Consider trying a brand new formula
  • Consider trying a formula made in another country
  • Talk to your physician about substitutes for hypoallergenic or specialty forumulas (as was the case in the above example)

OPTIONS for HOW to FEED YOUR BABY SAFELY

  • Consider discussing using whole cow’s milk if baby is over 6mo
  • If baby is close to one year discuss with physician options for toddler drinks
  • Consider using local milk bank

AVOID these options

DO NOT share breast milk with friends or purchase on the internet. There are significant infectious disease and storage safety risks

DO NOT water down formula

DO NOT make it at home

DO NOT use expired formula

If you are having difficulty finding formula and solutions please reach out to your physician.

Mondays with your MD: Headaches and Migraines

2022-06-20T13:50:23+00:00June 20th, 2022|Adults, Family Practice, Health Care, Urgent Care|

June is Headache and Migraine Awareness Month.
Did you even know that was a thing?

There are many reasons people get headaches and most of us have had a headache at some point.

Today we review the most common causes as well as what the most concerning warning signs are and when you should seek immediate care.

Headaches can be due to allergies, caffeine withdrawal and even a life-threatening aneurysm.

Typical headaches are tension-type headaches and migraines.

Tension-Type headaches

Tension-Type headaches are most common and are often caused by the following 3 things:

excessive caffeine intake

alcohol intake

vision problems

Migraines

We discuss Migraines in great detail in our June edition of
“Monthly Health Tips”


Migraines can be debilitating.
We look at symptoms, preventions, and treatments.

It is important to know that headaches

can sometimes be a sign of a life-threatening emergency.

The following signs are reasons to seek care immediately:

You are having your worst headache ever
You have loss of consciousness
You have uncontrollable vomiting
Your headache is worst upon waking
You have loss of vision

Mondays with your MD: What is Direct Primary Care?

2022-06-10T03:49:57+00:00June 10th, 2022|Direct Primary Care, Family Practice, Health Care, Membership, Urgent Care|

People ask me all the time…. What is Direct Primary Care?

Focused on your health.

In a traditional fee for service primary care practice, doctors are paid based on how many people they see, number of tests they order, or type of procedures they do. This leads to our current system of rapid visits with many tests and quick referrals. Many times doctors cannot take the the time to really listen, or think about what is best for your health from the patient perspective. In the existing system, doctors are not reimbursed for emails or phone calls and this creates a system where it becomes difficult to speak to your doctor outside of a harried office visit that you may have been waiting a long time for.

In direct primary care, instead of paying for each visit or procedure, you pay a monthly fee. This monthly fee frees the physician from the model that promotes productivity over quality and allows your physician to focus on you and what you really need. This leads to more time with your doctor when you need it and convenient easy access outside the doctor’s “office visit” by phone, text, email, etc.

The doctor you call. The doctor you trust.

Direct primary care doctors are dedicated to provide the high-quality unhurried care that is essential for your wellbeing and ongoing maintenance of your health. You can see your direct primary care doctor for all routine and preventive services like checkups as well as urgent care and chronic care management. Many times having this relationship with your physician and the access it provides, can save you visits to more expensive venues like the urgent care, hospital or emergency room.

Mondays with your MD: Keeping medications affordable

2022-06-06T13:57:34+00:00June 5th, 2022|Adults, Direct Primary Care, Health Care, Membership, Prescription Costs|

Medications do not need to be expensive.

At Roots Health DPC, we are making medications affordable for our patients. How?

We buy medications at wholesale pricing and sell them to our patients directly at wholesale cost – without marking them up. We remove the profit takers, pharmacy benefit managers, and retail pharmacies between patients and their medications, effectively lowering the cost of prescriptions by 50% to 90%.

Examples of medications for under $5/month

Medication Dosage
Metformin 1000 mg
Ibuprofen 600 mg
Lisinopril 10 mg
Amlodipine 2.5 mg
Sertraline/Zoloft 50 mg
Lovastatin 40 mg
Sumatriptan/Imitrex 100 mg
Lortadine/Claritin 10 mg

A simple idea to solve a complex problem

DPC stands for Direct Primary Care – we deliver health care services, including medications, directly to our patients. We provide medications at these rates because we believe that the people in our community deserve fair pricing on the medications they need to stay healthy. At Roots Health DPC, we are uniquely qualified to partner with our patients to determine which medications will best treat their medical conditions.

Mondays with Your MD: Gun Violence – A Public Health Epidemic

2022-05-29T22:40:56+00:00May 29th, 2022|Community, Public Health|

Firearms are the leading cause of death in children in the United States. Firearm deaths are completely preventable and occur at a rate more than 5x higher than drownings.


Prevention is key…
As with any health-related problem, prevention through education is a critical component. Firearms are present in 1/3 of households with children.
  • The best way to keep children safe is to NOT have a gun in the home.
  • If it is necessary to keep a gun in the home safe storage is critical. Guns should be kept unloaded and ammunition should be stored separately. Both should be locked and inaccessible.
  • Parents can speak to caregivers in homes where young children are visiting about guns in the homes where they play.
  • Talk to older kids about guns and safety.

In almost every documented case of active shooters, there were warning signs. In 4 out of 5 school shootings at least one other person had knowledge of attackers plan but failed to report it.

9 critical warning signs of violence:

  1. Suddenly withdrawing from friends, family and activities (including online or via social media)
  2. Bullying, especially if targeted towards differences in race, religion, gender or sexual orientation
  3. Excessive irritability, lack of patience, or becoming angry quickly
  4. Experiencing chronic loneliness or social isolation
  5. Expressing persistent thoughts of harming themselves or someone else
  6. Making direct threats toward a place, another person, or themselves
  7. Bragging about access to guns or weapons
  8. Recruiting accomplices or audiences for an attack
  9. Directly expressing a threat as a plan

Advocacy to protect children from gun-violence needs to occur a national level to have meaningful impact.

States with stronger gun laws have less gun violence overall. However, Chicago borders states outside of IL with fewer gun control laws.

Basic measure such as stopping assault weapon sales and advocating for high-capacity magazine limits, alongside ammunition regulation, and required background checks are all important. Increasing gun manufacturer liability is also critical.

Visit https://www.everytown.org/ to learn more about how you can work towards limiting gun violence.

Mondays with Your MD: Health Insurance is not Good Health Care

2022-05-22T19:04:31+00:00May 22nd, 2022|Adults, Copays, Family Practice, Health Care, Membership|

How accessible is health care in the richest nation? Why Health Insurance ≠ Health Care.

Many patients tell me that they love their doctor but that they cannot get through easily or book an appointment quickly. They pay thousands of dollars annually for “health insurance,” but are frustrated with their inability to access appropriate “health care.” Patients often go to an emergency room or an urgent care to be seen because it is the only option in the existing health care model.

The result: Americans visits the doctor less frequently and have the highest rate of avoidable deaths.

The United States spends 2x as much, per person, as other high-income countries, yet the US continues to have the lowest life expectancy and poorer health care outcomes when compared to other countries. Americans pay hefty premiums to health insurance plans every year. Where do the dollars go and why is health care access awful?

Traditional physician offices incur a large cost for taking care of patient needs outside of the actual patient office visit. For example, making a phone call to provide patient care is not compensated by insurance companies. Several other similar services that are instrumental to good health care include completing forms for patients, ordering and/or reviewing labs, and writing prescriptions. Restrictions placed by insurance companies make it difficult to take care of patients outside of the visit.

What if health insurance was the same as other insurance products?

A good example is car insurance. You expect to pay out of pocket for your gas, oil change, and maintenance/repairs. You have a high deductible low premium insurance that covers you in case of a car accident. In the analogous healthcare model, patients have catastrophic health insurance coverage with low monthly premiums and a high deductible.

Pairing health insurance with health care, through a physician direct primary care office, lowers out of pocket expense and improves health outcomes by providing access to obtain discounted screenings, preventative services, urgent care services, labs, and medications.

Health insurance companies have come between patients and their health. The health system in the United States is broken as evidenced by the out of control spending and health outcomes. Direct primary care offers an alternative that works. Direct primary care aligns values to prioritize patient health care needs with lower costs and better health outcomes. Find a direct primary care near you by searching https://mapper.dpcfrontier.com/

No waiting. Healthcare delivered when you need it.
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