The Director's Corner
Winter is here! At the Center for Family Medicine we are busy giving flu shots, pneumonia shots and helping our patients get ready for the colder weather.
For those older than 65 years old, and for those with chronic medical conditions - you may be a candidate for the high dose flu shot. Ask your doctor if you are a candidate.
For those older than 50 years old - ask about the Shingles vaccine.
For boys and girls - the HPV series of three shots to prevent cervical cancer is now recommended. We start this series about age 11.
We are proud to be once again designated a Gold Star Primary Care Practice by UnitedHealthcare Community Plan of Ohio for 2012. This is awarded only to offices that have met careful quality and efficiency goals. This is good news for all our patients as it means we are providing high quality and cost effective care. It is especially good for UnitedHealthcare members as it means we will have to seek prior approval from your insurance company less often.
We are in the process of interviewing and selecting another five residents for our Family Medicine residency program. There is a lot of interest in family medicine this year so we are certain to select some excellent new doctors.
We try to be responsive to your needs and several of the articles that follow were written in response to specific questions or concerns brought up by you, our interested patients. Please email us at email@example.com with the issues you would like covered in the newsletter and we will do our best to address them. We really do appreciate your feedback.
Elliot B. Davidson, MD,
Director, Center for Family Medicine
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CFM is on Facebook!
By Doug Harley, DO
The Center for Family Medicine (CFM) has embarked on a social media campaign to reach out to our faculty, staff, residents, rotating students, Family Medicine recruits, and our community. CFM is on Facebook and we are keeping you updated about what our team is doing at the residency, in our medical community, and in our local community. You will find posts about upcoming events, faculty/staff/resident achievements, community event participation, and interesting medical articles and issues.
Visit our Facebook page (Akron General Center for Family Medicine) for the most up to date information about what we are doing. If you "Like" the page you can view what is going on at our program. FYI - Liking a page does not allow us to view any of your Facebook posts or pictures.
Please also visit the Akron General Medical Center website at www.akrongeneral.org. Click the Centers & Services tab, then the Family Medicine hyperlink to visit the Center for Family Medicine’s website. If your search is for the Resident education component, please click the MedEd & Research tab, then Residency training, then follow the Family Medicine hyperlink to your destination.
Thank you for keeping the pulse on Family Medicine at CFM.
The PCMH Journey Begins
By Phillip Moser, CRNP
I want to take a moment and share with you an exciting adventure that is underway at the Center for Family Medicine. Patient Centered Medical Home is a concept that will focus on better communication with "you" our patient.
The PCMH concept will allow for better patient based services through many different avenues. This approach will include care coordination, better access to your personal physician and faster service!
You will start to see more information about PCMH as the program grows. Always remember that we are committed to providing you with the best care and service possible. Stay tuned and come with us on this very important journey.
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Welcome to Medicare and Yearly Wellness Visits
By Kathie Greene, MD
What does the doctor or your insurance company mean when they say you need a preventative health or health maintenance visit? Preventative health visits are visits in which your doctor reviews your personal and family history and other things which may affect your health. If areas which need work are identified, you and your doctor will work together as partners to improve your health. The doctor may make any necessary referrals (for example for a colonoscopy if it is due) and counsel you about lifestyle changes.
At 65, or when first enrolled in Medicare, one is entitled to a "Welcome to Medicare" visit. You pay nothing for this preventive visit or the yearly "Wellness" visit at Center for Family Medicine. The Part B deductible does not apply. Some other insurance companies also provide an annual wellness visit.
However, if your doctor or other health care provider performs additional tests or services during the same visit that are not covered under these preventive benefits, you may have to pay coinsurance, and the Part B deductible may apply. So remember when you come to your "Welcome to Medicare" visit, only issues which relate to preventing illness or keeping you healthy can be addressed.
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Litestyle Research Project
By Debra Gargiulo, MD
Obesity contributes to many chronic illnesses seen in the primary care office. Physicians explain to patients that they must change their lifestyles through diet and exercise in order to take better care of themselves. Patients, however, often find it difficult if not next to impossible to figure out and master the skills needed to do this.
Dr. Debra Gargiulo, a third-year resident in the Family Medicine residency Program at Akron General’s Center For Family Medicine, has taken on a project to give instruction and direction to patients in making these lifestyle changes. Through her residency research project, she also is seeking to determine how long patients need intervention before they can easily adapt the changes they have learned into their own routine. Dr. Gargiulo is working with the staff from the Litestyles program. This program is offered at all of the Health and Wellness Centers sponsored by Akron General Medical Center. The program includes physical fitness assessments and nutrition and exercise counseling. Those participating workout with trainers two times a week. They also meet with a nutritionist who gives advice on how to make better food choices.
The study is full and no more patients are being accepted into the study.
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Caffeine: Friend or Foe?
By LuAnn Beavers-Willis, MSN, RN, CDE, Education Coordinator
Do you need that jolt of your coffee or energy drink to get you going in the morning or keep you going during the day and evening? Caffeine is in many beverages and can be both a friend and also a foe if you take in an excess amount.
Benefits of caffeine often include that stimulating effect with more energy. Too much caffeine can affect your health resulting in insomnia, nervousness, restlessness, irritability, stomach upset, fast heart rate, and muscle tremors.
How much caffeine intake per day is too much? A moderate intake of 200mg-300mg which is equal to 2-4 cups of brewed coffee usually does not cause harm.
Nutrition facts on beverage cans or bottles does not indicate the amount of caffeine content per serving. The Center for Science in the Public Interest website has the following caffeine content for various beverages:
Generic brewed coffee-8oz=102-200mg •
Starbucks Grande-16oz=320mg •
Decaffeinated generic brewed coffee-8oz=3-12mg •
Tea brewed-8oz=40-120mg •
Starbucks Tazo Chait tea-16oz=100mg •
Snapple lemon, raspberry, or peach tea-16oz=42mg •
Vault soft drink-12 oz=71mg •
Mountain Dew-12oz=54mg •
Coke-12oz= 35mg •
Diet Coke-12 oz=47mg •
7up, Fanta, Fresca, Mug Root Beer, Sierra Mist, Sprite=0 mg •
Spike Shooter Energy -8.4 oz=300mg •
5 Hour Energy-1.93 oz=207mg •
Monster Energy-16 oz=160mg •
Red Bull Energy-8.3 oz=80mg •
Hot cocoa- 8oz= 3-13mg
Some suggestions for curbing your caffeine intake:
- Cut back gradually or drink 1 less coffee, soft drink, or energy drink daily
- Avoid beverages with caffeine late in the day
- Go decaffeinated
- Shorten brew time or go herbal
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Weight Loss Medication Qsymia
By Phil Maletich, PharmD, PGY 1 Pharmacy Practice Resident
Qsymia is the newest addition to the prescription medication weight loss market. Originally introduced by Vivus with the brand name Qnexa, Qsymia is a combination of two medications. The first medication in Qsymia is topiramate, which is a medication used to prevent seizures and migraines. The second medication is phentermine. Phentermine is a stimulant medication that can decrease appetite.
Qsymia is only for those who are overweight. Eligible patients are either obese or have a body mass index (BMI) greater than 27 with a condition such as high blood pressure or diabetes. The medication must be used with a reduced calorie diet and increase in physical activity, and may achieve a weight loss of up to 5%-10%, or 10 to 20 pounds over one year for a 200-pound person.
Qsymia should never be used by pregnant women, patients with eye or thyroid problems, or while using certain antidepressants. Common side effects are rapid heart rate, dizziness, constipation, trouble sleeping, and dry mouth. If used long term, this medication may harm the heart, and further evaluation of Qsymia must be performed before it can be widely recommended.
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By Jane Freeman, LISW, Director of Behavioral Science
Here in Northeast Ohio, many of us struggle with S.A.D, Seasonal Affective Disorder, during the winter months. S.A.D. is a form of depression which is more common in the winter months in areas where the sky is overcast much of the time.
The lack of direct sunlight may cause people to experience sluggishness, increased appetite leading to weight gain, excessive sleep, social withdrawal, lack of interest in normal activities, unhappiness and irritability. It tends to be experienced more by women and symptoms seem to increase as we get older. Thyroid imbalances and other conditions may have symptoms which mimic S.A.D., so it is important to talk with your doctor if you are experiencing these symptoms in order to get the correct diagnosis which leads to the right treatment for you.
If we cannot afford to spend the winter in Florida, we can still seek relief from this condition by a less expensive means: light therapy. Spending 20-30 minutes a couple feet from a broad spectrum, very bright light (10,000 lux) every morning can help reduce the symptoms. Unlike tanning beds, these are special lights which block out the harmful rays of the sun. These light boxes can be bought at some local drugs stores or through the internet. Instructions are to keep eyes open but not look directly into the light. Usually several weeks of light exposure are necessary to reduce symptoms. Any kind of exercise, but especially outside, can also help us feel better.
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