Medical

2019-massage

Massage Isn’t A Luxury Anymore; It’s a Necessity!

When you think of massage, do you think of special occasions like Mother’s Day or Valentine’s Day?  Do you think massage is just for people with injuries or people who have nothing better to spend their money on?  Well, think again!  In this day and age, massage is not a luxury anymore; it’s a necessity!  […]

When you think of massage, do you think of special occasions like Mother’s Day or Valentine’s Day?  Do you think massage is just for people with injuries or people who have nothing better to spend their money on?  Well, think again!  In this day and age, massage is not a luxury anymore; it’s a necessity!  Almost every person can benefit and needs a massage on a regular basis to prevent and help manage knots as well as overall tightness in muscle tissue throughout the body.  Whatever your walk of life, stay at home mom, a person who travels or who sits at a desk all day long; we are all prone to these issues.

So, what are knots? According to 1Healthline, “muscles knots are hard, sensitive areas of muscles that tighten and contract even when the muscle is at rest.” Knots can also radiate pain to another part of the body. These are called trigger points.  Skeletal muscle is made up of muscle tissue fiber, made of “small fiber like units called myofibrils, “as explained by 2Medeiros and Wildman, myofibrils break down into an even smaller unit which is called the sarcomere, the smallest unit of muscle tissue.  Messages are sent to the sarcomere through nerve impulses that allow muscles to contract.   Sarcomeres are stimulated by the regulation of calcium, both intracellularly and extracellularly.  3AMTA explains that when muscles are overworked, it can cause an “influx of calcium into the sarcomeres in the affected area which, in turn, causes the sarcomeres to contract.”  This ultimately causes undue tension in muscle tissue fiber forming knots, which can eventually become trigger points.

You may be wondering what you are doing that would cause your muscles to be overworked or overloaded?  It’s called life!  Overworking our bodies physically is a common reason for these knots to develop, but also emotional stress, poor diet, and reduced water intake can be a factor.  According to 4Medical News Today, common causes of muscle knots include “stress and tension, injuries related to lifting and repetitive motion, poor posture, prolonged bed rest or sitting without stretching.”  Who doesn’t have stress in their life, whether it be at home, work or otherwise?  Stress, among many other components, can deplete our body’s supply of minerals, which we desperately need for optimal organ and muscle function.  Another reason why drinking enough quality (filtered or purified) water throughout the day is so important.

Not only does stress affect our muscles adversely, but also repetitive motion.  Obvious examples of repetitive motion could include a worker on an assembly line or a builder using a hammer.  However, a hardworking mom uses repetitive motion when rocking her baby to sleep, over and over again.   A violinist uses her arms and shoulders in a repetitive motion performing in a concerto.   Athletes use the same muscles repetitively, as well as the average person that works out using various exercise programs such as weight lifting, cross fit, cycling, Zumba, Insanity or P90X!  The most overlooked way to develop knots is by just sitting at a desk without getting up to stretch and move around, which will reduce lymphatic flow and blood circulation, leading to muscle stiffness.

Now that we know what knots are and how we get them, let’s talk about how to manage them. Prevention is the best remedy!  Drink half your body weight in water in ounces, generally no more than 100 ounces a day.  Eat plenty of fruits and vegetables that will naturally hydrate you, not to mention provide essential antioxidants and phytonutrients.  Limit caffeine since this is a natural diuretic and causes frequent urination, which causes a loss of minerals.

Even with our best efforts to prevent knots, we will get them at some point.  Consistent massage with a licensed massage therapist is absolutely essential to help loosen the knots and allow the tissue to return to a normal state.  Massage therapists use various strokes and techniques, such as effleurage, petrissage, stripping, tapotement, as well as trigger point therapy and myofascial release.  Massage will increase lymphatic movement and blood circulation, allowing toxins to be filtered and released through the lymph nodes, spleen, liver, and kidneys.  5Athletico Physical Therapy agrees that “massage is not just some occasional luxury saved for vacations and spa days. Massage therapy can help keep your muscles healthy, pliable, and oxygenated.”  Licensed massage therapists are plentiful, whether in private practice or working at a spa and have hours and prices to accommodate anyone’s schedule or budget.

Start feeling better; schedule your massage today!

Share This:

2019-got-anxiety

Got Anxiety?

Odds are, you or someone you know probably does.  Anxiety disorders are the most common mental health diagnoses in the United States, affecting 40 million adults, or roughly 18% of the population (aada.org).   So, what is anxiety?  Anxiety is a healthy and normal emotion.  The American Psychological Association (APA) defines anxiety as “an emotion characterized by feelings […]

Odds are, you or someone you know probably does.  Anxiety disorders are the most common mental health diagnoses in the United States, affecting 40 million adults, or roughly 18% of the population (aada.org).   So, what is anxiety?  Anxiety is a healthy and normal emotion.  The American Psychological Association (APA) defines anxiety as “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.”  Anxiety can remind us of our “to do” list, upcoming deadlines, or help us focus before that big presentation.  These are not necessarily negative things.  So, then what’s the concern with anxiety?  A person goes from feeling normal healthy anxiety levels to having a psychological disorder when they feel disproportionate levels of distress, worry, or fear over an emotional trigger.

Anxiety is an overarching, general term that includes several psychological disorders.  Some such disorders are: Generalized Anxiety Disorder, Panic Disorder, Post-Traumatic Stress Disorder, Phobias, and Obsessive-Compulsive Disorder.  These disorders are treated with a variety of methods.  Many are traditional, and some are newer concepts in the field of psychology.  The first traditional method of treating anxiety is with medication.  Several types of medications are used to treat anxiety, such as Selective Serotonin Reuptake Inhibitors (SSRIs), Benzodiazepines, and Beta-Blockers.  These medications can be prescribed by your primary care physician or a psychiatrist.  Another traditional method to treat anxiety is through outpatient therapy.  Therapy methods could include the use of Cognitive Behavioral Therapy, Exposure Therapy or even Hypnosis.

The treatment methods listed above may not come as news to many of you, as they have been in use for several years in the mental health field.  There are, however, some very new and interesting methods for people to learn to manage their own anxiety without the help of a doctor or therapist.  The first of which is through proper diet and nutrition.  There is ample evidence of causal links between certain vitamin and mineral deficiencies and anxiety.  Studies have shown lack of vitamins D, B6 and B12, magnesium and zinc can all be related to increased levels of anxiety.  Adding these vitamins to your diet through supplements or food intake can help reduce anxiety levels.  Other nutrients shown to help reduce anxiety include tryptophan, vitamin E, and omega 3 fatty acids.  Exercise is another effective way to manage your own anxiety.  When the body is active, the brain produces endorphins which are hormones that promote feelings of wellbeing and improve mood.   20 minutes of cardio 3 times a week can do great benefits for one’s mental wellbeing.  Higher level activities that require concentration such as playing an organized sport can also keep the mind occupied and limit racing thoughts.

Meditation is also an excellent strategy to manage one’s anxiety levels independent of a mental health professional.  Meditation is the practice of engaging in contemplation and reflection.  Through meditation, one tries to focus their thoughts in a specific direction and not allow the mind to wander.  Many people find the practice of meditation difficult at first, but with practice, it becomes easier over time.  In the fast-paced modern world, there are many distractions for our minds and many opportunities for thoughts to wander, but this practice can have great benefits in helping us to control the directions of our thoughts.  There are many options to help one who wants to begin the practice of meditation.  One of the most recent options is the use of smartphone apps.  These apps are convenient as your phone is always with you making them readily available to use over a lunch break or before bed to help you put your mind at ease.

Overall, anxiety is becoming much more prevalent in our society.  In the information age, we are aware of so much happening around us that it is not uncommon to feel overwhelmed and anxious.  If you or someone you know is experiencing unhealthy levels of anxiety, please do not feel ashamed or stigmatized, these feelings are all too common.  Please consult your physician and discuss the treatment options to find what method will work best for you.

Share This:

Peer Services, the Future of Mental Health

To be successful in business, it is imperative to evolve and adapt to meet the changing needs of your customers over time.  The mental health field is no exception.  I have seen many changes in the mental health field over my 15-year career.  One of the most exciting changes in Pennsylvania was the addition of […]

To be successful in business, it is imperative to evolve and adapt to meet the changing needs of your customers over time.  The mental health field is no exception.  I have seen many changes in the mental health field over my 15-year career.  One of the most exciting changes in Pennsylvania was the addition of Peer Support Services for adults.  Peer Support Services is an individualized, recovery-focused service that allows individuals the opportunity to manage their own recovery and advocacy process.  Peer Support staff serve to enhance the natural supports in the client’s life and improve their coping and self-management skills.  Peer Support Services began in the Lehigh Valley back in 2008 with few providers.  Peer Support Services are a radical departure from a traditional mental health service.  In a traditional mental health service, you have a professional often with advanced education and credentialing or licensure providing a clinical service to a person struggling with a mental health diagnosis.  Often times this professional is perceived by the client as an authority figure, with formal educational training, and can create an imbalance in the client/provider relationship.  The client does not and will not perceive the clinician as equals.   The fault in this dynamic is that clinicians often have no or limited personal experience with mental health struggles.  This is where the need for a new service was identified.

Peer Support Services are provided by Certified Peer Support (CPS) staff.  To be eligible to become a CPS staff you must have at least a high school diploma and a documented mental health diagnosis yourself.  You must be progressing well in your own mental health recovery.  This is quantified by having at least 12 months of employment or volunteer experience in the last three years.  If a CPS candidate does not meet the vocational requirements, they may also have 24 credit hours of post-secondary education in the previous three years.  If a candidate meets these requirements, they are eligible to register for the two-week Peer Support Certification course.  Upon successful completion of the course, they are eligible to be hired by a Peer Support provider and begin providing Peer Support Services to clients.

The Peer Support/client relationship is much different than the traditional provider/client dynamic seen in other mental health service lines.  Due to having their own mental health diagnosis, peer staff can say “I’ve been there,” or “I’m doing well, so can you” and are living proof that recovery is possible.  They can serve as a role model, mentor, and support to assist a client in managing their mental health symptoms.  This is much different than the traditional provider/client dynamic.  Clients often perceive their CPS worker as an equal through shared experience.  This creates a stronger bond and often better results than a traditional mental health service.

Peer support services are also much more cost effective than a traditional mental health service.  Due to the reduced educational requirements of the staff versus a service like outpatient therapy, the state can offer the provider a lower reimbursement rate for services rendered.  Therefore, this service is cheaper to operate from the state government’s perspective and often more effective than other mental health services geared toward serving adults.  Many agencies have decided to invest in Peer Support Services and also in their Peer Support Staff over the past few years.  The state has followed suit and done the same.  In December 2017, Pennsylvania began allowing providers to offer Peer Support Services to transitional-aged youth (ages 14-21).  We are now also seeing specialized Peer Support Services such as forensic Peer Support that works with clients involved in the criminal justice system, or Drug & Alcohol Peer Support which works with dually-diagnosed individuals who have a mental health diagnosis and co-occurring substance abuse problem.  Peer Support Services are growing exponentially. It is exciting to see where this service can go in the future and the positive changes these staff can help make in the lives of those they serve.

If you or someone you know is interested in becoming a CPS staff or would benefit from receiving Peer Support Services, please contact Pennsylvania MENTOR at (610) 867-3173, or visit our website at www.pa-mentor.com.

Share This:

My Insurance Doesn’t Cover Hearing Aids. Now What?

The purpose of this article is to inform the consumer of questions to ask when deciding whether to purchase a plan to cover hearing aids and when it may be beneficial to pay out of pocket.  If you find yourself in an audiology office and are ready to purchase hearing aids, you may want to […]

The purpose of this article is to inform the consumer of questions to ask when deciding whether to purchase a plan to cover hearing aids and when it may be beneficial to pay out of pocket.  If you find yourself in an audiology office and are ready to purchase hearing aids, you may want to ask some of the questions explored below as well.

When you are over the age of 18, Pennsylvania Medicaid doesn’t cover the cost of hearing aids. However, several Medicare/Medicaid supplement plans do cover hearing aids. Most customers don’t know that many of the extra benefits these insurance plans offer are also offered when you pay out of pocket for the hearing aids. If you are in a reputable office that is bundling their prices it’s common to have an extended and complimentary trial period, free batteries, at least five years of in-office service, and an extended warranty of 2-3 years on the hearing aid.  Often these plans list extra benefits as something you are getting because you have their plan. When reading these “extras,” it seems as though they are giving you something beyond what you would normally receive if you purchased the hearing aids out of pocket. As a consumer who has never purchased hearing aids, this may seem like a great deal. There are some things to consider when signing up or paying extra for this benefit if you are doing so because you plan to purchase hearing aids. Some of the things to think about is:  Where are you able to use your benefit?  Will you have access to an audiologist who can adjust your hearing aids?  Is your insurance going to cover additional visits to your audiologist?

Most insurance plans require you to go to a specific office for your hearing aids.  This takes the freedom of choice away from the consumer and may put limits on your satisfaction of the care you receive.  For example, this office may not be near your hometown. You may need to travel to get to one of these offices, and you may also not be happy with the provider you are assigned to in that office. As I talked about in previous articles, you can either buy a hearing aid from a dispenser or an audiologist. Regardless of whom it is the insurance is sending you to, it’s important that you have a positive experience and you trust they have your best interest at heart. The average person will have their new hearing aid for five years before replacing them. You want to make sure you buy them from someone who you want to go back and see for follow up appointments during that time frame.  Follow up appointments are usually a few times a year for cleaning, reprogramming based on changes in your hearing needs, cleaning wax out of your ears, and minor in-house repairs of the hearing aids.

Your insurance plan may also offer a hearing aid that you purchase over the internet.  If they offer that as an option, you may want to ask some details about the follow-up appointments.  Some examples are: will you have access to a local audiologist to help you if you need the hearing aid reprogrammed, cleaned, or if you have questions regarding use and wear of the hearing aid?

Lastly, you will want to consider whether or not the insurance is going to cover the cost of visits to the audiologist after your trial period.  It is a state law in Pennsylvania that you have at least a 30-day trial period with hearing aids. The law states that if you return the hearing aids within that 30 days, you are required to get your money back. The office you purchase them from is allowed to keep 10% of the cost up to $150.00.  Your insurance plan may state that they allow you an extended trial period, sometimes 45 days, with the option for a full refund. To be honest, often times you would receive that regardless of having an insurance benefit. It is an advantage to have this option. However, you want to make sure the insurance is going to pay for visits beyond that 45-day trial period. As I discussed above, it is common to go back for follow up visits in the years after purchasing the hearing aids.  As an audiologist, I want consumers to be informed as possible when making these important decisions about their hearing and quality of life.  If you or someone you care about is ready to try hearing aids, please consider the information and questions listed above to make as informed a decision as possible.

Share This:

America’s Continuing Autism Epidemic

Merriam-Webster’s dictionary defines autism as: “a variable developmental disorder that appears by age three and is characterized by impairment of the ability to form normal social relationships, by impairment of the ability to communicate with others, and by repetitive behavior patterns.”  On April 26th, 2018 the Center for Disease Control and Prevention released its most […]

Merriam-Webster’s dictionary defines autism as: “a variable developmental disorder that appears by age three and is characterized by impairment of the ability to form normal social relationships, by impairment of the ability to communicate with others, and by repetitive behavior patterns.”  On April 26th, 2018 the Center for Disease Control and Prevention released its most updated autism prevalence estimates for America’s children.  These estimates are pulled from data in a biennial report based off of the evaluation of medical and education records.  1 in 59 children are now estimated to have an Autism Spectrum Disorder.  Let that sink in.  1 out of every 59 children.  This new ratio is an increase of 15% from the last reported estimate in 2016.  This most recent increase in prevalence continues the trend that researchers have seen over the last twenty plus years.

When I began my career in the mental health field in 2004, the autism prevalence ratios were estimated to be 1 in every 166 children.  Throughout my career, I have witnessed this drastic increase in autism cases create the need for a plethora of new services and supports for children to address the social and behavioral needs associated with autism.  Many providers decided to implement autism specific variations of existing mental health programs.  One of the most popular of these services is Behavioral Health Rehabilitative Services or commonly referred to as BHRS.  BHRS services are intensive mental health therapies that are provided in the child’s home, in community settings and occasionally in the classroom.  These services are focused on identifying interventions to help achieve a child’s behavioral treatment goals and to transfer those skills from the provider to a parent, teacher, etc.  The increase in autism diagnoses has also created the opportunity for providers to create new programs to address this need such as afterschool groups that focus on improving social skills.  They have also begun to create support groups for parents and siblings of those with an autism diagnosis.

The mental health and developmental disabilities fields have successfully evolved and adapted over the years in an attempt to meet the growing needs of children diagnosed with autism.  There are additional supports in the home, community and the classroom for these children.  There are also government and private grants available to families to help manage the additional cost of needed sensory and adaptive communication devices for these children.  But what will happen to these children when they grow up, or “age out” of educational and children’s mental health services?  What supports are available for adults diagnosed with autism?  What supports are available to families to help with their adult child with an autism diagnosis?  The answers to these questions are pretty alarming.  Depending on your location, there are very few if any supports tailored to adults with autism in these fields.

For our nation to fully manage the continued autism epidemic; there will have to be some significant changes in our government and to the adult mental health system.  Our legislators and representatives will have first to acknowledge that the lack of supports, services, and funding for adults with autism is a current problem.  Second, they will have to acknowledge that the problem will only get worse in the future as the ever-increasing ratios of children with autism age out of services.  These adults will need assistance with housing, life skills, employment supports, and socialization.  Our legislators and representatives will need to increase funding for mental health services to allow providers to develop programs to meet the needs of these adults.  Providers will need to step up and use the increased funds to develop new programs, thinking outside the box to support this unique population.  Staff in these fields will have to become more educated on providing supports to adults with autism.  They say it takes a village to raise a child.  In order to support individuals with autism throughout their entire life, not just their childhood, we as a society will have to pull together to help our nation manage this continuing autism epidemic.

Share This:

Who Can Sell Hearing Aids?

In the state of Pennsylvania, there are two different licenses that will allow you to sell hearing aids, an Audiology License and a Hearing Aid Dispensing License. The training and education that you need to obtain these licenses are very different. These differences are often misunderstood by the general public and will be explored below. […]

In the state of Pennsylvania, there are two different licenses that will allow you to sell hearing aids, an Audiology License and a Hearing Aid Dispensing License. The training and education that you need to obtain these licenses are very different. These differences are often misunderstood by the general public and will be explored below.

In 2007, the degree requirement to become a clinical audiologist was changed.  A Master’s degree was no longer acceptable to obtain licensure and all audiologists were now required to obtain a clinical doctoral degree.  At this time, if one wanted to become an Audiologist or an Au.D., they would now need to first complete a bachelor’s degree in Speech and Audiology, Communication Disorders, or a related field.  Upon completion of a Bachelor’s degree, a candidate would then apply for a doctoral program which is an additional 4 years of school.  Doctoral coursework includes many topics such as: education, anatomy and physiology of the ear and hearing, the science of sound, the diagnosis and treatment of hearing and vestibular disorders, hearing aids and their progression from analog to digital devices, programming and adjusting hearing aids, and counseling and treatment of adults and children of all ages with hearing loss.  Within those classes you learn about candidacy for treatment options, one of the most common of which is hearing aids.  However, the treatment of hearing loss is not limited to just hearing aids but also includes cochlear implants, bone anchored hearing devices and implantable hearing devices.  Audiologists get the opportunity to do clinical rotations in a variety of settings which can help to determine one’s career path.  Some of these settings could include working with an Otolaryngologist or more commonly called an ear, nose and throat physician.  Another possible clinical training setting for doctoral candidates is in a hospital.  When doing clinical internships, a doctoral candidate would perform testing, fitting and dispensing hearing aids on adults or children.  They could also conduct inter-operative monitoring, vestibular testing & rehabilitation, might also work with outside businesses to adhere to Occupational Safety and Health Administration (OSHA) regulations.  The candidate may also choose to use the business management training and clinical experience to open up a private office in the community. When a candidate finishes their Doctorate of Audiology, they will then obtain their Pennsylvania clinical audiology license.  It is then in their scope of practice to dispense and sell hearing aids as stated by Pennsylvania medical guidelines.

The other way one can legally dispense hearing aids in the state of Pennsylvania is to obtain a Hearing Aid Dispensing license.  To obtain this license, there is a high school level educational requirement, and the candidate must find another licensed Hearing Aid Dispenser to conduct an internship with.  During the internship, the candidates are taught to program and adjust hearing aids.  They are also taught to instruct adults on the use and expectations of hearing aids. Most of the time, this internship is done with someone who was willing to hire the candidate work and sell hearing aids at the same office. When the internship is complete, that candidate must then sit for a written state test.  Upon passing that test, they are awarded a Hearing Aid Dispensing license for the state of Pennsylvania.

When choosing a licensed hearing aid dispenser, it is up to the customer’s discretion which of these two licensed dispensers to choose.   It is important for the customer to realize the different level of educational requirements and clinical knowledge between the two.  Not all hearing aid dispensers are created equal, and it is important for a customer to be able to distinguish between them.  If you are in the market for a hearing aid, I hoped this article helped you to be able to make a more informed decision on your purchase.

Share This:

Staying Ahead in Business with Botox (and a Few Other Things)

It’s tough out there.  Seasoned professionals are constantly forced to look behind them to see if the up-and-coming (and often younger) professionals are nipping at their heels. Many professional women are no longer ashamed to admit they’ve had a little Botox.  Men, increasingly worried about the younger/cheaper competition, are a different story. Competition in the […]

It’s tough out there.  Seasoned professionals are constantly forced to look behind them to see if the up-and-coming (and often younger) professionals are nipping at their heels.

Many professional women are no longer ashamed to admit they’ve had a little Botox.  Men, increasingly worried about the younger/cheaper competition, are a different story.

Competition in the boardroom and beyond is driving more and more professional men into our practice for a few non-surgical tweaks to stay youthful and competitive on the job.

Here’s a list of what we see most:

Botox and Fillers

 They don’t call it “Brotox” for nothing.  With a few units of Botox, we can get rid of wrinkles and reshape the brows, eyes, mouth, and neck.  Botox injected skillfully by a board-certified dermatologist, can even eliminate the need for some surgeries.

Fillers, such as Juvederm, can help smooth out deep creases and acne scars.  Used together, a more youthful face can help men and women remain relevant and look refreshed.

The name of the game with both is that I can offer subtle changes with no downtime.  Results are seen in less than two weeks.

Hair Restoration

Hair replacement surgery was a big thing a few years ago.  Techniques are always improving, but there’s downtime to consider.

We’re seeing a different area of no-downtime growth (literally and figuratively).  We started offering PRP injections in our office to restore hair late last year.  Our phones have been ringing off the hook.

We are using the Selphyl® Platelet-Rich Fibrin Matrix System. Your own blood is drawn and spun in a centrifuge to separate the cells from the plasma. The plasma is then injected into your scalp where your hair is thinning.

You have to commit to three treatments or more and then wait for your result to grow in.  It works best for those just starting to lose their hair and who want to thicken things up before those hairs are lost forever.  The treatment works for men and women with thinning hair.

Photofacials, Lasers, and Microneedles

 Non-surgical skin procedures have seen an incredible resurgence.  In fact, the American Society of Aesthetic Plastic Surgeons, a group that keeps track of cosmetic trends, says IPL Photo Rejuvenation was the fifth most popular non-surgical procedures for men in 2017. We’ve been huge fans of IPL for years!

IPL harnesses light to help zap away signs of aging from your face, neck and even hands., The gentle treatments use broad spectrum light to attack sun damage and redness.  There is a little discomfort and minimal downtime.  Four to six treatments are required to get the best results possible.

Laser resurfacing is a step above the IPL treatments.  The Erbium laser is designed to remove moderate lines and wrinkles. There’s also a bit of recovery time.  The CO2 laser is for more advanced treatments.  Downtime can be up to two weeks.  Results are long-lasting.

Finally, there’s a skincare newcomer that is coming on strong. Microneedling is exactly what it sounds like.  Tiny needles make small channels in your skin where we can infuse serums to hydrate your skin.   We’ve had such great success with these collagen builders; we now offer three levels of this treatment.  After a few treatments and a little time, your own collagen plumps up your skin.

In fact, Aesthetica boasts over 30 devices, laser, and RF, that allow us to customize a treatment to rejuvenate your skin.  We can tweak the appearance and texture, minimize scars and even remove unwanted hair.  There’s something for men and women in our advanced arsenal.

The best way to put your best face forward is to focus on high-quality skin care and gently, minimally invasive treatments.  Figure out what your individual goal is, and we can customize the right combination of treatments to meet or exceed your expectations.  A few non-surgical tweaks can help you stay competitive at work and at play.

David B. Vasily, M.D., F.A.A.D. is an American Board of Dermatology certified dermatologist with over 30 years of experience in the field of dermatology and skin care. Founder and president of Lehigh Valley Dermatology Associates, Inc, Dr. Vasily is a fellow of the American Academy of Dermatology, the American Society for Laser Medicine & Surgery, and the American Society for Dermatologic Surgery.

Share This:

Forget the App; There’s a Test for That

How many of you have had your blood taken during an annual exam?  That’s right, the yearly blood test.  It’s relatively standard these days to get a report detailing your Complete Blood Count (CBC) that tells you how many red and white blood cells and platelets you have pumping around, and your levels of iron.  […]

How many of you have had your blood taken during an annual exam?  That’s right, the yearly blood test.  It’s relatively standard these days to get a report detailing your Complete Blood Count (CBC) that tells you how many red and white blood cells and platelets you have pumping around, and your levels of iron.  Add to that the standard blood chemistry assays which test for blood urea nitrogen (BUN), carbon dioxide (CO2), creatinine, glucose, and potassium, chloride, and sodium, and you have quite a snapshot of your health.  (Check online for reference levels and what each test tells you; there’s a lot of useful resources.)
What’s relatively new and interesting in the healthcare field, however, aren’t those standard tests that have been around for decades, but the newer, more complex assays.  There are three relatively interesting growth points in the diagnostics industry right now; companion diagnostics, genetic testing, and biomarker tests.
Companion diagnostics were almost forced on the pharma industry, and for good reason. When a pharma giant brings a drug to market, they have to conduct a bunch of clinical trials, eventually including humans.  Throughout the years, the FDA and these companies learned that just because a drug was doing what it was supposed to, that didn’t mean it wasn’t ending up somewhere that was less than ideal.  Or the concentrations were too high or too low for certain people based on their individual metabolism.
The idea of testing for the amount of drug in an individual gained popularity; how much of a drug is in their bloodstream, or liver, or in a cancerous mass.  The FDA soon started requiring testing, and the pharma industry initially partnered with others to make the diagnostic tests.  That is until they realized they could sell the test and the drug; double the income.  Companion diagnostics were born, and now most new drugs are accompanied by a blood test to either screen the patient’s health prior to using the drug, or for levels of the active drug in the body. Those tests are actually a required part of the treatment in some cases.
Genetic testing is well known to individuals with a family history of certain diseases.  A large diagnostics company has a line of genetic screening assays on the market that test for certain genes that predispose you to certain cancers.  Their most popular is for breast cancer and utilizes a specific genetic mutation in the BRCA1 and BRCA2 genes.  If you have the mutation, you’re more likely to get breast cancer at some point during your life than those who do not.  This allows you to drive your own future, and individuals who test positive for the mutations then are urged to undergo more frequent cancer screenings.  Some even opt for a preemptive double mastectomy.  Knowledge, in this case, is innately very powerful.
Biomarker assays take it one step further.  Certain diseases, Alzheimer’s, for instance, are caused by a progressive change that takes place in your body that is not readily visible.  In the Alzheimer’s example, there are a number of proteins that exist in the fluid around our brain that are supposed to be there.  Our own neural cells make these proteins.  Research has shown that individuals who develop Alzheimer’s show a shift in these proteins, specifically in the ratio of one protein to another, that predicts your progression into having the disease.  Yet the only way to positively identify those with the disease is during an autopsy.
That’s exactly how it starts; some research figures out how something affecting our health happens.  Maybe eventually a drug will be developed to reverse or stop the changes that lead to Alzheimer’s.  In the meantime, a test will probably be first on the market to identify people with a higher likelihood of progression.  Then further studies on those people can help determine how we can fix it.
The future of diagnostics in healthcare was cemented years ago, yet innovation keeps pushing the realm of possibility into reality.  Add to that the sheer availability of most tests (they can be ordered online!), and the idea they now have assays that show the overall “age” of your cells (lookup telomere testing), life expectancy is sure to be above 100 before we know it.
This all leaves us with some interesting questions to ask of ourselves.  Do you want to know if that drug or therapy is working correctly?  The answer is most likely yes.  But on the other hand, would you want to know how your health will be in 10 or 20 or 30 years? Would you make any changes in your lifestyle now to possibly live longer or decrease your chances of disease?  Those questions are very personal, and the answers are probably as individualized as we are just being human.

Share This:

The Future of Health Insurance

The Patient Protection and Affordable Care Act passed on March 23, 2010. The underlying philosophy was to make coverage available and affordable to all Americans.  At the time, there were approximately 45 million uninsured individuals in the US. Today, that number is about 28 million. The tax credits or subsidies have helped many to afford […]

The Patient Protection and Affordable Care Act passed on March 23, 2010. The underlying philosophy was to make coverage available and affordable to all Americans.  At the time, there were approximately 45 million uninsured individuals in the US. Today, that number is about 28 million. The tax credits or subsidies have helped many to afford health insurance coverage. The expansion of Medicaid in Pennsylvania has also allowed more to find the coverage they need. Yet health insurance rates have been on a steady increase for both employers purchasing health insurance coverage and for individuals. The ACA has imposed a myriad of regulations on health insurance carriers and the Federally Facilitated Marketplace in Pennsylvania; also known as the Exchange.

President Trump campaigned on repeal and replacement of the ACA, but that has not yet come to fruition. The House passed the AHCA, American Health Care Act. The Senate created its own bill, BCRA, the Better Care Reconciliation Act. Versions of each, with necessary updates, continue to be discussed among the Legislators.  There is a bipartisan group of 43 in the House, the Problem Solvers Caucus. They want to discuss the reforms needed within the ACA. Their main concerns are: to continue the Cost Sharing Reduction subsidies for individuals below 250% of the Federal Poverty Limit; a dedicated stability fund to help states to keep costs down (reinsurance); exempt “small” businesses from the employer mandate by raising the definition to those businesses with more than 500 employees; repeal of the medical device tax, a 2.3% tax on items like pacemakers and knee replacements; and the ability to sell insurance across state lines.

There are a few other ideas that have continued to garner support as a way to fix the ACA. One of those is to increase the rating ratio from 3:1 to 5:1. Currently, a 64-year-old cannot be charged more than three times the 21-year-old. Along with this comes the suggestion to give more generous subsidies to older Americans. There are discussions of price controls on prescriptions drugs, allowing Medicare to negotiate pricing, and reviewing how other countries control the prices of pharmaceuticals. The use of bundled payments for care versus episodic payments has helped to reduce costs. A knee replacement, as an example, would be one payment to the Hospital and another to the Doctor for pre-operation, operation, and post-operative care.  Antitrust reform to control the hospital mergers; the consolidation of services can be positive, but the elimination of competition often drives prices higher. Tort reform has always been debated as a way to reduce costs. The abuse of malpractice suits means that hospitals and doctors over-treat and over-test.

The idea of “Medicare for All” was a campaign highlight for the Democrats in the last presidential election process. There has been talk about reducing the eligibility to age 55, instead of 65, to enroll in Medicare. Of course, this would require some changes in the type of plans offered. Those 55 and older and still actively at work have demands for health care that are different from those who are retired.

There is not much language available now to show how we would transition from our current system to a “Medicare for All” system. Private insurance companies have no role in the Sanders version of single-payer, other than providing supplemental insurance. The biggest concern is how to pay for it. Vermont studied the viability of a single-payer Exchange for their state, before scrapping the idea, in part, because of cost. It was on the ballot for Colorado voters, who turned it down. California continues to debate the idea of a state single-payer Marketplace. Financing has been a stumbling block. Rep. Conyers has over 100 backers in the House for his version of a single-payer legislation. It will be a tough road ahead with a Republican-controlled House, Senate, and President.

A recent Pew Research Center poll shows that overall, 33% of Americans believe health care should be a single-payer setup. The poll also found that roughly 60% of Americans believe the government is responsible for making sure all Americans have health insurance. Where do you stand on the issue? Use your vote in the upcoming 2018 elections to make your voice heard.

Share This:

Recharge – Reset – Repeat

How many times have you felt the need to get out of town for the weekend to recharge and feel like yourself again? In today’s fast paced society we are stressed more than ever before and often do not do enough to reset and recharge. At some point in our life, we must cope with […]

How many times have you felt the need to get out of town for the weekend to recharge and feel like yourself again? In today’s fast paced society we are stressed more than ever before and often do not do enough to reset and recharge. At some point in our life, we must cope with stress. You cannot always anticipate when something will make you feel overwhelmed. Often, the best you can do is to use the healthy coping skills that you have developed throughout life to help you manage your current stressors.

Managing stress comes in all shapes and sizes. In times of change, you want to realize and understand your perception and interpretation of the situation that determines how change affects us. You want to change toxic and irrational thought patterns, such as “I must be competent at all times!” and replace absolutes with “I am not perfect- I am doing the best I can do.”

Stress does not always have to be negative. Some aspects of stress can be both healthy and rewarding, such as engaging in a sport or recreational activity as well as working hard to complete a project. Work stress can also be seen as positive. Too many times the stress one encounters at work does not stay there which can negatively affect our relationship with others and yourself. Work stress can help one grow and change. Work stress forces one to learn new skills and creative ways to think to solve problems. Practicing self-care techniques improves the body and the mind. Remember how important it is to meet the physical and psychological needs for exercise, rest, good nutrition, and recreation. Disconnect from the screens we are connected to and try new activities!

It is important to remember to focus on what you can control, not what you cannot control. Do not attempt to control the uncontrollable! Change can be overbearing. A way to make change more bearable is to break the change up into smaller steps and short-term goals. Remember to welcome feelings, both good and unpleasant, and learn to cope well with the “bad” ones. When you are stressed and experience unpleasant feelings, the best thing is to recognize and accept them. Unpleasant feelings are unavoidable and normal. They grow and intensify when you push them out of sight. Those who do not judge their feelings and accept their own doubts and limitations will have less stress and enjoy their lives more.

No matter how stressful things can be, do not forget to laugh and use your sense of humor. Reach out and connect with others, so you do not feel alone. When you develop good, supportive relationships change is easier to understand. It is important to not keep your feelings in and isolate yourself. Remember you can seek professional help when you feel over-stressed. It is not a sign of weakness; it shows strength and courage to realize that help is needed.

There are many ways to manage stress. A few good rules include:

  • Do not take responsibility for the things you cannot control
  • Take care of yourself, or you can’t take care of anyone else
  • Rushing can increase stress, remain in the present
  • Be accepting of yourself, don’t ignore feelings and needs; accept limitations
  • Limit the “should’s”
  • Be accepting of others
  • Ask for support when you need it
  • Accept, Alter or Avoid a negative situation
  • If you never make mistakes, you’re not learning anything
  • Life is not fair or a contest, do not compare
  • One has to begin where one is

Share This: