Healthy Giving is Healthy Living

Ever wonder why it feels good when you give a little bit of something to someone else? Whether it’s a smile, a helping hand, your time or some money, the act of giving has a profound positive effect on both you and the person you are sharing with. So do something good for someone else and you just did something good for yourself! Saints, wise people, and religious leaders have all prescribed good deeds, charitable works and the act of giving unselfishly. Now science has the same prescription as well. In Oprah Winfrey’s Lifeclass Oprah Winfrey’s Lifeclass, 6 ways that giving can make a person healthy are discussed:

1. Simply contemplating generosity or giving was shown to boost protective antibodies in saliva;  
2. Connecting to people through active listening and speaking with self reference was shown to reduce the risk of heart attacks; 
3. Sharing in pain by reaching out to others in a similar circumstance actually reduces your pain;  
4. Most people think that you can catch more colds by hanging out with more people, but the opposite is also true. As long as you practice good cold season courtesy (keeping your hands clean, sneezing in your inner-elbow instead of on someone), studies show that being socially active can help you stay healthier. Volunteering is a great way to give back and be socially active; 
5. Did you know that giving love helps heal wounds faster? In a study, heals took a day longer to heal when couples argued; 
6. A soothing touch is good for you and a friend. A study showed that giving massages also reduces the stress hormone cortisol and alleviates anxiety and depression! 

So in reality, when you’re giving, you’re getting something more in return because your good health is your most valuable asset.

Another important aspect of giving is gratitude. Giving is the ability to share something you have with someone that does not have. Gratitude is the positive recognition of the ability to share or give. When you give, you can feel good, when you appreciate your ability to give, you can feel even better. A recent study conducted by the University of Texas Health Science Center reported that you can be 25% happier, healthier and more positive in general by simply writing down every night before you sleep 5 things you are grateful for. Being able to read this article, and sleep under a roof, are 2 things already. Try it and see how you feel in 10 weeks!

So in this holiday season and time of giving and gratitude, remember, good things happen to good people. When you’re giving and you’re thankful for being able to give and/or for the gifts you get, you’re getting more in return- a healthy, happy life!

For daily updates on news, information and more on health care and wellness, join avecinia wellness center's facebook page (facebook.com/avecinia) and follow avecinia on twitter (twitter.com/avecinia4health). avecinia wellness center is Fresno's premier integrative medicine and wellness center. We combine internal medicine and primary care with health management, weight management, acupuncture, aesthetics (Botox, Juvederm, Radiesse, Obagi and more) and massage therapy for a holistic approach to health. We use a robust electronic health record program and patient web portal to enhance our delivery of services and to help our patients reach their optimal well-being. To learn more, visit www.avecinia.com. If you are looking for a primary care doctor in Fresno or the Central Valley and would like to become a part of the avecinia family, visit our website and click on new patient registration. Let Dr. Unaiza Hayat and/or Ali Kunkel, MPA, PA-C, become your trusted guides. Our Aesthetic, Weight Management, Acupuncture, Health Management and Massage Therapy services do not require us to be your primary care physician. Learn more at www.avecinia.com We look forward to meeting you!

Medicare Open Enrollment and Advantage Plans

Did you know Medicare Open Enrollment is happening now through December 7th?  Do you have a Medicare Advantage Plan or wondering what one is? Medicare Advantage Plans are basically private versions of Medicare.  They sometimes cover more services than Medicare A and B, such as include Medicare Part D.  However, sometimes they do not cover all services provided by Medicare.

The Federal Government used to subsidize these private health insurance plans but the Patient Protection and Affordable Care Act is reducing this subsidy to save costs.  

One of California’s largest Medicare Advantage plans is pulling out of Medicare in 2012.

As of 2012, Freedom Blue Medicare Advantage Plan will no longer be available.  If you are currently covered through Freedom Blue, you should have been notified of the upcoming change and your need to choose a new Medicare Plan. The Open Enrollment period is October 15 – December 7, now is the time you can change your Medicare health plan and Part D coverage and/or return to Original Medicare. Coverage changes become effective January 1, 2012. We know this can be an overwhelming task and want to help you understand what this means to you.

Freedom Blue is a PPO plan, which means you select an "in network" doctor from a long list of providers.  You don't usually need a referral to see a specialist or an "out-of-network" doctor.   However, if you see an out of network provider, the PPO covers you at a lower rate than in-network and you will have a larger coinsurance or patient responsibility amount. PPO is the most flexible type of plan with the largest list of in network providers. 

With the termination of Freedom Blue, there will no longer be a PPO Medicare Advantage Plan available to Beneficiaries in Fresno County.  The options available are:

Traditional Medicare, you can use any doctors and facilities that accept assignment for Medicare.  Most doctors and facilities do accept Medicare assignment, such as avecinia.      

HMO, which requires you to use only doctors and facilities that are contracted with that particular HMO.  You generally need a referral from your primary care doctor to see a specialist.   Avecinia is not a contracted with any HMOs

HMO-POS,  similar to an HMO, you also have the option to receive some services from doctors or hospitals that are not in the plan's network, usually at a higher cost than a standard HMO plan. Avecinia is not contracted with any HMO-POS plans.

**Some Medicare Advantage plans offer Medicare prescription drug coverage, but other plans do not.    Don't forget to explore your prescription drug options.

    

These plans all have their pros and cons, and varying degrees of out of pocket costs.  Make sure that you educate yourself so you can choose the best plan for your health and your budget.  In our experience with Medicare and Medicare Advantage plans, we have found traditional Medicare the easiest to work with.  Traditional Medicare may not offer all the services some Medicare Advantage plans offer, but we have found that traditional Medicare is less likely to deny or request prior authorization for benefits it does cover. 

A great resource to help you better understand your Medicare choices is HICAP (the Health Insurance Counseling & Advocacy Group - http://www.cahealthadvocates.org/HICAP/).  HICAP provides free, objective information and counseling about Medicare.  The Fresno representative is Wayne McMillen at Clovis Senior Center.  Appointments can be made by calling 559-324-2750 (here’s a link to their October Newsletter with an article by Mr. McMillen: http://www.ci.clovis.ca.us/SiteCollectionDocuments/SeniorServicesDivision/October2011Newsletter.pdf)

For daily updates on news, information and more on health care and wellness, join avecinia wellness center's facebook page (facebook.com/avecinia) and follow avecinia on twitter (twitter.com/avecinia4health). avecinia wellness center is Fresno's premier integrative medicine and wellness center. We combine internal medicine and primary care with health management, weight management, acupuncture, aesthetics (Botox, Juvederm, Radiesse, Obagi and more) and massage therapy for a holistic approach to health. We use a robust electronic health record program and patient web portal to enhance our delivery of services and to help our patients reach their optimal well-being. To learn more, visit www.avecinia.com. If you are looking for a primary care doctor in Fresno or the Central Valley and would like to become a part of the avecinia family, visit our website and click on new patient registration. Let Dr. Unaiza Hayat and/or Ali Kunkel, MPA, PA-C, become your trusted guides. Our Aesthetic, Weight Management, Acupuncture, Health Management and Massage Therapy services do not require us to be your primary care physician. Learn more at www.avecinia.com We look forward to meeting you!

Preventive Visits (Physicals) and what it means for you!

The Good news about Preventive Visits/Physical/Well-Visits!

Have you heard the good news- “Preventive Visits” are 100% free to you! That sounds like great news doesn’t it?  It is, but it’s very important to know what “preventive” means so you can take full advantage of the opportunity.  The easiest way to determine what is a preventive visit (versus diagnostic) is to think of it as an information gathering visit to determine what your current state of health and well-being is and how it corresponds to other people of your age and gender. It’s best to do it when you are feeling well (thus the common moniker “well-visit”), you don’t have any current or new health concerns to discuss during the visit (thus no change in medication, no new prescriptions are given, no normal screening labs are ordered),  and /or no follow-up for a health issue discussed during the visit is scheduled.   For example, during your Physical/Preventive/Well-Visit, your doctor may notice that you are at risk for diabetes and have not been tested.  Your doctor then decides to test you. That screening/testing is part of your preventive visit.  However, if you are diabetic and you are at your Physical/Preventive/Well-visit and you are having complications due to your diabetes that are addressed by your doctor, that preventive/physical visit is now two visits: A physical/preventive visit and a diagnostic care visit where you will be responsible to pay a co-pay/co-insurance or deductible.   The same also applies if you are coming to your doctor and the doctor performs a routine screening related to the visit that may have been covered as preventive if you had come in for a preventive visit.  The screen is part of your diagnostic care and as such you will be responsible for the co-pay/co-insurance deductible for that visit.   So regular preventive care can help you stay well, catch problems early on, save you money and may be potentially life-saving.

So what can you expect during a Preventive/Physical/Well-Visit?

The rules for what is considered a preventive visit or part of a preventive visit and what isn’t are set by the Center for Medicare and Medicaid Services and your Health Insurance company.   As your health care provider, we are required to submit accurate health records indicating the exact reason for your visit and everything that was done and discussed during your visit. Each concern is grouped into a visit code and a diagnostic code.  That is how the different topics and health concerns addressed at your visit are organized into “preventive” versus “diagnostic” care.   Any attempt to not accurately account for everything puts you at risk and undermines our ethical obligations.  With that said, there isn’t a set rule as to how a Physical is conducted. Each doctor or practice will develop its own method of gathering necessary information (basically the purpose of a Physical) to see what is your current state of health and well-being.

Generally you can expect all, some or a variation of the following (courtesy of WebMD):

History: This is your chance to mention any complaints or concerns about your health. Your doctor will also likely quiz you about important behaviors, like smoking, excessive alcohol use, sexual health, diet, and exercise.  The doctor will also check on your vaccination status and update your personal and family medical history.

Vital Signs: These are some vital signs checked by your doctor:

·         Blood pressure: less than 120 over 80 is a normal blood pressure. Doctors define high blood pressure (hypertension) as 140 over 90 or higher.

·         Heart rate: Values between 60 and 100 are considered normal. Many healthy people have heart rates slower than 60, however.

·         Respiration rate: Around 16 is normal. Breathing more than 20 times per minute can suggest heart or lung problems.

·         Temperature: 98.6 degrees Fahrenheit is the average, but healthy people can have resting temperatures slightly higher or lower.

General Appearance: Your doctor gathers a large amount of information about you and your health just by watching and talking to you. How is your memory and mental quickness? Does your skin appear healthy? Can you easily stand and walk?

Heart Exam: Listening to your heart with a stethoscope, a doctor might detect an irregular heartbeat, a heart murmur, or other clues to heart disease.

Lung Exam: Using a stethoscope, a doctor listens for crackles, wheezes, or decreased breath sounds. These and other sounds are clues to the presence of heart or lung disease.

Head and Neck Exam: Opening up and saying "ah" shows off your throat and tonsils. The quality of your teeth and gums also provides information about your overall health. Ears, nose, sinuses, eyes, lymph nodes, thyroid, and carotid arteries are also examined.

Abdominal Exam: Your doctor can use a range of examination techniques including tapping your abdomen to detect liver size and presence of abdominal fluid, listening for bowel sounds with a stethoscope, and palpating for tenderness.

Neurological Exam: Nerves, muscle strength, reflexes, balance, and mental state are assessed.

Dermatological Exam: Skin and nail findings could indicate a dermatological problem or disease somewhere else in the body.

Extremities Exam: Your doctor will look for physical and sensory changes. Pulses can be checked in your arms and legs. Examining joints can assess for abnormalities.

Male Physical Exam

An annual physical exam for men might also include:

• Testicular exam: A doctor can check each testicle for lumps, tenderness, or changes in size. Most men with testicular cancer notice a growth before seeing a doctor.
•  Hernia exam: The famous "turn your head and cough" checks for a weakness in the abdominal wall between the intestines and scrotum.\
•  Penis exam: A doctor might notice evidence of sexually transmitted infections such as warts or ulcers on the penis.
•  Prostate exam: Inserting a finger in the rectum lets a doctor feel the prostate for its size and any suspicious areas.

Female Physical Exam

A woman's annual exam might include:

• Breast exam. Feeling for abnormal lumps may detect breast cancer or benign breast conditions. The doctor will also check the lymph nodes in the underarm area and look for visual abnormalities of the breasts.
• Pelvic exam: The pelvic exam allows examination of the vulva, vagina, and cervix. Routine checks for sexually transmitted infections are often done. A Pap test can screen for cervical cancer. 

Laboratory Tests

There are no standard laboratory tests during an annual physical. However, some doctors will order certain tests routinely:

• Complete blood count
• Chemistry panel
• Urinalysis (UA)

Unless symptoms already suggest a problem, these tests are unlikely to provide useful information.

A lipid panel (cholesterol test) is recommended every five years. Abnormal cholesterol levels increase the risk for heart attacksand strokes.

Physicals Should Emphasize Prevention

• At age 50, it's time to begin regular screening for colorectal cancer. People with immediate family members with colorectal cancer may need to be screened before age 50.
• For most women, age 40 marks the time to begin annual mammogram screening for breast cancer.
• Everyone should have their cholesterol (lipids) checked every five years after age 20, according to the American Heart Association.

When making an appointment for a preventive service, make sure you inform your physicians at the time you are making an appointment that it is for a covered preventive service.  Make the appointment when you truly are well so the visit can focus on verifying your health and helping you manage your good health.  Check with your insurance company which other services are considered “preventive” and thus have no co-pay/co-insurance or deductible.  For example, most insurance companies are now fully covering a variety of immunizations such as: Hepatitis A and B, Flu, Herpes Zoster, Pneumococcal and more.  All you have to do is come in specifically for and only for a covered vaccination and it’s totally free to you (your health insurance will be billed and your health insurance carrier will cover your co-pay, co-insurance and any deductible).  The best way for you to know which services your plan considers “preventive” and free to you is to call your insurance company and ask. Visit avecinia’s list of  health insurance companies it is contracted with to find your insurance company’s website/contact information.  Generally, the preventive services listed under the Affordable Care Act will be covered services.  Take advantage of this great opportunity to save money and save your life today!

For daily updates on news, information and more on health care and wellness, join avecinia wellness center's facebook page (facebook.com/avecinia) and follow avecinia on twitter (twitter.com/avecinia4health). avecinia wellness center is Fresno's premier integrative medicine and wellness center. We combine internal medicine and primary care with health management, weight management, acupuncture, aesthetics (Botox, Juvederm, Radiesse, Obagi and more) and massage therapy for a holistic approach to health. We use a robust electronic health record program and patient web portal to enhance our delivery of services and to help our patients reach their optimal well-being. To learn more, visit www.avecinia.com. If you are looking for a primary care doctor in Fresno or the Central Valley and would like to become a part of the avecinia family, visit our website and click on new patient registration. Let Dr. Unaiza Hayat and/or Ali Kunkel, MPA, PA-C, become your trusted guides. Our Aesthetic, Weight Management, Acupuncture, Health Management and Massage Therapy services do not require us to be your primary care physician. Learn more at www.avecinia.com We look forward to meeting you!

Fall Allergies

Fall in Fresno!

Fall is a beautiful time of the year in Fresno- the temperatures cool down, fruit is abundant and it’s time for a new year at school!  We hope these tips will help you and your family enjoy Fall in Fresno to the fullest!

Fall is Back to School time!

Fresno, Clovis and Central Unified school districts started school in August. This year the state of California required 7^th-12^th graders to have proof of TDAP vaccination.  The TDAP vaccine lasts about 10 years.  Another important vaccine to consider is the Flu vaccine. The flu vaccine changes every year and it’s a good idea to check with your primary care physician about getting this year’s flu shot.

 When kids go back to school, they are bombarded with a variety of germs.  Sometimes a sniffle or stuffy nose, itchy or watery eyes and nose can be an allergic reaction to dust, pollen, mold or some other allergen.  Other times it can be the first sign of a cold.  If the child has a fever, they may also be getting  a flu.  The best protection against either allergies or the cold is to remind your kids to wash their hands often (they don’t always have to use anti-bacterial soap though), avoid touching/rubbing their eyes and cough in their sleeves!  If your child shows signs of trouble breathing, wheezing, coughing, you may want to make an appointment with your primary care physician to screen for asthma.  Increased pollen counts, chalk dust, mold in schools may be potential allergens that can lead to asthma as well.

If your child has food allergies, going back to school is an important time to remind your child to be extra careful about sharing food that may contain items they are allergic too. It’s a good idea to update the school with a list of food allergies your child may have or provide them with such list if you haven’t already.

Air Quality in Fresno and the Central Valley

In general, the air quality around Fresno and the Central Valley does tend to improve in the Fall.  However, if you live near a farm, remember the fall is when many crops are dusted with pesticide (such as cotton crops).

Tips on easing Fall Allergies

• Pollen is at its peak between 10 a.m. and 3 p.m.  Visit the American Academy of Allergy, Asthma and Immunology website at www.aaaai.org to see what the pollen count is in your area;
• Avoid food allergies by packing your child’s lunch (it’s a healthier option too); inform the school about potential food allergies and check to see if they have Epi-Pens available;
• Before you turn on the heater (if you need to this Fall/Winter)- get your heat ducks cleaned of trapped mold and other allergens;
• Use a high efficiency particulate air (HEPA) filter if you aren’t already with your heating system. 

With a little precautions, you and your family can have a fun, fulfilling Fall in Fresno!

For daily updates on news, information and more on health care and wellness, join avecinia wellness center's facebook page (facebook.com/avecinia) and follow avecinia on twitter (twitter.com/avecinia4health). avecinia wellness center is Fresno's premier integrative medicine and wellness center. We combine internal medicine and primary care with health management, weight management, acupuncture, aesthetics (Botox, Juvederm, Radiesse, Obagi and more) and massage therapy for a holistic approach to health. We use a robust electronic health record program and patient web portal to enhance our delivery of services and to help our patients reach their optimal well-being. To learn more, visit www.avecinia.com. If you are looking for a primary care doctor in Fresno or the Central Valley and would like to become a part of the avecinia family, visit our website and click on new patient registration. Let Dr. Unaiza Hayat and/or Ali Kunkel, MPA, PA-C, become your trusted guides. Our Aesthetic, Weight Management, Acupuncture, Health Management and Massage Therapy services do not require us to be your primary care physician. Learn more at www.avecinia.com We look forward to meeting you!

How to stay cool when going back to school- Guest Blog by Corinne Soares, LCSW

How to stay cool when going back to school

When my son was born almost 6 years ago the transition into motherhood was a big one, but I handled it well by having a great support group and asking plenty of other mom's for advice. Then last year I transitioned again - into motherhood of a school age child. I am happy to say I survived my son's kindergarten year (with a few tears from both him and I of course) and now we are gearing up for first grade.

The first day of school will quickly be upon us and it can create stressful feelings in both parents and kids. I always feel it is better to be proactive rather than reactive, so here on some ideas on easing the transition back into school:

1. Take the mystery out of the first day of school. If your child is attending a new school make sure they are familiar with the school. Take them on campus, show them their classroom, bathroom locations, administration offices and where drop off/pick up is. This can help ease any anxiety your child may have about how they will navigate their new surroundings. Many school's also have a 'meet and greet' with the teachers a week before school. I encourage you to attend these with your children so you can both meet their teacher and see their classroom.

2. Stock up on supplies! With all the budget cuts in the schools it has left classroom supplies very limited. Be sure your child is stocked up on supplies appropriate to their grade level. This can also build some excitement in your children as they prepare their backpacks with fresh paper, binders, crayons and pencils. Also be sure you have a meal plan prepared. If your child will eat a hot lunch be sure they have money on their school account or stock your fridge with some of their favorite lunch items for cold lunch. Disney Family Fun offers some fun and fresh ideas for your kid's lunches and snacks.

3. Start the school routine early. Summer vacation can throw kid's schedules off in a big way. As a parent I am often guilty of letting my kids stay up later during the summer time, causing my kids to go to bed later and have a hard time waking up in the mornings. One or two weeks before school starts begin to implement their school week schedule. Have your kids go to bed and wake up during their school hours so the first week of school isn't a shock to their system.

4. Keep the learning experience strong, year around. Summer learning loss occurs when kids do not engage in educational experiences throughout the summer. A recent segment on the Today show stated that kids can lose approximately 2.6 months of their grade level during the summer months. This can cause kids to feel very frustrated when school starts again and make homework a battle. With fun summer activities it can be hard to coax your kids into traditional learning activities, so make them fun! Many video games or phone's now have educational apps or programs kids can benefit from. You can also engage them in outdoor learning activities so kids don't have to choose between the outdoors or brushing up on their skills.

5. Keep an open dialogue going with your kids and the school. As the school year begins talk to your kids about what they like about school and what they dislike. It is normal that your child isn't going to love everything about school. Build on the good points to keep your child motivated. If there are ongoing concerns be sure to communicate with your child's teacher to see if education services such as tutoring or an IEP is needed. Parents and teachers both want their kids to succeed so work together, not against each other.

So take a deep breath and put on a smile. Transitions can be bumpy but with the proper tools and right attitude, you and your child can make the transition back into school as smooth as possible and set the stage for a great school year.

This special guest blog was written by Corinne Soares, LCSW.  You can read more of Corinne's informative blogs here: Notes from a Therapists Desk. Join Corinne and avecinia wellness center on August 16th at 6pm for a special, "Back to School" night at avecinia wellness center. Learn more tips and techniques to helping your family have a great school year, what Fresno Unified, Clovis Unified and the State of California are requiring for vaccinations and more! Call us at 559-450-7299 to learn more and RSVP!


For daily updates on news, information and more on health care and wellness, join avecinia wellness center's facebook page (facebook.com/avecinia) and follow avecinia on twitter (twitter.com/avecinia4health). avecinia wellness center is Fresno's premier integrative medicine and wellness center. We combine internal medicine and primary care with health management, weight management, acupuncture, aesthetics (Botox, Juvederm, Radiesse, Obagi and more) and massage therapy for a holistic approach to health. We use a robust electronic health record program and patient web portal to enhance our delivery of services and to help our patients reach their optimal well-being. To learn more, visit www.avecinia.com. If you are looking for a primary care doctor in Fresno or the Central Valley and would like to become a part of the avecinia family, visit our website and click on new patient registration. Let Dr. Unaiza Hayat and/or Ali Kunkel, MPA, PA-C, become your trusted guides. Our Aesthetic, Weight Management, Acupuncture, Health Management and Massage Therapy services do not require us to be your primary care physician. Learn more at www.avecinia.com We look forward to meeting you!

Obesity in Fresno and You!

The Central Valley has the highest overall rate of obesity in California (See Prevalence of Obesity amongst Adults Age 18 and Over) and almost 1 in 3 kids in California are overweight or obese.   Obesity amongst minority (ethnic and socio-economic) children is even more rampant.  The cost of obesity, to families, employers, the health care industry and the government is approximately $21 billion (Obesity and Diabetes: Two Growing Epidemics in California, UCLA Center for Health Policy Research, August 2010).  Without serious efforts to address this growing epidemic, there may be no turning back. 

It will take a collective effort, the effort of health care providers, parents, children and the community to start making a difference. The following are examples of things parents and children can do, health care providers and the community can do and an example of something being done right here in Fresno!

Parents and children:

Parents are the biggest influences in their children’s lives. As a parent, you have the power to turn off the TV, select what you and your family will eat, structure how you will spend time with your kids and be healthy role models.  Start with:

• Let your kids let it out, the energy that is.  Get your kids to play, run around, be physical for at least an hour a day. Avoid using restriction of play as a disciplinary measure;
• Turn off the tube.  Not only does TV time decrease play time, the “foodless fridge” also inundates your kids with marketing for sugary snacks and other unhealthy food;
• Get them to bed.  Create a sleep friendly environment and habits. DO NOT PUT A TV OR COMPUTER IN THEIR ROOM.  Have quiet time before bed time.  Talk to your doctor about including safe, natural sleep supplements such as melatonin in your diet.  Studies show that children and adults who sleep less than 8 hours have higher levels of hormones that make you feel hungry and lower levels of hormones that make you feel satisfied; and
• Use the kitchen as family time by cooking healthy meals with your kids.  Not only will the family save money by not eating out, you can eat healthier, teach your kids good habits and bond with them all at the same time.  Who knows, you may even inspire the next Martha Stewart or Emeril!

The community and you:

The community you live in is a reflection of you.  Unfortunately in Fresno and the Central Valley, we have the highest rate of obesity and diabetes in California.  Studies indicate that higher rates of obesity and diabetes impact poorer areas more than wealthier areas.  This can be due to more restricted access to gyms, inadequate food choices, and lack of health care. 

However, the lack of financial resources cannot be an excuse.  Here are some ways you and your community can work together to combat obesity: 

• Here in the San Joaquin Valley, we have access to beautiful, natural gyms- our vast amount of parks, trails and other places to be physically active.  Go for a walk with a loved one, make sure you wear sunscreen;
• If a park is too far or it’s too hot, the community should ask for local schools to be open during the weekend so gyms can be used to hold free fitness classes.  For example, a local business can sponsor a trainer to hold 30 minute aerobic classes on the evenings and/or weekends; and
• Local government can help by restricting the number of permits for fast food restaurants in low-income neighborhoods and incentivizing more grocery stores or farmers markets to locate within those same neighborhoods.   Sometimes people need help in making better choice.

Local business can work with the community to promote healthier living.  That’s what we are doing.  Recognizing the severity of the obesity epidemic in the Central Valley, avecinia wellness center (www.avecinia.com) partnered with Marjaree Mason Center (“MMC”)  (www.mmcenter.org) and donated the services of Registered Dietician Sunny Yingling, MS, RD to develop a nutrition program for MMC clients.  The MMC serves over 86,000 meals, with more than half going to children, children who statistically are more likely to be or become obese. The program helps the MMC pick nutrient dense food items for its clients who then use recipes learned in classes taught by Sunny to bond with their children over meal preparation.  This past June, we partnered with Granville’s Sageberry grand opening to raise money and awareness about childhood obesity and the nutrition program. Through the nutrition program, avecinia, other local businesses and MMC are able to make a small, but important, step in the fight against obesity.   If you are part of a local business and would like to know how you can help make Fresno better, feel free to contact Aamer Hayat at aamer@avecinia.com.

For daily updates on news, information and more on health care and wellness, join avecinia wellness center's facebook page (facebook.com/avecinia) and follow avecinia on twitter (twitter.com/avecinia4health). avecinia wellness center is Fresno's premier integrative medicine and wellness center. We combine internal medicine and primary care with health management, weight management, acupuncture, aesthetics (Botox, Juvederm, Radiesse, Obagi and more) and massage therapy for a holistic approach to health. We use a robust electronic health record program and patient web portal to enhance our delivery of services and to help our patients reach their optimal well-being. To learn more, visit www.avecinia.com. If you are looking for a primary care doctor in Fresno or the Central Valley and would like to become a part of the avecinia family, visit our website and click on new patient registration. Let Dr. Unaiza Hayat and/or Ali Kunkel, MPA, PA-C, become your trusted guides. Our Aesthetic, Weight Management, Acupuncture, Health Management and Massage Therapy services do not require us to be your primary care physician. Learn more at www.avecinia.com We look forward to meeting you!

Your Health is Your Wealth! Managing the costs of healthcare.

How to make more money by investing in yourself "The greatest wealth is health!"   I'm sure you've heard of that famous quote by Virgil.  In the past year, the health care debate was mentioned almost every day in the news and became part of our daily conversation.  As the economy tumbled, the costs of health care became even more apparent.  Job loss meant health insurance loss.  Employers started cutting costs by shifting health insurance costs to employees.  For the first time, people had to start including healthcare in their budget.  For a nation in which 1 in 3 individuals is overweight,  1 in 5 is obese and 1 in 10 have diabetes, these direct health care costs are expensive.  In a difficult economy or economic situation, you might be saying to yourself "Well, if I go see the doctor 2-3 times this month, that is going to cost me $300-$400 this month! I don't have that money!"  What we don't seem to realize is that if we don't invest in our own healthcare now, these costs are only going to rise. The perfect scenario to demonstrate the importance of investing in one's own health is a diabetic patient.  Here are just some of the statistics that show how expensive having a disease can be: The average health care costs for treating a diabetic patient is $10,000 a year (United Health Care); The average person with diabetes spends up to $900 a month for syringes, supplies, medicine and doctor's visits (The Cost of Diabetes); and The 15 year risk for a heart attack for a person with poorly controlled diabetes is 16.9%.  The costs over that period: $271,000 (The High Cost of Diabetes also a great website to see what happens if you don't take care of yourself; Your $15-$25 co-pay investment today will give you a $271,000 return "tomorrow"). Now, what does this mean to you?  Well, if you are a diabetic patient, or someone that has other chronic disease such as high cholesterol, hypertension, or hyperthyroidism (which are other expensive diseases), what could you do if you suddenly had $900 a month to do whatever you wanted or needed to do instead of spending on medicine, supplies and doctor's visits? Adding $900 a month to your monthly net income isn't a gimmick or get rich quick scheme. It can be done. Let's look at our diabetic patient example (based on an actual patient):   Prior to taking a proactive step, patient would come in every 2-3 weeks regularly or would only come in once every 3 months for medication renewal.  Diabetes Medication alone cost him $500 a month; After agreeing to work with us to help him,  the patient came in 4 times in the 1st month to jump start his plan which required initial longer, complex visits- Office Visit Avg $125- total $500 For the next 3 months after month 1, once the plan was in place and patient was proactively participating, we were able to reduce his visits to once a month. The once a month visits were to review his labs, check progress and start taking patient off of the diabetes drugs he no longer needed. At end of Month 2, patient reduced A1C to 5.7.  Office Visit Avg- $100, total for 3 months- $300 In month 4, patient had lost significant weight and maintained his A1C at 5.7 and was no longer on any diabetes medication.  Office Visit - $100.  Savings from reduction in medication- $500. Month 5's appointment was 3 months after month 4. Patient no longer had to have regular, complex office visits. Office Visit - $100 Next office visit in Month 8- $100  Next office visit, Month 11- $100  Total: $3,2000 Office Visits- $1,200 Medicine- $2,000 Total if patient decided not to invest in his health: $6,300 to $6,500 Office Visits- Range from $300 to $500 Medicine - $6,000 As this comparison shows, by investing in your health, you can save 50% or more just in your first year.  Imagine compounding the savings, or worse, the expense! Sure at first it may seem like it cost a lot more to do something about your health, but do the math, or talk to us about helping you do the math!   We think you are worth the investment. We hope you do too! As always, if you have any questions, feel free to email me at aamer@avecinia.com.  If you would like to put together a plan, contact Colette Vaquilar, our Patient Specialist, at billing@avecinia.com.  She will be happy to help you invest in your health!  For daily updates on news, information and more on health care and wellness, join avecinia wellness center's facebook page (facebook.com/avecinia) and follow avecinia on twitter (twitter.com/avecinia4health). avecinia wellness center is Fresno's premier integrative medicine and wellness center. We combine internal medicine and primary care with health management, weight management, acupuncture, aesthetics (Botox, Juvederm, Radiesse, Obagi and more) and massage therapy for a holistic approach to health. We use a robust electronic health record program and patient web portal to enhance our delivery of services and to help our patients reach their optimal well-being. To learn more, visit www.avecinia.com. If you are looking for a primary care doctor in Fresno or the Central Valley and would like to become a part of the avecinia family, visit our website and click on new patient registration. Let Dr. Unaiza Hayat and/or Ali Kunkel, MPA, PA-C, become your trusted guides. Our Aesthetic, Weight Management, Acupuncture, Health Management and Massage Therapy services do not require us to be your primary care physician. Learn more at www.avecinia.com We look forward to meeting you!

Dad, He-Man, Superman. Whatever you call him, he's special!

Father's day is June 19^th, celebrate your father's good health with him!

Men's health in their 20's, 30's, 40's, 50's and beyond!

Father's day is June 19^th! But fathers and other important men in our lives should be honored every day. A good way to honor them is to make sure they honor and value their health. The more they value their health, the more father's days we all get to celebrate. Unfortunately, many men don't value their health enough. According to the American Academy of Family Physicians, only 50% of men 45 years and younger had a physical exam in the past two years. Men are also 30% more likely than women to be hospitalized for preventable conditions such as diabetes. Here are some important men's health issues and reminders for each age group!

20-30's

The 20's and 30's are the best time for a man to develop the right habits, such as:

• Getting regular exercise (at least 30 minutes a day, 3-4 days a week);
  
• Eating well by learning portion control, how to read nutrition labels, and eating your veggies;
  
• Giving up bad habits or not even picking them up-smoking is the number 1 cause of preventable death (lung cancer) and alcohol induced accidents are the leading cause of death in young men (alcohol also lowers male hormones, killing your sex life!); and
  
• Saying "Hi" to your doctor! Get to know your doctor now so as you age your doctor can help you keep track of your health.
  

40's-50's

Most men reach their 40's having achieved their career goals, started young families and are looking forward to another 40- to 50 years of quality life. It's not too late to start good habits

• Definitely start with exercise. The American Academy of Family Physician's Men's Health study showed that nearly 40% of men between the age of 45 and 54 don't exercise at all. However, they do watch at least 20 hours of TV a week! You can still incorporate 30 minutes of physical activity 3 to 4 times a day and have 18 hours of TV left;
  
• Have you tried Salmon with Tomato and Dill rice? No? Maybe you've had an olive or two? If not, you're missing out on an easy way to incorporate a Mediterranean diet into your routine! Mediterranean diets are rich in whole grains, fruits, vegetables, fish and other lean protein which lower your risk of heart disease, diabetes, depression, Alzheimer's and even prostate cancer. And go ahead and drink that extra cup of coffee- studies show that men who drink 6-8 cups of coffee (caffeinated or decaf) a day are less likely to develop prostate cancer then men who don't drink any; and
  
• Now that you've become friend with your doctor, don't hold back. The more they know about you, the more they can help you age gracefully! A few important things to consider: Get a physical/preventive exam every 1-5 years; Learn about prostate cancer and ask your doctor if it's time to start getting regular exams; talk to your doctor about skin cancer. According to the Skin Cancer Foundation, skin cancer is the most common cancer among men over the age of 50! Make sure you wear a UVA/UVB broad spectrum sunscreen with at least SPF 15. Apply it 2-3 times day, especially when you're out on the golf course or are spending a day outside. Try Colorescience Protect Aftershave moisturizer with SPF 20 or Obagi's Award Winning NuDerm SPF50 sunscreen. Both are 33% off and available at avecinia wellness center during our Big June Sale!
  

60's and beyond!

65 is the new 50 and 85 is the new 65. If you've been living a healthy life since your 20's and 30's, this is certainly true. Even if you haven't, there's still hope for you. But you are going to have to work for it.

• Treating chronic disease conditions such as diabetes or hyperlipidemia (high cholesterol) is imperative;
  
• If you have Medicare, take advantage of several free, preventive services now offered. Start with your Medicare Annual Wellness Visit. This is a great opportunity for you to discuss your current health, your health concerns for the next 5 years and more;
  
• If you are retired, this is the perfect time to take up new hobbies. Staying physically and mentally active keeps your body and mind healthy and happy. A good exercise routine can help you double your hand grip strength in 3 months. Hand grip strength is a good indicator of long term survival; and
  
• Staying fit can also help you have an active sex life. 15-25% of men over 65 years of age experience erectile dysfunction (ED). ED can be caused by alcohol use, smoking, certain medications, anxiety, depression, obesity, diabetes and heart disease. It's also an early warning sign of atherosclerosis (hardening of the arteries).
  

With the proper attention to your health and well-being, you can live into your 100's and your loved ones can celebrate more fathers' days with you. Think of all the gifts you can get!

Happy Father's Day!



For daily updates on news, information and more on health care and wellness, join avecinia wellness center's facebook page (facebook.com/avecinia) and follow avecinia on twitter (twitter.com/avecinia4health). avecinia wellness center is Fresno's premier integrative medicine and wellness center. We combine internal medicine and primary care with health management, weight management, acupuncture, aesthetics (Botox, Juvederm, Radiesse, Obagi and more) and massage therapy for a holistic approach to health. We use a robust electronic health record program and patient web portal to enhance our delivery of services and to help our patients reach their optimal well-being. To learn more, visit www.avecinia.com. If you are looking for a primary care doctor in Fresno or the Central Valley and would like to become a part of the avecinia family, visit our website and click on new patient registration. Let Dr. Unaiza Hayat and/or Ali Kunkel, MPA, PA-C, become your trusted guides. Our Aesthetic, Weight Management, Acupuncture, Health Management and Massage Therapy services do not require us to be your primary care physician. Learn more at www.avecinia.com We look forward to meeting you!

Happy Mother's Day: Women's Health in their 30's, 40's, 50's and beyond!

Mother’s Day is May 8^th! We dedicate this blog to celebrate our wonderful mothers and all the incredible women in our lives.  The blog discusses common hormonal and skin health issues for women in different age groups and some tips to help them live happy, healthy lives!  If you are in the Fresno, California or Central Valley area, we invite you to our special event “Celebrating You: Women’s Health in your 30’s, 40’s and 50’s and beyond!” to learn more about these health concerns and others! Visit our Facebook Event Page or call us at 559-450-7299 to learn more and RSVP!

In your 30's

Physiologically, women in their mid to late 30’s may have a decrease in metabolism; function of the ovaries and of estrogen production.   To offset a decreased metabolism, it is important to include or increase exercise on a regular basis.  A few women in their late 30s may begin to experience peri-menopausal symptoms.  If you notice hot flashes, night sweats and fatigue, see your doctor about menopause. 

Tips:

• Form a walking, workout or other exercise group. Doing activities in group help individuals stick to a regimen; 
• Watch your caloric intake. A snack here and there will add up; 
• Keep a log of your period to gauge irregularity; 
• According to homeopathic medicine, soy (from soy milk or Japanese diet) can help relieve symptoms of menopause.

Women in there 30’s will notice fewer breakouts, however the first signs of aging will begin to appear. The skins natural process of exfoliation decreases and expression lines form. Uneven pigmentation and brown spots may become more apparent, especially in women with lighter skin. There will be a decrease in moisture in the skin and roughness may develop.  It is important during these years to have a good skin care regimen and stick to it.

Tips:

• Drink plenty of water and incorporate into your daily habit; 
• Find a good sunscreen, something that is broad spectrum with SPF 20 or higher and use it regularly if you are not already.  We recommend Obagi’s Nu Derm SPF 50 or Colorescience Pro SPF 50 Mineral brush; 
• Start using a moisturizer- some moisturizers will also have sunscreen in it.  We recommend Vivite’s Daily Moisturizer with SPF 30; 
• Talk to your doctor about using a serum with Vitamin C or Vitamin E. We recommend Obagi’s Professional C Serum or C-RX System.

In your 40’s

Symptoms of peri-menopause begin to occur in a around the mid to late 40s. This is a transitional period when a woman’s body shifts from regular ovulation to infertility. During this time the menstrual cycle becomes irregular and women may have a lighter or heavier flow. Hot flashes, vaginal dryness, and sleep disturbances can occur.

Tips:

• During this time a mammogram every 1-2 years is an important preventative health tool; 
• Women consider incorporating a Vitamin D and calcium supplement daily to help prevent a decrease in bone density

During this time collagen breaks down causing a significant loss of elasticity in the skin as well as continued moisture loss.  Photo-damage (Sun) becomes more obvious, including blotches, freckles, and age spots. Eyelids may have droopiness and/or puffiness develops under the lower lids.  Signs of skin changes may be more apparent on the chest as well.

Tips:

• Drink plenty of water; 
• Dermal fillers can help give back lost elasticity.  Juvéderm® XC and Radiesse® are good fillers;
• Vitamin C serums help rebuild lost collagen; 
• A chemical peel, microderm abrasion, or IPL/Laser resurfacing can help lift off dead skin and produce new, younger looking skin.  We recommend Vivite’s Glycolic Peel or Obagi’s Blue Peel Radiance for peels and E-matrix Sublative Rejuvenation;

In your 50's

A loss of estrogen contributes to the loss of elasticity and some women find they bruise more easily. The average age for menopause to occur is 51, and is defined as an absence of a menstrual cycle for 12 months. For most women it occurs over 1-3 years however some women have symptoms for many years. Irregular periods will be present along with other common symptoms. These symptoms include hot flashes, night sweats, sleep disturbances, skin flushing, moodiness, vaginal dryness, headaches, and a decreased interest in sex.

Tips:

• There are different treatment options, ranging from non-pharmacological symptom management to hormone replacement therapy, depending of a woman’s symptoms and the severity.  Speak with your primary care provider which type of therapy may help you best. If you don't have a primary care provider, visit us at www.avecinia.com to learn more about how we may be able to help you!

Women in their fifties with notice a decrease in facial fat and muscle causing loose and sagging skin. There is also an increase in uneven pigmentation and a decrease in skin thickness.

Tips:

• Talk to your physician about dermal fillers and complementary skin rejuvenation systems such as Obagi’s NuDerm or Vivite’s Glycolic System;
• Sublative Rejuvination/IPL/Laser may be good alternatives to more severe surgical procedures.

Aging is a natural process that is different for every person physically and emotionally. It is important to be aware of the different changes you will see when looking in the mirror as well as internal changes. Practicing preventative health care beginning at an early age through diet, exercise, and stress management is important to prevent health issues that effect women such as cardio-vascular disease, skin, breast and other cancers and more.  Live a long, healthy, prosperous life. You deserve it and others are counting on it! 

For more information on women's health, visit these websites:

http://www.healthywomen.org/

http://www.helpguide.org/life/healthy_eating_diet.htm

http://www.womenshealth.gov/

This blog was written by Melissa Moore, RN.  Melissa is currently an extern at avecinia wellness center and will graduate in May with her Masters in Nurse Practitioner degree from California State University, Fresno.

For daily updates on news, information and more on health care and wellness, join avecinia wellness center's facebook page (facebook.com/avecinia) and follow avecinia on twitter (twitter.com/avecinia4health). avecinia wellness center is Fresno's premier integrative medicine and wellness center. We combine internal medicine and primary care with health management, weight management, acupuncture, aesthetics (Botox, Juvederm, Radiesse, Obagi and more) and massage therapy for a holistic approach to health. We use a robust electronic health record program and patient web portal to enhance our delivery of services and to help our patients reach their optimal well-being. To learn more, visit www.avecinia.com. If you are looking for a primary care doctor in Fresno or the Central Valley and would like to become a part of the avecinia family, visit our website and click on new patient registration. Let Dr. Unaiza Hayat and/or Ali Kunkel, MPA, PA-C, become your trusted guides. Our Aesthetic, Weight Management, Acupuncture, Health Management and Massage Therapy services do not require us to be your primary care physician. Learn more at www.avecinia.com We look forward to meeting you!