Heart Health and You- Part 2- Exercise!

How strong is your heart? The healthy heart can produce enough energy in an hour to lift a one-ton car off the ground, and accumulate enough pressure to squirt blood at a distance of 30ft! Although most of us would like to think that our own heart has this ability; it’s not usually the case. In fact heart disease is the number one cause of death in the United States today with a whopping 599,413 deaths per year. This number is especially concerning because although some people are more genetically inclined to develop a cardiac illness, for most of us it’s 100% preventable. Earlier this month, we discussed the many different foods and beverages that will aid you in your journey to becoming heart healthy and in this second installment, we will be providing some simple and effective exercises that you can utilize in combination with your new and improved diet.

For most of us, getting regular exercise seems like a chore with no gratification. The idea of pain, sweat and tears without the instant gratification of seeing results isn’t very appealing when deciding whether or not to leave the comfort of your couch. However, any moderate-intensity exercise like swimming, jogging, Pilates or yoga is excellent for your fitness without feeling like you’re going to cough up a lung. Exercising your heart muscle means exercising your body: no need for a gym, just a bit of motivation and a good pair of walking shoes. If you “don’t have time” then fit shorter but more frequent periods of time, like 5-10 minute intervals several times a day throughout your day. Take the stairs, park your car further away from the door, and definitely count in those house chores such as mowing the lawn, vacuuming, or a short brisk walk around the block at lunch or for a break. The gaming console Wii also has several fun games such as Wii Sports or Wii Fit Step Aerobics – which is great exercise you can do with your kids-make it a family affair.

For adults that are 65 and older or anyone with chronic conditions or limited mobility, you still need the same amount of exercise as younger people but the activity can be less intense. Practice balance exercises to help prevent falls and injuries. Balance techniques are used frequently as exercises in yoga or more simple forms of balancing exercises such as walking heal-to-toe, standing on one foot, or standing up and sitting down without using your hands. Use good judgment and follow your doctor’s advice.

When these components are combined with a healthy diet, the outcome will hopefully be a much healthier heart and surely a much longer life. These tips make choosing to live a heart healthy life an accessible and reasonable goal to work towards so get started today! You are responsible for the health of your heart and the health of your life! Get the support of your family and primary care provider and get that blood pumping!

Part 2 of our February blog was written by Dania Abdul-Resoul, an intern at avecinia wellness center.  Dania is a pre-physical therapy student at Cal State Fresno.


For daily updates on news, information and more on health care and wellness, join avecinia wellness center's facebook page and follow avecinia on twitter . 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!

Beauty Isn't Just Skin Deep!

What is between 16 and 21 feet,  hosts up to 50 million different living organisms and some parts regenerate every 27 days?  Your skin! 

Your skin is one of your most vital organs. It protects your inner organs from radiation, bacteria, and other harmful agent.  It reflects your physiological and psychological health, and can be the difference between a bad day, a good day and a great day.

The two most common skin problems, acne (both pubescent and adult) and sun damage/aging (wrinkles, discoloration, sunspots, cancer) have been around since the beginning of time. So have various skin protection and healing remedies.  Ancient Egyptians used soaps made from animal oil, vegetable oil and salts.  Fenugreek was used to create soothing face masks and Cleopatra used to bathe in milk to help exfoliate and rejuvenate her skin.  In ancient Greece, masks of honey were used to treat acne. Today, you can buy or make many of these ancient remedies or turn on the television to see the latest therapy.

What causes Acne?

Acne is a part of the normal pubescent experience. Some teens exhibit more acne than others because their body is creating more of the oils that trap bacteria (P.Acnes) residing in hair follicles in the skin.   This trapped bacteria continues to grow and produces the pimples, blackheads and whiteheads.  In much the same way, almost 50% of adult women and 25% of adult men experience acne as well.  A hormonal change, such as when starting a birth control pill, hormone imbalance due to stress and/or poor nutrition, or other factors are usually related to an increase in acne.  It’s important to remember though that there is no direct relationship between the food you eat and acne.  However, because the skin is the bodies largest organ, eating well keeps your skin healthy, just like any other organ.

Treating Acne!

Having acne can be stressful, treating it doesn’t have to be.  Once the root cause of acne is identified, treating it can be as simple as following the right plan for you.  Because acne starts by bacteria being collected deep in hair follicle roots, it’s important that any acne treatment utilized is able to penetrate deeply into the skin to get to this bacteria.   The next important step is to help the skin control how much oil is produced/applied and trapped on the skin.  The sebaceous glands produce oil and overactive ones produce more.  In some cases, certain cosmetics include excess oil that is then trapped in follicles as well.  A good cleanser can help control how much oil is present on the skins surface and how much gets trapped in the hair follicles.  However, you don’t want  a cleanser that simply over dries your skin. Oils are essential to helping your skin look and feel healthy.

I look too old for my age!

If acne isn’t the issue but skin discoloration, sunspots and the appearance of fine lines and the development of wrinkles has you looking and feeling older than you are, then you may need something to help heal your skin.   If you spend a lot of time in sun, like to tan (outdoors or in a sun tanning bed), live in an area with poor air quality or a lot of pollution or smoke, free radicals associated with these environmental factors accelerate the skin’s aging process.  Free radicals are unstable molecules that attack nearby stable molecules to steal their electrons.  By stealing electrons, they create more unstable molecules, thus, for example in your skin, break down the collagen in your skin that normally gives you that youthful resilience.  Normally your body can develop anti-oxidants to help control free radicals but when excessive environmental factors overwhelm your system, your body needs help. 

Nature to the rescue!

One effective, natural way to battle excessive free radicals and the damage they cause is using Vitamin C.  Not only is Vitamin C a powerful antioxidant that neutralizes free radicals, it is crucial to the production of collagen and therefore helps produce collagen where it has broken down. 

Sure you can eat a lot of Oranges to get your Vitamin C, but in order to effectively treat and reverse the breakdown of collagen and its effects on the skin, you have to be able to apply Vitamin C directly to the skin and let it be absorbed.  The best type of Vitamin C for this is stabilized ascorbic acid (you can tell how stable a Vitamin C serum is by seeing how quickly it oxidizes or becomes brown and crusty near the containers opening).  Serums can come in concentrations from 5% to 20%, with 5% being ideal for sensitive areas and 20% being the most effective at reducing brown spots, discoloration, fine lines and other signs of damage caused by free radicals.

How can avecinia wellness center help you?

We have developed two new services to help you address acne or the early signs of aging:

“Clear” is a combination therapy designed to diagnose and treat the cause of Acne.  We start with a 30 minute consultation session to understand your diet and nutrition habits and determine whether their might be an hormonal issue to address.  Then you get a combination treatment of 3 Obagi Radiance Treatments and a 3 month supply of Obagi Clenziderm Acne Treatment.  The Radiance and Clenziderm treatment work together to cleanse your skin of dead skin and bacteria and get you back on track to clear, smooth skin.  

“Glow” is a combination therapy designed to refresh and revitalize your skin. We start with 3 Obagi Radiance peels and a 20% Obagi Professional-C Serum.  Obagi’s Professional- C  Serum is rated by Allure as a “Beauty Best Buy” and is consistently rated as one of the best Vitamin C Serums available.  Obagi’s Professional C-Serum is specifically designed to be more stable and penetrate deeper into your skin to help reduce the visible and not so visible signs of aging.  The “Glow” package also comes with Obagi’s new SPF 50 sun protection moisturizer to help you protect your new, refreshed skin.  The sun screen protects you from both UVA and UVB particles as the Professional C Serum corrects damage caused by free radicals and repairs collagen.

Call us today to come in and find out what may work best for you!  Starting a healthy skin care regimen now can get you the healthy, beautiful skin you want before the summer!

Visit our website at www.avecinia.com to see our prices and our sales.  Call us today to make an appointment and be ready for a beautiful new you for the summer! This article was reviewed by Dr. Unaiza Hayat, MD.


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!

Heart Healthy for American Heart Month

Heart Health

From the beginning of time, the heart has held, well….. a special place in our heart. The ancient Egyptians believed the heart was where the soul lived, where wisdom came from, where memory was stored and where emotions sprang forth.  It was considered the most important of the body’s organs.   The ancient Greeks had similar beliefs about the heart.  Yet now, cardio-vascular disease is the number 1 cause of death globally (approximately 29% of all global deaths http://www.who.int/mediacentre/factsheets/fs317/en/) and the leading cause of death for both men and women in America.  In 2006, more than 1 in 4 Americans   died of heart disease.  In 2010, heart disease cost the United States approximately $316.4 billion in health care services, medications and lost productivity.  In California, the leading cause of death (35%) is due to Heart Disease and Stroke.

 

However, just as the ancient Egyptians and Greeks valued the heart, you can too.  February is American Heart Month and it’s the perfect time for a heart tune-up! Our health blog this month will help you recognize the risks and symptoms of heart disease and give you simple, easy to follow tips to help you become heart healthy! And if you are planning on being at the Central Valley Go Red For Women Fashion Show and Luncheon (Friday, February 11, 2011 https://ahafresno.ejoinme.org/MyEvents/20102011CentralValleyGoRedLuncheon/tabid/234136/Default.aspx) stop by our booth to say hi!

Risks

High cholesterol, high blood pressure, diabetes, cigarette smoking, elevated Body Mass Index or BMI (overweight or obesity) and physical inactivity are major risk factors for heart disease.  The best way to mitigate all of the risk factors for heart disease is by addressing elevated BMI  (being overweight/obese) and your first step in addressing that risk is by… well, taking a few steps.  Reducing your weight by just 10% can significantly decrease your blood pressure, lower your blood cholesterol and reduce your risk of diabetes.

   

Symptoms

It can be difficult to “catch” cardio vascular disease because the build-up of cholesterol or rise in high blood pressure is usually gradual.  It is usually at the time of an event (such as a heart attack) that a person knows they have a disease. The most common symptom or sign of cardiovascular disease is angina or chest pain. You may feel tightness, burning, or swelling in your chest with angina.  However, these symptoms can also occur with heartburn, so you must consult your health care provider if they occur.  If you are also having heart palpitations, dizziness, nausea and excessive sweating, it is more likely to be a cardio vascular event such as a heart attack.

During a heart attack, symptoms may last 30 minutes or longer and are not relieved by rest or oral medication.

To learn more and print a handy symptom guide, visit Mayo Clinic’s Heart Disease Symptom Guide.

If the symptoms are severe, immediately call 911.

Prevention - So how do you get started on a heart healthy lifestyle?

1.       First, speak with your primary care provider about your concerns! 

a.       At avecinia wellness center, we have a strong history of addressing our patient’s heart health issues and can work with you to develop a heart healthy plan.  We also partner with other great health and wellness providers, such as Fitness Studio 108, to help you get the most comprehensive attention to your heart;

b.      We offer many resources on our website and facebook page.  You can also log on to your Patient Portal and research any of the questions you may have.

2.       Use the web to learn more!

a.       If you don’t know where to go, visit our “Your Health” link on our Facebook page for a list of trusted resource.

b.      Or  visit one of these health related web resources:

                                                                   i.      The American Heart Association’s Tools for Your Heart Health site

                                                                  ii.      The Centers for Disease Control and Prevention Heart Disease site

                                                                iii.      The Mayo Clinic Heart Disease site

                                                                iv.      The California Heart Disease and Prevention Program site

c.       Use the web to track your progress. Keeping a log is a proven way of remembering where you started, how you’re doing and measuring  your success.  The American Heart Association has a several different progress trackers here.

3.       Get your friends and family involved!

a.       The more, the merrier. Having the support of friends, family and loved ones makes it easier to overcome any challenges and more fun to celebrate the achievements!

                                                                   i.      Take a 30 minute family walk together at least every other day.  Use the time to unwind, connect, and encourage family fitness.

                                                                  ii.      Cook dinner together.  Having more meals at home saves lives and money -Food at restaurants usually have higher fat content and portions are much larger than necessary.  Cooking at home allows you to control the amounts of fats, oils, and sugars used.  It’s also a great way to learn and teach healthy eating habits.  Here’s a great link to heart healthy cooking:  WebMD

                                                                iii.      Share your plan with your family.  Let them know you are serious so they can help you on the difficult days and keep you on track.

Ready to get healthy?

We recognize it may not be easy to take the first steps necessary to live a heart healthy life. But it’s not impossible.  To see how incorporating physical activity and a healthier diet can change your life, view this report by Christina Lusby of KSEE 24 on Bob Tharp.  Bob lost over 80 pounds, has his diabetes under control, and is saving $500 a month all by incorporating physical activity and a proper diet into his routine with the guidance of avecinia wellness center.  Bob and avecinia are now working on developing a diabetes management support group for Fresno and Central Valley residents. We plan on having our first, free meeting in March!  To learn more about our program or join the mailing list, email us at wellness@avecinia.com with Diabetes Support Group in the subject line.

Get started today though by at least having an honest conversation with yourself, your loved ones, and your primary care provider on why you want to become heart healthy!

Medicare's Annual Wellness Visit

Healthcare Reform was a hot topic in 2010 and continues to be as we start the new year!  There are many benefits introduced by the reform and one very important one that is set to start January 1^st, 2011 is Medicare’s new Annual Wellness Visit!  You may be asking yourself, “What is an Annual Wellness Visit?”   and  “Is it worth it for me to come in when I’m not sick?”- the answer to the second question is easy- YES!  If you want to know what an Annual Wellness Visit is, read on!

The Annual Wellness Visit  is Medicare’s answer to providing a preventive (or well check) visit with a few extras that research has found helps you live healthier, happier lives. AND IT’S ALL FREE for Medicare patients (if you have a Medicare Advantage plan, verify with your insurance provider that they too will cover your co-pay and deductible for Medicare’s Annual Wellness Visit)!  Prior to enacting this new law and benefit, Medicare did not cover the physical portion of a preventive visit and only covered certain screening tests.  More importantly, it did not give physicians and their patients a chance to sit down and talk about their general health, well-being and what the future may hold.  Now, by scheduling and attending your Annual Wellness Visit when you are not sick, you can get the following along with a wellness visit:

1. Measurement of individual height, weight, Body Mass Index (“BMI”) , blood pressure (“BP”), and other routine measurements as deemed appropriate, based on the beneficiary’s medical/family history;
• Measuring your BMI, blood pressure and other vitals gives us a quick picture of your current health.  We can tell if you are at risk for diabetes, cardiovascular disease and other health concerns just by a few simple, but vital, pieces of information.
2. Establishment of individual’s medical, family and social history;
• Knowing your most up to date family, medical and social history helps us determine if there are genetic or other reasons your risks may be greater than the average person.
3. A list of prescription medication;
• By reviewing your current list of medications, we can make sure you are not being prescribed too many medications or medications that have negative interactions with each other.  Our Athenahealth Electronic Health Record program will in most cases have a current list of medications if you have been getting them from a pharmacy and using your insurance.
4.  Establishment of a list of current providers and suppliers that are regularly involved in providing care to the individual;
• Knowing who else you are seeing and for what health issues allows us to better coordinate your care and get in touch with the right physician if we need to.
5. Detection of any cognitive impairment that individual may have (review of risk of depression, mood disorders, Alzheimer’s, etc.);
• A simple questionnaire helps us determine if there might be potential  mental health issues we should plan for while we can. 
6. Review of individual’s functional ability and level of safety;
• This will help us make sure that you are not in any danger of hurting yourself.
7. Establishment of a list of risk factors and conditions for which more intervention is recommended or is under way;
• Knowing and understanding the health risks you may be facing can save you the trouble of unnecessary visits to the hospital or even worse when it is too late.
8.  Personalized health advice and possible referral/follow-up for other covered preventive services such as weight-loss consultation, smoking cessation, diabetes management consultation; cholesterol management consultation, high blood pressure consultation, fall prevention and/or nutrition.
• Medicare realizes the importance of prevention and along with providing for a free Annual Wellness Visit, is also offering free services designed to help prevent, manage and reduce the most common health concerns for patients your age.
9. Establishment of a written screening schedule/checklist for the next 5-10 years as recommended by the United States Preventive Services Task Force;
• Knowing when to get proper screening is just as important as knowing what types of screening you may need.
10. (Not a part of the Annual Visit as of 1/3/2011 but it is a discussion we recommend you have with your primary care physician during your Annual Wellness Visit)Voluntary advanced care planning if desired (verbal or written information regarding the patients wishes in case an injury or illness  causes the patient to be unable to make health care decisions at that point)
• This is an important but often over-looked aspect of your health and well-being.  Knowing what you would like done, or not done, when it comes to important health decisions is good for your family, your provider and you.  Why wait until you can’t make that decision to have someone else make it for you?

Each year after your initial Annual Wellness Visit, your provider should follow up with you with another wellness visit where your list of medications, providers, risk factors are updated and your current health and well-being are re-evaluated.   If you can make your follow up wellness visit right after your Annual for the same day 12 months later, you won’t have to remember about making it later.  

What does this all mean for you/Why you should make an appointment for your Annual Wellness Visit?

A stitch in time saves nine.  This time honored adage has never been truer when it comes to your health and well-being.  Preventive medicine, that is medicine and services that help you from being sick or help you manage your current conditions so they don’t get worse, is the most important thing you can do to save your life, save your money, help your family,  and even help the overall health care system and the American economy.   For example, if during your Annual Wellness Visit, it is determined that you have or are at risk for Diabetes and then you take advantage of the free Diabetes Management services, you are more likely to control or not even get Diabetes.  Controlling or not even getting Diabetes can save you hundreds of dollars a month just in prescriptions.  We have had patients save over $500 a month by getting their Diabetes under control. If you don’t control your Diabetes and end up in the hospital because you need to be put on dialysis, your bill can be in the thousands.  That can be money in your pocket and money the hospital and government can save. 

Other benefits of getting your annual wellness visit and the yearly follow up are:

·         It’s an opportunity for you and your health care provider to discuss your health during a time when you are not in for a sick visit and therefore are not worried about  a how you’re feeling at the moment;

·         Planning out what visits you might need, based on your health condition and risk factors, in the beginning of the year can help you make sure you have the time to take care of the things you need to take care of;

·         It’s an opportunity have an open and honest discussion with family members (after your visit, you should meet with family members to discuss what you and your health care provider discussed during our annual visit such as your current health, risks, additional screenings that might be necessary, and what you would want done in case of an emergency);

·         IT’S FREE!

So make your appointment today!  You can call our office at 559-450-7299 to make an appointment or make an appointment request through the patient portal (go to www.avecinia.com, then click on “My Account” to access your patient portal).  When making an appointment, make sure you ask that it is for your Annual Wellness Visit (as long as you have not had your Welcome to Medicare Visit in the past 12 months or you are not new to Medicare within the past 12 months).  Your appointment will be for approximately 25-30 minutes (including time to fill out some questionnaires).  Although we have a list of your current medications, providers, family, personal and social history in our Electronic Health Record program, bring a list so we can confirm the information is accurate.  During your visit, you will be asked to complete a questionnaire that will become part of your Personalized Prevention Plane.  If you would like to fill this questionnaire out with the help of someone prior to the visit, just ask us and we can mail, email or fax it to you or you can download a copy from the Patient Portal under “Medical Forms” (the forms will be called Medicare Annual Wellness Visit Forms). 

 

We are excited that Medicare is offering this incredible, valuable opportunity for you without any cost to you! We highly recommend you make your Annual Wellness Visit appointment as soon as possible, or if your family member or loved one is with Medicare, have them make an appointment as soon as possible (or make it for them if you are their care taker).  See you soon!

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!

Healthy Holiday Eating Strategies

Thanksgiving, and thus, the holiday season is rapidly approaching! It’s an exciting time of family, friends, giving, and, oh yes, FOOD! Many start worrying about their weight and their waistlines, especially those who are working on lowering that number on the scale.

According to the National Institute of Health, the average weight gain during the holidays is only about 1 pound. That’s right, about 1. The problem is that most Americans don’t ever lose that pound of weight gain and it begins to add up over the years, increasing the risk for many chronic diseases.

Don’t panic. It’s important to recognize that you can enjoy holiday foods (it’s part of the fun!), but you want to stay balanced in the meantime. You don’t have to be afraid with a few strategies in mind:

1. Don’t attempt to diet and lose weight, instead try to maintain your weight. (This is a more realistic goal and will help you to feel successful through the holiday season) If you continue to lose weight, that’s great, and you can certainly continue to do so by maintaining healthy eating behaviors you’ve developed, but keep your expectations realistic.
2. Exercise to compensate for the extra calories you might be consuming, and to help relieve holiday stress. (This could be a walk with friends and family or outside playing with the kids)
3. Don’t skip meals, trying to “save up” for that big holiday meal. (This will contribute to ravenous hunger, causing you to overeat.)
4. Limit alcohol as much as possible. (A mixed drink can have as much as 500 calories per cup!) Calorie content of drinks:

• Beer: approx. 140 – 200 calories per 12 oz.
• 1.5 oz. shot of liquor: 115 – 200 calories
• 4 oz. wine: 60 – 160 calories
• 8 oz. margarita: approximately 400 calories
• 8 oz. egg nog: approximately 350 calories

5. Put your snacks & appetizers on a small plate instead of a large one and limit your trips to the buffet. Wait 20 minutes before getting another plate of food. (It takes 20 minutes for your brain to get the message that you are full.)
6. Take smaller bites and eat slowly. Try taking time to enjoy your food and the conversation with the people around you.
7. Substitute butter and margarine with plant sterol based products like Benecol and Take Control.
8. Try a healthy recipe for popular dishes such as Mashed Potatoes:

• 5 medium russet potatoes (medium white or red potatoes can also be used)
• 2 green onions, white and part of green, finely chopped
• 1/3 cup fat-free half and half (low-fat milk or whole milk can also be used)
• 1/4 cup fat-free or light sour cream
• 1 tablespoon butter (or no- or low-trans fat margarine or plant based sterol product)
• 1/2 teaspoon minced or crushed garlic (optional)
• Salt and pepper to taste

Preparation:

1. Pierce each potato several times with a fork and microwave the potatoes on HIGH until they are tender throughout (about 20 minutes depending on your microwave.) You can also bake or boil the potatoes until tender if you prefer. Let potatoes cool a few minutes.

2. Peel off skins (and discard) and add the potato flesh to a large mixing bowl along with the green onions, fat-free half and half, sour cream, butter or margarine, and garlic.

3. Beat on low speed until fairly smooth and blended. Add salt and pepper to taste.

Yield:

6 servings

Nutritional Information:

Per serving: 187 calories, 5 g protein, 37 g carbohydrate, 2 g fat (1.2 g saturated fat, 0.6 g monounsaturated fat, 0.1 g polyunsaturated fat), 6 mg cholesterol, 3.5 g fiber, 55 mg sodium (not including salt to taste).

9. Forget the “all-or-nothing” mindset. Instead, focus on “sometimes” and “for special occasions” to consume certain foods and beverages. Depriving yourself of special holiday foods isn’t a healthful eating strategy.
10. Remember that it is a holiDAY, not a holiWEEK! Make the special occasions special!

Have a Happy Thanksgiving!

This blog was written by Sunny Yingling, MS, RD.  Sunny is one of avecinia wellness center's trusted resources and we refer many of our patients needing diet and nutritional counseling to Sunny.  Sunny is a Professor of Nutrition at Clovis Community College and can regularly be seen on Central Valley Today on KSEE 24.  Sunny also works with our friends at Fitness Studio 108.  If you have any questions or would like to make an appointment with Sunny, you can email her at sunnymarie3@hotmail.com.

avecinia wellness center is Fresno's premier integrative medicine and wellness center and your partner in optimal well-being! We invite you to join us on facebook and follow us on twitter 

    

Health Care, Wellness and the Affordable Care Act of 2010

As the valley’s premier Integrative Medicine and Wellness center, avecinia wellness center is committed to your care and well-being.  As such, we are committed to helping empower you so you can make the best choices when it comes to your healthcare and well-being.  Your choice in health insurance should never effect your decisions about improving your health and well-being.  However, since the cost of health insurance is an important factor, it is vital for you to be well informed so you can make the best choice for you and/or your family. We hope the following information helps guide you towards better health and well-being.

In March of 2010, the President signed into law the hotly debated Affordable Care Act.  Whether you agree with the act or not, it is now the law and many of its provisions and benefits kicked in September 23^rd.  But they only apply to new plans, or plans that begin on or after September 23, 2010.   Here is a summary of these benefits, benefits to come and how they affect you (we categorize them by who they affect).  As always recommended, call your insurance provider, employee benefits manager, or a licensed Health Insurance Broker if you have questions about your plan.

For everyone:

•   Preventive Care
• Plans starting on or after September 23, 2010 will cover all your costs for a Preventive Care visit.  That means you do not have to pay a copayment, co-insurance or any deductible for preventive health services such as recommend screenings, vaccinations and counseling.  Keep in mind that coverage is only for in-network providers, and is only applicable if the preventive service is the primary purpose of the visit.  If the preventive service is in addition to other services, your plan may require to pay for the visit. If you have questions, please call your health insurance provider to verify which services are considered preventive and are free to you (i.e., you have no copay, co-insurance or deductible).  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.  If you need to discuss any service or health issue outside what your health insurance plan covers as a preventive service, your provider has to submit that information to the health insurance plan and you may be billed for the visit because it is no longer considered a preventive visit.   
• An End to Pre-Existing Conditions for Children
•  Health Insurers cannot deny children (under 19 years old) health insurance because of preexisting conditions. A ban on adult discrimination will take effect in 2014.  That means if your plan went into effect after September 23, 2010 and in November your child is hospitalized because of a severe asthma attack.  Your new plan cannot deny payment for the hospitalization due to your child’s “pre-existing condition.”  Keep in mind that insurance companies are now reducing the number of children only plans. When looking for an insurance plan, make sure it covers your kids!
•  Coverage for young adults under the age of 26
• Under the Affordable Care Act, if your plan covers children, you can now add or keep your children on your health insurance plan until they turn 26.  This applies to your kids even if they are married or can get insurance from their employers group plan.  Your child does not have to be living with you or be financially dependent on you.   Keep in mind that you must enroll your children within the open enrollment period. 
• Doctor Choice & ER Access
• The Act helps preserves your choice of primary care physician within your health insurance plans network.  It also prohibits health insurance plans from requiring a referral before you can see a OB-GYN in your network.  Importantly, the Act prevents health insurance plans from requiring higher copayments or co-insurance for out-of-network emergency room services and it prohibits plans from requiring prior approval before seeking emergency room services from a provider or hospital outside of your plan’s network. Keep in mind that you will still be responsible for the difference between the amount billed by the out of network provider and the amount paid by your health insurance plan.
•   Insurance Cancellation
• Health Insurers cannot retroactively rescind (declare your policy invalid from the date you started your policy) your insurance policy for an honest mistake or missing information that has no bearing on your health.  That means if your plan went into effect after September 23, 2010 and you are later diagnosed with cancer, your health insurance provider cannot rescind your plan because you left out your hospitalization for a broken arm 6 years ago. Keep in mind that intentionally falsifying or misleading the insurance company still gives them cause to rescind your policy.  Your health insurance provider has to give you 30 days notice before it can rescind your policy so you can appeal the decision or find new coverage.
• Appealing Health Plan Decisions
• You now have the right to appeal your health insurance providers denial of payment, service or treatment.  If your plan upholds its denial, you have the right to ask for an independent review.  Keep in mind that your state may have additional rules/regulations that effect your appeal.  For more information in California, click here.
• Lifetime and Annual Limits
•  Lifetime limits on most benefits are prohibited on plans issued or renewed after September 23, 2010.  Annual Limit are being phased out as well.  No plan that begins after September 23, 2010 can set an annual limit lower than $750,000.  By January 1, 2014, no annual limits will be allowed on most covered benefits. Keep in mind that the ban on limits only applies to essential services.  Some plans may be eligible for a waiver if complying with the ban on the limit would mean a significant decrease in benefits or increase in premiums.

For Medicare:

• Preventive Care
• Medicare must now pay for 100 percent of the cost of annual physicals and other preventive care visits (see above for more information).
•  Seniors Receive “Donut Hole” Rebate
•  Seniors with Medicare prescription drug coverage that have reached their coverage gap in 2010 will get a 1 time tax free $250 rebate. Beginning in 2011, Medicare recipients will receive 50% off of covered brand-name drugs while in the “donut hole.”
•  Stronger Medicare Anti-Fraud provisions
• Visit www.stopmedicarefraud.gov to see how you can help curtail Medicare fraud.

For Businesses:

•  Small business tax credit for providing health insurance
• Small business with less than 25 employees may be eligible for a tax credit of up to 35% to offset the cost of providing health insurance to their employees.  If you are a small business owner, check with your accountant to see if you qualify or how you can qualify.
• Wellness Program Grants for Small Business
•  Small business with less than 100 employees may be eligible for grants to cover Wellness Programs that started after March 23, 2010.  Grants will be available in 2011.
• Early Retirement Reinsurance Program
• The Act provides $5 billion in financial assistance to employers and unions to help them maintain coverage for early retirees age 55 and older who are not yet eligible for Medicare.

To learn more about the provisions of the Affordable Care Act, visit www.healthcare.gov.  To learn more about Medicare, visit www.n4a.org.  
This video is a helpful summary

Choosing an Health Insurance Plan

If you are purchasing a health insurance plan on your own or your employer gives you the option to select from a variety of health insurance plans, visit the California Department of Insurance PPO Ratings to learn which plans had the best rankings. According to the Department of Insurance, Aetna PPO, CIGNA PPO and Health Net of California PPO rated the highest as rated by their members across a variety of standards.  As a practice, we have noticed that Aetna, CIGNA, and United Healthcare provide coverage for a wide range of services, have less administrative burdens, and are more consumer friendly and oriented than other health insurance companies.  You can also contact a licensed Insurance Broker who will help guide you through the insurance maze and help you find the plan that best fits your needs.  A broker will do this for you for free because they get a commission from the insurance company.  Overall, insurance companies pay the same amount of commission so a licensed broker should not be swayed towards one policy or another but should help you find the solution that is best for you.  If you are looking for a broker or have questions in general, contact Shane Moore at Valley Employee Benefits & Insurance Solutions.  He can be reached at (559) 325-2500 or by email at shane@valleyemployeebenefits.com.  If you have other questions, please call or email avecinia wellness center’s insurance specialist, Colette Vaquilar at (559) 450-7298 or billing@avecinia.com. Visit www.avecinia.com and "like" us at www.facebook.com/avecinia




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!