R-Questions, Answered

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Dr. Robin Miller will be joining us at our newest practice opening in Voorhees, NJ. We’ve asked her a few questions to let us know a little bit about her. Have more questions you’d like answered? Stop by an open house or come in for a meet and greet.

  1. Where are you originally from?  Magnolia, NJ
  2. Why did you study medicine? I wanted to be like the doctor I had when I was growing up, I wanted to help people stay healthy.
  3. What was the hardest part of medical school? Memorization
  4. What do you do on a day off? I love to do needlepoint, read, and cook.
  5. What’s your favorite TV show? The original NCIS
  6. Do you have bad handwriting? (They say all doctors do) It’s true, I have horrible handwriting. 
  7. What’s is different about Direct Care that excites you? I love having more time with my patients to truly promote health and wellness. 
  8. What’s the simplest piece of medical advice you can give? Wear seat belts, exercise, don’t smoke, and portion control your food. Ok that’s more than one piece of advice, but all are important. 

Dr. Miller’s office is currently accepting pre-enrollment so don’t hesitate to sign up and see what else you may have in common.

Open Dialogue with your Doctor

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Questions. A fundamental aspect of any conversation. Asking questions can help you feel at ease and bring clarity to any discussion. And one person you’ll really want to be sure that you’re asking questions of is your doctor.

While we previously discussed the role of patient engagement, asking your doctor questions is a continuation of that conversation. While R-Health doctors have the patient’s best interest in mind, sometimes messages can be lost in translation, or otherwise misconstrued, which is why questions are needed for clarity. Too often patients go along with a plan without having a full understanding, which can ultimately cause the plan to fail. Thus, TIME provided a list of things you should be asking your doctor.

  1. “What are the different treatment options?” – Regardless of your condition, there should be a shared decision-making process about your options.
  2. “What outcome should I expect?” – Knowing outcomes may impact your decision on moving forward with a treatment and/or which option to choose.
  3. “Do we have to do this now, or can we revisit later?” – Gives your doctor more time to consider the severity of an ailment, which may halt pre-mature action. Some health issues work themselves out with time. Others need to be addressed sooner.
  4. “Is there anything I can do on my own to improve my condition?” – Making changes to your lifestyle can be very important. If you treat your body correctly, it pays you back with good health.
  5. “What are the side effects?” – Patients should know of possible side effects ahead of time so they can factor them into their decision-making on the course of treatment and/or what to expect from it.
  6. “How will I hear about my test results?” – If not explicitly stated, it’s important for the patient to know how they will receive test results to prevent uncertainty and anxiety.
  7. “How much will this cost me?” – There are many uncertainties regarding cost due to insurance, different tests or medications, etc. Therefore, it’s important to ask in order to financially prepare for that commitment.
  8. “What questions haven’t I asked that I should have?” – Sometimes amid asking your doctor questions, he or she may forget to mention a discussion topic they wanted to introduce. Therefore, this question can help serve as a reminder for the doctor, and get you more information.

Questions don’t always have to be this heavy. But at R-Health, we want to foster an opening and trusting dialogue between our doctors and patients. Take the initiative. Ask for help. Get your questions answered. You have tremendous access to your R-Health doctor, whether by phone, email or other electronic media.  Your R-Health team is willing and able to answer any questions you may have.

Right Track to a Healthy Heart

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Cardiovascular disease, also known as heart disease, is the leading cause of death in this country. Just as there are many misnomers, there are many different views of what causes heart disease. While focusing on heart disease from a different lens in hopes of discovering the true culprit, it’s important to acknowledge that science is always being tested and retested; hence, today’s tips and insights may change over time, in the overall effort to get it right. The views below are my views and those of a growing number of physicians and healthcare professionals.

Typically, one of the first questions I often hear is, what causes heart disease?

Fat is one idea often mentioned as a cause behind heart disease, but that’s not always the case.

It is also believed that cholesterol contributes to heart disease, but that is also in doubt.

I am happy that I am not the only one saying this.

The Telegraph also discussed their extensive research in debunking cholesterol’s role in heart disease, stating “Lowering cholesterol with medications for primary cardiovascular prevention…is a total waste of time and resources.” Primary prevention is classified as preventing the first episode of an illness. So primary prevention for heart disease is preventing the first heart attack. Secondary prevention would be aimed at people who have already had a heart attack.

So what does cause heart disease? I believe it’s a lifelong energy imbalance, what you eat and what you burn, combined with how well your body safely processes and stores energy. A major part of this process has to deal with the hormone insulin. One of Insulin’s most important jobs is to store excess energy, as mostly fat, which can be used in the future when you’re low on energy (i.e. illness, fasting, exercising, etc.). The problem however lies with excess fat. Excess fat from both the fat in foods, and the carbohydrates you eat can be stored in fat cells. Interestingly the excess carbohydrates are converted to fat to be stored.

However, our body’s ability to store fat is not unlimited. When fat cells reach their storage limit, they begin to resist any more energy intake, from the likes of insulin, which lead to what we call Insulin Resistance (IR). Short term insulin resistance (IR) isn’t harmful and may even be protective for the body, however long term IR can be extremely harmful.

The following may occur if you have chronic Insulin Resistance:

Obesity
High Blood Pressure
Diabetes
Heart Disease
Dementia-Alzheimers
Fatty Liver
Many, many others but the above items account for much of what most physicians treat in their practices.

When the body deals with long term IR, this excess fat, as a result of high insulin intake, leads the fat to dangerous places in the body where it was not meant to be.

Where can this fat go?

• Retinas – Which can lead to vision issues
• Liver – Can lead to fatty liver, obesity, diabetes, and cirrhosis
• Kidneys – Can lead to reduced kidney function, which can ultimately lead to dialysis
• Skin – Can lead to skin infections, skin tags, and/or old skin
• Pancreas – Can lead to diabetes, pancreatitis
• Artery walls – Leads to heart disease

The last might be the worst of all. Excess fat in artery walls leads to plaque, which in turn can build up, thicken, and stiffen artery walls, which makes blood flow through your arteries to your organs and tissues very challenging. Unbalanced diets that increase levels of insulin, coupled with lack of exercise, and unhealthy habits like smoking, all rapidly increase your chances of heart disease.

However, the first step in prevention is to alter your diet and lifestyle to reduce insulin resistance.

How do you do this?
• Eat fewer carbs
• Eat less often (consider Intermittent Fasting) (IF)
• Exercise more (start burning your stored-up energy) – this allows for more safe energy storage.
• Sleep better with normal day-night cycle – this balances your cyclical hormones
• Reduce your stress
• Avoid cigarettes
• Keep alcohol moderate to low

If you’re interested in more ways to keep your heart safe, or any of the other disease processes that Insulin Resistance causes, and would love some counselling on how to prevent/reverse these disease process from starting or advancing, don’t hesitate to call your R-Health doctor and schedule and appointment.

Vaccinations, Please

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One of the common misconceptions revolving around healthcare happens to deal with immunizations. Many people may believe that the need for immunizations ends in adolescence, but that couldn’t be farther from the truth. Every year there are thousands of adult cases of serious health problems that lead to hospitalization, or even death that could have been prevented by immunization. August is National Immunization Awareness Month and the goal is to highlight the importance vaccinations play in the health of people of all ages.

WebMD lists a few reasons to get immunized:

  • Immunizations protect you and/or your children from dangerous diseases, and help reduce the spread of disease to others.
  • They are often needed for entrance into schools or day cares, and sometimes needed for employment, or travel to another county.
  • Getting immunizations cost less than the treatment for the disease you are trying to get protected from.

Furthermore, as we mentioned, while the importance of vaccines for children is well known, the trend doesn’t quite carryover to adulthood and Healthmap helped discuss this trend. One of the main barriers is that adults simply don’t realize they need immunizations. While many may receive a flu vaccine, many more are unaware of the need for others. For example, the shingles vaccine is recommended for adults 60+, yet less than 16% of that population has received it.

We believe we should continue to encourage everyone, including adults, to get their vaccines. Even if you received them as children, as you get older they tend to wear off, and you can especially be susceptible to illness if you have chronic diseases. Adults with heart disease, lung disease, or diabetes are especially urged to stay up to date with vaccines. The CDC recommends that all adults get the following vaccines:

  • Influenza vaccine (every year to protect against the flu)
  • Td vaccine (every 10 years for tetanus)
  • Tdap vaccine (Protects against tetanus, whooping cough, and should use during each pregnancy)
  • Other vaccines (shingles, HPV, measles, mumps, hepatitis A and B, etc.)

Vaccinations are important no matter what stage of life you’re in. Preventable diseases tend to reappear when immunization rates drop so it’s vital to keep up with your vaccines. Luckily, R-Health members can get their vaccines right in the office, at no additional cost to you. Last minute vacations are still in the works, and back to school season is just a few weeks away, so be sure to consult with your doctor and schedule any immunizations you and/or your children may need. If you have questions or fears about any vaccines, your R-Health doctor is available for a free and open discussion. Your individual health is always our top priority.