Prostate Cancer Awareness

September is prostate health awareness month. Just in 2017, the American Cancer Society reported over 160,000 new cases. Outside of skin cancer, prostate cancer is the most common cancer in American men, affecting about 1 in every 7 during their lifetime. September is a month for raising awareness of prostate health in hopes of encouraging men to get their necessary screenings.

There are a variety of symptoms related to prostate cancer, chief among them are urinary. Cancer Treatment Centers of America (CTCA) described these symptoms being a result of the proximity between the prostate gland to the bladder and urethra. The following can be urinary symptoms of prostate cancer:

  • Burning or pain during urination
  • Difficulty urinating (trouble starting/stopping while urinating)
  • More frequent urges to urinate at night
  • Loss of bladder control
  • Decreased flow or velocity of urine stream
  • Blood in urine (hematuria)

Outside of urinary symptoms, other signs and symptoms that may be related to Prostate cancer:

  • Swelling in legs or pelvic area
  • Numbness or pain in the hips, legs, or feet
  • Lingering bone pain that leads to fractures
  • Painful ejaculation
  • Blood in semen

While Men’s Health offers a few tips for a healthy prostate, one of the best methods to prevent Prostate Cancer from affecting your life is to get screened. There is no definitive opinion on when or how often men should get screened, but it is important for the screening to occur.

Research has indicated that typically, men who are aged 40 or older, should be screened for risk factors. The Prostate Cancer Foundation urges all men to be proactive in their prostate health plan, but especially men who are at higher risk (i.e. positive family history or African American men).

There are different prostate screenings, including but not limited to a digital rectal exam (DRE) and prostate-specific antigen (PSA) test. If either of these tests detect an abnormality, doctors may recommend some additional test including:

  • Ultrasound
  • Collecting a sample of prostate tissue
  • MRI

These tests typically aid in confirming the presence of Prostate cancer and the extent to how aggressive it is may be.

As you can see, prostate health is important, especially if you’re at higher risk. Although many prostate cancers grow slowly, it’s best to get your screening sooner rather than later to treat any cases early. As always, your R-Health doctor is available for you to help answer any questions you may have, so reach out to your doctor to help you decide what’s best for you.

Back to Healthy Foods

It’s September and Back to School season. Between the books, school supplies, outfits, and event scheduling, healthy eating is often the last thing people focus on. However, it’s important to stay focused on health, especially as work/school days get longer, activities more vigorous, and time becomes more limited. A healthier diet for children may lead to less stress for parents.

Healthy eating can be very simple if you have the right tips. The Huffington Post published a few Healthy Back to School Tips which we’ll discuss.

  1. Start the day off right – Eating breakfast as a family is not only great bonding experience, but also a time where you can prepare a nutrient-filled breakfast that last children until lunch. I know many adults who skip breakfast. Growing children may do better with a nutritious morning meal.
  2. Nix the added sugarAvoid soda and other sugary drinks (i.e. iced tea, fruit punch) as well as sugary foods/condiments like cookies, ketchup, and sugar sweetened cereals to improve your children’s overall diet and avoid sugar rushes.
  3. Swap juice for whole fruitFruits are rich in fiber with high water content, and can help avoid added calories found in many juice pints.
  4. Pack a healthy snack – Always pack at least one fruit and vegetable. Some great options include apples, pears, bananas, yogurt, hummus, baby carrots, and nuts.
  5. Keep portions healthyIt’s important to serve healthy portion sizes to your children. Proper portion sizing prevents nutrient imbalance, overeating and even mood swings.
  6. Skip the white food – White bread, rice, and pasta are notoriously low in fiber, high in processed carbohydrates and lead to overeating. There are plenty of healthy non-processed alternatives such as white beans, cauliflower, along with most green vegetables that grow above ground such as lettuce, spinach, broccoli, and asparagus
  7. Get moving – Integrating exercise and sports is always a great way to keep your children healthy. Since it’s the beginning of school year, there are always an abundance of activities children can partake in, so make sure they’re active.

These are just a few simple tips to keep your children’s diet in check and healthy especially during frenzied times like the beginning of the school year. We know that a Happy wife means a Happy Life. Well, healthy children make happy parents! If you are searching for more health tips, your R-Health doctors are always available, ready to help answer any questions you may have.

R-Questions, Answered

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

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

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

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.

It’s Time to Engage

When afforded access to great healthcare, that’s when the real work begins. Your health goals and outcomes aren’t solely reliant on the doctor, but that responsibility also falls on you. Patient engagement is the first step towards the management of your health. According to the University of North Carolina (UNC) School of Medicine, increased patient engagement leads to better patient outcomes, a higher quality of care, and lowered health care costs. It also helps in developing prevention and chronic disease self-management programs that many new practices are modeled after. However, let’s further discuss the upsides of patient engagement.

Increased communication – Physicians and patients can communicate with one another more often and provide updates and timelines on a patient’s conditions

Increased patient satisfaction – With open dialogue channels between patient and doctor, patients become more confident regarding diagnoses and conditions since they are privy to more information.

Prevention – We utilize health-related information systems to help improve health outcomes and to identify trends of health and disease earlier.

Furthermore, there are challenges when it comes to patient engagement. However, our R-Health doctors make it easy by having your health as their top priority. Our doctors:

  • Respect your individual needs
  • Lead and manage your care
  • Coordinate your care with other providers and facilities
  • Provide care for short-term and long-term illnesses based on up-to-date standards of care
  • Refer you to community resources that fit your needs

We have a few suggestions on how to stay engaged with your doctor:

  1. Partner with your doctor to develop a care plan (inform your doctor of any illnesses)
  2. Follow your care plan, and let your doctor know if you have difficulty with it
  3. Keep your appointments and contact your doctor if you can’t make it
  4. Check your patient portal for clinical summaries and instructions after each appointment
  5. If you have any question that needs answering, don’t wait, feel free to reach out to your doctor at any time

Despite aids from technology and the availability of your doctor, engagement isn’t effective if you don’t take the initiative to use these tools and seize more control of your health outcomes. With R-Health you have unlimited access to your doctor, so now it’s your turn to get engaged!

Stay Easy, Breezy

The summer heat can be intolerable to some and indifferent to others. But for the most part, you would find that majority of people prefer not to be bombarded with summer heat waves. While there’s only so many times you can cool off in the pool, we thought it best to share tips on how to stay cool in the summer, and which foods may help.

Keeping cool during high temperatures is imperative. It’s not only about comfort but also the health risks that are heat-related. Per WebMD, there are a few heat-related illnesses:

  • Heat exhaustion – Develops from loss of large amounts of water and salt in body from excessive sweating. May interfere with brain function, and may be susceptible to people with heart, lung, or kidney problems
  • Heat cramps – also occurs when the body loses excessive amounts of fluids and salts. Can result in spasms of larger muscles throughout the body, which may be induced by people who work and/or exercise in hot environments
  • Heat stroke – The most severe of the three listed. Occurs from long, intense heat exposure to the body. Harshly affects the brain that regulates body temperature, disallowing the body to cool down.

As you notice, these are threats that may gravely affect the body if you are not proactive. However, MedicineNet provided a few ways to keep cool:

  1. Alter your pattern of outdoor exercise to take advantage of the cooler times (early mornings or late evenings)
    • If you can’t change, lessen the intensity and/or the duration
  2. Wear loose fitted clothes, preferably of lighter color
    • Cotton clothing will keep cooler than most synthetics
  3. Fill a spray bottle with water and keep it refrigerated, and use for a quick spray when you’re outdoors
    • Also, keep water bottles in the freezer to take with you outside
  4. Fans can circulate air better even in an air-conditioned house
  5. Drink plenty of water, sports drinks, and other sources of electrolytes
    • Avoid caffeine and alcohol, as these will promote dehydration
  6. If you don’t have air conditioning arrange to spend parts of your days in areas that are cool
    • e. Shopping malls, public libraries, movie theaters, etc.
  7. Use common sense – if the heat is unyielding, stay indoors and/or avoid direct sunlight and hot asphalt surfaces

Furthermore, staying indoors and carrying portable fans aren’t the only way to stay cool. There are plenty of foods that are not only healthy but very refreshing during hot summer days. GreenLiving shared some fruits and vegetables that help you stay energized and cool for the summer.

  • Fruits
    • Watermelon – A summer favorite, it contains 90% water and has big amounts of vitamins A and C
    • Cantaloupe and Honeydew Melon – Another fruit packed with water, they are low in calories and high in potassium. Also, a great source for losing weight and helping with cardiovascular issues
    • Citrus fruits – These may include oranges, grapefruit, lemons and limes – keeps you refreshed and looking younger, due to the nutrients that help with healthy skin.
  • Vegetables
    • Cucumber – Another water fresh food that helps flush toxins out of the body and maintain healthy tissue and skin
    • Radishes – They are a great source of vitamin C and have antioxidant and anti-inflammatory properties
    • Leafy greens – These may include spinach, arugula, and herbs like mint, and focusing on the latter, mint has great cooling properties. It can relieve indigestion and inflammation and can be used for a lot of your iced teas
    • *Be mindful, don’t consume any of these foods if you are sensitive/allergic*

As you can see, there are many ways to thwart any inconveniences that come with intense summer heat. Following these tips will surely help and may even encourage you to spend more times outdoors. However, if you have any further questions on combatting the heat, or other foods to consume, be sure to visit your well air-conditioned, R-Health doctor’s office!

R-Health Announces Funding from Reinvestment Fund

$2 Million Loan to Support Further Direct Primary Care Expansion in New Jersey

R-Health, a leader in innovative primary care solutions, today announced the company has closed on a $2 million loan from Reinvestment Fund. The funding will support R-Health’s continued expansion of Direct Primary Care practices throughout the State of New Jersey.

R-Health’s expansion in New Jersey is focused on the State’s program to provide a no cost membership to an R-Health Direct Primary Care practice to public sector employees and their family members enrolled in the New Jersey State Health Benefits Program (SHBP) or School Employees’ Health Benefits Program (SEHBP). R-Health currently has four practices in Ewing, Haddonfield, Moorestown, and Washington Crossing, providing exceptional relationship-based primary care to members of the SHBP and SEHBP.

The goal of the New Jersey Direct Primary Care program is to transform primary care from the legacy model that is episodic, transactional, and focused on treating illnesses and maximizing billing volume, to a refreshing new model that is continuous, relationship-based, and focused on helping patients achieve optimum health. Reinvestment Fund’s loan will support R-Health’s launch of multiple new locations across New Jersey including Cherry Hill, Hamilton, New Brunswick, and Voorhees, among others.

“We are thrilled to announce the support of Reinvestment Fund in R-Health’s continued growth and our goal to improve access to high-quality primary care for public sector workers across New Jersey,” said Mason Reiner, R-Health CEO. “It is critical to have the support of a renowned mission-driven lender that understands the positive social impact that can be achieved with better access to superior primary care.”

“R-Health has the opportunity to demonstrate how improved access and availability to personalized primary care can improve health outcomes and reduce costs for public sector workers and tax payers in New Jersey,” said Bridget Wiedeman, Senior Director for Health Services at Reinvestment Fund. “Reducing overall healthcare costs in New Jersey through improved primary care will also free up public funds for investment in other high-priority social services.”

R-Health’s approach to Direct Primary Care in New Jersey is focused on removing all barriers to high quality primary care. This includes a membership covered 100% by the NJ SHBP / SEHBP, no co-pays or other out-of-pocket costs for patients, 24/7 access to a personal primary care doctor, a patient panel that is less than half of a traditional primary care physician, and absolutely no fee-for-service billing. R-Health primary care doctors offer longer appointments, same-day and next-day appointments, little to no wait to see the doctor, and onsite lab draws. R-Health doctors also dispense medications for acute conditions and administer immunizations onsite, creating a one-stop-shop for comprehensive primary care.

More information can be found at www.r-health.md/nj.

About R-Health: R-Health delivers more effective care and a better patient experience – all at a lower cost. We partner with employers, unions, insurance companies and TPAs to offer primary care that’s truly collaborative. This is accomplished through the traditional core values of convenient, personal primary care; our innovative data analytics and patient engagement platforms that streamline care, delivering better outcomes, lower costs and a refreshing patient experience; and the proactive management of chronic conditions. For more information, visit www.R-Health.md.

About Reinvestment Fund: Reinvestment Fund is a catalyst for change in low-income communities. We integrate data, policy and strategic investments to improve the quality of life in low-income neighborhoods. Using analytical and financial tools, we bring high-quality grocery stores, affordable housing, schools and health centers to the communities that need better access—creating anchors that attract investment over the long term and help families lead healthier, more productive lives. Learn more at reinvestment.com.

Break Up with Stress

April marks the beginning of a time filled with transition and activity. With so much happening this time of year, it can be very stressful for some, and it’s important we recognize this early. With the start of a new quarter, the countdowns towards the end of the school year, and even the segue into the heart of spring, stressful moments await; which is why April is recognized as Stress Awareness Month.

In small bouts, stress isn’t all bad. It may help motivate, perform under pressure, and even keep your body at a heightened level of sharpness. Conversely, when you’re under heavy amounts of stress, this can lead to major emotional, psychological, and even physical consequences. Today we’ll discuss ways of identifying stress, and also some of the best strategies to deal with it.

The International Stress Management Association (ISMA) lists the following ways to identify stress:

  • Psychological Signs
    • Memory lapses
    • Worrying
    • Negative thinking
    • Depression and anxiety
  • Emotional Signs
    • Mood swings and irritability
    • Lack of confidence and self-esteem
    • Feeling out of control
    • Extra sensitivity to criticism
  • Physical Signs
    • Weight loss or gain
    • Aches and pains as well as muscle tension and grinding teeth
    • Indigestion and heartburn
    • Hyperventilating and panic attacks
    • Menstrual changes and loss of libido
  • Behavioral Signs
    • No time for relaxation or pleasurable activities
    • Prone to accidents and forgetfulness
    • Social withdrawal
    • Insomnia
    • Increased reliance on alcohol, smoking, recreational or illegal drugs

Stress comes in different shapes and sizes, and will never affect any two people alike. While these effects vary, there are staple activities we all can do to help cope with, or eliminate stress. According to Health.com, here are some ways to cope:

  1. Get some fresh air – Sights, sounds and smells redirect your focus. Vitamin D from sunlight may elevate your levels of feel-good serotonin.
  2. Rely on rituals – A consistent routine not only helps you sleep, but our bodies naturally crave it. It can help take back control over part of the day.
  3. Get out of your head – Stress lingers on your mind so immerse yourself in creative, involving activities.
  4. Exercise – Exercise lowers the symptoms related with mild depression, boosts your energy, all while keeping you calm and focused.
  5. Express your gratitude – Writing down your feelings of gratitude and/or expressing them to friends, family, and other close ones, has positive impacts on the brain.

April is a great month that needs to be enjoyed and not hampered by stress. If you’re looking for more ways to celebrate the month, check out beliefnet on ways to garner recognition for stress awareness. Additionally, if you feel you may be exhibiting some of these symptoms, don’t rationalize them. Talk with your R-Health doctor for solutions.