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Why Antibiotics Aren’t Always the Answer

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Antibiotics can effectively kill bacteria. Oftentimes when a patient has a bacterial infection and needs antibiotics, the benefits outweigh the risks. However, there are many everyday situations where antibiotics are inappropriate and can even be harmful. For instance, antibiotics cannot cure colds, flu, or other upper respiratory infections caused by viruses.

Common side effects of antibiotics can include:

  • Rash
  • Dizziness
  • Nausea
  • Diarrhea
  • Yeast infections
  • Severe allergic reactions

Other serious side effects include Clostridium difficile (C. Diff.) infection, which results in diarrhea that can lead to severe colon damage and even death.

One less discussed potential risk of antibiotic usage is that antibiotics kill not only “bad”, but also “good” bacteria in the gut microbiome, the microbes in your intestines. Using antibiotics kills a significant amount of this “good” bacteria or stops them from multiplying, thus affecting the normal “ecosystem” and function of the gut microbiome.

Finally, from a public health point of view, imprudent antibiotic use lead to antibiotic resistance. According to a recent article in BMC Medicine, the rate of antibiotic prescriptions has doubled from 2000 to 2010.  The report further states that “nearly 50 percent of outpatient antibiotics prescribed are unnecessary.” A report from the Centers for Disease Control and Prevention show that in the U.S. at least 2 million people have serious infections with antibiotic-resistant bacteria every year, and at least 23,000 die directly due to those antibiotic-resistant infections. In addition, at least 14,000 people die each year in U.S. due to C. Diff. infections.

Before asking your doctor for another antibiotic, I would like everyone to think about the potential risks, from a personal and societal perspective. Antibiotics may not be the right answer and oftentimes it is better to wait a few days to see if your body can ward off the infection naturally. The side effects and potential risks of antibiotic usage must be carefully considered, and the prescription of antibiotics needs to be treated with greater gravity.

What is Leaky Gut Anyway?

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When our body is healthy our cells lining our intestines should allow the absorption of important nutrients, while keeping substances out that could make us sick. Leaky gut happens when there is an increase of the harmful and inflammatory substances being absorbed because the walls of the intestines have been injured and there are bigger gaps between the cells.  These gaps allow passage of these harmful substances inside the body where they ordinarily would not go.  Unfortunately, when our body is chronically exposed to these substances or bacteria in the blood stream, it can cause local (GI symptoms or malabsorption) and systemic (whole body symptoms) reactions and inflammation.  Some common things that have been seen in association with intestinal permeability are – chronic fatigue syndrome, inflammatory bowel disease, irritable bowel disease (IBS), celiac disease, eczema, food allergy, inflammatory arthritis and even psychological conditions.
But how do these gaps get there in the first place? 

They seem to begin for some people following an infection, illness, medical treatment, or other major stressful event. It may happen because the usual balance in the intestine is disrupted. The disruption may be caused by medications (e.g., antibiotics, steroids, nonsteroidal anti-inflammatory drugs) malnutrition, surgery, burns, infection, alcohol consumption, cow milk intolerance, age, or stressful events in your life.  We also know that even for people who do not have celiac or gluten sensitivity, exposure to gliadins (a protein in gluten which is found in wheat, barley and rye) causes a greater increase in intestinal permeability.

How can the gaps be closed? 

We can help heal leaky gut by trying to figure out a little of what might have caused it in the first place – and avoiding it.  So, if it was a medicine or a food, or stress you would want to limit your exposure.  We also want to support our bodies natural digestion and give it the nutrients it needs to heal and calm inflammation and replenish a good balance of bacteria.

For more information, check out the University of Wisconsin site.

Partnership Announced Between Direct Primary Care Leader and National Insurance Captive

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PHILADELPHIA, Aug. 29, 2018 /PRNewswire-PRWeb/ — R-Health and Pareto Captive Services (“Pareto”) announced a partnership to bring enhanced primary care to Pareto’s clients (“captive members”). R-Health and Pareto, both based in the Philadelphia area, recognize the need to provide innovative solutions to tackle ever-rising healthcare costs facing employers and individuals.

R-Health is a national leader in enhanced primary care, supporting or managing over 40 practices in New Jersey and Pennsylvania. Pareto forms and manages employee benefit group captives that allow medium-size employers to mitigate the year to year volatility of self-insuring their health benefits. Nationwide, Pareto has more than 600 captive members, constituting more than 150,000 covered lives.

Through this new partnership, Pareto captive members will have access to R-Health’s growing number of Direct Care practices. In addition, the two companies plan to open four new practices in the Greater Philadelphiaarea in 2019. These innovative Direct Care practices will deliver enhanced primary care to Pareto captive members in the region, as well as other employers.

R-Health and Pareto are also partnering to launch two locations in the Kansas City area in September 2018, serving Pareto captive members in that market. With captive members located nationwide, Pareto and R-Health plan to launch other locations as dictated by need and growing demand.

“At R-Health, we believe that independent, relationship-based primary care is the foundation of transformational healthcare delivery,” said Mason Reiner, R-Health Co-Founder & CEO. “By partnering with Pareto, we can leverage our unique combination of clinical expertise and technology to provide patients with consistent access to their personal doctor, while achieving significant cost savings for employers through clinically integrated care delivery and innovative data analytics.”

“Pareto saw that our captive members needed a better primary care option for their employees, yet for most medium-sized employers, on-site clinics are not financially feasible and, often, can lead to further fragmented care,” said Andrew Cavenagh, Pareto Captive Services’ Managing Director. “By partnering with R-Health to create near-home practices, we can fill that void by offering better access to primary care and more time with their physicians. These offices offer convenient and comprehensive primary care to employees and their family members.”
Enhanced primary care can lower healthcare costs in many ways, including:

  • Reducing unnecessary emergency room and urgent care visits.
  • Better managing and therefore reducing the cost of chronic and high-risk conditions.
  • Offering longer appointments, that allow for more time for the patient and provider to interact.
  • Providing referrals to high-value specialists.
  • Increasing compliance with care plans by making many prescriptions available on-site.
  • Reducing costly complications by identifying and supporting high-risk and at-risk individuals.

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. R-Health delivers value-based healthcare two ways: through R-Health Direct Care, our innovative enhanced primary care model, and R-Health Accountable Care, our commercial and Medicare ACOs. For more information, visit https://www.R-Health.md.

About Pareto Captive Services
Pareto Captive Services forms and manages employee benefit group captives. The captives mitigate the year-to-year volatility and risk that is inherent in self-insurance, thereby allowing employers to focus on reducing healthcare costs. Members of Pareto captives gain access to an exclusive suite of risk management and cost-containment initiatives to help them in their quest to provide affordable and effective healthcare to their employees. Pareto continually seeks new and innovative solutions to employers’ healthcare benefit dilemmas and when solutions do not already exist, Pareto creates them. For more information, visit https://www.paretocaptive.com.

Media Contact
Carrie Hartman
carrie.hartman@r-health.md
Cell: 215.704.0917

 

SOURCE Pareto Captive Services

What You Need To Know About Hepatitis

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One of the biggest health threats in the world is hepatitis. Hepatitis is a very dangerous virus that comes in many forms, but they all have major impact on the liver. Over 300 million people are affected by this disease, many of whom are undiagnosed and untreated. Every 28th of July, organizations celebrate World Hepatitis Day, aimed at raising awareness and finding the missing cases by encouraging people to act on getting tested.

Hepatitis accounts for two out of every three liver cancer related deaths, and overall accounts for over one million deaths per year in the United States. While there are many types (Hepatitis A, B, C, D, and E), Hepatitis C is the most common form. It is most commonly transmitted through sharing needles, contact with infected blood, and less commonly, sex. However, it can also be transmitted through tattooing, piercing, and acupuncture.

Though in some instances symptoms may not appear, according to WebMD there are a few common symptoms for all types of hepatitis.

  • Dark urine
  • Stomach pain
  • Yellowing of skin/eyes
  • Loss of appetite
  • Fatigue
  • Pale or clay-colored stool

WebMD also supplied a few additional facts on Hepatitis C. Unlike hepatitis A and B, there is no current vaccine for hepatitis C. Although there is no cure, there are a few techniques that aid in prevention.

  • Never share needles – Though this plays a bigger factor for drug users who are at greater risk, even simple things like sharing a straw can pass on the virus.
  • Avoid direct exposure to blood – Particularly for healthcare professionals, it’s important to take steps to avoid direct contact with blood and be sure all tools used to extract blood are discarded or safely sterilized.
  • Don’t share personal items – Items like razors, toothbrushes, nail clippers, etc., can easily be infected with hepatitis C due to their constant exposure to blood.
  • Choose parlors wisely – Make sure tattoo or piercing shops are sanitary and their items used get cleaned or disposed for new customers.
  • Practice safe sex

Although World Hepatitis Day has passed, make sure to go out and get screened. With over 300 million cases left undiagnosed, you could be one of many living with the virus with no symptoms. If you have any questions be sure to reach out to your doctor, and they’ll be able to provide more information on hepatitis virus and ways to protect your liver.

The Appointment Pre-Check

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Longer appointment times with your doctor are almost viewed as a myth. Given the current state of healthcare, most doctors only spend an average of 20 minutes – or in many cases even less – with each patient before moving on to the next patient. Having such an abbreviated time with your doctor can be frustrating, especially if you come in with concerns and leave with more questions than answers.

This is not the case with Direct Care. With smaller patient panels, this removes the shuffling from patient to patient, providing the doctors with the opportunity to spend more time with a patient – listening, answering questions, and coming up with a diagnosis. This not only makes for more pleasant visits, but also it creates a great foundation towards your doctor being a partner in your health.

Nevertheless, with this added time in the Direct Care model, you have to know how to make the most of the time with your doctor and be sure to have all your questions answered. What type of questions should you ask? While it’s all depends on your specific concerns, Time Magazine shared some of top questions you should ask your doctor.

  1. What are the different treatment options?
    • Decisions should be made jointly with your doctor, so be sure you’re aware of all options.
  2. Do we have to do this now, or can we revisit later?
    • Some tests can wait, and added time can also give your doctor more time to diagnose your patterns.
  3. What outcome should I expect?
    • It’s important to know if there will be any changes that may affect your lifestyle.
  4. What are the side effects?
    • Whether you’re undergoing a procedure or taking new medication, it’s important to know about side effects beforehand to determine if you want to alter your treatment
  5. How will I hear about my results?
    • Be sure to get an adequate timeline from your doctor on when to expect your results.

It’s important to take advantage of the longer appointment times with your doctor afforded by Direct Care. Questions for your doctor can help give you more clarity on your health status and provide the answers you need to guide your next steps.

Primary Care Isn’t Secondary

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Primary care matters, plain and simple. Though in recent years it seems to be undervalued, primary care remains in fact a central part of everyone’s long-term health. How big of a role? According to the American Academy of Family Physicians (AAFP), areas with higher concentrations of primary care physicians are linked to lower death rates for cancer, heart disease, and stroke, while also leading to lower level of hospital admissions.

Primary care also helps lower the costs healthcare presents. In addition to fewer hospitalizations, there’s less duplication of treatment as well as better use of technology, all cumulating into 33% lower healthcare related costs.

Primary care reinforces the doctor-patient relationship allowing for a “continuity of care.”  You’re able to establish a relationship and build upon it year after year while receiving tangible benefits like acute, chronic, and preventive care, along with a wide range of other services. R-Health’s Direct Care Model allows for this multi-faceted, consistent approach.

  • Family Care – We’re able to see and treat family members of all ages. Having this continuity and trust allows the full scope of one’s health to put into context, especially how it may relate to the rest of the family. Having a strong relationship within the family helps the doctors with insight knowledge, given them understanding on health patterns that you may be facing, and can even save you from unnecessary tests.
  • Unlimited Access – Having a doctor to take care of the family is great, unless they’re unavailable. That’s not a problem with R-Health’s Direct Care model due to the 24/7 unlimited access available for patients to their doctors. Phone calls, a secure mobile app, and a member portal are just a few of the ways you’re able to stay in contact with your doctor no matter where you’re at.
  • Convenience – Not only are there no co-pays, but with the use of our data and technology systems, coupled with the care coordination, we remove the barriers to the doctors and our doctors help members navigate a complex health care system seamlessly.

Great primary care allows you to see the bigger picture. A doctor who can take care of all your needs, both long-term and short-term. And a model of healthcare that saves costs, but not at the expense of the doctor-patient relationship or the diverse health network that’s available.

Breaking Down Mental Health

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Mental health is an issue that affects millions of Americans. According to MentalHealth.gov, one in five adults experienced a mental health issue, and one in ten young people experienced a period of major depression. Signs of mental disorder may show as early as 14 years old, however, less than 20% of cases with diagnosable problems get treated.

When mental health issues are treated properly, it can result in you being able to live, work, and enjoy life to the fullest. However, if left untreated, mental health can affect your diet, sleep, stress, gut health, and exercise. Mental Health America shared a toolkit on the impact of mental health.

Diet and Nutrition

Both your physical and mental health are impacted by the quality of food you consume. Studies have shown those with a diet high in junk and processed foods are 80% more likely to have depression. Healthy diets including the consumption of more fruits, vegetables, fish, and other healthy foods are used as effective treatment methods for depression. A study showed one in three participants saw full relief of symptoms with a healthier diet.

Sleep

Sleep is a major key to a healthy body but more importantly, a healthy mind. Sleep accounts for our moods, memories, healthy organs, immune system, among other things. Sleep re-energizes cells, and increases the space between brain cells to allow free flowing fluid to clear away toxins. Poor sleep quality can lead to manic episodes, paranoia, anxiety, and depression.

Gut Health

There’s a very important connection between the gut and the brain. Your gut connects with the brain through hormones and neurotransmitters that help exchange messages. Gastrointestinal symptoms like indigestions, acid reflux, heartburn, diarrhea, and etc., are linked to mental health problems. Changes in your gut can be caused from a stress response, which may ultimately lead to diseases like Parkinson’s and autism.

Exercise

An hour of exercise has been linked to lower levels of anxiety and substance use disorders and less likely to have panic disorders, phobias, and depression. Exercise plays an important role in brain function in terms of protecting nerve cells, sending messages, and releasing endorphins among other things.

Mental health is a very important issue that we must continue to address. If you are experiencing some symptoms, or have some general questions, reach out to your doctor and get the assistance you need right away.

Optimizing Bone Health: Decrease Risk of Low Bone Density and Fractures

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Prevention is key for bone health – as with many health issues. Bone density peaks around age 30.  For most people after that, it steadily decreases with age. This even starts in the womb. Mom’s calcium and vitamin D levels influence bone density later in life, as does breastfeeding.  During childhood and young adulthood building a “bone bank” through adequate nutrition and weight bearing exercise is key to developing maximum peak bone density.  But, it’s never too late to start with healthy changes.  Maintaining good bone health can decrease the rate of bone loss and maintain quality of the bones, and there are many factors that play a role in this.

Food

Nutrition plays a big role in bone health. Calcium is often the first thing people think about, and though calcium is important it can be overdone. Too much calcium, especially if it is not balanced with magnesium and vitamin K can build up on artery walls.  Also, don’t rely on dairy – there is minimal link between dairy and bone health.
Try the foods in this list from the University of Wisconsin to promote bone health instead.

Onion family Fennel Parsley
Arugula French beans Pomegranate
Broccoli Garlic Prunes
Celeriac Leeks Red Cabbage
Chinese cabbage Lettuce Turmeric
Cucumbers Mushrooms Wild garlic
Dill Oranges & other citrus Soy (whole soy foods)

Too much of certain things can have a negative impact on your bones as well – so keep it to less than one alcoholic drink per day, and minimize cola and caffeine (except for tea) and don’t take more than 3000 iu of vitamin A.  Limit animal protein intake as well. The theory is that animal protein causes our blood to be slightly acidic, and to neutralize this effect our body steals calcium out of the bones.  Eat plenty of vegetables and fruit. A high vegetable to animal diet ratio seems to be protective against bone loss.

Vitamins and Minerals

Make sure you get adequate vitamin D. Vitamin D helps your body absorb calcium properly. Living in this area of the Northeast, we’re unable to make enough through the sunlight. Talk to your doctor about your levels and supplements.
Vitamin K, an important balance with calcium, is required for the activation of the hormone that tells our body to build bone.  Consider supplementing with vitamin K2 45-100mcg.  Magnesium helps keep the bones flexible. Try taking 400-800mg before bed. Talk to your doctor first if you are on blood thinners or if your magnesium dosage causes loose stools. Vitamin C, B vitamins, Potassium, and Zinc are all likely to be important as well.

Exercise

Benefits of exercise are seen at all age groups. Walking, other weight bearing exercise, and resistance training are all helpful. Vigorous walking at more than 3.8 miles per hour shows better benefit.

Smoking

Another reason to quit! Smoking increases fracture risk by as much as 40% compared to non-smokers.

Preventing Falls

The ultimate goal of prevention of bone density treatment is to avoid fractures, so preventing falls is a very important aspect of bone health. Exercise decreases fall risk and it maintains strength and coordination. Tai chi has been shown to reduce falls by improving balance.
Try these other tips from the Mayo Clinic to also help prevent falls:

1.  Talk to your doctor about your medications – some medications could cause dizziness
2.  Wear sensible shoes – avoid floppy slippers or shoes
3.  Remove tripping hazards – remove throw rugs that slip or stick up
4.  Make sure areas are well lit – use night lights
5.  Use assistive devices when necessary – like grab bars

Getting Your Bone Density Checked

Overall women have a higher risk of developing problems with low bone density because they have a lower peak bone density. Men with certain medical conditions or taking certain medications may be at higher risk too. Getting your bone mineral density checked is recommended if you are a woman over 65 years of age, or have the same fracture risk as a woman over 65.  You can calculate your fracture risk using this tool.  https://www.sheffield.ac.uk/FRAX/.

Bone density is checked with a test called a DEXA scan. Bone density in the hip and lower spine are the areas of the body that are X-rayed and then compared to a healthy 30-year-old of the same sex and given a score, called at T score. The more negative the number, the less dense the bones.  Osteoporosis is diagnosed with a T-score lower than -2.5.

Medication might be right for you if you have osteoporosis.  Talk to your doctor about this or any questions you have about your bone health or getting your bone density tested with a DEXA scan.

Why Environmental Health Matters

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Each first full week of April celebrates National Public Health Week. The goals of this week are to identify the issues that impact poor health and disease risks for individuals and communities and to start conversations and develop strategies that help build a healthier nation. Each day of the week focuses on a different aspect of public health, and our focus is Environmental Health.

Why is environmental health important? According to Office of Disease Prevention and Health Promotion (ODPHP) the environment plays a key role to the length and quality of your life. Poor environmental health is not only costly, but very hazardous. Per the ODPHP, 23% of all deaths (26% among children 5 years old or younger) are caused by preventable environmental factors. Therefore, to further understand it’s importance, below are some environmental factors that can affect your health.

  • Outdoor Air Quality
    • Poor air quality can lead to many issues: cancer, respiratory/cardiovascular system damage, and premature death.
  • Surface and Ground Water
    • Minimizing your exposure to contaminated water sources is important to your health as contaminated drinking and recreational waters from chemicals or infectious agents can cause serious illness.
  • Hazardous Substances
    • Substances like nitrogen dioxide from gas cookers or the removal of hazardous waste can filter into your water and air supplies, which when absorbed can be a dangerous health risk (especially for children).
  • Climate
    • Climate can affect air, food, water, disease risk, and mental health. It can increase asthma events and heat-related deaths, but can also impact sea level and cause natural disasters – which may spread diseases and also cause damage to your mental health during recovery periods.
  • Homes and Communities
    • With much time spent either at home, work, or school, your health can be impacted by the space you occupy: Indoor air pollution, inadequate heating or sanitation, or lead-based paint hazards can affect your health.

As you see there are plenty of environmental factors that can impact your health, but the Health Department at the University of Minnesota shared few suggestions on how to live a more sustainable life.

  1. Limit the use of toxic substances and unknown chemicals
  2. Buy organic, fair-trade products
  3. Carpool, bike, or use public transportation to prevent further air pollution
  4. Recycle

While there’s a need for long term sustainability to optimize public health, it’s important to take the initiative to ensure you’re living in a healthy environment. Check your homes, check the products you buy, but most important check in with your doctor to make sure you’re void of any disease risks.

Spring Into Action

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It appears winter is behind us (fingers crossed!). Short sleeves, ice cream, and warm nights aren’t the only reasons to get excited for spring. The season also brings surprisingly great health benefits as well.

Of the many benefits that encompass spring, Everyday Health narrowed it down to six things that should excite you and your health.

  1. Extra Daylight
    • Lack of Vitamin D can put your bones at risk, but during the spring you can soak up all the nutrients your body needs. (Remember to take precautions in order to balance healthy sun exposure versus burning.)
    • Extra sunlight serves as a natural mood booster and helps with seasonal depression some people suffer from during the dark fall and winter months.
  2. Healthier Home
    • Spring time means spring cleaning. Not only is it a great calorie burning exercise, but the cleaning of your home, car, office, and other areas can rid you of bacteria that may free you from spring colds and help seize control of your allergies.
  3. Spring-cleaned Diet
    • Around the warmer months you’ll find yourself eating less and going out more.
    • When you do eat, there are more healthy options available since many fresh fruits and vegetables are ripe for the taking.
    • Look for your spring produce at your local farmer’s market.
  4. Outdoor Exercise
    • With warmer temperatures you’re more inclined to explore the outdoors.
    • Studies have shown time outdoors helps with reduced stress and lowering blood pressure.
    • Warmer weather also offers more opportunity for outdoor exercises (e.g. runs, walks, swimming, etc.)
  5. No winter skin
    • Gone are the days of dry skin and with the added vitamin D you’ll surely be moisturized.
  6. Spring Break
    • These are the best times for vacations. Whether near home or getting away, getaways are great ways to manage stress and has been linked to reduced risks of breast cancer and cardiovascular disease.

As you see, there’s plenty to enjoy during these upcoming months, but be sure to keep your health as a priority. Reach out to your doctor if your experiencing any changes during these times, so you make the best of this season.