New model for medicine Physician happy with concierge practice after four years

February 18, 2013

New model for medicine Physician happy with concierge practice after four years

Dr. Doug Pitman takes calls from patients anytime and doesn’t mind consulting while on skis at Whitefish Mountain Resort. He even stops by their homes for consultations.

“I’m on call all the time,” he said. “When you know your patients as well as I know my group, you can really do a lot on the cellphone. But then again, I can see them instantly or later that day if I’m up skiing.”

After four years as a concierge physician at Whitefish Personalized Health Care, Pitman couldn’t be more enthusiastic about the risk he took after more than 30 years as a traditional family physician in Columbia Falls.

“In my mind, the concierge model is the biggest thing that’s happened to family doctors since we developed residency programs in the 1970s,” Pitman said.

Concierge doctors limit their patient base to provide personalized service and almost limitless availability to patients who pay an annual retainer.

Pitman works with a company called Signature MD to operate his practice and also now serves as the company’s acting medical director.

In that role, he serves as an information source to doctors considering concierge medicine and makes educational videos for patients and doctors for Signature MD’s

“They are the second biggest company that converts family practice and general internal medicine practices to the concierge model,” he said.

Pitman, 66, calls his concierge practice an anomaly because he works just 16 hours a week with a practice of about 100 patients. A full-time concierge physician typically maintains a patient base of 300 to 600 patients.

When he looked into the concierge model, Pitman wanted a way to continue practicing but on a smaller scale with a focus on wellness.

“I was burned out on traditional family practice as its evolved into running the numbers so you can keep your doors open,” he said. “Once I turned 62, I was free of debt and I could take a risk.”

He worked with Signature MD CEO Matt Jacobson to come up with what he calls a hybridized concierge practice where he could work part time with half-time malpractice insurance. Pitman said Signature MD’s research department performs thorough demographic studies of an area before working with a doctor to convert to the concierge model.

“Matt flew up and we did a week of basically recruiting patients,” he said.

The two came up with three different payment systems. His yearly retainer is $1,900 per patient with discounts for couples, half-time residents and a scholarship rate of $1,100.

His patients pay a retainer to Signature MD, which takes a percentage, then sends the rest to Pitman in quarterly payments. He maintains an office in the 1993 building in Whitefish but operates without employees or a billing service.

Pitman said the retainer pays for his availability and covers his overhead and salary.

“That frees me up to spend more time with patients and provide a much higher quality of care,” he said. “The last four years, I’ve gotten back to the basics of prevention and wellness.”

According to Pitman, his patients reap the benefit with his focus on their blood pressure, cholesterol levels and screenings by lowering their risk of heart disease, stroke and cancers of the breast, prostate and colon. He also makes certain they have their immunizations and see a dentist, dermatologist, ophthamologist and gynecologist, if appropriate, once a year.

“I don’t do any chronic pain management which is a big problem in family medicine,” he said. “There are chronic pain clinics. I don’t do any of that.”

His services include taking a medical history and a yearly executive physical examination. Pitman provides same-day appointments and said his contacts from 30 years practicing here get patients into specialists quickly.

If necessary, he makes house calls using his father’s old black bag from the 1950s.

“My dad was a doctor in New York on Long Island for about 35 years,” he said. “I think it was $3 for an office call, $5 for a house call and his records were all on 3X5 cards.”

Pitman’s annual executive physicals take two hours, include an hour follow-up visit and lab tests. He said Signature MD contracts with some state-of-the-art labs to assess cardiac and diabetes risk.

“The testing is sophisticated and it’s not unlike going to Mayo or Scripps and getting a very thorough examination each year,” Pitman said. “My patients look forward to it each year. They are very compliant, very interested in their own health. They have a lot to live for.”

Since becoming a concierge physician, Pitman said his biggest surprise was that patients want to talk and that getting to know patients pays off in better care. Sometimes the thing that concerns the patient the most comes out in the last 15 minutes of a two-hour exam.

“Nothing falls through the cracks because it is all about the time you spend with people,” he said. “The more time you spend with people, the more time you spend thinking about them and dictating a thoughtful physical.”

One patient, Benny Bee, the owner of six local radio stations, credits Pitman with saving his life. Bee became interested in the concierge system when he turned 65 and decided he needed regular “tune ups.”

He said he had known Pitman for years when he signed up as a concierge patient after reading his brochure. Bee liked the idea of not having to wait for two weeks to see a physician when he gets sick.

“Nowadays, it’s hard to get in to see a doctor if you’re in a hurry,” he said. “With concierge, I call to make an appointment and he says, ‘Just come on down’ or ‘I’m in your neighborhood so I’ll just stop by your house.'”

After signing up, Bee provided Pitman with the results of an executive physical he had received at the Mayo Clinic two years earlier. When he came in for the physical with Pitman, he said he was in the best shape of his life.

“I was down 20 pounds and had been exercising,” he said. “My blood work was great.”

Pitman recalled that he spent an hour going over Bee’s Mayo physical. It mentioned a test he should have had in the next three to six months but no one followed up to make sure he had it.

“I put him on my bicycle to do his wellness exam to write a prescription,” Pitman said.

He detected a problem and insisted that Bee go in for a treadmill test the next day for a heart evaluation. Three weeks later, he had triple bypass surgery to repair a main artery that was completely clogged and two others that were 70 percent clogged.

Now 68, Bee describes himself as 100 percent healthy. He remains completely sold on the personal relationship and quick access offered by concierge medicine.

He made a promotional video with Pitman and constantly recommends this model of medicine.

“If it wasn’t for me switching over to the concierge system, I probably wouldn’t be alive today,” Bee said. “Believe me it’s worth it. It pays.”

People interested in more information may visit the website

SignatureMD

Original Article

Revealed: Lupus may be contributing to Lady Gaga’s chronic pain

February 15, 2013

Revealed: Lupus may be contributing to Lady Gaga’s chronic pain

She is known for her energetic performances, so her decision to cancel the remaining dates on the American leg of her global stadium tour, left Lady Gaga’s Little Monster’s reeling.

The star revealed that she has been suffering from chronic joint pain that she has been concealing from her staff and fans.

“I’ve been hiding a show injury and chronic pain for sometime now, over the past month it has worsened,” Gaga announced in a series of tweets sent out Tuesday. “I’ve been praying it would heal. I hid it from my staff, I didn’t want to disappoint my amazing fans. However after last night’s performance I could not walk and still can’t.”

But just how dire is the star’s condition, and what role does Lupus, which she disclosed she was suffering from in 2012, play in her health issues?

“What we know about Lupus is it does have strong autoimmune characteristics,” pain specialist Dr. Akash Bajaj tells Celebzter. “This being said, Lupus independently can cause severe inflammation and pain. This can contribute to an acute synovitis, causing the pain to increase quite significantly.”

He continues: “Lady Gaga appears to be struggling with chronic pain, and synovitis. Synovitis is an inflammatory state of the joints. Depending on which joint(s) are affected, this can result in limited mobility, limited weight bearing activity, as well as fatigue and pain. It appears she has been dealing with this for quite some time, and given her active show performances, it is not that unusual.

“The best way to help mitigate pain and limitations associated with synovitis is rest and ice ( a great natural anti-inflammatory). Sometimes, if rest and ice don’t do the trick, then an anti-inflammatory injection in the joint may help.”

About Dr. Akash Bajaj;

Pain Specialist Dr. Akash Bajaj is a double board certified anesthesiologist and President of Remedy Pain Solutions, Inc in Los Angeles. He completed his undergraduate studies at UCSD, graduating summa cum laude and is a member of the prestigious Phi Beta Kappa & Golden Key Honor societies. He then went on to simultaneously earn his M.D. and a Master’s degree in Public Health (M.P.H.) from the New York Medical College. He then served a residency in Anesthesiology at UCLA Medical Center. Choosing then to sub-specialize in pain medicine, he completed an Interventional Pain Medicine Fellowship at the prestigious University of California San Francisco, selected as one of only five fellows, graduating in 2006. His lectures have been heard nationally on CBS Radio, as well as UCLA, and UCSF. Dr. Bajaj uses interventional therapies, medication therapies and Prolotherapy along with PRP (Platelet Rich Plasma that are contain bioactive proteins) to combat pain.

Original Article

Dr. Akash Bajaj MD

10 Fascinating Facts About Men, Sex and Testosterone

February 15, 2013

10 Fascinating Facts About Men, Sex and Testosterone

There’s far more to male sexuality than meets the eye.

Our culture has endowed women with some exotic qualities — mystery, hidden depths, secret knowledge; all very alluring. But also very explainable. For a long time, women had little voice, so of course we were a mystery. Mute the TV and you won’t understand what the show is all about.

Men, by contrast, are alleged to be much more direct; even their primary sexual characteristics are obvious, hanging out there like an awning, compared to the secret gardens of women. In fact, the male stereotype was so set in my mind that the first time a straight man said to me, “It doesn’t always have to be about sex,” I looked at him like a puzzled dog. Men, I thought, were supposed to be relatively simple creatures, driven by sex, food and sleep (and sometimes Star Wars).

In reality, men are every bit as complicated as women and thoroughly fascinating in their sexual mechanics, hormonal fluctuations and brain functions. Here are 10 fun facts about male sexuality that make men a little easier to understand.

1. “I’m not gay but my boyfriend Testosteronius is.”

Male sexuality was a different ballgame in ancient Roman times than it is now. One’s sexuality was defined not by preference for one sex or another, but as being “active” or “passive.” Active meant you were the penetrator and passive meant you were the penetrated. Sex was more about social status than anything.

N.S. Gill on About.com, reports that men of “good standing” were active, and they “initiated acts of penetrating sex. Whether you did this with a female or a male, slave or free, wife or prostitute, made little difference — as long as you were not on the receiving end, so to speak.” (Only freeborn youths were out of bounds.) It’s actually quite complicated, but, writes Markus Milligan in Archeology News, “From a societal perspective, to be ‘passive’ or ‘submissive,’ threatened the very fabric of masculinity, with feminine traits, submission and passive mannerisms being an act of the lower class and slaves.”

So in ancient Rome if you were on top you were a top. We’ll call you Testosteronius.

2. Making a man out of you.

Let’s keep talking about testosterone, or T, because there’s no discussing male sexuality without it, the “quienes mas macho” of hormones, the thing that literally makes men men. All embryos develop the makings of both male and female sex organs: testosterone, under certain conditions, stimulates the growth of the male organs. It waves its magic wand and voila! You get a magic wand.

And once it’s made you a boy it doesn’t just leave you hanging; it accessorizes you as a male, making your voice deeper, your body hairier and muscle mass bigger. You also get that most useful and attention-getting of ornaments, the testes, which in turn, produce testosterone, though it’s regulated in the brain by the hypothalamus and the pituitary gland, a little love triangle known as the HPG axis (hypothalamus, pituitary, gonad).

So that’s some of the technology of testosterone, which you probably think of as being at the helm of the male sex drive and manly traits. Interestingly, less than 100 years ago no one thought about it at all. Harvard Medical School associate clinical professor Abraham Morgentaler writes in Testosterone for Life (source of the HPF info) that, “For several thousand years, farmers have found that castrating domesticated animals made them infertile and more docile as well as greatly reducing their sexual activity. They did not know, however, that they were reducing a specific substance, because testosterone was not identified until the 1930s.”

By 1935, shortly after the T molecule was discovered, it was synthesized and in use as a medication (it still is: see #4).

3. T for two.

If you want to hear/read an amazing story about the power of this hormone, check out the Testosterone episode of This American Life in 2002, when producer Alex Blumberg interviewed Griffin Hansbury who transitioned from female to male five years before the story was produced. Hansbury’s first injection of testosterone was huge, giving him twice the amount that usually circulates in the system of high-T men. The changes were fast and included a raging libido (“It was like being in a pornographic movie house in my mind”) and…seriously…a sudden interest in science. From the transcript, Hanbury says

Blumberg’s response to Hanbury’s first admission to a new love of science?

“You’re just setting us back a hundred years, sir.”

4. Man-o-pause.

Sometimes testosterone goes on the decline, usually in middle-aged men. When it does, they experience something very similar to menopause, only it’s less obvious because men never stop getting their periods (well, you know what I mean).

It’s called andropause, and the symptoms — lowered sex drive, fatigue, lack of interest in work and hobbies, mood swings, loss of muscle mass, hot flashes — are often mistaken for run-of-the-mill aging.

Damon Raskin, an internist who sub-specializes in men’s health issues and is the supervising doctor for Ageless Men’s Health.com said in a phone interview that the natural decrease in testosterone affects some men more than others. And even younger men can experience sudden drops in testosterone, sometimes for unknown reasons, or because of genetics, diabetes or opiate abuse.

“As men age it is normal for testosterone to fall and some men are more sensitive to the fall than others. Sometimes men can have low testosterone and have no symptoms,” he says. A simple blood test from their primary care doctor can let men know if they have low T and if so they can get testosterone replacement therapy, usually a gel, patch or a injection.

Some of the symptoms of low T can also be confused with depression. Raskin says, “When I see a new patient who comes in thinking they may be depressed one of the blood tests that I do is a testosterone test. I check the thyroid, see if they’re anemic and check their testosterone.”

Bottom line: you can find your mojo. The answer to where it went might lie in a simple blood test.

5. A little squeeze goes a long way.

Before you get to middle age you should know something: Kegels are not just for women anymore.

Kegel is an exercise that strengthens the muscles of the pelvic floor so you can sail gracefully into your later years with fewer worries about incontinence and your internal organs slipping around like luggage on a turbulent flight. They’re done by squeezing internal pelvic muscles and can be done on the sly, anywhere. Women will often joke while they’re sitting at their desk or standing at a bar that they’re doing their Kegels “right now!”

But men should be doing Kegels too, because in addition to those health benefits they can also lead to stronger orgasms, prevent prostate trouble, problems with erectile dysfunction and premature ejaculation. Dr. Chaves at AskMen.com provides some additional exercises men can do to work the Kegels, my favorite being “For more advanced muscle building, you can place a light towel over your erect penis and squeeze to ‘lift’ the towel.”

When you can throw it out the window give me a call. Or at least put it on YouTube.

6. See ya!

Sure, I’d like to see that towel trick. Who wouldn’t? But it’s one of those great bromides that men are actually the more visual sex and two studies have indeed shown marked differences in the visual processes of men and women.

A 2012 study from the Center for Behavioral Science by Emory University researchers found that women are better at discriminating between colors while men are better at perceiving “fine detail and rapidly moving stimuli,” than women. A 2004 study, also by Emory University researchers, found that when men and women looked at erotic photos both sexes reported the same levels of arousal but set off “a frenzy of activity, particularly in the amygdala of the men.” (The amygdala is the part of the brain’s limbic system that is associated with emotion and anticipation.)

So we already knew that men and women see things differently in the figurative sense. Now we have some evidence that it’s true in the literal sense.

7. Sighs matter.

If men do, indeed, have a better eye for visual detail maybe that explains why they seem to fret over penis size despite stories like the one in Men’s Health that reported in one of their own surveys that only 7% of “sexually satisfied” women said size was “critical” to their desires.

But men will worry, no matter how much women tell them they shouldn’t. Even famous men worry. The wonderfully named Jay Dixit writes about the size matter in Psychology Today, reporting that he-man Ernest Hemingway once tried to reassure F. Scott Fitzgerald, telling him, “There’s nothing wrong with you. You look at yourself from above and you look foreshortened,” and “It is basically not a question of the size in repose. It is the size that it becomes. It is also a question of angle.”

Perhaps, The Medium-Sized Gatsby just wasn’t a title F. Scott was comfortable with.

8. Size really doesn’t matter, but it’s interesting.

I hesitated to include this next item, but it’s so weird and funny I have to tell you: there are now two apps for your phone that measure penis size.

The Predicktor, an Android app developed by a Toronto physician and the team at The Doctor Says, seems the more lighthearted of the two; read the story and video on the National Post website. You enter certain numbers, like the size of his “feet, his height, ring size, whether it’s a porn star (etc, etc.)” which leads one to wonder how to ask a guy all these things without him just saying “It’s six inches, okay? Is that okay with you?” It’s got all kinds of genital fun facts and is meant to reassure men that they’re probably more normal than they think. And if it doesn’t The Doctor Says also has an app where you can test your anxiety.

Then PC Magazine reports on “Condom Size,” an app for the iPhone which is meant to accurately measure you and see what size condom you ought to be wearing. The app invites the user to hold “his hard member against inches or CM on sides of the screen,” where there’s a yellow tape measure. (There is also probably the chance of you accidentally taking a picture and sending it to your boss because that’s exactly the kind of thing that would happen to you.) The user is also asked to take a piece of string, wrap it around to get an accurate measurement and hold that up to the “digital ruler.”

So, this is an app for people who can’t work a tape measure. If you can’t work a tape measure how can you afford an iPhone?

Glamour says “The app will give him his results, including a recommended condom brand but also…his world ranking according to penis girth and length!” A score of 100 percent isn’t a perfect score, it’s average. Anything over or under is, well, over or under.

9. The boy can’t help it, but neither can the girl.

So there are a couple of stereotypes we’ve dealt with here, like men’s visual nature being different and men worrying about penis size. A couple of items in this list from LiveScience, 10 Things Every Woman Should Know About a Man’s Brain, break those stereotypes, including their emotionality and vulnerability to loneliness. When it comes to cheating and one-night stands, the next study has no gender bias to offer. Another LiveScience story reports that in a 2010 Binghamton University study 181 young adults were asked about their sexual history and then DNA tested. Those with a variation of the dopamine gene DRD4 were more likely to report one-night stands and infidelity (dopamine is a neurotransmitter associated with pleasure and reward).

Researcher Justin Garcia said this doesn’t necessarily let the horn dogs off the hook because some people without the variant screwed around too, and some with the variant didn’t, just that “a much higher proportion of those with this genetic type are likely to engage in these behaviors.

Soooo, a dolphin might bite you and a shark might not bite you, but it’s more likely that a shark will bite you. Got it. Keep an eye out for sharks.

10. Come and get it and come…and get it.

Finally, all that sex has got to make you a little hungry so we’ll leave you with some more advice from AskMen.com, this one a list of the 10 Foods That Increase Your Sperm Count (just FYI: a new study from Harvard says a little less TV and a little more exercise will help, too). Of course, there are oysters which “contain a potent amino acid that increases testosterone in males and progesterone in females,” but the story also offers some surprises like garlic, which is full of allicin which increase blood flow to the nether regions, and bananas which are not only shaped appropriately, but full of vitamin B for stamina and bromelain which increases male libido.

But the most important one this week is dark chocolate, which “contains L-Arginine HCL, a powerful amino acid that has been clinically proven to double sperm and semen volume.”

Doesn’t everyone want to hear that chocolate is good for them on Valentine’s Day?

Original Article

Dr. Damon Raskin

Lady Gaga’s joint issues bring pain management to light, one expert talks options

February 14, 2013

Lady Gaga’s joint issues bring pain management to light, one expert talks options

Millions of people live with chronic pain, which can affect a particular body part like the hip, back, or neck, or be experienced as general all-over body pain.

Whatever part of you hurts, you just want the pain to cease.

Because pain symptoms vary from person to person, the right pain treatment must be tailored to the individual. Fortunately, there are many treatment options for pain management.

In the news, pop star Lady Gaga has called off shows this week in Chicago, Auburn Hills, Mich., and Hamilton, Canada, because of chronic joint pain the singer said she has been concealing from her fans and inner circle.

“I’ve been hiding a show injury and chronic pain for sometime now, over the past month it has worsened,’ Gaga tweeted on Tuesday. “I’ve been praying it would heal. I hid it from my staff, I didn’t want to disappoint my amazing fans. However after last night’s performance I could not walk and still can’t.

“To the fans in Chicago, Detroit & Hamilton, I hope you can forgive me, as it is nearly impossible for me to forgive myself. I’m devastated & sad. It will hopefully heal as soon as possible, I hate this. I hate this so much. I love you and I’m sorry.”

Lady Gaga has a hip labrum tear and synovitis, or severe inflammation of joints, and she is postponing the shows under her doctor’s orders.

Live Nation Global Touring has confirmed that the remainder of the Lady Gaga Born This Way Ball performances have been cancelled. After additional tests this morning to review the severity of the issue, it has been determined that Lady Gaga has a labral tear of the right hip caused by strenuous repetitive movements in her performances. She will need surgery to repair the problem, followed by strict down time to recover. This unfortunately, will force her to cancel the tour, so she can heal. Refunds for the cancelled performances will be available at point of purchase starting Feb 14, 2013.

Pain Specialist Dr. Akash Bajaj is a double board certified anesthesiologist and President of Remedy Pain Solutions, Inc in Los Angeles. He earned his M.D. and a Master’s degree in Public Health (M.P.H.) from the New York Medical College. He then served a residency in Anesthesiology at UCLA Medical Center.

Choosing then to sub-specialize in pain medicine, he completed an Interventional Pain Medicine Fellowship at the prestigious University of California San Francisco, selected as one of only five fellows, graduating in 2006.

His lectures have been heard nationally on CBS Radio, as well as UCLA, and UCSF. Dr. Bajaj uses interventional therapies, medication therapies and Prolotherapy along with PRP (Platelet Rich Plasma that are contain bioactive proteins) to combat pain. He spoke with Monsters and Critics about Lady Gaga’s health issues.

“Lady Gaga appears to be struggling with chronic pain, and synovitis. Synovitis is an inflammatory state of the joints. Depending on which joint(s) are affected, this can result in limited mobility, limited weight bearing activity, as well as fatigue and pain,” says Dr. Bajaj. “It appears she has been dealing with this for quite some time, and given her active show performances, it is not that unusual. The best way for the average person to help mitigate pain and limitations associated with synovitis is rest and ice – a great natural anti-inflammatory. Sometimes, if rest and ice don’t do the trick, then an anti-inflammatory injection in the joint may help.”

Original Article

Dr. Akash Bajaj

Boomers Vs. Their Parents: The Younger Generation Is Sicker

February 14, 2013

Boomers Vs. Their Parents: The Younger Generation Is Sicker

Obesity is the alpha and omega of modern societal health issues. So much that small children are getting adult onset diabetes and young teens and twenty-somethings are waddling past their grandparents who are trimmer and fitter, perhaps taking in 18 holes or playing tennis.

If you’re old enough to remember Sixties supergroup The Mamas and The Papas, then you probably recall their hit song “No One Getting Fat ‘cept Mama Cass.”

It was an autobiographical paean to the origins of the band, but it’s hook hanged on that fact that lead vocalist Mama Cass (Ellen Naomi Cohen) was quite unlike her slender musical peers, and weighed in at 300 pounds.

At the young age of 32, Cass died. Her official Cause of Death: Fatty Myocardial Degeneration due to obesity. Natural Causes, and not the often rumored ham sandwich she allegedly choked on.

Fast forward four decades, and a just released study shows that not only were those of The Mamas and The Papas generation less healthy than their parents but as it turns out, ended up looking much more like Mama Cass than they probably would ever imagined.

In short, the Baby Boom generation, the vain “me” generation who spawned fitness crazes like running, aerobics, mountain biking and mountain climbing, is turning out to be a health bust.

Despite vast amounts of money spent on their health care, the 78 million American born between 1946 and 1964 on almost every level are less health on average than their parents.

The study, published in JAMA Internal Medicine compared data on people aged 46 to 64 in two time periods – from 1988 to 1994 for the older generation, and from 2007 to 2010 for the baby boomers.

In terms of almost every common chronic disease, the younger generation had a higher incidence. Boomers had a higher percentage of people with high blood pressure, high cholesterol and diabetes than did their parents’ generation.
While 32 percent of their parents’ generation described their health as “excellent,” only about 13 percent of baby boomers did so.

The study also revealed that obesity was more common among baby boomers than their parents (39 percent versus 29 percent). In addition, 52 percent of boomers said they had no regular physical activity, while only 17 percent in their parents’ generation reported inactivity.

Boomers reported a higher degree of disability than their parents at the same age. But simply pointing out that obesity is the underlying cause of what ails the Me Generation is not enough.

“I agree that obesity is a big part of the problem but it’s important to acknowledge that obesity is multifactorial – it represents the perfect storm of reduced physical activity, changing patterns of eating, marketing of food, and disrupted life rhythms. Preventing or treating weight issues, then, requires a global look at people’s eating patterns, activity patterns, genetics and more,” says Lisa Capaldini, M.D., a San Franciso internist SignatureMD

“The issue of our healthcare system costing the most of any in the world again has many underlying causes. The obesity and poor lifestyle of most Americans is a significant contributing cause. Other significant causes have to include the emerging technology in healthcare driving costs, as well as defensive medicine from the legal climate leading to the ordering of more tests,” says Jeffrey Gorodetsky, an internist in South Florida SignatureMD

Both doctors agree that it takes an individualized approach to healthcare that often is missing in today’s healthcare system.

“The quick fix approach of appetite suppression pills is almost always ineffective. I find that the most helpful approach takes a lot of time – going through patient’s diet very methodically. There is also a role for secondary prevention in that there are obese patients who cannot lose weight and in their case targeted therapies to reduce the complications of obesity are also critical,” says Capaldini.

To put it another way, “more time spent on visits, better relationships leading to less defensive medicine and better preventative healthcare,” says Gorodetsky.
The only areas in which boomers’ health exceeded that of their parents are in lower rates of heart attack and emphysema, and they are less likely to smoke cigarettes, the study reported. The reduction in smoking – from 28 percent of the population to 21 percent – showed the value of conducting a concerted public health campaign.
Interestingly, both Drs. Capaldini and Gorodetsky practice concierge medicine which like the anti-smoking campaign of the last two decades focuses on prevention, but with personalized patient care rather than a public health initiative.

Signature MD

Original Article

Prescription Abuse is a Growing Problem in SoCal Even Among the Youngest

February 4, 2013

Prescription Abuse is a Growing Problem in SoCal Even Among the Youngest

The prescription drug epidemic is not only destroying lives all over the country but doctors say right here in southern california.

Now, continuing in our health smart series, Cher Calvin is here with an in-depth look at the ‘tiniest of addicts’.

According to the American Medical Association, there has been a sharp and dramatic increase of prescription drug abuse in pregnant women making newborns the new generation of drug addicts.

Last night we introduced you to a pregnant mother trapped in the throws of opiate addiction … Now, what doctors expect for her unborn baby.

“I never would have thought I would have picked up a drug while I was pregnant,” says Shaina Kenny.

But with two kids at home and another one on the way – Kenny did … her prescription drug of choice – roxycodone, also called ‘Roxies’.

“It wasn’t like I was going out on the streets buying heroin or cocaine. I thought is was OK because I’m getting them prescribed. This is medicine.”

For years, the 24-year old was unable to break free from the stranglehold of opiates – until the small voice of her three year old daughter inspired the pregnant mother to seek help.

“We were leaving to go run an errand one night which is what we called it,” Kenny says, “and she looked at me and started crying and said I don’t want you to run errands no more and I turned the car around and went home.”

After checking in to Forterus rehab, Kenny’s under gone extensive doctor visits and ultra-sounds – so far, all test results reveal a healthy baby.

“For anyone out there suffering from dependency there is help out there you don’t have to be like this, says Kenny.

Doctors at Cliffside Malibu rehabilitation also warn mothers can not only pass their opiate dependence on while pregnant, but also after giving birth.

“The opiates can be passed through breast milk and there are dangers of opiate dependence in the child,” Damon Raskin, MD from Cliffside Malibu Rehab.

And addiction experts insist just because it may be prescribed by your doctor – doesn’t make it safe.

“Opiates are more dangerous than heroin or cocaine combined. More people die from opiate addiction than from both those combined,” Richard Taite, Cliffside Malibu

The experts at Cliffside Malibu also told us its imperative to treat these mothers psychologically not just physically.

We will also keep you updated on the health of Kenny’s baby.

– Cher Calvin, KTLA News

Orignal Article

Cliffside Malibu

Testosterone dilemma, knowing why and when for male HRT

In light of baseball player Alex Rodriguez as Major League Baseball’s latest doping scandal and his investigation over performance-enhancing drugs including testosterone, and television flooded with “Low T” ads for men touted for low libido, energy and strength, what should men think about male HRT?

The Miami New Times said Tuesday that the three-time AL MVP bought human growth hormone and other performance-enhancing substances like testosterone during 2009-12 from Biogenesis of America LLC, a now-closed anti-aging clinic in Coral Gables, Fla., near Rodriguez’s offseason home. This trend in all sports is drawing censure and criticism for all athletes.

Yet in everyday life, men adding testosterone artificially to their systems by pill, patch or gel is becoming much more commonplace.

Published in 2011, by the Proceedings of the National Academy of Sciences, the study shows that testosterone production drops as males are forced to shift priorities, duties and mindset when they transition into fatherhood.

The study reveals men are evolutionarily wired to help raise their children and that testosterone may get in the way.

What is testosterone?

Testosterone is a hormone associated with perceived hallmarks of masculinity such as libido, aggression and musculature. Those can be useful qualities when competing for a mate, but less so when transitioning the hunter quality of men to the nurturer.

Some studies over the last decade had shown that fathers have lower testosterone levels than their childless counterparts.

To answer the question, scientists measured the testosterone levels of 624 Philippine men who were 21 years old. The researchers tracked the men — and their hormones — over the next 4.5 years. During that period, 162 who were single at the start of the study settled down and had kids and 257 remained single and childless.

The data revealed that the men with higher testosterone levels at the start of the study were more likely to become fathers. But these dads saw their testosterone levels plummet by 26% upon waking and by 34% at bedtime over the course of the study. Compare that to the bachelors, who saw modest age-related declines of 12% and 14%.

For fathers, the initial drop was abrupt: Men with newborns saw T-levels dive by 43% in the morning and 49% in the evening during the baby’s first month of life. As their infants grew, their hormone levels recovered — men with babies between the ages of 1 and 12 months took a testosterone hit of only 23% in the morning and 35% in the evening.

The Los Angeles Times reported that overall, men who devoted the most time to child care had the lowest testosterone levels, according to the study, which was published by the National Academy of Sciences.

“There’s something about being an active father that’s contributing to these dramatic declines,” said study leader Lee Gettler, a biological anthropologist at Northwestern University in Evanston, Ill.

Dr. Damon Raskin, M.D. –a board-certified internist in Los Angeles who is both an addiction expert and a men’s health specialist — spoke to Monsters and Critics about testosterone.

Dr. Raskin is the supervising medical director for a nationwide facility dealing with men’s health and anti-aging issues. He has worked with scores of patients with long-term steroid usage. He also is an attending physician at Cliffside Malibu, a leading addiction residential treatment center in Los Angeles.

“There is a tremendous difference between patients who suffer from low testosterone with symptoms such as fatigue, depression, low libido and low erectile dysfunction and the athlete who is trying to improve performance. Hypogonadism or low testosterone can be a serious medical condition with very real consequences such as low bone mass and increased risk for fractures,” explained Dr. Raskin.

“On the other hand, giving excessive amounts to men who don’t need it could lead to serious health risks such as liver disease, prostate disease, and aggressive behaviors. Human growth hormone (HGH) is not approved for use in the aging male, and there are serious potential risks to its use including development of diabetes and growths of cancerous tumors,” warned Dr. Raskin.

“The misuse of these drugs should not deter patients from checking their hormone levels if they indeed have symptoms. Under medical supervision, testosterone replacement can be safe and extremely helpful for those suffering from the condition.”

Orignal Article

Dr. Damon Raskin

Reality TMI: Brandi Glanville’s Vagina Monologue

Bravo “Real Housewife” Brandi Glanville comes clean in her memoir about opting in for some vaginal rejuvenation surgery, after her ex-husband Eddie Cibrian allegdly said unkind things about the mother of his children’s private parts to her face.

If you think you’ve heard and seen everything, pull up a seat.

Brandi Glanville has authored a new book, Drinking & Tweeting and Other Brandi Blunders, as the “Real Housewives of Beverly Hills” star opens up about the vaginal rejuvenation surgery she had after Eddie Cibrian’s affair with LeAnn Rimes.

“I would ask Eddie from time to time if my vagina was the same after childbirth. He always said yes, except once,” Glanville writes, as excerpted by Us Weekly. “He was actually quite vulgar.”

Glanville, 40, told Life & Style the she “decided that since Eddie had ruined my vagina for me, he could pay for a new one.”

Reportedly, Cibrian, 39, cut off Glanville’s credit card, so she charged the procedure to his account.

Brandi recalls that “a week after the vaginal rejuvenation surgery, he was on the phone screaming, ‘What the f–k cost you $12,000? Did you get a nose job?'”

She told him, “Yes. A nose job,” and hung up the phone.

Glanville is the mother of Cibrian’s two sons, Mason and Jake, and is adamant on revealing everything that went down during the dissolution of her marriage: “I haven’t done sit-down tell-all interviews,” she tweeted. “This book is my side and after the tour [it’s] done.”

A real Beverly Hills housewife, Grace Robbins, wife of the late author Harold Robbins, spoke to Monsters and Critics about the current array of Beverly Hills housewives on Bravo, and noted newcomer Brandi Glanville was not up to her heyday standards. “Brandi would have never survived in real Beverly Hills society in my day. But Harold would have loved her!”

Original Article

Grace Robbins

Safely quit xanax to regain control of your life and learn natural ways to beat anxiety

By Dr. Damon Raskin

Xanax is a potent benzodiazepine commonly prescribed for anxiety and panic disorders. Because people feel good when they use Xanax, it can be highly addictive. After all, if the medication makes you feel good and eases your anxiety, why wouldn’t you take more of it. However, Xanax works on the brain in such a way that the natural production of the chemicals that the brain uses to calm itself diminishes over time, thereby causing worsening symptoms and ultimately addiction. After a short time, the user must have the medication just to feel normal. This is how Xanax gains its foothold. Here is some advice in quitting Xanax and regaining control.

Do taper off

Because Xanax is potent, it is best to taper off its use rather than use a cold turkey approach. This should be done under medical supervision so that potentially dangerous side-effects of withdrawal are minimized. The type of medical supervision that is required will depend on the amount of the drug you’ve been taking, the period you’ve been taking it, and what other medications you are using. Medical supervision could range from periodic visits to your physician with phone calls as necessary to monitor side-effects to in-hospital care for very complicated cases.

Do be prepared for side effects

Side effects of Xanax withdrawal usually begin within 12 hours of tapering down the dosage. These can include: anxiety, panic, moodiness, nightmares, insomnia, and hallucinations. Remind yourself that these side effects are normal and will pass. Convulsions are rare, but also can occur. These can be dangerous and even life threatening and immediate emergency medical care should be sought.

If possible, have someone stay with you while you taper off Xanax. Not only will you have their support, but you will also have someone to call for emergency care if necessary.

Do seek medical support

If you are taking any medications in addition to Xanax, it is important to see a medical doctor before tapering off the medication. Depending on interactions with other medications, you may need a medically supported detox. In order to make your withdrawal from Xanax as safe and comfortable as possible, your physician will need to know what other medications you are taking. If there are any potential problems because of drug combinations, your doctor may ask to see a specialist in an addiction treatment center, drug detox clinic, or hospital setting.

Do psychological care is necessary

The reasons you were taking Xanax are still unresolved, even if you’ve got the Xanax out of your system. Find a psychotherapist who can help you process the underlying causes of your Xanax abuse/addiction. S/he will help you learn non-pharmaceutical coping mechanisms to deal with your anxiety.

Do use holistic tools to self-soothe

Yoga, meditation, journaling, walking, exercise, acupuncture – all these tools along with others will help you keep your anxiety in check, without Xanax or other medications. Use the activities that will help you feel your best – mind, body, and spirit – and make you feel good without medication.

Do not try to detox on your own

There are many side effects that can be uncomfortable and dangerous. With Xanax, it is important to taper off and do so under medical supervision. Some side effects, such as seizures, pose a significant health risk, including death. It is important that you withdraw from Xanax in the safest way possible, meaning under the care of a physician.

Do not be hard on yourself

Many people berate themselves for their drug abuse asking, “How did I get into this situation?” This only makes you feel bad and promotes relapse. Be kind to yourself. You probably began taking Xanax because you needed help with anxiety. Now you just need a different kind of help. It’s okay. Life is filled with challenges. You can get through this and find healthier ways of dealing with your anxiety. Meanwhile, recognize that most of the over-the-top emotions you may experience are not real, but drug induced. These emotions will subside with time.

Do not confuse side-effects with real problems

Many people coming off Xanax are more anxious than they were before they began taking the drug. This is a common side-effect of Xanax withdrawal. Ride out the feelings. With time, your brain chemistry will normalize and you will feel better again. Until that happens, use self-soothing techniques to calm yourself. Place your feet firmly on the ground to remind yourself where you are and breathe deeply to help bring your heart rate down if necessary.

Do not be afraid to seek out help

Psychotherapists, psychiatrists, and your physician can all support you as you recover from Xanax abuse. Don’t be afraid to seek out their help, letting them know honestly what it is that you are feeling and thinking.

Do not blame yourself

Xanax is an incredibly strong drug. Benzodiazepine abuse is rising, primarily because drugs like Xanax are so fast acting and potent. Anyone, literally anyone, can become addicted to these substances.

The most important thing to remember is that you’ve recognized that you have a problem and are taking the steps to overcome it. This is exactly what promoting and protecting your health is about.

Summary

Xanax addiction can be overcome. In order to safely separate yourself from this medication, please seek expert, medical support. Taper off the drug under the guidance of a physician. Be prepared for withdrawal symptoms and ask your friends or family to be with you as you detox. Psychological care will help you learn why you began to use the drug and help keep you from returning to it. There are also wonderful holistic treatments that will help you learn to self-soothe, overcoming your anxiety.

Original Article

Dr. Damon Raskin

Safely quit xanax to regain control of your life and learn natural ways to beat anxiety

By Dr. Damon Raskin

Do taper off

Do be prepared for side effects

If possible, have someone stay with you while you taper off Xanax. Not only will you have their support, but you will also have someone to call for emergency care if necessary.

Do seek medical support

Do psychological care is necessary

Do use holistic tools to self-soothe

Do not try to detox on your own

Do not be hard on yourself

Do not confuse side-effects with real problems

Do not be afraid to seek out help

Do not blame yourself

The most important thing to remember is that you’ve recognized that you have a problem and are taking the steps to overcome it. This is exactly what promoting and protecting your health is about.

Summary

Original Article

Dr. Damon Raskin