Tuesday, September 28, 2010

October Blog & News

OCTOBER BLOG / Clinic News
Office Schedule for October:
  • Vacation ScheduleClosed October 6 (Wednesday) though October 10th (Sunday) -we will be in the Smokies for a family reunion.  If you have an emergency, please go to the emergency room.  We will be back normal hours on Monday 10/11.  Sorry for any inconvenience.
  • Seminar:  I will be attending an advanced laser therapy seminar on the 16th and 17th.  I have to catch a plane early on Friday so I will close at 4 PM on 10/15 to make the plane.  Office will be closed Saturday 10/16-I will be in Denver.
Blog Addendum: 
This is a site that explains medicare that I ran across. Those of you wanting to know more about your benefits might want to check it out.  http://www.medicaremadeclear.com/#fbid=NuejHcC_Cxn.

Office News:
  • Dr. Riggs' has had an article republished in the European Aikido Journal-German Edition entitled "Aikido-Knieverletzungen" August, 2010.  This is the third republishing of his articles.  Another one will be republished in December.  Dr. Rigg's 2 articles (one on knee injuries and the other of pressure points) will have been published in English in Black Belt Magazine and Aikido Today Magazine, as well as the English, French and now German versions of the European Aikido Journal.  He has published numerous articles (7) in professional journals, one in a refereed journal.  Combined he has been published in 10 different professional and martial arts journals nationally and internationally.
Nutrition/Health News:
  • September 23rd Affordable Health Care Changes:  http://www.medscape.com/viewarticle/728665
  • Flu season is approaching.  If you have not had a flu shot, especially if you are older, it is advisable to get a flu shot and possibly a pneumonia shot.  Prevention is key.  Some chiropractic doctors don't believe in immunization.  I am not one. 
  • If you have a lot of allergies, make sure you are checking your air conditioning/heating filters regularly.  We are coming into cotton processing season so there will be a lot of allergens in the air.
  • From Futurity:  "Researchers have discovered the crystal structures of pumps that remove heavy metal toxins from bacteria, making them resistant to antibiotics."  This may allow them to desire less resistant drugs.

Friday, September 17, 2010

September Addendum-Schedule Change and More on Testosterone

The office will be open this Saturday (9/18/10) due to a change in my seminar schedule.  It will be closed next Saturday 9/25/10 and will be out of town.

More on Low Male Testosterone (source LEF):
  • Obesity causes men's testosterone to drop due to aromatase in adipose (fat) tissue converting testosterone to estrogen.
  • Falling testosterone levels predict and cause obesity and metabolic syndrome.  C-reactive Protein (CRP) increase is linked to declining testosterone (CRP indicates inflammation which plays a critical role in obesity, cancers and atherosclerosis).
  • Testosterone impacts metabolism of glucose, insulin and fat.
  • Decreasing testosterone may explain why men beyond middle age may have trouble shedding weight even with diet and exercise.
  • Experts now recommend checking testosterone levels regularly as an early risk indicator for metabolic syndrome.  All men should be checked in middle age even if not overweight.  Why don't doctors do labs for testosterone more often?  Men don't seem to have as many or as strong symptoms that are as strong as women needing hormone replacement. Men may also not be as likely to let the doctor know about all their symptoms or even seek medical advice when things like low libido, abdominal obesity or fatigue set in.  The changes are also gradual, 1-2% decline per year after age 30.  We likely play them off to aging.
  • Testosterone replacement therapy is effective in reducing body weight, fat content and insulin resistance.   Dr. Morgentaler of Harvard's Beth Israel Deaconess Medical Center contends that new evidence suggests that low testosterone is responsible for prostate cancer risk, not high testosterone.

Friday, September 10, 2010

Insurance Companies and Misinformation

The age of misinformation and the nice insurance companies are already at it:

Thursday, September 9, 2010
HHS Press Office

Sebelius calls on health insurers to stop misinformation and unjustified rate increases.  Affordable Care Act will help lower costs and crack down on unjustified rate increases

WASHINGTON, DC - U.S. Department of Health and Human Services Secretary Kathleen Sebelius wrote America's Health Insurance Plans (AHIP), the national association of health insurers, calling on their members to stop using scare tactics and misinformation to falsely blame premium increases for 2011 on the patient protections in the Affordable Care Act. Sebelius noted that the consumer protections and out-of-pocket savings provided for in the Affordable Care Act should result in a minimal impact on premiums for most Americans. Further, she reminded health plans that states have new resources under the Affordable Care Act to crack down on unjustified premium increases.

The text of Sebelius' letter is below.

Ms. Karen Ignagni
President and Chief Executive Officer
America's Health Insurance Plans
601 Pennsylvania Avenue, NW
South Building, Suite 500
Washington, DC 20004

Dear Ms. Ignagni:

It has come to my attention that several health insurer carriers are sending letters to their enrollees falsely blaming premium increases for 2011 on the patient protections in the Affordable Care Act. I urge you to inform your members that there will be zero tolerance for this type of misinformation and unjustified rate increases.

The Affordable Care Act includes a number of provisions to provide Americans with access to health coverage that will be there when they need it. These provisions were fully supported by AHIP and its member companies. Many of the legislation' s key protections take effect for plan or policy years

beginning on or after September 23, 2010. All plans must comply with provisions such as no lifetime limits, no rescissions except in cases of fraud or intentional misrepresentation of material fact, and coverage of most adult children up to age 26. New plans must comply with additional provisions, such as coverage of preventive services with no cost sharing, access to OB / GYNs without referrals, restrictions on annual limits on coverage, a prohibition on pre-existing condition exclusions of children

(which applies to all group health plans), access to out-of-network emergency room services, and a strengthened appeals process. And health plans that cover early retirees could qualify for reinsurance to sustain that coverage for businesses, workers, and retirees alike.

According to our analysis and those of some industry and academic experts, any potential premium impact from the new consumer protections and increased quality provisions under the Affordable Care Act will be minimal. We estimate that that the effect will be no more than one to two percent. This is consistent with estimates from the Urban Institute (1 to 2 percent) and Mercer consultants (2.3 percent) as well as some insurers' estimates.  Pennsylvania' s Highmark, for example, estimates the effect of the

legislation on premiums from 1.14 to 2 percent. Moreover, the trends in health costs, independent of the legislation, have slowed. Employers' premiums for family coverage increased by only 3 percent in 2010 - a significant drop from previous years.

Any premium increases will be moderated by out-of-pocket savings resulting from the law. These savings include a reduction in the "hidden tax" on insured Americans that subsidizes care for the uninsured. By making sure insurance covers people who are most at risk, there will be less

uncompensated care, and, as a result, the amount of cost shifting to those who have coverage today will be reduced by up to $1 billion in 2013. By making sure that high-risk individuals have insurance and emphasizing health care that prevents illnesses from becoming serious, long-term health problems, the law will also reduce the cost of avoidable hospitalizations.  Prioritizing prevention without cost sharing could also result in significant savings: from lowering people's out-of-pocket spending to lowering costs due to conditions like obesity, and to increasing worker productivity - today, increased sickness and lack of coverage security reduce economic output by $260 billion per year.

Given the importance of the new protections and the facts about their impact on costs, I ask for your help in stopping misinformation and scare tactics about the Affordable Care Act. Moreover, I want AHIP's members to be put on notice: the Administration, in partnership with states, will not tolerate unjustified rate hikes in the name of consumer protections.  Already, my Department has provided 46 states with resources to strengthen the review and transparency of proposed premiums. Later this fall, we will issue a regulation that will require state or federal review of all potentially unreasonable rate increases filed by health insurers, with the justification for increases posted publicly for consumers and employers. We
will also keep track of insurers with a record of unjustified rate increases: those plans may be excluded from health insurance Exchanges in 2014. Simply stated, we will not stand idly by as insurers blame their premium hikes and increased profits on the requirement that they provide consumers with basic protections.

Americans want affordable and reliable health insurance, and it is our job to make it happen. We worked hard to change the system to help consumers.  It is my hope we can work together to stop misinformation and misleading marketing from the start.


Kathleen Sebelius

Wednesday, September 1, 2010

September Blog Andropause

  • We will be CLOSED Monday September 6th for the Labor Day Holiday.  Have a safe and enjoyable holiday.
  • OFFICE HOURS:  I will be out of the office on Saturday September 18th weekend conducting a seminar in San Angelo.
  • School is back in session so keep an eye out for the kiddies.  Their attention spasns sometimes distracts them from their safety.  Remember unless you have a couple hundred you like throwing away, cell phones in school zones will cost you.
  • Please note our office does back to school physicals for sports. 
Andropause (male menopause):  As we age, it is not uncommon for our sex hormones to decrease.  Men experience this as well as women although sometimes our symptoms don't seem to be a noticeable.  We don't get hot flashes and have the emotional issues associated with the changed hormones.  I decided recently to have mine checked recently since I've moved over the 6th decade line and was starting to experince some of the symptoms.  That and a patient's husband also was undergoing replacement with good results.  Lo and behold mine were not only low but off the bottom of the range for testosterone (total and free) and DHEA-S.  So what are the symptoms of the so-called male menopause or "andropause"?  Note:  The WHO does not recognize the term but rather "hypogonadism" is the more appropriate term.
  • "male climacteric" including loss of libido and potencyDiminished sexual desire and erectile quality. In particular, a decrease in nocturnal erections is a significant sign of decreased androgens 
  • Mood changes. This can also be associated with decreases in intellectual activity, fatigue, depression, anger and poor spatial orientation, nervousness, impaired memory, inability to concentrate
  • decrease in lean body mass, along with decreases in muscle mass and strength.
  • decrease in body hair. 
  • decrease in bone density resulting in osteoporosis. Osteoporosis can often lead to increased incidence of bone fractures and breaks.
  • increase in fat surrounding the internal organs
  • fatigue
  • insomnia
  • hot flushes
  • sweating 
  • Andropause has been observed in association with Alzheimer's disease
If you are having many of the above symptoms, your hormone levels may be low.  Lab tests can be ordered by your doctor.