¿Es hora de su visita de bienestar de Medicare?

Por la Dr. Linda Eller | Proveedor de Medicina Familiar

¿Está usted o es un ser querido en el seguro de Medicare? Si es así, el bienestar debe ser lo más importante y la buena noticia es que está cubierto comenzando con la visita de bienestar de Medicare.

Dr. Linda Eller, Proveedor de Medicina Familiar

La visita de bienestar a través de Medicare no es el físico tradicional de pies a cabeza con el que la mayoría de las personas están familiarizadas. La visita de bienestar cubierta por Medicare es una visita anual para identificar y reducir cualquier riesgo de salud que su proveedor de atención médica pueda encontrar.

Las visitas de bienestar importan

La Visita de Bienestar de Medicare, aunque no es un examen físico tradicional, es una herramienta para que su proveedor médico encuentre brechas en su atención médica. Las preguntas que se hacen durante la visita son específicas y ayudan a reducir las preocupaciones al tiempo que permiten que su equipo de atención médica proporcione una mejor atención.

Qué esperar en su cita

En la visita de bienestar, tomamos un historial de salud completo usando un cuestionario de Medicare para entender las necesidades del paciente. Si ésta es la primera visita de bienestar de Medicare del paciente, comenzaremos con un ECG. Luego su proveedor discutirá los hallazgos del cuestionario y tratará las preocupaciones sobre su salud y bienestar.

Los proveedores realizarán un examen físico limitado para verificar la presión arterial, el peso, la visión y otras cosas dependiendo de la edad, el sexo y los antecedentes de salud del paciente.

Durante la visita, su proveedor puede hacer referencias a especialistas, ordenar laboratorios y discutir las pruebas de diagnóstico y diagnóstico por imágenes necesarias como mamografías o exámenes de detección del cáncer colorrectal. También hablaremos sobre los riesgos y signos de depresión, viajes y caídas, y otras preocupaciones de salud y bienestar.

Nuestra meta es crear un plan de prevención personalizado para ayudar a prevenir enfermedades y discapacidades de acuerdo a su salud y factores de riesgo.

Qué no esperar en su cita

Esto no es un físico tradicional. Puede sonar como si fuera, pero hay diferencias claras. La visita de bienestar de Medicare permite a los proveedores de atención médica tener una línea de base para la salud y el bienestar que Medicare sabe que es importante para este grupo de pacientes.

Los proveedores generalmente no abordan las condiciones de salud crónicas existentes ni reabastecen las recetas en esta cita. La visita es específica para encontrar y abordar cualquier preocupación nueva y planificar la atención médica del próximo año con el paciente.

Programar una visita de bienestar de Medicare cada año es importante y NOAH está aquí para ayudarle a mantenerse en el buen camino.

Si ésta es su primera cita en NOAH, le recomendamos que programe una cita de atención primaria antes de su visita de bienestar de Medicare. Queremos conocerle a usted, a su historial de salud, y discutir las condiciones preexistentes o crónicas con anticipación para crear el mejor plan de salud para el año que viene.

Who Should Get the New Bivalent COVID-19 Booster?

Along with the approval of the new bivalent COVID-19 booster comes new recommendations from the CDC that everyone who is eligible should receive this booster. So who needs which vaccines and when? NOAH’s expert and Pharmacy Director, Eric Scherf weighs in on the most frequently asked questions.

Q. How is this vaccine different from previous vaccines?

A. The new bivalent COVID-19 boosters protect against the original strain of COVID and the omicron variant. Previous vaccines and boosters have only been monovalent, meaning they only offered protection against the original strain of COVID-19.

Q. Which COVID vaccines should patients have before getting this vaccine?

A. To be eligible for the bivalent COVID-19 booster, patients should have completed their primary series vaccine and any boosters at least two months ago.

Q. Which bivalent COVID-19 boosters does NOAH offer?

A. NOAH currently offers Pfizer and Moderna bivalent boosters. Availability varies by clinic so patients having a preference of manufacturer should inquire when scheduling.

Q. What ages are eligible for the bivalent COVID-19 booster?

A. Patients ages 12 and up are eligible for the Pfizer bivalent booster and ages 18 and older are eligible for the Moderna bivalent booster.

Q. Can patients get the bivalent COVID-19 booster at the same time as their flu vaccine?

A. Yes! Patients can schedule to get the flu vaccine and bivalent COVID-19 booster during the same appointment.

Q. Will the bivalent COVID-19 booster make patients sick?

A. If patients experience any side effects, expect them to be minor and brief, as with previous COVID-19 vaccines, the bivalent booster may cause pain, redness and swelling at the injection site; fatigue; headache; muscle pain; joint pain; chills; nausea/vomiting and fever.

Q. How much does the bivalent COVID-19 booster cost?

A. At this time, COVID-19 vaccines and boosters are covered by the federal government. Insurance, if applicable, may be billed for costs associated with administration of the vaccine.

Q. How can I sign-up to get the bivalent COVID-19 booster?

A. Patients who would like to get the booster can request an appointment online or call 480-882-4545 to schedule.

For more details about COVID-19 vaccines and boosters, feel free to ask your NOAH provider or check out the CDC website.

5 Things to Know for Flu Season 2022-2023

Flu season is around the corner and NOAH is ready to keep you and your family protected. We know that with COVID there might be additional questions about the virus, symptoms, and the vaccines. NOAH has you covered with these top five things to know about flu season.

1. Flu Season is Almost Here

Flu season officially starts in October and can last through May of the following year. But the peak of flu usually happens around December through March with February being the month that often has the most flu cases nationwide.

2. Try These Safety Measures Stop the Flu

Many of the things we continue to do to slow or stop the spread of COVID like extra hand washing, more antibacterial gels and wipes, staying home when sick, and wearing masks (especially if sneezing or coughing), will help reduce the flu as well!

3. The Flu Vaccine Helps

Every year, flu shot manufacturers identify the strains of influenza A and B that pose the most risk for the coming season. Flu shots also include H1N1, and because of flu shots, H1N1 isn’t causing outbreaks anymore. Flu shots are adjusted every year with new influenza (flu) strains because it mutates like all viruses.  

4. Flu Shots are Optimized by Age Group

Children are a high-risk group with flu so anyone 6 months and older should get the flu shot. When children under eight are getting the flu vaccine for the first time ever, they will need to have two doses, given four weeks apart. The following flu seasons will be just one dose.

A high-dose flu vaccine made specifically to support the more fragile immune system of people ages 65 and up is also available during flu season.

5. Flu Shots and COVID Shots Can Go Together

The CDC says that it is safe to get the flu and COVID vaccines/boosters at the same time.  If you have any concerns about potential side effects or changes in effectiveness of the vaccines if given together we suggest talking to your NOAH provider to come up with a vaccine plan that is right for you. NOAH is administering bivalent COVID boosters along with flu vaccines in all of our health centers.

Almost everyone can and should get the flu shot every year. Even people with egg allergies can talk with their healthcare providers about egg-free vaccine options. The only people who shouldn’t get vaccinated for the flu are patients under 6 months old or someone with history of an anaphylactic reaction to the flu shot or one of its components.

The CDC has a lot of information about flu season including updated flu cases and vaccine activity on their website here. If you have questions about the flu vaccine or want to schedule your appointment, contact NOAH today!

Monkeypox: What You Need to Know

According to recent reports released by the Centers for Disease Control and Prevention (CDC), as of August 1 there have been over 5,100 reported cases of monkeypox in the United States with Arizona accounting for 50 of those cases. Our best defense against monkeypox is to keep it from spreading by understanding symptoms of the virus and how it’s transmitted. Dr. Vanyo-Novak, Family Physician and Medical Director for NOAH answers some of the most common questions.

Q: What is monkeypox?

A: Monkeypox is a virus that can cause fever, body aches, fatigue, swollen lymph nodes, and a rash that typically starts on the face, arms, and legs and spreads toward the trunk. 

Examples of Monkeypox rash:

Monkeypox Example

Though cases are on the rise, this infection is still rare and there is much you can do to protect yourself.

Q: Is monkeypox the same thing as chickenpox?

A: No, monkeypox is caused by a different virus. 

Monkeypox is most similar to Smallpox, a virus that last seen in the U.S. back in 1949. 

Though monkeypox and chickenpox both involve rashes that can itch and be painful, the rash in monkeypox starts as flat red spots that become raised within 1-2 days and then pus filled within 5-7 days.  The rash in monkeypox can involve the palms of the hands and soles of the feet, the rash in chickenpox doesn’t.  Monkeypox also causes swollen lymph glands, something you don’t usually see with chickenpox. 

Q: Who is at risk for monkeypox?

A: Anyone who comes in close contact with other people or animals infected with monkeypox.

Monkeypox can be spread through:

  • direct contact with the rash, scabs, or bodily fluid
  • touching items (clothes, linens) that previously touched the rash or bodily fluids
  • inhaling respiratory secretions during close face-to face contact or during intimate physical contact such as kissing, cuddling, or sex.
  • pregnant women can spread the virus to their fetus through the placenta 

Q: How do I protect myself and my family from monkeypox? 

A: There is a lot you can do to avoid contracting monkeypox, including: 

  • Avoid close, skin-to-skin contact with people who have rashes.  Avoid touching rashes or scabs on other people.
  • Do not kiss, cuddle, or have sex with someone who has suspected or confirmed monkeypox.
  • Do not share utensils or cups with someone who has suspected or confirmed monkeypox.
  • Do not touch bedding, towels, or clothes of someone who has suspected or confirmed monkeypox.
  • Avoid touching your face and clean your hands after touching other people or surfaces.  This can be done with soap and water or with and alcohol-based sanitizer. 
  • If you work in a NOAH Health Center or other patient care environment, make sure to wear appropriate personal protective equipment (PPE) and exercise good hand hygiene.

Q: Is there a vaccine for monkeypox?

A: Yes, there are two vaccines licensed by the Food and Drug Administration (FDA) for preventing monkeypox.  These vaccines are in limited supply and available through the Centers for Disease Control (CDC) and Health Department only.  Unlike most of our vaccines, the monkeypox vaccines can be given after a known exposure to the virus and still be effective.  At this time, the vaccines are mostly being used in high risk individuals who have had close contact with a confirmed case of monkeypox.

Q: What if I suspect I have monkeypox?

A: Please self-isolate until you can seek medical attention for further evaluation.  NOAH has an RN Nurse Triage line available to help assess your symptoms and determine whether a telehealth or in office visit is needed.  Testing for monkeypox can only be completed during an in office visit.  Please make sure to wear a mask and cover all open sores prior to entering any of our NOAH clinics.  This is to help decrease the spread of the virus.

Q: Is there treatment for monkeypox?

A: No, there is no specific treatment for monkeypox.  That being said, because monkeypox is so similar to smallpox and smallpox does have a treatment, TPOXX, this treatment can be approved under what’s called “compassionate use” for patients at extreme risk for complications.  This medication is only available through the CDC.  If a NOAH clinician believes a patient may need treatment for monkeypox they will help coordinate next steps with the CDC.  Though most cases of monkeypox will resolve on their own and not require treatment there are some instances where treatment is indicated (examples include patients with active HIV, intolerable pain from the monkeypox lesions). 

Q: What is NOAH doing to prevent the spread of monkeypox in our clinics?

A: NOAH Health Center teams follow specific guidelines to reduce the risk of exposure to infectious diseases.  Patients with symptoms indicating a potentially contagious condition are roomed upon arrival to the clinic. NOAH staff follow strict protocols for use of Personal Protective Equipment (PPE) and cleaning of the exam rooms and office equipment after each visit.

Q: Where can I learn more about monkeypox?

A: For the most accurate and up-to-date information, please visit the CDC website.

Women’s Health Week #3 – Contraception & Birth Control

By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week is May 8 -14 and this year NOAH is highlighting three health issues that women should be familiar with and discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

Contraception & Birth Control

Nearly 65% of all women between age 15 and 49 in the U.S. use some form of birth control. But the reasons why are more than pregnancy prevention. Learn more about the types and uses for contraception from two of NOAH’s family medicine providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs.

Why use birth control?

Birth control reduces the chances of an unintended pregnancy when used correctly. But beyond that, many individuals use hormonal birth control to help regulate menstrual cycles, prevent ovarian cysts, regulate hormones, and reduce menstrual pain, Acne, and excessive body hair growth.

What are different contraception options?

You have options but talk to your PCP or OBGYN about what method is right for you. Here are the different types of birth control available:

  • “The Pill” – A daily pill that combines two hormones: estrogen and progesterone. Failure rate: 7%.
  • Progestin-Only Pill – Like “The Pill” above but only the hormone progesterone. Failure rate: 7%.
  • Implant (Nexplanon) – This is a small rod placed in the arm by your doctor that gives a continuous dose of progestin slowly over 3 years. Low failure rate: 0.1%.
  • IUD (Intrauterine Devices) – These small T-shaped devices are placed in the uterus by your doctor. There are two options:
    • Hormonal: Releases a small hormone dose each day and can last 3 to 6 years. Low failure rate: 0.1% – 0.4%.
    • Copper: Can stay in your uterus for up to 10 years. Low failure rate: 0.8%.
  • Injection/Shot – This is a progestin shot every three months. The biggest side effect of the injection is weight gain. Failure rate: 4%.
  • Patch – The patch placed on a person’s skin releases hormones. A new patch is put on each week for three weeks, with no patch during the fourth week. These can be difficult in hot climates because it doesn’t stick as well. Failure rate: 7%.
  • Vaginal Ring – The ring releases estrogen and progesterone. You wear the ring for three weeks and then remove it on the fourth week. Failure rate: 7%.
  • Other methods:
    • Diaphragm – 16% failure rate
    • Male condom – 18% failure rate
    • Female condom – 21% failure rate
    • Cervical cap – 23% failure rate
    • Sponge – 24% failure rate
    • Fertility based methods (tracking cycle days, basal body temperature) – 26% failure rate
    • Spermicide – 28% failure rate

How to pick the right form of birth control?

Remember that not everyone will respond the same way to every form of birth control. And not everyone has the same reason for needing birth control. Be sure to discuss with your provider any types of current or previous forms of birth control used and any side effects so together you will find the right form of birth control for you!

Women’s Health Week #1 – Cervical Cancer

By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week kicks off on Mother’s Day every year. This year for Women’s Health Week from May 8 – 14, NOAH is highlighting three health issues that women should be familiar with and should discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

Cervical Cancer

Around 12,000 people are diagnosed cervical cancer every year. Understand more about this cancer from two of NOAH’s family medicine providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs.

What is Cervical Cancer and what causes it?

Cervical cancer is a cancer that forms at the lower end of the uterus. Most cervical cancers are caused by Human Papilloma Virus (HPV), the most spread sexually transmitted infection (STI). About 80% of people will be infected with this virus at some point in their lives, and most people’s bodies will naturally fight off the virus. For those who can’t fight it off, HPV can lead to health issues like cervical cancer later in life. That’s why the HPV vaccine is so important. More on that later.

How Can I Lower My Risk of Cervical Cancer?

Yes! First, get regular Pap smears/tests. According to the CDC, millions of women aged 21-65 haven’t had a Pap test in the last five years! Pap tests are covered by private insurance and Medicaid/AHCCCS and are the best way to diagnose any problems. Pap tests save lives.

Second, get the HPV vaccine if possible. It is safe and very effective at reducing the risk of getting HPV-caused cancers later in life.

The CDC estimates that around 93% of cervical cancer cases could be prevented by regular Pap tests and HPV vaccine.

How Often Do I need a Pap Test?

It used to be that Pap tests were recommended every year. With what we know now about HPV and cervical cancer risk factors, that recommendation has changed. The new recommendation for people also being tested for HPV is every three years for people aged 21-29, and every five years for people 30-65.

Who Can Get HPV Vaccines?

Typically, the three-dose HPV vaccine is recommended for males and females around age 11 or 12. We wrote all about the HPV vaccine here!

Understanding Food Allergies

Food allergies are getting more attention in recent years – which is a good thing! Around 32 million Americans, including 5.6 million children, are living with a potentially life-threatening food allergy. The more we know about allergies, the better!

Food Allergy vs Food Sensitivity

First things first; food allergies and food sensitivities or intolerances aren’t the same thing. Food allergies are a serious medical condition where your body’s immune system reacts to a specific food protein. It can look like getting a rash or hives, swelling, dizziness, itching, and even anaphylaxis (a serious reaction that can affect breathing and blood pressure read more here).  

If someone thinks they or a family member may have a food allergy, a medical provider should be the one to test and diagnose the allergy.

Food sensitivities or intolerances do not involve the immune system. Things like lactose intolerance, gluten sensitivity, and others are in the digestive system. They can cause serious discomfort like bloating, constipation, cramping, and nausea, but they can’t be fatal. Read more about food sensitivities.

Most Common Food Allergies

People can be allergic to many different kinds of food. Common food allergies are:

  • Peanuts – One of the most common food allergies in children and adults, peanuts – a legume (different from a tree nut) – is usually a lifelong allergy.
  • Milk and Dairy Products – Cow’s milk is the most common allergy in infants and young children, though most outgrow it. It is also one of the most common adult food allergies too.
  • Eggs – A common food allergy for babies and children, many will outgrow it. Some adults remain allergic, and it can be to egg whites, or egg yolks since they contain different proteins.
  • Shellfish – Allergies to this type of seafood, including shrimp, prawns, lobster, and crayfish are typically lifelong, though most people don’t experience a reaction until they are an adult.
  • Soy – Most common in infants and young children, most outgrow a soy allergy. Soy is a legume like peanuts but being allergic to one doesn’t mean someone will be allergic to the other.
  • Wheat – This allergy affects children the most, but many outgrow it by age 10. This is not the same a celiac disease, wheat allergies are to the proteins found in wheat, not gluten.
  • Tree Nuts – Not the same as peanuts, tree nuts include almonds, cashews, walnuts, and more. An allergy to these nuts also includes things like nut butters and oils. Being allergic to one type of tree nut increases the risk of becoming allergic to other tree nuts.

What Next?

If you or a loved one is diagnosed with a food allergy, try not to feel overwhelmed. While it does mean you need to change what you eat, there are many resources and people and groups to support you, including NOAH’s Nutrition Services team.

Make sure you have a proper diagnosis with a medical provider. Discuss with them what the diagnosis means. Will the child outgrow it? What medications should you have? What does a severe reaction look like?

Finally, the most important thing to know is that the best way to prevent an allergic reaction to food is to avoid that food. That is what most doctors recommend along with having an epi-pen on-and always to treat any reaction to food allergies. Even a small amount can cause a reaction, but here are some tips.

There is promising news about a new intensive treatment called “food allergen desensitization” which is available and can resolve the allergy in some cases – though definitely not all cases. If you are interested in learning more about this treatment, ask your medical provider if this is right for you.

To get you started on figuring out your food allergies and staying safe, check out our recipes with different ingredient options.

How Important is Healthy Skin?

Did you know your skin is the largest organ in your body? Your skin protects you, tells you a lot about your overall health, and it grows and changes with you throughout your life. Our skin has a big job to do, which is why keeping skin healthy is so important.

Here are some useful tips to keep your skin healthy at every age.

Pay Attention to Dry Skin

Dry skin can be the result of environmental factors, or it can be because of what is happening inside our bodies. Either way, pay attention to it and hydrate your skin. Drinking a lot of water – 8 glasses – throughout the day, is one of the best things you can do for your skin (and other parts of your body!).

Dry skin can also become a problem if not treated with itching, flaking, even bleeding from dry skin. Many of us in Arizona have to deal with “hard water”, or water heavy in calcium and magnesium. This can make it harder for soap to wash off your skin, so spend a few extra seconds rinsing your hands, face, and body. Moisturize with ointments, creams or lotions after showers, baths, and handwashing, but make sure they don’t contain alcohol which can have the opposite effect.

Baby’s Skin Can Have Different Needs

Babies are a wonder, and so is their skin! Baby acne, birthmarks, diaper rash, hives, eczema, and others are common in babies, but they are things all new parents and caregivers should be familiar with. The American Academy of Dermatology Association has detailed information about these conditions and many more. If you ever have questions about your baby’s skin, talk to your NOAH provider.

Protect Your Skin from the Sun

The great news is that sunscreen is both the easiest and best way to protect your skin from harmful ultraviolet rays. Try for SPF 30 and wear it all year on whatever part of you isn’t protected by clothing – think hands, arms, face, even the tops of your ears. Sun can cause skin aging and increase the risk for certain types of skin cancer.

Everyone deals with some types of skin troubles during their life. Whether it is acne, blackheads, rashes, or dry skin, it is helpful to know how to protect your skin and when it’s time to call your provider. If you have any questions, make an appointment with your provider.

It’s Time to Talk About Colorectal Cancer Screenings

If you are over 45 then it’s time to talk to your doctor about Colorectal Cancer Screenings. We know it isn’t anyone’s favorite topic, but it is easier than you may think to get screened.

A few Colorectal Cancer facts to know before we talk about screenings:

  1. Colorectal Cancer is colon cancer and rectal cancer combined because they both begin in the large intestine.
  2. If caught early, around 90% of people survive this cancer diagnosis. Catching it early is critical!
  3. More men than women are diagnosed with colorectal cancer each year, but not by much. So everyone should be screened.
  4. It might make you a little uncomfortable to talk about, but discussing Colorectal Cancer and screenings saves many lives!

At NOAH, It’s Our Job to Save Your Butt!

All jokes aside, our providers WANT to talk to you about Colorectal Cancer and get you screened.

NOAH is here to discuss colon and rectal cancers with you. We want all of our patients to know the risks, the signs and symptoms (or lack of!), how easy it is to get screened, and that by talking about this can save lives! We have more details about Colorectal Cancer risks, ways to reduce your risks, and a few more details about screenings here. Our NOAH Nutrition Services team also put together some tips on ways to reduce your risk for Colorectal Cancer with food!

As you saw in the video, there are options for screenings and we will help you find the one that is right for you. Request an appointment with a NOAH provider today online or by calling 480-882-4545.

Colorectal Cancer Risk, Prevention, and Detection

Colorectal Cancer Fact A

March is colorectal cancer awareness month and “It’s Our Job to Save Your Butt!” In all seriousness though, colorectal cancer is the fourth most diagnosed form of cancer and the second leading cause of cancer death in the United States. According to the American Cancer Society the overall lifetime risk of developing colorectal cancer is about 1 in 23 (4.3%) for men and 1 in 25 (4%) for women. The good news is that if caught early nine out of ten people diagnosed will survive.

Risk Factors for Colorectal Cancer

  • Age 50 or older
  • Lack of physical exercise
  • Being overweight or obese
  • Certain types of diets
  • Family history of colorectal cancer
  • Personal history of inflammatory intestinal conditions
Colorectal Cancer Fact B

How to Prevent Colorectal Cancer

Colorectal Cancer Screening

NOAH providers recommend people at average risk for colorectal cancer begin regular screenings at age 50. How often you get screened depends on the type of test you get.

Here’s a look at how the different options at NOAH stack up:

TEST NAMETYPEHOW IT WORKSPREPHOW OFTENCOST
VARIES BY INSURANCE

(Often Covered in Full)
Fecal Immunochemical Test (FIT)Stool sample collected at home and mailed to a lab for testingLooks for blood in the stool.NoneEvery yearLeast expensive
Cologuard TestStool sample collected at home and mailed to a lab for testingLike the FIT test, looks for blood in the stool but also checks DNA in the stool for abnormal (possibly cancerous) cells NoneEvery 3 yearsMore expensive than FIT test but less expensive than a colonoscopy
ColonoscopyVisual screening performed in a hospital or specialized clinicChecks for polyps (small growths in the colon or rectum) that may be cancerous or pre-cancerousRequires bowel prep before the procedure and anesthesia duringEvery 10 yearsMost expensive

Talk with your provider about which type of test is right for you. Then, be sure to follow through with your testing, understand your results and even schedule a reminder on the calendar for your next screening.   

Questions? Ask away, we don’t mind because it’s our job to save you’re butt! Request an appointment today!