Time For Your Medicare Wellness Visit?

By: Dr. Linda Eller, DO

Are you or a loved one on Medicare insurance? If so, wellness should be top-of-mind and the good news is, it’s covered starting with the Medicare Wellness Visit (MWV).

Dr. Linda Eller, Family Medicine

The wellness visit through Medicare isn’t the traditional head-to-toe physical that most people think of. The MWV covered under Medicare is an annual visit to identify and reduce any health risks your healthcare provider might find.

Why Wellness Visits Matter

The Medicare Wellness Visit, while not a traditional physical, is a tool for your medical provider to find gaps in your healthcare. The questions asked during the MWV are specific and help to narrow down concerns while allowing your healthcare team to provide better care.

During the pandemic, many people skipped preventative and wellness appointments with their primary care provider. This included patients missing their MWV. Right now, we are contacting and encouraging patients to come in, starting with an MWV. Now is the time to get back to your doctor.

What to Expect at a Medicare Wellness Visit

At the wellness visit, we take a complete health history and use the MWV questionnaire from Medicare to understand a patient’s needs. If this is a patient’s first MWV, we will start with an EKG. Then your provider will discuss findings from the questionnaire and address concerns about your health and wellness.

Providers will do a limited physical exam to check blood pressure, weight, vision, and other things depending on a patient’s age, gender, and health history.

At the MWV, your provider can make referrals to specialists, order labs, and discuss necessary imaging and diagnostic tests like mammograms or colon cancer screenings. We will also talk about the risks and signs of depression, trips and falls, and other health and wellness concerns.

Our goal is to create a personalized prevention plan together to help prevent disease and disability according to your health and risk factors.

What a Medicare Wellness Visit Isn’t

This isn’t a traditional physical. It may sound like it is, but there are distinct differences. The MWV allows healthcare providers to have a baseline for health and wellness that Medicare knows is important to this patient group.

Providers don’t generally address existing chronic health conditions or refill prescriptions. The MWV is specific to finding and addressing any new concerns and planning for the next year’s healthcare with the patient.

Having your annual MWV is important, and NOAH is ready to make sure you get back on schedule. If this is your first appointment at NOAH, we want to get to know you, your health history, and discuss preexisting or chronic conditions before your MWV.

Give our NOAH team a call today at 480-882-4545 to schedule an appointment and plan for a healthy and productive year ahead.

Skin Cancer Awareness Month

Skin cancer is the most common type of cancer in the U.S. However, it is also a cancer that can be prevented in some cases. For Skin Cancer Awareness Month, let’s dive into the types of skin cancer, the risk factors, and how to prevent or reduce your risk for skin cancer.

Types of Skin Cancer

There are seven different types of skin cancer, but three types are the most common.

  1. Basal cell carcinoma (BCC)

BCC is the most common and while anyone can get BCC, it is more common in people with fair skin. BCCs typically develop after years of repeated sun exposure or indoor tanning and looks like a small skin-colored or light pink growth or bump found most often on the head, neck, and arms where people usually get more sun exposure.

  • Squamous cell carcinoma (SCC)

The second most common form of skin cancer is SCC, which is also more common for people with fair skin but can happen to anyone. SCC looks like a firm red bump and is more common on the areas with more sun exposure, including face, ears, neck, chest, arms and back.

  • Melanoma

Known as the most serious, melanoma tends to spread. Melanoma is much less common than BCC or SCC, but it is also the deadliest type of skin cancer, which makes early detection even more important. Melanoma usually shows up as a dark spot, or a growth on an existing mole.

Risk Factors

Like with many cancers, the risks don’t follow a strict list of risk factors. But there some things that we do or don’t do that can have an impact.

  • Sun exposure, sun burns, and using indoor tanning beds can seriously increase your risk for skin cancer, as well as skin damage like premature aging and sunspots (also called age spots).
  • Skin tone and how your skin reacts to sun – like if you burn easily – matters. People with fair or light skin are more prone to sunburns and sun damage.
  • Some things, like genetics and family history can have an impact on someone’s risk of developing skin cancer. While you can’t change this risk factor, knowing means you and your doctor can be proactive.

Prevention

Overall, the best thing people can do to reduce their risk is reduce sun exposure and UV exposure (like indoor tanning beds) and get to know the moles and spots on your body, so you know if anything looks out of the ordinary.

Wearing protective clothing and sunscreen can provide a lot of protection. Wearing SPF 15 or higher when you go outside can decrease your risk of SCC and melanoma by 40% or more!

Having an annual skin exam can help spot any serious or potentially questionable spots or growths early. Your doctor should also know if you have had skin cancer in the past, if you have a family history, or are at a greater risk from overexposure to sun.

If you have any questions about spots on your skin, or if it’s been a while since your last skin exam, contact NOAH today and make an appointment.

Stroke Awareness Month

Do you know the signs of a stroke? The sooner someone with a stroke gets help, the better. People who are treated during the first few hours have a better chance of survival and less chance of having permanent disabilities from the stroke.

Signs of a Stroke

Knowing the signs can save a life. It happens every day. The signs are organized to the memorable acronym F.A.S.T.

F – Face drooping. The face can be drooping on one side or be numb. If you are unsure, ask the person to smile.

A – Arm weakness. Can the person raise both arms? Are they both the same height? Does one arm droop?

S – Speech problems. A speech issue could be the person having slurred speech, trouble talking, or is hard to understand.

T – Time to call! If the person is showing ANY of these symptoms, it is time to call 9-1-1 and get them to the hospital immediately.

These are not the only symptoms of a stroke, but they are the best immediate way to recognize one. Other signs that someone may be suffering from a stroke include numbness especially on one side of the body, confusion or trouble understanding things, vision trouble, dizziness and trouble walking, and a severe headache that comes on suddenly.

Risk Factors

There are things that make you or someone in your life at a higher risk of stroke. These risks include high blood pressure, smoking, diabetes, obesity, low physical activity, high cholesterol, heart disease, and having a previous stroke. Working with your healthcare team to improve some of these areas can reduce your risk of having a stroke.

Other risks are out of your control but knowing them is important to your ongoing medical care and wellness. Some of these factors are include gender because women have more strokes than men, age as risk increases with age, race, and family history.

Knowing your risk factors will help you manage your risk so talk to your NOAH provider today if you have any questions or concerns.

Stroke is one of the top causes of death and disability in America, so knowing the signs and what to do can save a life. Every minute counts during, so act F.A.S.T.!

Maternal Mental Health Awareness Month: More Than Postpartum Depression

By: Alyssa Fagan-Clark, LMSW |Behavioral Health Counselor

During May, we celebrate Mother’s Day and Maternal Mental Health Awareness month! We often think of new motherhood as a time of excitement, care giving, happiness, and a deep sense of love. And while it is often all these things, conditions like postpartum depression can also be a period of intense struggle and uncertainty for many mothers and their loved ones.

According to Postpartum Support International, perinatal mental health disorders are the number one childbirth complication. One out of every seven mothers will face some form of postpartum mental health disorder, and the number is much higher for women of color with one of every three mothers impacted.

According to the CDC, the rate of maternal depression diagnoses at delivery is increasing. In 2015, the rate had increased seven times from where it was in 2000! This is more than the slight emotional changes most women – around 80% – experience in the 3-5 days after childbirth known as the “Baby Blues” period.

The “Baby Blues” happens after childbirth, when a woman’s body undergoes extreme hormonal and physical changes, in addition to the added emotional stress of caring for a newborn. This period typically lasts 2 weeks or less. Symptoms of the “Baby Blues” usually include moodiness, tearfulness, feeling overwhelmed, and general tiredness. While these emotional changes are normal and expected for most women, significant mood changes occurring for moms past this two-week period are a sign that she likely needs additional mental health support. While postpartum depression is a term many people may be familiar with, there are many other types of mental health disorders new mothers face.

Perinatal mental health disorders can include:

  • Anxiety
  • Depression
  • Obsessive compulsive disorder
  • Post-traumatic stress disorder
  • And in rare cases, psychosis

Mothers who experience symptoms of these disorders may find themselves scared, uncertain, or even ashamed. Most mothers don’t expect complications like this during a time they thought they would be their happiest.

There are some risk factors for perinatal mental health disorders, including:

  • Personal or family history of mental illness
  • Economic stress
  • Having a baby who experienced a NICU stay
  • Experiencing an especially stressful or traumatic birth
  • Certain health diagnoses such as a thyroid issue or diabetes

A new mother’s best and most immediate source of help may be close friends and family members, who can recognize if she is struggling emotionally and assist her to get connected with professional support.

Luckily, the NOAH behavioral health team has mental health practitioners who are specially trained to work with new mothers (and fathers) who are struggling with mental health needs in this special time. If you or a parent you know needs care, please contact NOAH today.

Food Allergy Awareness Week

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 only way to prevent an allergic reaction to food is to avoid that food. Even a small amount can cause a reaction, but here are some tips. To get you started, check out our recipes with different ingredient options.

Asthma and Allergy Awareness Month

May is Asthma and Allergy Awareness Month. This time of year is one of the worst for most allergy and asthma sufferers – which is around 65 million Americans.

Asthma is the result of inflammation and narrowing of our airways. Symptoms of asthma attacks include difficulty breathing, chest pain, wheezing, and coughing. For some, symptoms are mild, while for others, it can seriously affect daily life.

Tips to prevent asthma attacks:  

  1. Know what triggers your asthma attacks is key. Keep a diary for several weeks to keep track of your symptoms and note the environments that triggered them. Asthma can also be triggered by emotional changes including stress and anxiety.
  2. Avoid smoke of any kind. Smoking has been linked to more severe symptoms and more frequent hospitalizations in asthmatics. Even secondhand smoke exposure can trigger symptoms, so avoid public places that allow smoking.
  3. Stay up to date on your vaccinations. Those with asthma are at greater risk to have complications from the flu or pneumonia and are more likely to be hospitalized from them. Age-appropriate and annual vaccinations (like the flu shot) as recommended by your doctor will protect you in many ways.
  4. Take asthma medications as prescribed. Long-term medications are meant to prevent symptoms, so take them even when you feel well. Always carry your medication with you to work, school, or when traveling. If you find yourself using short-term inhalers more often, your symptoms are not well-controlled, and you should talk to your doctor.
  5. Limit allergens at home. Dust can lead to inflammation and trigger an asthma attack, so changing bed linens and vacuuming often can be helpful. Using an air purifier can also help prevent buildup of dust mites.

Asthma is a chronic condition, and its symptoms can change over time. It is vital to get regular checkups, so if you are overdue, make an appointment today. While it can’t be cured, there are many medications to manage symptoms and help you breathe easy.

Understanding Colorectal Cancer

March is Colorectal Cancer Awareness Month

Around 150,000 Americans will be diagnosed with colorectal cancer in 2021. Colorectal cancer is the third most common cancer in the US for men and women combined. The more we understand this disease, the better chance of catching it early and beating it.

What is colorectal cancer?

Colorectal cancer is cancer in the colon, rectum, or both. It can be diagnosed as bowel cancer, rectal cancer, or colon cancer. A majority of this type of cancer first develops as abnormal growths inside the colon or rectum. These growths can become cancerous later if they aren’t removed.

Who gets it?

The American Cancer Society estimate that about 1 in 21 men and 1 in 23 women in the United States will develop colorectal cancer during their lifetime. People who get a form of this cancer are typically – but definitely not always – diagnosed between the ages of 63 and 72.

Black Americans are at a 20 percent greater risk of developing colon, bowel, or rectal cancer. The devastating reality is that Black Americans are 40 percent more likely to die from it as well.

What causes colorectal cancer?

There are many causes or risk factors. Some may be connected to other health conditions and diseases resulting from long-term health disparities in different communities. Some risk factors include:

  • Low-fiber, high-fat diet
  • Diabetes
  • Sedentary lifestyle
  • Intestinal conditions like colitis and Crohn’s disease
  • Family history of colon cancer
  • Obesity
  • Smoking or heavy alcohol use

How to recognize signs and symptoms?

There are several consistent signs that something may be wrong with a person’s bowel, colon, or rectum.

  • Regular or constant stomach discomfort including pain, gas, bloating, or cramps
  • Occasional or regular changes in bowel habits like constipation or diarrhea
  • Unexplained weight loss
  • Blood in stool

When to see a doctor?

Earlier is ALWAYS better. The sooner a problem is identified the better the outcome, and that’s the same whether it is abnormal growths in the colon, or if it has become cancer. These symptoms may indicate colorectal cancer, or it can indicate a number of other health conditions that need medical attention.

However, these cancers can develop with no symptoms at all. This is why screenings and regular check-ups with your medical provider are so important. If you have any concerns, talk to your healthcare provider.

If you need an appointment, call 480-882-4545 or request an appointment online.

Physical Activity for Every Age

By Daniel Smoots, MD Family Medicine 

Physical activity and exercise can seem like one more item to add to the to-do list, but there are good reasons why striving to get daily movement and exercise on to your family’s schedule is so important. There are many benefits to look forward to, from better physical and mental health, to quality family bonding time. Developing good exercise habits with your children provides an opportunity for encouragement and positive feedback which builds self-esteem and confidence, and helps motivate and maintain good habits as they grow. 

Why should we exercise?

  • Exercise is shown to improve physical health: controls weight, strengthens bones and muscles, gives you more energy, and leads to more restful sleep 
  • Activity and exercise are good for mental health: reduces anxiety, depression, and leads to higher self-esteem, and improved mood

How much exercise should a child get (CDC recommendations)? 

  • Children of different ages need different amounts of exercise, according to the CDC
  • 60 minutes of moderate-intensity activity each day (ex: fast walking, playing)
  • Vigorous-intensity activities 3 times a week (ex: running, playing fast-moving sport)
  • Muscle and bone strengthening activities 3 times a week (ex: climbing, push-ups, jumping)
  • Toddlers should engage in active play throughout the day 

How much exercise should an adult get?

  • 150 minutes (or 30 minutes 5 days a week) moderate-intensity aerobics each week 
  • Muscle and bone strengthening 2 times a week (resistance or weight training)

What are good ways to exercise together as a family?

  • Take a family walk, go to the park, hike, bike ride or rollerblade, play a game (ex: tag, hide and seek), try yoga, go swimming
  • Play sports. Soccer, basketball, tennis, racquetball can be played at varying levels depending on your family’s ages and skill levels

How to make exercise more engaging for children?

  • Make an activity chart to pick from or check off, spin a wheel to choose the activity, have them create and lead a new game, or build an obstacle course (add some competition for timing for who gets through the fastest)
  • Have them count the steps. Take the stairs, park further away in parking lots 
  • Have a dance party (helps get the “wiggles” out, and also a good aerobic activity when done for at least 10 minutes to upbeat music)

Make it a time that the family looks forward to by keeping it simple and fun, trying new things, and learning new skills. Find a way to get moving together as a family and feel and see the benefits!

March is Endometriosis Awareness Month

Test your knowledge

An estimated 11 percent, or nearly 7 million women in the U.S. have endometriosis.

That’s more than the number of women who suffer from asthma (9.8%), more than the number of women who suffer from heart disease (6.2%), and it is just slightly less than the number of women who will develop breast cancer during her lifetime (13%).

It effects a lot of women every day.

Endometriosis is a health condition that involves tissue that typically grows in the uterus or womb but begins to grow where it shouldn’t. When this happens, it can cause pain, digestive problems, and even infertility. It can happen to any female, but it is more common in women who are in their 30s and 40s.

Signs and symptoms

The pain women feel is the most common symptom of endometriosis. However, the pain is different for different women, including:

  • Pain in the lower back and pelvis that doesn’t go away
  • Painful menstrual cramps
  • Intense discomfort in the intestines or during bowel movements
  • Pain after or during sex

It is important to know that how intense or severe the pain is, doesn’t matter. People with mild pain could have a more advanced case of endometriosis. The pain can also increase over time.

Treatment and prevention

After a doctor does a full exam and diagnoses a patient with endometriosis, there are a few different types of treatment options to discuss.

Medication – Some medications will likely include hormones, usually a hormonal birth control pill or implant, as a starting point. Hormones aren’t a permanent solution but will typically provide some relief of the pain and reduce the additional growth of endometriosis.

Surgery – If medicine isn’t helping, your endometriosis is severe, or you can’t get pregnant, your doctor may suggest surgery. You will likely start hormone medication after the surgery if not trying to get pregnant.

Other treatments – Over the counter pain medicine like acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) can help with discomfort. Some women have relief with other things like acupuncture and herbal supplements, but there is no research or proof that these things provide consistent relief.

There is good news and bad news about preventing endometriosis. The bad news is you can’t prevent it. The good news is that there are a number of things you can do to decrease your odds of developing it. Because endometriosis is tissue that grows with increases of the hormone estrogen, the goal is to keep that level low with:

  • Regular exercise which helps reduce body fat, which then reduces estrogen.
  • Reducing or eliminating caffeine because it can increase estrogen levels.
  • Opting for a low-dose hormonal birth control pill, patch, or ring.
  • Reducing or eliminating alcohol because more than one drink per day can rise your estrogen levels.

Pregnancy and endometriosis

How endometriosis affects a woman’s ability to get pregnant isn’t fully known. But many women – as many as half – with fertility problems had endometriosis. The good news is that many women can still get pregnant! Each patient is different, and every patient’s doctor will recommend the best approach.

Having a medical home with consistent medical exams and conversations with a comprehensive medical team is the best approach. NOAH’s providers work with patients of all ages and health backgrounds. Learn more and make an appointment today.

Honoring Black History in Healthcare: Week 4 – Enslaved Women and Modern Gynecology

Throughout February, NOAH will share and honor Black History Month with snapshots of just a few of the important, impactful, and life-saving stories of Black history in healthcare in America. One of our primary goals at NOAH is ensure quality healthcare for every member of our community. To do that, we will look at where we have been, what we have accomplished, and how we will collectively achieve this goal.

Enslaved Women and Modern Gynecology

By By Jennifer Perry, MD, PGY-3

Dr. James Marion Sims has been named the “father of modern gynecology” for his contribution of tools, such as the speculum, and surgical techniques related to women’s health. He was named president of the American Medical Association in 1876 and president of the American Gynecological Society in 1880. However, Dr. Sims’ success has overshadowed the suffering of enslaved women that contributed to his work.

Seven women participated in Dr. Sims’ experimentation over a four-year period. Lucy, an 18-year-old who was unable to control her bladder after a traumatic birth, was his first subject. She had a vesicovaginal fistula, a connection between the bladder and uterus which wasn’t uncommon for women who endured traumatic deliveries in the 19th century. Dr. Sims placed naked Lucy on her knees and elbows with her head in her hands for the procedure while several male doctors watched. The entire surgery was conducted without anesthesia. As imagined, Lucy experienced extreme pain as Dr. Sims operated. A sponge was placed in Lucy’s bladder to drain the urine, which led to severe infection. Lucy almost lost her life, but this did not stop Dr. Sims from performing a similar procedure on six other enslaved women.

Enslaved women were considered property and did not need to give their consent for medical procedures. Dr. Sims performed more than 30 surgeries on one woman, Anarcha, without anesthesia. Despite reports of displayed agony, including screaming, it was believed that Black people did not experience pain like White people, so anesthesia was not utilized. However, once Dr. Sims perfected his technique, he performed surgery on White women under anesthesia.

Statues of Dr. Sims have been erected in Central Park and Philadelphia in dedication to his contribution to medicine. Those statues have sparked many protests because of the controversy of honoring a man who performed non-consensual medical experiments on Black women. The New York City statue was moved out of Central Park in 2018, and to Dr. Sims gravesite in Brooklyn, NY. In the same year, the monument in Philadelphia was removed and replaced by a plaque that educates the public of the origins of the monument and the Black females whose bodies were used for the advancement of medicine.

To learn more about the medical ethics involved with this story, read this article from the Journal of Medical Ethics.

Read our other Black History in Healthcare stories:

Week 1: The Innovations of Dr. Charles Richard Drew

Week 2: Understanding the Tuskegee Study

Week 3: The Lasting Impact of Henrietta Lacks