@drportnay

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Tuesday, January 25, 2011

Getting Aerobic

Why get Aerobic exercise: Aerobic exercise makes your muscles - including your heart muscle - stronger. It can also help you manage other heart disease risk factors such as:
  • high blood pressure
  • smoking 
  • excess weight
  • stress
What is Aerobic exercise: Any exercise that-- 
  • is rhythmic and steady
  • you can do without stopping
  • uses large muscle groups
  • raise your heart rate
How should you do it:
  • Warm up (5 minutes)
    • slowly raise your heart rate with mild exercise
    • do slow, gentle stretching exercises
  • Aerobic exercise (20 minutes)
    • raise heart rate with more intensive exercise
    • any activity will do
    • do not exercise for long periods of time at a level where you cannot carry on a complete sentence
  • Cool Down (5 minutes)
    • slowly lower your heart rate
    • stretch

Saturday, January 8, 2011

If Drug Copays Have You Down, Check For A Coupon

I found the following story on the NPR iPhone App:
http://www.npr.org/blogs/health/2011/01/07/132740446/if-drug-copays-have-you-down-check-for-a-coupon?sc=17&f=1128

If Drug Copays Have You Down, Check For A Coupon
by Scott Hensley

- January 7, 2011

A few months back I went to the doctor to make sure some ribs I broke while biking were healing OK. And, like a lot of patients, I dropped the old line, "Oh, and there's one more thing I need to ask you about," just as we were wrapping up.

It was new doctors, and I needed a prescription for a daily brand-name medicine I've taken for years.

Well, the doctor not only wrote the prescription, she also gave me a card supplied by the drugmaker to help defray the copay. That last bit I wasn't expecting. But maybe I should have been.

There are coupons or subsidy cards to reduce copays for about half of the top 100 brand-name drugs sold in this country, according to a recent report from health analyst Richard Evans at Sector & Sovereign Research.

Some of the drugs with deals include cholesterol-fighter Lipitor and the heartburn pill Nexium and Aciphex, according to Evans' report.

By offering the help, drugmakers are able to neutralize, to some extent, steeper copays your insurance plan may have put in place to steer you to a preferred drug. That's often a generic or a brand-name medicine the plan gets at good price. The assistance is limited to people with private insurance.

A Kaiser Family Foundation survey of employer health plans last year found that the average copay for the first tier of drugs, usually generics was $11. From there, they went up to $28 in the second tier, $49 in the third tier (more details here). Copays in the lower tiers have gone up a lot in the past few years, too.

Even small differences in copays can have a big influence on people's choice of medicines. That's why insurers and employers have used them to encourage use of medicines that may cost them less.

There's been a lot of criticism of the cards for circumventing that system, as  the Wall Street Journal and NPR's Planet Money reported in 2009. Makers of brand-name drugs have said doctors and patients should make a choice of prescription drugs without being swayed by the costs.

Still, when it comes to the costliest drugs, the direct subsidies for patients bely big financial hits to employers and insurers. A winning strategy for drugmakers is "to price their drug as high as they possibly can and offer that copay assistance broadly" to protect patients, biotech analyst Joshua Schimmer told the New York Times earlier this week.

For me, I've tried a popular generic rival to the regular medicine I take, but it didn't work as well. I'd cough up the full copay, as I have in the past, for the usual medicine. But when i filled the new prescription and used the card I saved about $6, which I'll probably blow on a couple of fancy coffees. [Copyright 2011 National Public Radio]

To learn more about the NPR iPhone app, go to http://iphone.npr.org/recommendnprnews




Tuesday, January 4, 2011

Food, Inc.

movie_poster-large.jpg


I watched the movie Food, Inc. recently. It is a terrific account of the current state of the food industry here in the United States. The movie documents the highly mechanized food industry which is now controlled by just a handful of corporations. The films argues that these few corporations are mostly unregulated. It also argues that these corporations are greatly contributing to our growing obesity epidemic and exposing our population to food born illnesses.

The movie features interviews by experts Eric Schlosser and Michael Pollan. I would definitely recommend Pollan's Omnivore's Dilemma - its a terrific read. 

After watching the movie, I visited the
official movie's website.

The website goes on to list educational information on important issues as well as lists 10 simple things you can do to change our food system.


I am very proud of our current government. In the past few weeks, 3 extremely important pieces of legislature has been or will be passed.

  1. Meat, poultry to have nutrition labels by 2012
  2. President to Sign Landmark Child Nutrition Bill
  3. Obama to Sign Bill to Improve U.S. Food Safety
This is amazing. We now have:
  • new legislation that gives the U.S. Food and Drug Administration unprecedented powers to keep the nation's food supply safe
  • a bill which sets nutritional standards for all food sold in schools, and mandates an increase in the meal reimbursement rate for the first time in over three decades and also expands enrollment of already-qualified students in federal meal programs, provides funding for farm-to-school programs, and expands access to breakfast programs.
  • labels will be mandatory on 40 popular cuts of meat and poultry products beginning in 2012, a measure that will make it easier for consumers to understand the content of the foods they buy
All three of these issues were specifically discussed in the movie.

This is terrific news for all Americans and will hopefully lead to a healthier and better informed consumer. 


Kidney Stones

I recently wrote an email to a friend who has been suffering from kidney stones. In it, I summarized what I knew about what to eat to try to avoid them. I thought it might be good to share it with my online followers. Here it is...

"Dear XXXX,

Debbie told me that you've been trying to eat healthy -- keeping in
mind your kidney stone.

Here's what I know about the healthiest way to eat for patients who have suffered a kidney stone.

We know that most stones contain calcium oxalate. Contrary to
conventional wisdom, a diet high in calcium is actually helpful. The
dietary calcium binds oxalate and then it is excreted when you poop. This helps reduce the binding of calcium and oxalate in the blood which in turn is filtered by the kidneys where/when stones are then formed.

Studies have shown that the Mediterranean diet is the healthiest way to eat for kidney stone formers (also the heart healthiest diet). This
diet consists of high intake of fruits and veggies, nuts and legumes, and low fat dairy and whole grains. The key to this diet is also low intake of sweetened beverages and red and processed meats. A high fat diet (meat and/or dairy) is the worst way to eat.

I hope this helps"