Schedule GI Procedures Before Health Insurance Deductible Resets

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You should never delay urgent medical procedures, but you could save money by scheduling elective and screening procedures after you have met your deductible.

Preventative Appointments and Colon Cancer Screenings

Have you ever considered waiting until the last quarter of the calendar year to schedule a colon cancer screening or GI procedure?  Annual well visits and screenings are usually covered at 100 percent under most insurance plans, but labs and diagnostic testing fees are often the patient’s responsibility. Waiting until you have met your deductible means that additional tests and labs may be covered, or at least, may be more affordable.

A colonoscopy is one procedure that can be less expensive if you have met your deductible. Under most private insurance plans and Medicare, colonoscopy screenings are covered at 100 percent for adults between ages 50 and 75. Because young-onset colon cancer incidence is steadily increasing, the American Cancer Society recommends screening colonoscopies starting at age 45. If you are under 50 and choose to have a screening colonoscopy, your cost-sharing responsibility could be much lower if you have met your deductible.

Diagnostic Colonoscopies

If you have a history of polyps or colon cancer, or you receive a positive result from another colon cancer screening test, your colonoscopy likely will be considered diagnostic. It can make financial sense to schedule a diagnostic colonoscopy after meeting your deductible.

The amount that you will pay for the colonoscopy will depend on whether you have met your deductible or not. If you schedule the procedure at the end of the year when you have already met your deductible, you may not be responsible for any out-of-pocket costs. However, if you wait until January, when your deductible resets to zero, you could be subject to a physician fee, facility fee and laboratory diagnostic fee.

Elective GI Procedures

You could also save money by scheduling other GI procedures at the end of the calendar year. Diagnostic testing and treatments for certain digestive conditions are not considered urgent and can be scheduled at a time that is most convenient for the patient. If your GI doctor has suggested a test, lab or procedure to improve your digestive health, it is most cost-efficient to schedule the appointment when you are close to meeting your deductible. Do not delay too long, though. With the approaching holidays, appointment availability will rapidly diminish, so look over your calendar and call soon.  

Elective GI Procedures to Schedule Before September Include:

Before you schedule your GI procedure, call your insurance provider. Request a cost estimate for the procedure and ask how close you are to meeting your deductible. Having all the facts can help you plan effectively and can stretch your healthcare spending dollars. 

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Prevent Eye Disease by Exercising with Family Regularly

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Exercising is a great way to spend time together as a family and to maintain healthy vision.

When is the last time you played basketball, frisbee or flashlight tag with your family? How about the last time you went on a family hike or bike ride? Physical activity is essential for men, women and children of all ages. It helps with weight management, mental alertness and disease prevention. According to the American Academy of Ophthalmology, many eye diseases can be delayed or even prevented by exercising regularly.

Protect Your Vision with Regular Exercise

Physical activity benefits the entire body – and especially the eyes. Studies show that being active for only 30 minutes a day reduces the risk for chronic conditions like hypertension, high blood sugar, obesity and high cholesterol. These diseases are known as metabolic syndrome, and they can be precursors to heart disease, stroke and diabetes. As for visual health, many eye diseases like glaucoma, diabetic retinopathy and age-related macular degeneration are linked with metabolic syndrome, and fortunately, exercise can help limit their effects.

Model Healthy Habits for Kids

Cardiovascular fitness, like healthy eating, is a life skill that must be learned. It’s not enough to simply tell children to be healthy. Parents need to form their own positive, diet and exercise habits and then model those behaviors for their children.

Len Saunders, acclaimed author on family fitness, says, “…children are watching their parents’ every move, mirroring their every action; if a parent is sedentary, there is a good chance their children will be too. However, parents who eat healthily and exercise with their children on a regular basis are teaching them many valuable lessons” (PBS).

Make Exercise FUN for the Family

If you’re just getting started with family exercise, keep it simple! Walking, swimming, hiking, playing tennis and doing yard work are just some of the activities the whole family can enjoy. Exercising together can be much more fun and can make “working out” go by faster. Try putting the kids in charge of accountability for your family’s commitment to fitness. That way, they won’t let you skip out on a workout!

Here are some ways to blend fitness and fun:

1. Take a family walk each night after dinner.

2. Swim at your local pool or community center on the weekends.

3. Participate in a couch-to-5k race and train together. Invite extended family and friends to join you and create a team t-shirt.

4. Locate a yoga studio in your area and take a weekly class together.

5. Create a backyard boot camp. Use a free app like Sworkit to set up a cardio circuit.

Keep Safe During Exercise

Before you implement your exercise plan, contact your family physician or eye doctor to make sure that your workout plan is appropriate for your family’s level of fitness. You can always increase the duration and intensity of your workout, so begin slowly and be patient. So, get out there, get moving and have FUN!

If You’re Pregnant, Decide on Newborn Circumcision Now

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When boys are born, they have a covering on the end of their penis, called the glans or foreskin. Circumcision is an elective (optional) procedure to remove this foreskin. It can be performed by an obstetrician-gynecologist (ob-gyn), is ideally done within the first two days after the baby is born and is brief, usually taking just a few minutes.

Deciding whether or not to circumcise an infant is very important and parents should ask questions or discuss concerns with their doctor while a woman is still pregnant—not after the baby is born. It’s important to discuss both the potential benefits of circumcision as well as the possible problems that could develop as a result of the procedure, even though it is considered low risk.

Pros and Cons of Circumcision

Although circumcision is not necessary, the medical reasons why a parent might decide on circumcision is because it helps reduce risks for:

  • Infection
  • Penile cancer
  • Phimosis (a condition where the foreskin cannot contract)
  • Sexually transmitted infections or diseases
  • Urinary tract infections

In contrast, some parents choose not to circumcise their infant boy. Some of the medical reasons include possible bleeding or infection, the possibility of cutting the foreskin incorrectly or concerns about improper healing or urinary issues developing.

Concerns About Baby Circumcision Pain

Another concern many parents have is about the pain a baby experiences during the procedure. In past decades, pain medication was not typically used during circumcision. However, today it is used more often and recommended by many experts, including the American Academy of Pediatrics (AAP).

Local anesthesia can be used by a doctor or an ob-gyn to reduce the baby’s discomfort, usually administered by an injection or as a cream. Parents choosing to circumcise their baby should make sure to discuss pain relief with their doctor prior to the procedure, and if they would like to be with their baby during the procedure, they should also discuss that with the doctor.

About the Circumcision Procedure

To perform circumcision, a doctor will follow the steps below:

  • Administer anesthesia, if it is being used. Creams can take up to an hour to be effective, and if the baby urinates, it can come off. Injections take about 5 minutes to become effective and are considered better at relieving pain.
  • The ob-gyn will clean the area.
  • A tool called a probe is used, separating the foreskin from the penis.
  • A clamp is attached to the penis, and the foreskin is removed using a scalpel. (Note that sometimes devices other than a clamp may be used.) There is little bleeding and stitches are not needed.
  • A dressing or plastic ring is placed on the cut to prevent it from rubbing against the baby’s diaper and irritating it, and gauze is wrapped around the penis.
  • It usually takes 7-10 days for the penis to heal. Parents should follow all care instructions provided by the doctor.

When to Perform Circumcisions

Finally, keep this in mind: when a boy is older, it may be possible to circumcise him, but the older he gets the greater the risk. A 2014 study in the Journal of the American Medical Association reported the follow results:

  • Boys Under 12 Months: 0.4 percent experienced circumcision complications
  • Boys 12 Months to Nine Years: Risks increased 20-fold for boys in this age group who were circumcised, compared to infants
  • Boys 10 and Older: Experienced a 10-fold higher risk after circumcision, compared with infants

The lesson? If parents decide to circumcise their son, the best decision is always to do it as early as possible.

To learn more about what the American Academy of Pediatrics has to say about infant circumcision, click here.

GERD and Sleep Apnea: Which Causes the Other?

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Sleep apnea and gastroesophageal reflux disease (GERD) are two conditions that appear unrelated. However, research shows a correlation between the two.

What Are Sleep Apnea and GERD?

Sleep apnea is a disorder that causes people to stop breathing during sleep. Obstructive sleep apnea (OSA), the most common type of apnea, occurs when the airway is blocked by soft tissue at the back of the throat. Many people who experience sleep apnea are unaware that their sleep cycle is interrupted throughout the night because they do not awaken completely. They usually complain of daytime sleepiness, headaches, forgetfulness and dry mouth.

About 60 percent of people with sleep apnea have chronic acid reflux, also known as gastroesophageal reflux disease (GERD). Acid reflux occurs when the lower esophageal sphincter remains open and gastric acid backflows into the esophagus. Common symptoms of GERD include heartburn, chest pain, a sour taste in the mouth and bad breath. However, it is possible to have GERD and not experience symptoms at all.

GERD Treatment Helps Remedy Sleep Apnea

Although researchers do not fully understand the relationship between sleep apnea and GERD, studies show that sleep disturbances may induce GERD and that untreated acid reflux impairs sleep. One study followed 48 adults who experienced GERD over three times per week. The men and women who had the most severe GERD symptoms also reported the worst sleep problems.  

The good news is that treating either sleep apnea or acid reflux appears to improve both conditions. Because sleep apnea and GERD are challenging to diagnose, they can go undetected for years. It is essential to be aware of the symptoms of each condition so you can receive prompt diagnosis and treatment.

Schedule an Appointment with a GI Specialist

If you have acid reflux on a regular basis and do not sleep well, make an appointment with a gastroenterologist to be evaluated for GERD. An upper endoscopy can detect inflammation or tissue damage to your esophagus, and you can begin treatment immediately. Talk to your gastroenterologist about your sleep problems as well. You may need to be referred to a sleep specialist or pulmonologist. 

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How to Spot Signs of Vision Problems in Children

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Vision problems in children are not always obvious, but yearly comprehensive eye exams identify eye issues early before they affect school performance.

Poor Vision and Schoolwork

Clear vision is essential for students to learn effectively. According to the American Optometric Association, one out of four kids in the United States has an undetected vision problem.  This means that up to twenty-five percent of students are at a disadvantage when teachers use visual aids like whiteboards and screens.

Studies show that when children cannot see clearly, their academic performance suffers. Visually compromised kids have trouble concentrating, and they may avoid participating in class. They often fall behind in their classwork and homework, which affects their test scores and quarter grades. It is easy to see how vision problems can be misdiagnosed as attention disorders, learning disabilities or behavioral issues.

Symptoms and Signs of Vision Problems in Children

Many young children with poor eyesight are unaware that their vision is not healthy. A parent or a teacher is usually the first person to associate a possible vision problem with the change in behavior or school performance.

Here are a few warning signs that your child may need to see an eye doctor:

1. Excessively rubbing the eyes

2. Sitting too close to screens

3. Complaining of headaches

4. Inattention and distractibility

5. Squinting or tilting the head

6. Closing one eye to see more clearly

7. Sensitivity to light

8. Holding a book too close

9. Avoiding participation in sports, outdoor games or group activities

10. Getting lower grades in school

Schedule an Eye Exam with an Ophthalmologist

Give your child the best possible start by scheduling an appointment for a comprehensive eye exam. At the appointment, an eye doctor will screen your child for refractive errors like nearsightedness, farsightedness and astigmatism as well as many eye diseases. Getting prompt vision correction will help your child to feel confident and successful this school year. 

Herniated Disc: Symptoms, Treatment and Surgery Options

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If a disc in the spine herniates, a doctor may recommend herniated disc surgery. Understanding more about what happens when discs herniate, as well as the treatment options available, can help you know if surgery might be right for you or a family member — now or in the future.

When a Disc Herniates

Spinal discs are spongy cushions located between the vertebrae. If discs become worn or injured, the bones of the vertebra can rub together leading to pain and other problems.

Discs can also become herniated (pressed out from between the bones). Sometimes, herniated discs can rupture. When a disc ruptures in this way, it may pinch nerves, leading to pain, weakness and numbness. A herniated disc is also referred to as a “slipped,” “ruptured” or “prolapsed” disc.

Symptoms of a Herniated Disc

If symptoms don’t improve after a few months, a doctor or surgeon may recommend a type of herniated disc surgery. The goal of herniated disc surgery is to take pressure off of the nerves that are being irritated by the damaged disc.

If you or someone you care about is struggling with one or some of the following issues, herniated disc surgery could be the best option:

  • Difficulty standing or walking
  • Difficulty sleeping due to spine pain
  • Inability to perform daily activities
  • Pain, in addition to numbness or weakness
  • Issues with incontinence (bowel and bladder control)

Treatment for Disc Herniation

Every patient with a herniated disc has unique circumstances and challenges related to the disc. For instance, some ruptures may happen to the lumber (lower) discs and may be severe. Other ruptures may occur farther up the spine and may be mild.

Fortunately, there are several different surgeries doctors can use to treat herniated discs.

Discectomy

During this procedure, the herniated disc is removed. Depending on the patient, the surgeon may be able to use a minimally invasive procedure called microdiscectomy. This surgical option involves smaller incisions than traditional surgery, and the surgeon may remove all or just part of the damaged material. The traditional surgery, called open discectomy, is also an option.

Lumbar Laminotomy

Lamina is a term used to describe bone tissue that protects the spinal cord. Sometimes it needs to be removed so the surgeon can access and treat a herniated disc. When only part of the lamina is removed, it is called a laminotomy. When all or most of it is removed, the procedure is called a laminectomy.

Depending on the patient, there may need to be two separate procedures: one to address the lamina and another to remove the herniated disc.

Spinal Fusion

Another surgery option is a spinal fusion. This procedure happens after a discectomy or laminotomy. During spinal fusion, the surgeon fuses the two vertebrae on either side of the disc, so they heal into a single bone. A fusion is used to stabilize the bones and reduce or eliminate pain.

Artificial Disc Replacement

As an alternative to spinal fusion, sometimes a damaged disc can be replaced with an artificial one. However, this surgery can only be used on the lumbar vertebrae (the discs at the bottom of the spine).

After Herniated Disc Surgery

Herniated disc surgery can relieve pain, weakness and numbness. However, as with any surgery, patients need to practice proper self-care during recovery and rehabilitation. This means consistently following doctors’ instructions, taking proper doses of medications, walking when instructed, attending physical therapy and performing prescribed exercises.

Do I Have Gastroparesis or GERD?

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Gastrointestinal distress can be painful, embarrassing and disruptive. Fortunately, most GI conditions can be alleviated with the help of a gastroenterologist. Two GI disorders that can have similar symptoms are gastroparesis and gastroesophageal reflux disease (GERD). Here are some similarities and differences between the two disorders.

Gastroparesis

One common type of GI distress is gastroparesis, a form of digestive tract paralysis. Although few people have heard of gastroparesis, it affects one out of 25 Americans. This chronic condition is characterized by slow, irregular stomach contractions that interrupt or prevent normal digestion.

When digested food material does not pass into the small intestines within a normal timeframe due to gastroparesis, pain and abdominal bloating can result. Other symptoms of gastroparesis include heartburn, cramping, nausea and a persistent feeling of fullness. Because the condition is relatively unknown, gastroparesis can be mistaken for other types of GI disorders like GERD.

Similarities Between Gastroparesis and GERD

Many symptoms of gastroparesis mirror symptoms of GERD. Both disorders may be accompanied by abdominal pain, indigestion and a sensation of fullness, so they are easily confused for one another. It is equally important to receive prompt treatment for each of these disorders, as undiagnosed GERD can lead to Barrett’s esophagus and untreated gastroparesis can result in malnutrition and weight loss.

Differences Between Gastroparesis and GERD

GERD is chronic acid reflux caused by a weakness in the lower esophageal sphincter (LES), the valve the separates the esophagus and the stomach. Gastroparesis, in contrast, often develops after an injury to the vagus nerve, which is responsible for stimulating contractions in the stomach and intestines.

Unlike gastroparesis that develops due to stimulus interruption, GERD flare-ups often are determined by diet. Eating spicy, greasy, creamy or acidic foods or drinking caffeinated beverages, soda or alcohol can aggravate reflux. Lifestyle choices like overeating, wearing tight clothing or lying down after meals can also exacerbate the condition.

Patients with GERD usually experience upper GI pain because stomach acid leaks into the esophagus and causes inflammation. On the other hand, those with gastroparesis tend to have lower GI distress due to food moving slowly through the digestive tract.

Call a Gastroenterologist

Gastroparesis and GERD can cause long-term health problems if you are not under a doctor’s care. If you are experiencing gastric pain or GI distress, make an appointment with a board-certified gastroenterologist for a full exam and consultation.

And remember, August is Digestive Tract Paralysis Awareness Month, so take a moment to inform your friends and family about the condition and encourage them to prioritize their digestive wellness!

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High-Fat Diet Could Prevent Glaucoma Development

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A high-fat, low-carbohydrate diet may help prevent retinal degeneration that leads to glaucoma.

A recent study published in the Journal of Neuroscience found that a ketogenic diet prevented damage to the retinal ganglion cells in mice that were on the cusp of developing glaucoma. Retinal ganglion cells are neurons located on the inner surface of the eye. These cells are the main component of the optic nerve, which transmits visual information to the brain. In people who have glaucoma, spikes in eye pressure can cause the optic nerve to degenerate resulting in permanent vision loss.

A research team at Northeast Ohio Medical University fed a group of mice a ketogenic diet comprised of 90 percent fat for eight weeks. At the conclusion of the testing period, the mice had high antioxidant levels and less degeneration of retinal ganglion cells.

This study is not the first time researchers have tested the effects of a high-fat diet on degenerative nerve diseases. Doctors have used ketogenic diets since the early twentieth century to treat epilepsy in children. Limiting carbohydrate intake has been linked to improvements in many other conditions like Alzheimer’s disease, sleep disorders, autism, Parkinson’s disease and even brain cancer. 

According to the Glaucoma Research Foundation, over 3 million Americans have glaucoma, but half are unaware because there are generally no early symptoms. When symptoms develop, it often means that permanent vision loss has already occurred.

The most effective way to prevent glaucoma damage is to schedule annual comprehensive eye exams with an ophthalmologist. A complete eye exam includes screening for glaucoma, cataracts, macular degeneration and many other degenerative conditions. 

Signs You Need a Hip Replacement

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Hip replacement is a procedure that can lead to greater freedom, reduced or eliminated pain and a better quality of life. While it can be life-changing for many, such as people with osteoarthritis, knowing exactly when the time is right can be challenging.

Assess the Hip Issue

The first step is to assess the hip problem. Pay attention to your symptoms and record details, so you can be well-informed and discuss the information with your doctor. Here are some questions to ask yourself:

  • Are you unable to perform certain daily tasks, like walking up stairs or getting out of a chair because of stiffness, swelling or hip pain?
  • Is it hard to get to sleep, or do you wake up frequently due to hip pain?
  • Do you avoid walking, shopping or staying active because you want to stay off your hip?
  • Have you tried other treatments, like medications or physical therapy, but still have ongoing pain?

If some or all of these issues are affecting your life, hip replacement could be a good option for you — but there are still more things you should consider.

Other Factors that Contribute to Timing of Hip Replacement Surgery

When considering hip replacement, step back and look at the big picture. In addition to thinking about your pain level and stiffness, also consider:

Age

  • If you are younger: Hip replacement may allow you to continue your favorite sports or activities, or even try new ones. However, younger patients will likely need to have a second hip replacement in the future (known as revision surgery), since artificial hip joints typically have a lifespan of approximately 20 years.
  • If you are older: After the procedure, you should have greater freedom, ability and independence. However, it can take many months (up to a year) to recover and rehabilitate after the procedure.

Physical Health

  • Bone density: Osteoporosis or osteoarthritis causes the bones to weaken. This might mean it is not the right time for hip replacement, depending on your specific condition. Consult with your doctor to determine what is best for you.
  • Overall health: If you have another health issue or any unhealthy lifestyle habits, it might not be the right time for hip replacement. However, if you change your habits, it could become a possibility. For instance, if you stop smoking or lose weight, your overall health could improve, which could make the near future a good time for hip replacement surgery.

Tend to Your Emotional Health

When thinking about surgery for yourself, it’s normal to have questions and concerns. But if you are very anxious when you think about hip replacement, it may not be the right time for you. Here are some tips on how to manage or reduce anxiety:

  • Ask your doctor about strategies other patients have used to manage their anxiety regarding hip replacement.
  • Avoid random Internet searches about the procedure, which often provide incorrect or biased information. For more information, ask your doctor to recommend trusted medical websites.
  • Visit another doctor for a second opinion.
  • Talk to a mental health counselor about your anxiety.

The Bottom Line

Remember that hip pain can occasionally flare-up, then improve. You should only consider a hip replacement if you are experiencing chronic pain that is significantly impacting your life and other non-surgical treatments have not brought you any relief.