Posts tagged with Neucare

Free-Hut-Hut! Free Kids Sports Physicals.

Free, Hut, Hut! Get your kiddo(s) a FREE sports physicals Saturday, July 27th.

Free, Hut, Hut! Get your kiddo(s) a FREE sports physicals Saturday, July 27th. by Ryan Neuhofel

NeuCare Family Medicine is conducting FREE sports physicals for children ages 10-19 years.

.............................................................................................

W. Ryan Neuhofel, DO, MPH, "Dr. Neu", is the physician and owner of NeuCare Family Medicine in Lawrence, KS; a Direct Primary Care medical practice. He is a board-certified Family Physician.

For more information about NeuCare, visit NeuCare.net or Facebook or Twitter.

Information contained here is intended for general health education only. All personal health and medical issues should be managed by a health professional.

NeuCare Family Medicine is a paid sponsor and advertisor of Wellcommons.com and Lawrencemarketplace.com

Reply

Flu-mageddon is upon us. What to do?

Google Flu Trends: United States, As of Jan 11, 2013.

Google Flu Trends: United States, As of Jan 11, 2013. by Ryan Neuhofel

If you've been hiding under a rock for the past week, you may have missed that influenza season is in full effect. We had historically low flu seasons the past 2 years, so this flu epidemic is undoubtedly worse than in recent years. More cases and possibly more severe illness are being reported coast to coast. According to Google trends, Kansas is just now in the midst of it's "spike". It has not yet peaked, but many experts are predicting the worst season in the past decade. In any case the flu is going to be with us well into February.

Is it time to panic? No, but you do need to take some common sense precautions when dealing with the flu.

How can I prevent the flu? Is it too late for the vaccine?

  • If you haven't done so already, get your vaccine NOW. It takes 1-2 weeks for the vaccine to take effect, so if there is any chance it will be helpful it needs to be done yesterday - or preferably October! As I wrote previously, the flu vaccine is not 100% effective but it's safe and the best thing available to lower your risk or severity of illness. Preliminary data shows this year's flu vaccine to be a 99% match for Type A (which account for 80% of the circulating strains), but only 67% for Type B (20% of circulating strains).
  • Your mom was right. Washing your hands frequently and thoroughly can help prevent the spread of germs, including the flu. Alcohol-based hand sanitizer works fine and is convenient, but soap and water may be even better.
  • If a family member has the flu should I start Tamiflu? It depends! See below.
  • Staying at home when reasonable (see below for who should see a doc) will lessen the chances you infect others.

If I get sick should I see the doctor? or the ER?

  • Most people whom get flu-like symptoms do NOT need to rush to the doctor. Otherwise healthy, young to middle age people will typically fight off the flu virus without complication or the need for prescription medications.
  • Several high high risk groups that are more susceptible to severe illness with the flu are the very young (less than age 2), older people (age 60+) and those with chronic diseases (especially lung diseases, low immune states, uncontrolled diabetes.).
  • Although any case of the flu is miserable, "severe" worrisome symptoms would include shortness of breath, wheezing, fever lasting longer than 3 days, not tolerating any liquids by mouth for 24+ hours or passing out.
  • If you do decide to see a doctor most patients can be handled in a primary care physician's office, but more severe cases may require an ER visit or hospitalization.

Do I need to take anti-viral medications (ie. Tamiflu)?

  • FOR TREATMENT: The effectiveness of anti-viral medication in treatment of influenza is a controversial issue. At best it decreases the duration of symptoms by 1-2 days. Also, it must be started within the first 24-48 hours of symptoms to have any measurable effect. I think it’s a reasonable medication to try, but I only strongly recommend it to those at high-risk.
  • FOR PREVENTION: If you have close contact with known, proven influenza, the Rx treatment for flu can also be used to lower risk of transmission (in theory at least). Not everyone whom is exposed needs preventive Tamiflu, but it should be considered in high risk groups.

W. Ryan Neuhofel, DO, MPH is the physician and owner of NeuCare Family Medicine; a Direct Primary Care medical practice. He is a board-certified Family Physician (American Board of Family Medicine) and Fellow-candidate in Wilderness Medicine.

For more information about NeuCare, visit their website or Facebook or Twitter.

Information contained here is intended for general health education only. All personal health and medical issues should be managed by a health professional.

NeuCare Family Medicine is a paid sponsor and advertisor of Wellcommons.com and Lawrencemarketplace.com

Reply 4 comments from Ryan Neuhofel Boston_corbett

Are New Year’s resolutions worthless?

New Year's resolutions. Worthwhile or plain silly?

New Year's resolutions. Worthwhile or plain silly? by Ryan Neuhofel

New Year's Day usually brings a sense of optimism about “doing better” in the next year. Nearly half of Americans make a self-commitment to some type of lifestyle change once the calendar page is turned; despite everyone knowing that a majority of New Year’s goals fall short in the long run. So why do people perpetually make them year after year? Are they any more likely to succeed than resolutions at other times of year? A Canadian family physician, Dr. Mike Evans, made a great video discussing the statistics behind this issue.

Consistently, the #1 New Year’s resolution is “weight loss” and about half of resolutions are health related. I often get asked advice about how to achieve these goals. From my experience, the commonality among most successful lifestyle changes (at New Years or otherwise) is preparation and planning. Aiming to “lose 30 pounds” in 2013 is admirable, but not something that can typically be ‘willed’ to happen just after the shiny ball drops.

When I inquire about how people plan to achieve their New Year’s weight loss goal, I often hear ill-defined plans such as “less junk food”, “more salads” or “more runs.” While these efforts are well-intended, they are vague moving targets that don’t often produce consistent behavioral change or long term results.

Your chances of success are much better with the initiation of very specific, well defined and preferably trackable activities. Small, frequent actions such as “drinking a large glass of water before every meal” or “walking 2 flights of stairs 5 times every day at work” are not feats worthy of a Facebook post. But they are examples of habits that lead to successful New Year’s resolutions - and there is no better time to start than tomorrow.

Wishing you a happy & healthier New Year!

Dr. Neu


“Dr. Neu” is the physician and owner of NeuCare Family Medicine; a Direct Primary Care practice. He is a board-certified Family Physician (American Board of Family Medicine) and Fellow-candidate in Wilderness Medicine.

For more information about NeuCare, visit their website or Facebook or Twitter.

NeuCare Family Medicine is a paid sponsor and advertisor of Wellcommons.com and Lawrencemarketplace.com

Reply 2 comments from Carolyn Crawford Marilyn Hull

Procrastinators $10 Flu Shot Holiday Party

Early indications are that we are set to have an unusually early (and possible severe) flu season. Kansas has not yet seen widespread cases reported but the eastern US is already seeing a spike. If you have not yet received your flu shot, it needs to be done as soon as possible - as it takes about 2 weeks to provide protection. However, it's not too late and sometimes good things come to those who wait - like $10 flu shots!

Get a $10 flu shot IF you wear an ugly Christmas sweater AND bring a donation for Just Food.

Get a $10 flu shot IF you wear an ugly Christmas sweater AND bring a donation for Just Food. by Ryan Neuhofel

If you'd still like to get your flu shot and enjoy some hot cocoa and old-fashioned Holiday jingles, please join us this Saturday morning. The fee is $10 cash IF you wear an ugly Christmas sweater AND bring a donation for Just Food (details below).

  • Saturday, Dec 15, 9a - noon
  • NeuCare Family Medicine in Medical Arts Building at 346 Maine St. (across from LMH)
  • Public welcome. Ages 3 years & up. Not required to be a NeuCare member. No insurance required.
  • RSVP appreciated (info@neucare.net), but not required

Fee (details)

  • Grinch = $20 each

  • $5 discount for wearing an appreciably ugly Christmas sweater (Dr. Neu to judge)

  • $5 discount for donating 3 canned items or $5 cash to Just Food

  • Cash only. Supplies limited.

  • Please print and complete a CONSENT FORM prior to arrival. Forms will be available on-site as well.


W. Ryan Neuhofel, DO, MPH (Dr. Neu) is the physician and owner of NeuCare Family Medicine. He is a board-certified Family Physician (American Board of Family Medicine) and Fellow-candidate in Wilderness Medicine.

For more information about NeuCare, visit them online or Facebook.

Information contained here is intended for general health education only. All personal health and medical issues should be managed by a health professional.

NeuCare Family Medicine is a paid sponsor and advertisor of Wellcommons.com and Lawrencemarketplace.com

Reply 3 comments from Riverdrifter Ryan Neuhofel Karrey Britt

The flu shot doesn’t always work but you should still get it

As flu season arrives (it’s officially here now) I am urging procrastinators to get vaccinated ASAP. People often cite negative personal experiences with the flu shot as a reason for declining my recommendation. The most common concerns I hear about the flu shot are “it gave me the flu” or “doesn't work for me.” Is that possible? And why does it not work sometimes?

Influenza A Virus.

Influenza A Virus. by Ryan Neuhofel

Let’s tackle the first issue because it’s a much simpler topic. Is it possible for the shot to give you the flu? The short answer is ‘no.' Flu vaccines are either “dead” or “inactive” viruses so they cannot replicate, infect or spread through the body. However, stories of people getting sick (including actual influenza) after getting the flu vaccine are not crazy talk. So what’s the deal? There are several plausible explanations for getting “sick” despite getting a flu shot. (in no particular order)

1) Strong immune response following vaccine. The flu vaccine does cause a low-grade immune response by design. That’s how all immunizations work. The degree of the response can vary from mild to more severe. A more severe immune (inflammatory) response can give flu-like symptoms, including fatigue, low-grade fevers and body aches last for several days (48-72 hours) following your shot.

2) Poor immune response. Some people whom get the flu shot do not gain “immunity” because of a variety of factors. This issue is most common in the very young or old, so guidelines now recommend giving young children 2 doses for their first time and possibly “high dose” vaccines to the elderly. In fact there is still plenty of legitimate debate about the vaccines effectiveness in these high-risk populations (ironically the ones whom will most benefit from the vaccine).

3) Immunity lag time. Your immune system will require approximately 2 weeks to fully gain immunity from the vaccine. So, the vaccine is not immediately protective. During that lag time, it is very possible to get infected with a live flu virus.

4) Not 100% flu strain coverage. This is probably the biggest “downfall” I hear from well-read patients, but it’s a complex and evolving issue. There are 2 main subtypes of flu but dozens of strains circle the globe each year and are constantly mutating in to new forms. Each year’s North American vaccine is based on a carefully planned study of which flu viruses are most likely to be common here based on international trends. This process has markedly improved over the years and the 2010-2011 vaccine was a 94-99% match for the strains that eventually became common in the U.S.

5) Not 100% preventive against infection. Even if you have full immunity to the circulating viruses, you can still become infected with those viruses. In theory, your immune response will be much quicker and stronger (lessening the severity and length of the flu), but you may still become sick.

6) Other viral illness. A whole host of other viruses exist that can cause flu-like illness. The flu shot does not protect against these “common cold” viruses (adeno, rhino, etc.). They are less severe than influenza, but can make you feel pretty crummy and in bed for several days.

Given all of these potential pitfalls of the flu vaccine, why should you get one at all?

For all the reasons listed above, the current flu vaccine is not close to being 100% protective. Our public health marketing effort has probably oversold the effectiveness of the flu shot in many ways. It’s nowhere near as effective as other vaccines (measles, tetanus, etc.) at preventing illness or death. However, it’s the best available way to lower your risk of contracting the flu, becoming very ill from influenza and passing the virus to family and friends. Exercising regularly and eating a well balanced diet does not guarantee avoidance of cardiovascular disease or cancer (or contracting the flu), but I’m not afraid to recommend them either.


W. Ryan Neuhofel, DO, MPH (Dr. Neu) is the physician and owner of NeuCare Family Medicine. He is a board-certified Family Physician (American Board of Family Medicine) and Fellow-candidate in Wilderness Medicine.

For more information about NeuCare, visit them online or Facebook.

Information contained here is intended for general health education only. All personal health and medical issues should be managed by a health professional.

NeuCare Family Medicine is a paid sponsor and advertisor of Wellcommons.com and Lawrencemarketplace.com

Reply 1 comment from Marilyn Hull

Interpreting a Cholesterol Panel. The good, bad and ugly.

Do you have questions about cholesterol? What should the LDL be? and what about the "good kind"? Dr. Neu explains how to interpret a lipid (cholesterol) panel in the cartoon below.

Dr. Neu shows how to Interpret your cholesterol numbers.

Dr. Neu shows how to Interpret your cholesterol numbers. by Ryan Neuhofel


W. Ryan Neuhofel, DO, MPH (Dr. Neu) is the physician and owner of NeuCare Family Medicine. He is a board-certified Family Physician (American Board of Family Medicine) and Fellow-candidate in Wilderness Medicine.

For more information about NeuCare, visit them online or Facebook.

Information contained here is intended for general health education only. All personal health and medical issues should be managed by a health professional.

NeuCare Family Medicine is a paid sponsor and advertisor of Wellcommons.com and Lawrencemarketplace.com

Reply

Strike a Pose for What Ails You: Free Intro to Yoga event.

Curious about yoga? or how it can improve your general health and fitness? or will it work for your medical issues? and what about the hot kind? . . . . Get your questions answered at a free public event.

Katherine Marshall-Kramer doing a "fish" pose at the 2012 Bishnu Charan Ghosh Cup (International Yoga Asana Championship) in Los Angeles, CA.

Katherine Marshall-Kramer doing a "fish" pose at the 2012 Bishnu Charan Ghosh Cup (International Yoga Asana Championship) in Los Angeles, CA. by Ryan Neuhofel

NeuCare Family Medicine invites the public to join us this coming Tuesday as we discuss the use of yoga as a treatment for physical and mental health issues. There will be a brief presentation about the basics of yoga (with a focus on Bikram style) by Hannah Cooper, RN (NeuCare nurse and 2012 USA Yoga Kansas state champion) and Elizabeth Marshall (Kansas' first Bikram Yoga Instructor and owner of Bikram Yoga College of India in Lawrence). Dr. Neu will also be present to share his thoughts about yoga and it's usefulness for a variety of medical conditions. After the presentation, we will watch a demonstration of some yoga poses with the help of Katherine Marshall-Kramer (2012 USA Yoga National Youth Champion). Participants can join us in trying out a few poses if they'd like. (We promise we'll try not to laugh)

Tuesday, July 10th. 5-6pm at NeuCare's clinic in the Medical Arts Building at 346 Maine St, Lawrence, KS 66044.

Free and Open to the Public. RSVP (email: info@neucare.net -or- Phone 785.727.4131) required. Space is limited.

More about our guests . . . .

Elizabeth Marshall graduated from Bikram’s Teacher Training in 2000 and then opened her studio here in Lawrence. She coaches competitors for regional, national and international competition and works with many different bodies in her yoga. She is on staff at the Bikram Yoga Teacher Training where she helps others develop their teaching abilities while continually evolving her own teaching techniques.

Katherine Marshall-Kramer started practicing yoga at the age of 11. She holds a 2009 international bronze medal, 2010 national silver medal, and is the current USA youth champion. She currently attends Free State High.


“Dr. Neu” is the physician and owner of NeuCare Family Medicine. He is a board-certified Family Physician (American Board of Family Medicine) and Fellow-candidate in Wilderness Medicine.

For more information about NeuCare, visit them online or Facebook.

NeuCare Family Medicine is a paid sponsor and advertisor of Wellcommons.com and Lawrencemarketplace.com

Reply

Why I opted out. My decision not to wait for a healthcare fix.

Early in my medical training I envisioned myself as an old-fashioned family doctor. Marcus Welby, MD was well before my time, but he seemed like a good fictional role model for a naive student-doctor. (Especially considering Dr. Cox of Scrubs was my alternate choice.) After finishing my primary classroom studies, I was eager to leave the stacks of paper behind and to learn from real clinicians caring for real people. After donning my short white coat (sans leisure suit), I quickly realized my romanticized vision didn’t mesh with my new reality.

As I advanced through medical school and into my Family Medicine residency, I was increasingly exposed to the “inner workings” of health care. Behind the scenes I saw much of the doctors’ time spent on issues other than patients’ health. Seemingly, the documentation about what they did took more time that what they actually did. My mentors frequently vented behind a mountain of charts about the decline of their profession. (Maybe the TV show just failed to show Dr. Welby filling out 5 pages of paperwork after he treated a simple sprained ankle?)

Hospital and clinic staffs consisted of small armies of people to do coding, billing, following up on denied claims, prior-authorizations and on and on. To financially support this administrative structure, the doctor(s) would take on more patients. The average primary care physician is now responsible for 2500-3500 people! I was frequently told “efficient” doctors could handle double and triple booked schedules - and it would be required to keep a private practice afloat. Unfortunately, this efficient pace allowed very little time to answer patient questions, educate about chronic diseases, calm somebody’s fears or listen to a patient’s bad joke.

During my training patients would frequently tell me about frustrations with their health care experience. While most people personally liked their physician, many felt disconnected and fed-up with the complexities of basic communication. After hearing the same stories again and again, I started to feel sympathetic towards these complaints. Despite our hard work and good intentions, medical practices often treated patients merely as vessels for billing codes. Doctors seemed to be unwittingly insulating themselves from the very people whom they committed to providing care. And this sympathy was directed towards the fortunate insured people with so-called ‘access’.

Don’t get me wrong, I met numerous amazing, compassionate physicians whom cared deeply for their patients. From my perspective, the doctors and patients were both losing in this system. I increasingly asked my colleagues, “Why do we do it this way?”, “Wouldn’t it be more efficient if . . .” and other annoying questions. Usually my inquiries were met with puzzling stares and flippant answers such as, “Because this is just the way it’s done.” Despite everyone agreeing that the system “sucked”, all parties seemed miserably complacent.

Sure, many doctors were passionate about “reform” and had wide-ranging opinions about political fixes to our problems. I was encouraged to join (give money to) organizations, write representatives, march in the street, wish on birthday candles, etc., etc. But why should anyone be hopeful that such advocacy will be productive? Over the past 40 years, our country’s health care has been reformed by numerous rounds of bureaucratic acronyms - only to have the Gordian knot become increasingly tangled. A perpetual Groundhog Day was not my idea of a fulfilling career.

While people hold their breath about the fate of the Affordable Care Act, I remain skeptical about any topdown solutions to our conundrum. I am not waiting for another round of regulatory tweaking to improve the value, access and quality of my professional services. We all deserve better, but we are not going to get it without some disruptive innovation from the grassroots. I believe doctors and patients can and should return to a direct, cooperative relationship for most health care issues. Maybe physicians never have been the caricatures from the golden days of television, but I’m happily and stubbornly naive. Something has been lost and we should fight to get it back again.


“Dr. Neu” is the physician and owner of NeuCare Family Medicine; a Direct Primary Care practice. He is a board-certified Family Physician (American Board of Family Medicine) and Fellow-candidate in Wilderness Medicine.

For more information about NeuCare, visit them online or Facebook.

NeuCare Family Medicine is a paid sponsor and advertisor of Wellcommons.com and Lawrencemarketplace.com

Reply