01 Aug

More Than An Ounce: An Internist’s View On Preventive Care..By Jonathan Finks, M.D.

Written by Lori Mallory 2 Comments

Last Thursday in my afternoon clinic I watched quietly while a middle-aged woman tried to coax her resistant, slightly confused, ailing mother into allowing me to examine her. “Remember mom, doctors heal people. They help fix the sick. That’s why we’re here.”

It occurred to me that I hadn’t seen the 40-something daughter in my clinic for over three years and that I had already observed signs of her following in her obese, debilitated mother’s footsteps. On their way out, I asked how she was doing.

Her response was, “A bit tired and overworked.” I said she needed to make an appointment to come see me and she replied, “No, doc. I’m not sick.” I wished I had more time to convince her that she didn’t need to be ill to benefit greatly from an appointment.

Benefits Of Seeing A Doctor

Many people avoid doctors because they associate them with illness and inadequacy in themselves. Reminding people that seeing a doctor can help them avoid illness, keep them healthy, and make them the best they can be is a critical concept that has become more important in today’s age of managed health care.

The adage ‘an ounce of prevention is worth a pound of cure’ is especially and critically true when applied to health care. Rather than treating a condition after it has progressed, preventive care focuses on avoiding disease and maintaining optimum health. Extensive studies prove that when it comes to beating life-threatening illnesses, early diagnosis is key. Early diagnosis often means before symptoms present themselves.

What Is Internal Medicine?

Doctors of internal medicine, also known as internists or ‘Doctors for Adults,’ receive special training that focuses specifically on the care of adults in all stages of life. In addition to diagnosing common illnesses and providing guidance with preventive care, an internist is trained to solve puzzling diagnostic problems and treat complex chronic illnesses.

Caring for Patients . . . For Life

Establishing a relationship with an internist you trust is like enlisting a partner who invests their knowledge and experience in your own personal well being. An internist’s job is to care for their patients for life – in the office, during hospitalizations, in nursing homes. In today’s complex medical environment, that kind of consistency is imperative for quality care. When other medical specialists are involved, internists coordinate their patient’s treatment, ensuring the critical transfer of information regarding their patient’s history, expectations, and concerns.

Keys To Health And Longevity

The blueprint for preventive health care remains the same even after years of medical advancement and discoveries. The basics bear repeating. A healthy lifestyle is composed of a number of factors. Among the most important are:

Eating a healthy and well-balanced diet

Engaging in regular exercise

Managing your stress

Getting restful sleep

Using alcohol in moderation

Quitting smoking

In addition, find a doctor you trust and see them regularly. Routine health care visits are used to monitor many conditions, including heart disease, high cholesterol, hypertension, osteoporosis, and obesity, and they provide opportunities to screen those at risk for the most common cancers.

Establish A Relationship With An Internist

More than an ounce of prevention includes establishing a relationship with an internist who has been trained to help you invest in your future well-being, one who provides you with care for all stages of your life.

Bio: Jonathan Finks, M.D.

Dr. Jonathan Finks graduated from the University of Kansas Medical School with a Doctorate of Medicine in 1999. He completed his combined residency in Internal Medicine and Pediatrics at the University of Kansas Medical Center where he served as Chief Resident in 2003. Dr. Finks is board certified in both Internal Medicine and Pediatrics and is a member of the American Medical Association, American Academy of Pediatrics, and the Kansas Medical Society. Dr. Finks sees patients at the Menorah Medical Center office in Overland Park. In his spare time, he enjoys indoor soccer, canoeing, attending theatre and having adventures with his wife, young daughter, and a big yellow lab.

18 Jul

WATER: Why You Need It. How Much You Need. And How To Tell If You’re Hydrated.

Written by Lori Mallory 4 Comments

Post written by Mallory Bratton, MS, RD, LD, Dietitian, Kansas City Internal Medicine

Who knew two hydrogen atoms and one oxygen atom (H2O) combine to make such a refreshing and important liquid?

Water consumption is important all year-round, but during the summer (particularly a summer as hot as this one has been) it is even more crucial. In this type of hot summer weather we often hear, “Make sure you drink plenty of water,” but very few understand exactly why water is so vital.

The human body is made up of 2/3rds water. In other words, water is used in almost every bodily process. Summertime heat causes people to sweat more, which means we lose water more rapidly than on cooler days. While drinking liquids in general is important, drinking liquids isn’t enough.

People need water because it can be used efficiently and quickly by our bodies. Most other beverages such as iced tea, lemonade, sodas, sports drinks, and juices are often filled with sugar, caffeine and sodium. These beverages are not used in the body as effectively as water. Most of those beverages are also a source of empty calories, meaning there is little-to-no nutritional value while being high in calories.

To prevent dehydration in the first place, always carry water. Reusable plastic water bottles are easy to take on the go and make increasing water consumption much easier. It has also been shown that drinking through a straw makes a person drink more, so use a reusable water bottle with a straw and you’re well on your way to hydration!

Be aware of signs of dehydration before they start.
It is important that you listen to your body and be aware of dehydration symptoms. Although this seems odd, the best indicator of your hydration level is the color of your urine.

If the urine is bright yellow, this indicates dehydration. A healthy, hydrated person will have very pale yellow urine. Thirst is another indictor of hydration status. If you are thirsty, then you are likely already dehydrated. It is the body’s way of telling you that more water is necessary.

Here are several good things to keep in mind when it comes to water:

Recommendations vary, but everyone should make it a goal to drink at least 64 ounces of water per day. This should be even higher on hot summer days.
Don’t forget about toddlers and children. They need water too.
Ice in the glass takes up space, so make sure you are still drinking a full glass.
To keep track of how much water you have consumed set out eight pennies on the kitchen counter in the morning. Each time you finish a glass of water take a penny away.
No matter what people say, cold water is no different than room temperature water. The body uses the water the same way.
Water may be clear, but try to “go green.” Think about the day and how water can be consumed without adding to landfills. Use reusable plastic bottles.

10 Jul

Soak Up The Sun This Summer With These Safety Tips

Written by Lori Mallory 0 Comments

Post written by Lori Groom, Advanced Registered Nurse Practitioner at Kansas City Internal Medicine

Oh, how we love to feel the warming rays of the summertime sun on our bodies! However, it’s important to remember that the warm feeling can wreak havoc on our skin, which is the body’s largest organ. Prolonged exposure to the sun’s ultraviolet light can have damaging effects to our skin.

The National Institute on Aging has stated that sunlight is a major culprit of wrinkles, dryness and age spots. Excessive sun exposure is linked to skin cancers, which is the most common form of cancer in the United States. Three types of skin cancer are Basal, Squamous and the Melanoma, which is the deadliest. According to the American Academy of Dermatology (AAD), one in five Americans will develop some form of skin cancer during their lifetime.

How can you protect your skin from the damaging effects of the sun?

Sunscreen, clothing, lip balms, and sunglasses are all protective barriers from damaging sun rays. Let’s look at each in a little more detail.

SUNSCREENS

Sunscreens come in a variety of applications with as many SPF formulations. Sunscreen should be worn by everyone over the age of 6 months. Children under 6 months should not have prolonged exposure to the sun. The purpose of sunscreen is to protect skin from Ultraviolet ( UV) radiation. There are two types of UV radiation, UVA and UVB. Sunburns are caused by UVB rays, while UVA rays penetrate the layers of the skin and cause wrinkles, leathering and other light-induced effects of aging.

Sunscreens should indicate the Sun Protection Factor (SPF) on the label. SPF is a measure of the sunscreen’s ability to prevent UVB rays from damaging the skin. For example, let’s say your unprotected skin becomes red after 20 minutes of sun exposure. By using a sunscreen with an SPF of 15, you would prevent reddening 15 times longer, giving your skin coverage for approximately five hours.

Sunscreen should be chosen based on activities planned and length of sun exposure. Look for a sunscreen with broad spectrum protection. The following key active ingredients should be on the label: PABA derivatives, salicylates, and/or cinnamates (octylmethoxycinnamate and cinoxate) for UVB absorption; benzophenones (such as oxybenzone and sulisobenzone) for shorter-wavelength UVA protection; and avobenzone, ecamsule (MexorylTM), titanium dioxide, or zinc oxide for the remaining UVA spectrum.

These ingredients are essential to filter both UVB ( cause of sunburns ) and UVA ( causes of premature aging and skin cancers).

Look for The Skin Cancer Foundation’s Seal of Recommendation, which guarantees that a sunscreen product meets the highest standards for safety and effectiveness.

Sunscreens are not effective longer than two hours after application, so reapplication is necessary for prolonged sun exposure.

You should apply sunscreen 15-30 minutes before going out into the sun. When applying sunscreen, it is important to apply an adequate amount to cover all exposed areas of the body. One ounce, about the size of a shot glass is needed to cover the entire body. So for a day at the pool you should use one quarter to one half of an eight ounce bottle. Sunscreen should be reapplied after swimming, sweating and toweling off.

CLOTHING

Clothing can provide protection from the sun’s rays. A wide brimmed hat offers protection to the scalp and ears. Baseball caps are not as effective since ears are left exposed. Clothing manufactures’ are now making garments with Ultraviolet Protection Factor (UPF) which indicates how much of the sun’s rays are absorbed by the fabric.

According to the Skin Cancer Foundation, clothes with certain qualities can prevent harmful rays from reaching the skin. Clothing made of unbleached cotton, high-luster polyesters, and thin, satiny silk can absorb or reflect UV radiation, preventing damaging rays from reaching the skin. Clothes with a tight weave or knit prevent penetration of harmful rays. Darker materials absorb UV light, keeping it away from your body.

LIP BALM

It is important to protect our lips from sun damage. The lip is a common site for skin and lip cancer, primarily because of extended sun exposure. Early signs of sun damage are cracked, peeling, scaly lips that aren’t helped by lip balm or petroleum jelly.

This may be a sign of actinic keratoses. The condition can be the earliest stage of the development of skin cancer and has the potential to progress to deadlier forms of the disease.

Lip protection includes the following: apply a lip product with SPF greater than 15 every 2 hours. While in the sun avoid putting baby oil, petroleum jelly or high shine lip gloss on your lips. If you wear lipstick , darker shades provide more defense than sheer glossy shades.

SUNGLASSES

Eye protection is as important as skin protection while in the sun. Prolonged UV exposure to the eyes can cause reddening of the whites of the eyes, in the same manner a sunburn occurs on the skin.

Over time, UV exposure can cause cataracts and macular degeneration of the eyes. The skin around the eyes will wrinkle more with sun exposure. Sunglasses should have the following qualities: large frames to protect more of the eye, UV 400 protection, impact resistant and gray and brown shades are less apt to cause distortion of colors.

23 Apr

Preventive Medicine and the Pursuit of Personal Health…By Dr. Andrea Arvan

Written by Lori Mallory 2 Comments

By Andrea Arvan, M.D., Kansas City Internal Medicine

The buck stops here. One of my favorite quotes. This clearly states a sense of accountability and proactivity for one’s actions. It shows integrity, bravery and a sense of taking charge.

Taking Responsibility to Improve One’s Health

Preventive Medicine has the same sense of proactivity. Taking responsibility and seeking out ways to improve one’s own health. Most doctors want to prevent disease, but preventing disease is based on the will and desire of the patient who comes to the doctor as well.

For example, it would be great to stop the blood pressure medications that patients take. If a patient eats a whole food diet, walks daily, avoids sodium, reduces the stress in his or her life and possibly takes a supplement or vitamin, it might be possible.

But, if there is a family history of hypertension, it may be that lifestyle changes alone are not enough and conventional medicine may be necessary for the health of the patient.

What is Preventive Medicine?

Preventive Medicine is the field of medicine where the patient and the physician (and public health departments) are partners in the endeavor to eliminate illness and, more importantly, to prevent illness. This is key. It is no longer just about a patient being told what to do.

It is also about a patient seeking advice to produce an improved outcome in his or her life. Although separate fields, there is a synergy between Integrative Medicine and Preventive Medicine, and Integrative Medicine at the level of prevention can be very effective in the pursuit of personal health.

Three Levels of Preventive Medicine

Preventive Medicine is usually divided into three levels.

Primary Level: Refers to health promotion and keeping disease from being established. This is when your doctor tells you to eat healthy and exercise. It also refers to things like immunizations and wearing helmets.

Secondary Prevention: Refers to the detection and management of early disease. Examples include mammography and colonoscopies.

Tertiary Prevention: Refers to the treatment of symptomatic diseases to prevent progression of the disease or symptoms, such as physical therapy after a stroke or pain management treatments. The Integrative/Preventive Medicine physician should be able to give advice on prevention or to direct the patient to others who may also help them in their pursuit of health.

Treating the Whole Body

If, for example, breast cancer runs strongly in a patient’s family, the physician will want them to get yearly mammograms, breast exams, and MRIs, if necessary. The physician may advise them to eat a low fat diet, stop smoking, severely limit alcohol, etc. This is nice conventional advice.

But the Integrative Medicine physician might also refer them to a cancer prevention nutritionist or to meditate. He or she might want them to take supplements to boost certain aspects of the immune system. The purpose is to treat the whole body because all cures come from within.

Patients Often Need Help Changing Their Lifestyles

As a physician, I can only treat illness. I cannot cure it. I cannot even cure high blood pressure. Cures are more complicated. It may require conventional treatment, but it definitely requires treatment that involves the patient as a whole person and with the commitment of that patient.

And patients often need help changing their lifestyles. It is the physician’s responsibility to help that patient see their part and to guide them through their part of the equation for optimal health.

Because the cure may be complicated by a chronic illness, such as emphysema, the goal may not be to cure but to greatly improve. Because the problem facing a patient may involve issues outside of their control, for example inheriting the BRAC gene increasing the risk for breast or ovarian cancer, the goal may be to reduce the risk, increase the effectiveness of the patient’s immune system and maybe making hard choices like getting a mastectomy or hysterectomy.

The Greatest Gift of All: The Gift of Health!

The ultimate goal would be to provide the largest number of appropriate options available and the Preventive/Integrative Medicine practitioner could be their guide.

All of us can give our family the greatest gift of all, the gift of health. Those who model a healthy lifestyle promote a healthy lifestyle for the people they love around them.

12 Mar

PREVENTION: A NEW WORLD OF HEALTH CARE!

Written by Lori Mallory 1 Comment

Post written by Lori Mallory, CEO, Kansas City Internal Medicine

I first want to be sure everyone knows that this post comes from the perspective of a non-physician or non-clinical person.

As a health care leader, it is exciting, and in fact downright exhilarating, to witness a major transformation in the health care delivery system in our country. (Please also note, that my viewpoint has nothing to do with politics or health care reform.)

It does however, have everything to do with the tide change we are currently experiencing from a universal focus on acute and chronic illness to a focus on prevention strategies.

I just heard a new fact (to me) recently from the American Heart Association: Not only is Heart Disease and Stroke the leading killer of both men and women, but:

90 percent of all people have at least 1 risk factor contributing to heart disease. Eighty-percent of these are risk factors that behavior modification can address.

WOW! 80%! As a leading primary care group in our region we must be a part of this SHIFT in education and empowerment of our communities to GET HEALTHY. Our Mission Statement is to “Be an Ambassador for a Healthy Kansas City” and we take that very seriously.

I am proud to say, as Chief Executive Officer, that our team spends more time focusing on prevention discussions and strategies than perhaps any other business issue. We are intentional about the health of our patients and community. Two of the recent projects surrounding this include:

1. Medicare Wellness Physical

KCIM is proud to be a strong Medicare leader, with over 52% of our practice in this category. Medicare has finally seen the importance of prevention and now has a Medicare Wellness Physical that we are pleased to participate in. Focusing on a prevention plan with our patients is just good medicine. For more information on the Medicare Wellness Physical, click here.

2. National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home Accreditation

Over 2 years ago, in partnership with Blue Cross and Blue Shield of Kansas City, KCIM began our adventure toward achieving this key accreditation. This patient-centered model ensures that the focus is on both a prevention plan as well as managing our current health conditions. We are proud to be accredited as a Level 3 Medical Home, the highest designation possible. For more information on the National Committee on Quality Assurance, click here.

We have a few other really exciting initiatives that we will be announcing soon, so watch this blog, our Facebook Page, our new Twitter account, and the news media for that information.

I want to assure you that if you are concerned about HEALTH, WELLNESS and PREVENTION, KCIM is a LEADER and has your HEALTH as its number one priority!In the end, your health is all you truly have and the idea that we can live healthier and more vibrant lives is something we can all get excited about.

As my boys get older, I definitely envision the desire to be an active and healthy grandmother some day. Last year, on a family ski-vacation, I went up the lift with an 83-year-old greatgrandma, who was their teaching her great-grandkids how to ski! How cool is that? Health in action.

We hope that you will join us in this “movement” toward HEALTHY lifestyles!

Category: Prevention & Healthy Lifestyle