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David Katzman, MD & Jennifer DeLaney, MD
Internal Medicine Specialists

The holiday season is a time to celebrate and share our many blessings and express thanks for family and friends. Reflecting back on this past year, I believe the best gift of all is the gift of health. Taking care of yourself is the best gift you can give to a loved one, and it yields many positive returns! You can start by making sure to see your physician annually for a wellness check-up. There is extra time scheduled during this visit, so sit down and have that conversation about how to best manage your health by focusing on wellness and prevention!

The doctors and office staff wish you and your family a wonderful holiday and 
may you find joy in all the simple pleasures of the season! 

Holiday Office Hours

  Please note the office will be CLOSED on the following dates:

Monday, December 26th, 2016 

Monday, January 2nd, 2017

Make Your Wishes Known!
From our friends at the Mayo Clinic

Advance Directives are written, legal instructions regarding your preferences for medical care if you are unable to make decisions for yourself. They help guide decisions by your doctors or caregivers if you are terminally ill, seriously ill or are cognitively impaired. By planning ahead, you can get the medical care you want, avoid unnecessary suffering and help relieve loved ones of decision-making burdens during moments of crisis or grief. They can also reduce confusion or disagreement about the choices you would want people to make on your behalf.

*Power of Attorney: A medical or health care power of attorney is a type of advance directive in which you  name a person to make decisions for you when you are unable to do so. The person you name can be a spouse, other family member, or friend. Even if you have other legal documents regarding your care, not all situations can be anticipated and some may require someone to make a judgement about your likely wishes.

*Living Will: A living will is a written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, particularly in the setting of a "terminal" illness. They often address a number of end-of-life decisions including resuscitation such as CPR, breathing machines, tube feeding, and dialysis.

*Do Not Resusitate: You don't need an advance directive to have Do Not Resuscitate (DNR) orders, which say you do not want heroic life-saving measures such as breathing machines, CPR or shocking the heart. You can make your preferences known to us and we will put them in your medical record. 

If you have any questions, concerns, or just need some guidance in this process please give Dr. Katzman or Dr. DeLaney a call for assistance or your attorney for legal advice. 

Antibiotics: They Can't Hurt - Or Can They?
David Katzman, MD

Antibiotics have been one of the greatest lifesaving discoveries of modern medicine, but their use can also have a down side.
In the setting of a well-defined or strongly suspected bacterial infection, antibiotics are appropriate and necessary therapy.  However, as with all medications they come with risks.  As physicians, we weigh the risks of taking antibiotics and are careful in deciding when to prescribe them.

Some of the side effects you should be aware of:

  1. Allergic reactions: these can range from life-threatening anaphylaxis to annoying or uncomfortable rashes.
  2. Diarrhea: a very common side effect. Also, there can be overgrowth of a particular bacteria in your intestine called clostridium difficile (“c-diff”) which can be a life threatening infection requiring hospitalization and surgical removal of the colon.
  3. Drug interactions: especially with blood thinners, cholesterol medicine, antidepressants, oral contraceptives or immunosuppressants.
  4. Sun sensitivity: almost all antibiotics can cause you to sunburn easily.
  5. Liver or kidney failure: almost all antibiotics can cause this.
  6. Resistance of bacteria to future infections: many bacteria have become resistant to multiple antibiotics given their frequent use.
  7. Weight gain: Numerous studies show that antibiotic use changes intestinal flora which can change how you absorb food. Even short courses of antibiotics can cause permanent weight gain.

    By carefully weighing the risks and benefits of antibiotic therapy. We aim to maximize your health while minimizing your risk of adverse side effects. (link to antibiotic article in May 2016 newsletter).
Sugar and Spice Pecans with Dried Fruits
Egg whites are a fat-free alternative to the melted butter in traditional spiced nut recipes. 

1 egg white
4 cups pecan halves (about 1 lb)
1/2 cup sugar
1 tsp ground cinnamon
1 tsp ground ginger
1/4 to 1/2 tsp ground cayenne pepper
1/4 tsp salt
2-six ounce packages dried cranberries with raisins and golden raisins (Sun-Maid)

Preheat oven to 350 degrees. Whisk egg white in a large bowl until foamy. Add pecans; stir until evenly coated with egg white. Stir together sugar and next 4 ingredients; sprinkle evenly over pecans. Stir to coat. Spread pecans in a single layer on a baking sheet coated with cooking spray. Bake 18-20 minutes or until pecans are toasted and dry, stirring once after 10 minutes. Remove from oven; break nuts into individual pieces if necessary. Cool. Mix with dried fruit. Makes 7 cups.

Per serving: calories 83; cholesterol 0 mg; fat 6 g; sodium 12 mg; carbohydrate 8 g; fiber 1 g. serving = 2 Tablespoons

Office News

Important Vaccine Information: Is your college student protected?

Meningitis B: Please call to make an appointment for your college student in the practice to receive the Meningitis B vaccine. Even if your child has been vaccinated for meningococcal disease they may not be vaccinated against Meningitis B. Before 2014 there were no approved vaccines in the US for Meningitis B. The CDC recommends that a Meningitis B vaccine be given to adolescents and young adults. Please call ahead and we can order and administer the vaccine in the office. Currently most insurance carriers do not cover this, but please check with your individual plan. The out of pocket cost for the vaccine is $164.00. 

Mumps: There have been mumps outbreaks at several US colleges. If your student attends one where there is an ongoing outbreak they should get a booster of the MMR vaccine. Please call the office to find out what to do! 

Flu Vaccine:
It's not too late to get your flu vaccine! We still have plenty of  flu vaccine available in the office if you haven't received one yet. It's a great time to have your college student stop by and get vaccinated while they are home on winter break and also get them in for their annual physical! Call now to reserve an appointment! 

Insurance Cards for 2017: Please let us know if you have received a new insurance card recently! We must have the correct information to obtain approval for your medications, ordering labs and scheduling diagnostic tests. We will continue to check and update all cards at your office visit. 
Please check with your individual insurance carrier concerning updated formulary changes on the medications you take and alternatives available if they are not covered.  Also, please check ahead of time before your next annual visit to see if your individual insurance plan covers labs for a well-visit or if your plan requires a diagnostic code. This is not information that is relayed to us by your insurance carrier and we want to prevent you from receiving an invoice from Quest. This will allow us to expedite your services in a more timely manner. 

Billing Concerns and Questions: Thanks for being so patient this past year as the office has gone through some changes. Tonya would like to thank everyone for referencing their invoice number on their check. Please continue to reference invoice numbers on every check, and it is ok to pay more than one invoice on one check as long as they are from the same doctor. Tonya can be reached via e-mail and she is available to return your calls on Wednesdays. 

Please visit our website if you missed past newsletters. The newsletter archives can be found by hovering your mouse over the "Medical Links" tab. 

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