Greg Nicholaides

By Brian P. Dunleavy, Oct. 2 (UPI)

Telemedicine is on the rise during the pandemic, but not all medical services can move online, researchers say.

The number of in-office visits to primary care physicians in the United States were 50% lower in the spring compared with the same periods in 2018 and 2019, a study published Friday by JAMA Network Open found.

At the same time, more than 35 million telemedicine consultations — in which patients communicate with their doctors by phone or online — were held in April, May and June, a 30-fold increase over previous years, the data showed.

While some medical services can be performed remotely, rates of important tests such as blood pressure and cholesterol monitoring fell by up to 50% across the country, as the public avoided doctors’ offices and other healthcare settings because of the COVID-19 pandemic, the researchers said.

“These are large, clinically important declines involving two of the most fundamental elements of primary care — the prevention of heart attacks and strokes,” study co-author Dr. G. Caleb Alexander told UPI.

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“Telemedicine may be very suitable for some types of primary care, but it is very limited for others,” said Alexander, a practicing internist and professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health.

As the COVID-19 pandemic spread to the United States in February and March, many medical practices discouraged non-essential health visits or closed offices altogether and moved many services online.

In their analysis, Alexander and his colleagues reviewed primary care consultations in the United States, by quarter, for 2018, 2019 and the first half of 2020.

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In 2018 and 2019, during each quarter, or three-month period, between 120 million and 130 million in-office visits to primary care practices occurred across the country.

However, in the first quarter of 2020 — January, February and March — this figure fell to roughly 118 million, the data showed.

In the second quarter of this year — April, May and June — it dropped again to just over 99 million, the researchers said.

RELATED The Telemedicine boom may outlast COVID-19 pandemic.

Meanwhile, telemedicine consultations, which accounted for approximately 1% — or about 1.4 million per quarter — of all primary care appointments in 2018 and 2019, increased four-fold — to just over 4 million visits — in the first quarter of this year and 30-fold — to just over 35 million visits — in the second quarter.

Because certain tests cannot be performed remotely, the number of blood pressure assessments performed across the country fell by 50% in April, May and June, compared with the same period in 2018 and 2019, the researchers said.

Similarly, cholesterol testing dropped by 37% over the same period, they said.

“Our findings suggest that one potential collateral effect of the pandemic — in addition to the direct harms — may be poorer assessment and control of cardiovascular risk factors like blood pressure and cholesterol, and potentially, higher rates of heart disease as a consequence,” Alexander said.

“Telemedicine is here to stay, but I think it is highly unlikely that it will replace face to face care because there is simply too much that is important that can’t be done through a webcam,” he said.

Fine Cooking Magazine

Depending on where you live, what is in season or available at your local farmer’s market might look different week to week, or not. But healthy eating can’t just be limited to the summer and autumn months of plenty and harvest. Below are links to information about cooking with fresh ingredients year round, in any region of the US.

Fresh Spring Produce

Spring is when produce begins to grow, making this the time of year for lettuce, some root vegetables, and fruit like apples and strawberries. Other seasonally ripe ingredients include avocado, asparagus, broccoli, and mushrooms. Peas and asparagus are other ingredients common to spring dishes.

If you’re looking for springtime recipes, salad might come to mind first, but fresh young veggies also taste great cooked. If you live in an area of rainy spring days, seasonal soups can be another great choice. Here are some lists of springtime recipes:

Bon Appetit shares 44 recipes to get you in the spring spirit

BBC Food collected the top 20 spring recipes

Food & Wine Magazine shares 28 seasonal spring recipes

Summer Seasonal Produce

In summer, the fruits of spring continue to be in season as new veggies also ripen. Tomatoes, bell peppers, eggplant, corn, and cucumbers are just some of the produce that hits its peak in summer. Raspberries, blueberries, blackberries, plums, and peaches also inspire some of the sweet summer flavors we know and love.

Summer is a time for grilling and relaxing, meaning cold side dishes like pasta salad or coleslaw might be on the menu of your traditional weekend. There are always exciting summer recipes to try, like the ones on these lists:

Taste of Home lists 101 fresh and easy summer recipes

Cooking Light shares over 45 recipes using seasonal summer ingredients

Delish compiled a list of the best non-alcoholic seasonal summer beverages

Best Fall Produce

Autumn’s freshest produce includes sweet potatoes, beets, pears, apples and squashes like the pumpkins you start to see everywhere for Halloween. Grapes, persimmons, and more hearty greens like kale or chard are also at their full ripeness.

Fall’s lower temperatures make this an exciting time to get back in the kitchen for slow-cooked meals. Many recipes on these fall lists feature yummy sauces or broths:

Saveur created a fall recipe and produce guide

Food Network shares recipes that use just five fall ingredients

Country Living lists over 75 recipes for easy fall meals

Fresh Produce in Winter

In winter, most fresh produce is going to be root vegetables like potatoes, sweet potatoes, yams, turnips, and onions. Some squashes and apples also ripen in winter. But your favorite fresh food from other seasons is still likely to be available as well, whether fresh at the grocery, frozen, or canned.

Winter calls for warming recipes that help us keep well through the stresses of the holidays and the annual flu season. Make the most of your extra time indoors with some of these recipes:

Eating Well figured out their 10 most popular winter recipes

Root & Revel lists 100 recipes using fresh winter ingredients

AllRecipes offers a catalogue of options for winter meals

Eat Balanced Meals for Year-Round Health

While different produce is fresh at different times, many ingredients are available year-round at the local grocery in some form. As you find favorite healthy seasonal recipes from these lists and others, keep making them your own to nourish your body. No matter what the time of year, it’s always a good idea to eat right!

We at Greg Says like to say that health insurance doesn’t actually ensure your health, a healthy lifestyle does that.

Healthy Heart Tips

When you leave the house these days, you probably think to yourself, “phone, keys, wallet… face mask.”  Masks are essential in keeping you and those around you safe by reducing the spread of COVID-19.  In today’s world, face masks are needed for practically every activity where you might come into contact with another person; this includes the gym. But how do you get the most out of your workout (and remain safe) while wearing your face covering?

Below, we’ll go over how wearing a face mask affects you, plus what to do and what not to do while wearing a mask during your daily dose of exercise.

Why Wear a Mask During Exercise?

Masks are recommended by the CDC and other healthcare professionals to help stop the spread of COVID-19 in shared spaces. Many scientists have also been studying the benefits and adversities of donning a mask during exercise. Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, found one’s heart rate will likely increase 8-10 beats per minute while wearing a mask, but that would only be noticeable during high-intensity exercises.  An informal study at the University of New Mexico also found that some people may experience dizziness upon exertion.  On the bright side, the more you exercise with a mask on, the more your body will be used to reduced oxygen levels while you work out, meaning when this is all over and you can ditch the mask, you will be an unstoppable powerhouse!

While wearing a mask may seem slightly unpleasant, you’re still encouraged to wear one to avoid potentially spreading any infectious particles throughout an indoor environment.  People suffering from any pre-existing respiratory conditions – such as COPD, asthma, cystic fibrosis, chronic bronchitis, pulmonary fibrosis, or any other condition affecting their heart and lungs – could be at a higher risk of adverse effects and should consult their physician before attempting to exercise with a face mask.

Ultimately, as long as you consult your primary physician and monitor how you’re feeling throughout your workout, you should be fine to exercise while wearing a mask.

To Do or Not To Do

OK, so now you know the potential effects of sporting a face covering while being active, but let’s break it down a little more.

Here is a list of “dos and don’ts” recommended by scientists and athletes:

• Do: Wear a cloth face covering made from synthetic materials. These tend to hold less moisture and will allow you to breathe easier. Try to get cloth masks that are marketed as having two layers or fewer; these are better at preventing overheating. Be sure to pack extra masks to change them out if you plan to exercise for more than 30 minutes.
• Don’t: Wear a paper mask or any form of surgical/PPE wear. These accumulate a ton of moisture and result in difficult breathing and diminished effectiveness when it comes to blocking any germs.
• Do: Take the break. Exercising with anything covering your nose and mouth will restrict the amount of oxygen going to your lungs. If you start feeling dizzy, nauseous, shortness of breath, numbing, or tingling, that’s your body warning you your oxygen is running low. It’s essential to listen to your body, and if it tells you to slow down, then switch your run for a walk and allow your breath to stabilize.
• Don’t: Overexert yourself. If you haven’t worked out in a while, wearing a mask could make getting back into the rhythm even harder. Take it slow. Overexertion can trigger other adverse effects, such as lack of oxygen, heart arrhythmia, low blood pressure, low blood glucose, and dehydration.  All of these could lead to serious health risks and complications that could further restrict your gym time.

Avoid the Gym Altogether

If you’re more comfortable staying away from the gym during this time, you’re in luck. There are still plenty of ways to achieve your health and fitness goals.

Here are some unconventional ways to get fit and stay safe:

• At-home workouts are all the rage. You can find great personal and group workout classes online. Don’t have the equipment? Look around your home and get creative. A backpack that weighs 10 pounds is the same as a 10-pound medicine ball.
• Be sure to maintain a balanced diet. We know snacking is tempting in times of uncertainty but try to go for carrots and hummus versus chips and dip.
• Take your workout outdoors. Sunshine and sweat is the perfect combo for a great workout. If you need some form of social contact, try tennis. This sport allows you to work out and see a friend from a safe distance.

If you’re immunocompromised, it’s best to avoid public spaces and limit your exposure. If it’s unavoidable, use the CDC‘s recommended precautions when going out to prevent yourself and those around you from contracting and spreading this disease.

As summer draws to an end, it’s time for the great pumpkin invasion. Soon (if not already) pumpkin spice flavored and scented everything will be available for your autumn enjoyment. Why do some of us love this stuff so much? According to science, it’s less about the taste and more about the aroma – pumpkin spice makes us happy.

Pumpkin spice is typically a combo of nutmeg, ginger, cinnamon, and allspice. Sometimes clove makes an appearance, too. The first pumpkin spice thing was created in 1934 by McCormick & Company, who introduced the mix so that their customers wouldn’t have to buy four bottles of spices to make pumpkin pie.

Why We See Pumpkin Spice Everywhere

As you’ve probably noticed, pumpkin spice is no longer limited to pie. Seventeen years ago, Starbucks popularized pumpkin spice in its now infamous seasonal latte. Since then, pumpkin spice has crept into an amazing number of products – including pasta sauce, potato chips, Spam, cereal, deodorant, beef jerky, nut milks and even Marshmallow Peeps.

Last year, Forbes valued the entire pumpkin-spice industry to be worth an estimated $608 million. But are pumpkin spice products a healthy treat?

Is Pumpkin Spice Bad for My Teeth?

There’s nothing inherently unhealthy about nutmeg, ginger, cinnamon, and allspice. Some have even been credited with having antioxidant, anti-inflammatory and immune-boosting benefits. But that’s assuming you’re consuming actual spices, not artificial flavors. The problem is, pumpkin-spiced foods and drinks often contain lots of added sugar, which is not good for your teeth or your overall health. But you can still enjoy pumpkin spice! Here’s how:

Make or purchase your own spice blend – Use it to flavor hot beverages, or sprinkle it on your oatmeal or yogurt. Or anything that you feel could use a little fall flavor.

Check out healthy pumpkin spice recipes online – Here’s a good place to start, especially if you’re following a paleo eating plan.

Pick the right treat – Try to choose a pumpkin-spice item that has no or lower amounts of added sugar.

Brush your teeth afterwards – If you do have a sugary snack, be sure to brush your teeth or rinse your mouth with water after you finish.

Limit the lattes – Besides all that sugar, coffee is an acidic drink that can weaken dental enamel plus stain your teeth. Skip brushing for an hour after having acidic foods or drinks to avoid damaging softened enamel (rinse with water instead).

Avoid sticky pumpkin-spiced treats – The longer sugar lingers on your teeth, the more damage it can do.

See a dentist regularly for checkups and cleanings – No matter what season it is, it’s important to see your dentist twice a year to keep coffee and these sweet treats from dimming or damaging your smile.

At Greg Says we advise that if budget constraints are keeping you from getting the dental care you need, consider getting a dental savings plan – an alternative to traditional dental insurance that can save plan members 10-60% on a wide variety of dental treatments.  Go to www.dentalplans.com for details.

Sept. 14, 2020 (HealthDay News)

Here’s evidence that prescription drugs don’t have to cost a fortune: New research finds Medicare saved billions as more generic cholesterol-lowering medications became available, even though the number of Americans using the drugs increased.

“One of the most important contributors to our health care costs is expenditure on prescription drugs,” said study author Dr. Ambarish Pandey, a cardiologist and assistant professor of internal medicine at University of Texas (UT) Southwestern Medical Center. “The switch to generics is an effective strategy to cut the costs incurred by health systems.”

Between 2010 and 2018, patents on a number of cholesterol-lowering drugs expired – including Crestor and Zetia – and generic versions became available.

For the study, researchers analyzed Medicare Part D Prescription Drug data from January 2014 through December 2018. They found that the number of prescriptions for statins and other cholesterol-lowering drugs climbed from 20.5 million to 25.2 million in that period, a 23% increase.

But even though prescriptions for the drugs rose, total costs decreased, according to the study.

The number of prescriptions for generic cholesterol-lowering drugs rose by 35%, from 17.8 million to 24 million, while overall spending on statins fell by 52%, from $4.8 billion in 2014 to $2.3 billion in 2018.

Statins are the most popular type of cholesterol-lowering drug in the United States, prescribed to more than 35 million people.

During the study period, Medicare still spent $9.6 billion on brand-name cholesterol-lowering medications, but could have saved an additional $2.5 billion of that by switching to generics more quickly when they became available, the researchers noted.

The findings were published Sept. 9 in the journal JAMA Cardiology.

“It’s important for our health care system to find avenues to become more cost-efficient and accessible,” said study first author Dr. Andrew Sumarsono, an assistant professor of internal medicine at UT Southwestern.

“Even though there is still a lot of work to be done, it is encouraging to see how quickly patients switched to generic options once they became available,” Sumarsono said in a UT Southwestern news release. “This rapid switch to generics saved Medicare a lot of money.”

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