So, What Is Presbyopia?

A lot of people have heard the term Presbyopia before, but not everyone knows the whole story.  While the word may sound  complicated, the condition is actually quite simple to understand.  Presbyopia is a change in our eyes’ ability to focus on close objects.  This change is a natural part of the aging process, and it usually presents itself when folks are in their 40s.

Common signs of presbyopia include:

• Blurry vision when focusing on close-up objects
• Trouble reading small print, especially in low light
• Holding objects far away from the face to see them better
• Headaches

So, why does presbyopia happen?  The lens of the eye is responsible for keeping objects in focus.  The unique flexibility of the lens allows us to focus on distant objects as well as close-up objects.   Presbyopia occurs when this soft lens begins to harden, reducing its flexibility and hindering the eye’s ability to focus on nearby objects.

Thankfully, there are many things we can do about it.  Read on to find out a few ways we treat presbyopia today.

Presbyopia Treatments

For some patients, eyeglasses or contact lenses may be enough to combat their presbyopia symptoms.  In more serious cases, or for those wishing to avoid corrective lenses, modern ophthalmology offers a few  solutions.

Here are two of the most common ways we treat presbyopia today:

• CK Surgery: CK Surgery for Presbyopia, also known as Conductive Keratoplasty, is a non-invasive, non-laser treatment.  Instead of a scalpel, a CK procedure uses radio-frequency energy to reshape the cornea and change the way the eye focuses light.
• Presbyopic IOL: A Presbyopic IOL is a replacement lens aimed at total vision correction.  These IOLs, such as the ReSTOR® Multifocal Lens, are implanted through a safe procedure similar to that of a cataract patient.  Furthermore, presbyopic IOLs have the added benefit of preventing cataracts from developing in the future, as the natural lens is completely replaced.

Ophthalmologist in Winchester

To learn more about presbyopia treatment or to schedule an appointment at our Winchester Ophthalmology Offices, we encourage you to contact us today.  We can be reached at (540) 722-6200 and look forward to meeting you soon.

Source: http://www.seeclear.com/blog/presbyopia/so-what-is-presbyopia

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Cholera outbreak in Malaysian Borneo

New cases of cholera continue to reported in the Bintulu district of Borneo. Travellers should avoid buying drinks with ice, uncooked salad dishes and ice-cream, as the water used may not have been boiled to decontaminate it. They should also avoid premises that are not spotlessly clean.

Source: ProMed Newsgroup

For further advice, contact the Globe Travel Health Centre on 01603 667323

Source: http://www.globetravelhealthcentre.com/travel-advice/cholera-outbreak-in-malaysian-borneo.html?utm_source=rss&utm_medium=rss&utm_campaign=cholera-outbreak-in-malaysian-borneo

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Fertility – a much wider issue

When people are broached with the subject of fertility, one often associates it is to an individual family’s desire to have children. However, as Professor Nargund expresses in her paper “Declining birth rate in Developed Countries: A radical re-think is required”, the subject touches society much more widely as a whole for both the developed [...]

Source: http://www.createhealthclinics.org/blog/fertility/fertility-a-much-wider-issue/

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Reducing our Environmental Impact to Create Healthy Communities

Note: Today we have a guest blog post from Bernard Tyson, president and chief operating officer of Kaiser Foundation Hospitals, Inc., and Kaiser Foundation Health Plan. He recently wrote about Kaiser Permanente’s work to reduce its environmental footprint – not just as an business imperative, but as a core strategy for improving the health of its members and the communities it serves. Read more about Bernard Tyson through his bio in the Kaiser Permanente News Center.

There is little disagreement that greenhouse gas emissions, which are known contributors to climate change, have led to a rise in pollution and adverse health impacts. In fact, the World Health Organization estimates that urban air pollution causes about 1.2 million deaths per year and exacerbates cardiovascular and respiratory illnesses, particularly in sensitive populations like the elderly and young and in minority communities that are disproportionately impacted by urban and industrial activities.

Ironically, the health care industry – responsible for preventing and treating these types of illnesses – also contributes to the problem. According to a study by the University of Chicago, 8 percent of the total carbon emissions in the United States are attributable to health care activities. Not surprisingly, hospitals are by far the largest carbon emitters due in large part to strict requirements for temperature control, ventilation and lighting, and, of course, 24/7 operations.

Compounding the problem is the fact that many hospitals and health care facilities were built decades ago and have not been remodeled to use energy more efficiently. This is a similar situation to many government-owned buildings across the country. Late last year President Obama announced a multi-billion dollar government and private sector commitment to finance building renovations to make government-owned properties more energy efficient, and to create jobs in the process. The energy performance contracts proposed by the federal government, with improvements paid for by energy savings, are similar to those being used by schools, colleges and municipalities.

Given that the health care industry in America has nearly 600,000 facilities – and many of their workforces are equal in size to large government agencies (Kaiser Permanente’s workforce, for example, is of similar size as the U.S. Department of Homeland Security), health care organizations have a real opportunity to adopt sustainable business practices that reduce emissions, increase energy efficiency and the use of clean energy. This in turn will better protect public health and create jobs, achieving results that are in line with our focus on wellness and prevention, and helping grow the economy.

In January, Kaiser Permanente set an aggressive business strategy of reducing our greenhouse gas emissions by 30 percent by 2020, as compared to 2008 levels. To achieve this goal, we are adopting sustainable energy measures, both related to the construction of new facilities and the upgrading of existing facilities, such as installing new lights and window-film installations. These measures will not only reduce the impact of our operations on the environment, but are expected to save roughly $1 million per year in energy costs as well, which is good news for our members.

We are also investing in clean energy sources, such as deploying solar energy and fuel cell generation capacity at facilities throughout California.  In Maryland and the District of Columbia, we are purchasing renewable energy credits to offset 100 percent of our carbon intensive activities in those markets.

And Kaiser Permanente is not alone. Last year for Earth Day, Digital Health committed to reducing greenhouse gas emissions and energy use, and increasing sourcing of power to green energy. The University of California at San Francisco has also established a robust sustainability strategy to reduce carbon emissions with an ultimate goal of becoming climate neutral.

I hope these climate change commitments are just the beginning for our industry. Together, we have an opportunity – and a responsibility – to help prevent climate related illnesses and improve the health of our communities.

Source: http://centerfortotalhealth.org/2012/tyson-healthy-communities/

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Top 5 Patient Benefits of iLASIK™

Since its inception, laser vision correction has been changing the lives of our patients, enhancing vision and reducing or eliminating our patients’ dependence on eyeglasses and contact lenses.  Now, our practice is proud to offer what many consider to be the most advanced LASIK system available: iLASIK™.  Not sure what this cutting-edge procedure is all about?

Here is our list of the Top 5 Patient Benefits of iLASIK:

1. Fully-customized procedure. iLASIK is not a one-size-fits-all procedure.  Rather, using cutting-edge 3D eye mapping, iLASIK creates a one-of-a-kind image that is used to guide your LASIK procedure.  This unique “roadmap” means a fully-customized procedure in keeping with your unique anatomy and medical needs.
2. Completely bladeless. Where some LASIK systems rely on metal blades, iLASIK creates a corneal flap using a precise laser.  This completely blade-free system is an ideal alternative for those hesitant about “going under the knife.”  What’s more, this method often results in better and faster healing following the procedure.
3. Cool laser technology. A second laser – the one used to make the actual vision correction – can be understood as a “cool laser.”  Using pain-free, ultraviolet light, iLASIK works to reshape the cornea and achieve better vision.  What’s more, vision correction takes only seconds per eye.
4. Iris registration. Cutting-edge iris registration technology ensures that iLASIK’s laser remains aligned, even if you move your eye.  This offers not only a more precise procedure, but very often a quicker procedure as well.
5. Most patients achieve 20/20 vision or better. Of course, the most important benefit of iLASIK is its remarkable results.  And, while each patient’s results will vary, most iLASIK patients achieve 20/20 vision or better following the procedure.

iLASIK in Winchester

To learn more about iLASIK, contact us today and schedule a consultation. Our offices are located in Winchester, serving Virginia, West Virginia and Maryland, and you can reach us directly at (540) 722-6200.  We look forward to meeting you.

Source: http://www.seeclear.com/blog/lasik/top-5-patient-benefits-of-ilasik%e2%84%a2

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A nurse practitioner-directed intervention improves the quality of life of patients with metastatic cancer

Gerardo Colon-Otero, M.D., with the Department of Hematology/Oncology at Mayo Clinic in Florida, discusses results of a randomized pilot study that show that an intervention that explains the benefits of hospice and addresses advanced directives early in the course of treatment leads to measurable improvement in the patient’s emotional and mental quality of life (QoL).

The study was published in the Journal of Palliative Medicine online ahead of print on May 4, 2012.

ABSTRACT
Background
There is a paucity of randomized studies evaluating the value of palliative interventions on a prospective basis in newly diagnosed oncology patients. We sought to prospectively evaluate quality of life (QoL) outcomes in advanced cancer patients who received discussion-based palliative care interventions from an advanced registered nurse practitioner (ARNP) integrated into the oncology team, and compare these outcomes with a control population.

Methods
Patients with metastatic cancer were randomized to standard care or an ARNP-directed intervention that included discussions of the benefits of hospice, discussions on living wills and advanced directives (Five Wishes document) along with an assessment of QoL. Relevant endpoints included change from baseline QoL and improvement in hospice knowledge.

Results
From Nov. 13, 2008, through July 28, 2009, 26 patients were accrued at the Mayo Clinic in Jacksonville, Fla. The study closed early due to published data demonstrating the benefits of early palliative care interventions in the management of metastatic cancer patients. Statistically significant improvements from baseline were noted in emotional and mental QoL assessments in the intervention group that were not seen in the control group. Patients found it useful to have the living will and Five Wishes documents offered as part of the ARNP intervention.

Conclusions
An ARNP-directed intervention that explains the benefits of hospice and addresses advanced directives early in the course of metastatic cancer patients’ treatment is well-received by the patients and their relatives and leads to measurable improvement in the patient’s emotional and mental QoL.

Authors
Gerardo Colon-Otero, M.D., Stephen H. Dyar, Jr., M.D., Mary M. Lesperance, A.R.N.P., Robert P. Shannon, M.D., Jeff A. Sloan, Ph.D.

Clinical trials at Mayo Clinic
Metastatic cancer, to bone

 

Source: http://physicianupdate.mayoclinic.org/2012/05/23/a-nurse-practitioner-directed-intervention-improves-the-quality-of-life-of-patients-with-metastatic-cancer/

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Simplifying LASIK Basics – Part 3: Safety and Results

Is LASIK just a passing thought? Or, are you ready to jump in with both feet, so to speak? Either way, two of the first things to consider are safety and what types of results you can expect. Continued advancements make LASIK safer and more effective than ever before. Still, LASIK is surgery, and you owe it to yourself to choose a reputable doctor and practice, who, in turn, owe you a full disclosure – standard procedure at Eye Consultants of Texas. As the third in our Simplifying LASIK Basics series, here are a few highlights about what you should know.

How Safe Is LASIK? Any surgery comes with risks, and amazing advancements have proven LASIK to be one of the safest surgical procedures today. At Eye Consultants of Texas, we won’t perform LASIK if we determine a patient is at high risk, which, according to the American Academy of Ophthalmology (AAO), is low. Generally speaking, AAO suggests that 2% or less of all patients have complications or side effects; from discomfort or difficult vision (that usually disappears over time), to more extreme cases where it can last longer. A thorough, necessary examination can reveal potential risks, and determine if you’re a candidate for LASIK at all. If it turns out that you are not a candidate, there are other vision correction options you and your doctor can discuss.

What Types Of Results Can You Expect? If you’re a LASIK candidate, it must be medically verified that you can achieve a level of visual improvement that makes the surgery worth it in the first place. Everyone expects to see 20/20 without corrective eye wear, and a majority of patients achieve this. There are also cases where the result may be less than 20/20. This can depend on how severe your eyesight is prior to surgery, which you can discuss with your doctor. Our LASIK patients generally tell us that they can see better without glasses or contacts than with them before they had the procedure. Once again, your doctor should only perform LASIK if he or she honestly feels you really need it.

How Quickly Does Your Vision Improve? Most of our LASIK patients are amazed at how well they can see right after surgery. Vision should continually (and gradually) improve over the next few days, and continue to improve after that. The thing to remember: your eyes will need time to adjust and heal. There may be some mild “scratchiness” and discomfort right after surgery. This should go away, and prescribed medication will help with discomfort and healing. Necessary follow-up visits carefully monitor your progress, to ensure proper healing and that there are no complications.

Can You Ditch Glasses And Contacts Altogether? LASIK isn’t permanent, and, in some instances, glasses may be needed for reading or seeing up close. The natural aging of the eyes can also have an effect. So why have it in the first place? Most people who have LASIK can see a noticeable improvement in their vision for many years, with far less dependency on corrective eye wear for simple day-to-day tasks. Which can be life-changing if you’ve had to rely on glasses or contacts for most (or all) of your life! Here are a few things patients tell us, quoted from our Patient Experiences page on our website:

“No more fumbling for my glasses and bumping into furniture just to get to the bathroom in the morning. This has been the coolest part…Eye Consultants of Texas did a fantastic job and I could not be happier with the results.” 

“If I would have known how easy my life would be after LASIK, I would have had the surgery a long time ago! I had four pairs of glasses for different purposes; I probably spent $1,000 a year on eye care. Dr. Labor and his team were very patient with me and listened to all of my concerns.”

Until our next Simplifying LASIK Basics blog, if you’d like to know more about LASIK at Eye Consultants of Texas, please call our office in Grapevine at 877-516-4364, conveniently located to Dallas/Fort Worth.

This blog is a broad overview of LASIK surgery for general informational purposes only. In no way is it intended as actual medical advice. Safety and results are assessed as they apply to each specific patient. Always seek a medical or eye care professional for advisement based on your individual health and specific eye care needs. 

 

 

Source: http://www.eyectexas.com/blog/lasik-safety-and-results/

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Former Opioid Use Advocate Admits He Was Wrong

A former champion of opioid use for pain management has changed his tune, and he is sending out a strong warning against misusing the treatment that he once championed. Dr. Russell Portenoy's public change of heart underscores the urgency of addressing this important health crisis: addiction to opioid derived pain medicines.

Source: http://www.spine-health.com/blog/former-opioid-use-advocate-admits-he-was-wrong

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Extubation in remote locations

Source: http://adventuredoc.net/2012/12/22/extubation-in-remote-locations/

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Vast Majority of LASIK Patients Satisfied, Reports ESEC

LASIK, which stands for laser-assisted in situ keratomileusis, has become one of the most popular vision correction surgeries in the world, with thousands of procedures performed every year.  The numbers, however, don’t paint the whole picture.  A surgery’s true measure of success is how many patients are satisfied with their results!  The Eye Surgery Education Council (ESEC), a leading provider of eye surgery information, is reporting on just that.

“LASIK vision correction has the highest patient satisfaction rate of any elective surgery,” explains the ESEC, “95.4%, according to a 10-year survey of scientific studies from around the world.”  Clearly, this degree of patient satisfaction speaks volumes.  Furthermore, the ESEC reports that “In a recent study, about 97% of LASIK surgery patients said they would recommend it to a friend or relative.”  While LASIK is not for everyone and there are risks and benefits to consider, these figures certainly speak for themselves.

LASIK Results

So, what can LASIK do for you?  First, let’s take a look at the procedure itself.  LASIK eye surgery improves vision safely and precisely by reshaping the cornea to correct nearsightedness (myopia), farsightedness (hyperopia) and astigmatism.  The procedure is tailored to your specific medical needs.

Of course, the goal of every LASIK procedure is 20/20 vision.  Looking at one of the most common eye issues, nearsightedness, the ESEC reports that “Studies of mildly or moderately nearsighted patients show that one year after having LASIK surgery: 98% have obtained 20/20 vision.”  So, do you think LASIK may be right for you?  The only way to find out is to schedule a consultation!

LASIK Consultation

To schedule your LASIK consultation, contact us today.  Our offices are located in Winchester, serving Virginia, West Virginia and Maryland. Book your appointment at (540) 722-6200.  We look forward to working with you.

Source: http://www.seeclear.com/blog/lasik/vast-majority-of-lasik-patients-satisfied-reports-esec

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A difficult Airway

Source: http://adventuredoc.net/2012/12/22/a-difficult-airway/

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The 7 Steps To Amazing Health

We are excited to announce that Dr. Wendy Schauer, D.C., the author of, “The 7 Steps To Amazing Health” will be a featured guest today for Jim Edwards from 7 Day eBook and I Gotta Tell You.  Jim will be interviewing Wendy on her book and how she came to write it. 

As soon as the interview is available we will be sure to post it here.

Yours In Health!

G.E. Moon II

 

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Source: http://www.abundanthealthcenter.com/blog/the-7-steps-to-amazing-health

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Illness following consumption of infected shellfish in the West of Ireland

A dozen people have become ill after gathering and eating shellfish from the shoreline in parts of the west and south-west of Ireland. Illness has been reported in Galway, Mayo and Sligo. It is possible these are linked to marine algal blooms occurring naturally in these areas.

Bivalve shellfish such as mussels, cockles, oysters, scallops and clams should only be purchased from reputable suppliers, (who manage the risks with a national monitoring propramme), not gathered in the wild for home consumption.

Source: ProMed Newsgroup

For further advice, contact the Globe Travel Health Centre on 01603 667323

Source: http://www.globetravelhealthcentre.com/travel-advice/illness-following-consumption-of-infected-shellfish-in-the-west-of-ireland.html?utm_source=rss&utm_medium=rss&utm_campaign=illness-following-consumption-of-infected-shellfish-in-the-west-of-ireland

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Adventure Doc: Weekly on Expedition and Travel Medicine

Source: http://adventuredoc.net/2012/03/06/adventure-doc-weekly-on-expedition-and-travel-medicine/

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Healthcare provider interaction

Source: http://adventuredoc.net/2013/01/03/healthcare-provider-interaction/

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Interview With Wendy Schauer – Author of The 7 Steps To Amazing Health!

Here is a link to an interview that “foodie”, health advocate, and grass fed beef rancher Lisa Wilcox recently did with author Wendy Schauer.

http://nwlocalgrassfedbeef.com/interview-with-wendy-schauer-author-speaker-chiropractor-kettlebell-trainer/

Yours In Health!

G.E. Moon II

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Source: http://www.abundanthealthcenter.com/blog/interview-with-wendy-schauer-author-of-the-7-steps-to-amazing-health

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Interview With Wendy Schauer – Author of The 7 Steps To Amazing Health!

Here is a link to an interview that “foodie”, health advocate, and grass fed beef rancher Lisa Wilcox recently did with author Wendy Schauer.

http://nwlocalgrassfedbeef.com/interview-with-wendy-schauer-author-speaker-chiropractor-kettlebell-trainer/

Yours In Health!

G.E. Moon II

• Share this on Facebook
• Share this on LinkedIn
• Share this on Reddit
• Add to a lense on Squidoo
• Stumble upon something good? Share it on StumbleUpon
• Share this on Technorati
• Tweet This!
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Source: http://www.abundanthealthcenter.com/blog/interview-with-wendy-schauer-author-of-the-7-steps-to-amazing-health

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Medicare And Medicaid Overpayment Suit Upheld

Whistleblowers, Lucas Matheny (“Matheny”) and Deborah Loveland (“Loveland”), brought an action against Medco Health Solutions (“Medco”) claiming that Medco and its subsidiaries failed to report and refund to the federal government $69 million in Medicare and Medicaid overpayments.  The plaintiffs, former employees of Medco, used the authority of the False Claims Act to bring their lawsuit.  The False Claims Act allows private individuals to sue an entity on their own and the government’s behalf.  In doing so, the individuals receive compensation for being a “whistleblower”, which is usually between 15% and 25% of the funds recovered, including reasonable expenses, attorney fees and costs.

Matheny and Loveland knew of the overpayments to Medco, but were told that because of insufficient manpower to process the necessary forms, the overpayments would not be refunded to the government.  Matheny and Loveland claimed the overpayments were transferred to fictitious patient accounts and perfect records with a zero percent error rate were created using a specific computer program.   In addition, Medco filed a false certificate of compliance with the government, knowingly concealing millions of dollars in overpayments. 

When the lawsuit was first heard by the court, it was dismissed, due to the court noting that the plaintiffs’ complaint had been amended three times and failed to state a claim. However, on appeal, the court concluded that Matheny and Loveland had sufficiently alleged the existence of a false record.  Additionally, the court held that the defendants (Medco) knew the records were false and were to be used to avoid a financial obligation to the government.

The Matheny v. Medco Health Solutions matter is a prime example for healthcare providers to be careful with potential overpayments and how to handle those overpayments should they occur.

Source: http://www.pagingdrblog.com/2012/07/09/medicare-and-medicaid-overpayment-suit-upheld/

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Venous Access in Austere Settings: Part One

Source: http://adventuredoc.net/2012/12/02/venous-access-in-austere-settings-part-one/

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Molecular outcomes of neuromyelitis optica (NMO)-IgG binding to aquaporin-4 in astrocytes

Vanda A. Lennon, M.D., Ph.D., with the Departments of Laboratory Medicine and Pathology and Neurology, discusses research that identifies critical properties of neuromyelitis optica, a potentially debilitating neurological disease that is often misdiagnosed as multiple sclerosis (MS).

Dr. Lennon’s team isolated and identified an antibody unique to NMO that may interfere with the transport of the water. In some areas of autopsied brain tissue studied, there was an accumulation of water in the myelin itself that the team believes may lead to the secondary destruction of the myelin in NMO and potential misdiagnosis of NMO as MS.

The study was published online in the Proceedings of the National Academy of Sciences on Nov. 29, 2011.

ABSTRACT
The astrocytic aquaporin-4 (AQP4) water channel is the target of pathogenic antibodies in a spectrum of relapsing autoimmune inflammatory central nervous system disorders of varying severity that is unified by detection of the serum biomarker neuromyelitis optica (NMO)-IgG. Neuromyelitis optica is the most severe of these disorders. The two major AQP4 isoforms, M1 and M23, have identical extracellular residues.

This report identifies two novel properties of NMO-IgG as determinants of pathogenicity: 

• The binding of NMO-IgG to the ectodomain of astrocytic AQP4 has isoform-specific outcomes. M1 is completely internalized, but M23 resists internalization and is aggregated into larger-order orthogonal arrays of particles that activate complement more effectively than M1 when bound by NMO-IgG.
• NMO-IgG binding to either isoform impairs water flux directly, independently of antigen down-regulation.

We identified, in nondestructive central nervous system lesions of two NMO patients, two previously unappreciated histopathological correlates supporting the clinical relevance of our in vitro findings:

• Reactive astrocytes with persistent foci of surface AQP4
• Vacuolation in adjacent myelin consistent with edema

The multiple molecular outcomes identified as a consequence of NMO-IgG interaction with AQP4 plausibly account for the diverse pathological features of NMO: edema, iflammation, demyelination and necrosis.

Differences in the nature and anatomical distribution of NMO lesions, and in the clinical and imaging manifestations of disease documented in pediatric and adult patients, may be influenced by regional and maturational differences in the ratio of M1 to M23 proteins in astrocytic membranes. 

Authors
Shannon Hinson, Ph.D., Michael F. Romero, Ph.D., Bogdan F. Popescu, M.D., Ph.D., Claudia F. Lucchinetti, M.D., James (Jim) P. Fryer, Hartwig Wolburg, Petra Fallier-Becker, Susan Noell, Vanda A. Lennon, M.D., Ph.D.

Source: http://physicianupdate.mayoclinic.org/2012/03/22/molecular-outcomes-of-neuromyelitis-optica-nmo-igg-binding-to-aquaporin-4-in-astrocytes/

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