Month: October 2019

Vegetarian Pot Pie

admin

22 October 2019

Hi, thank you for coming back for the latest edition of Beyond Primary Cares blog; where I highlight healthy and fun recipes, healthcare news, advice for medical conditions, as well as how membership for care works! Dr. Jeff O’Boyle is the owner of Beyond Primary Care, which is a new approach to family medicine and addiction medicine that creates the time and space your healthcare deserves. Beyond Primary Care is the only Direct Care clinic serving patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County giving families and employers peace of mind with healthcare costs by providing affordable, accessible, and authentic primary care services. 

The primary purpose of the blog is to introduce healthy lifestyle concepts and answer common questions I receive from patients that I believe are important. I want to start discussions that will help educate, benefit, and improve your well-being. 

This featured recipe is a Vegetarian Pot Pie. These recipes are my attempt, in a way, to bridge that Doctor’s adage of “Eat Better & Exercise More.” In this post, I will showcase a healthy meal made on a budget, my pictures are pretty decent, and that is how I got into this food endeavor.

Vegetarian Pot Pie

Prep Time: 15 minutes
Total Time: 45 minutes

Ingredients

¾ cup chopped yellow onion (~½ onion)
1 large clove garlic, minced
2 cups veggie broth
2 cups frozen mixed veggies (corn, carrots, green beans)
¼ cup milk
¼ cup unbleached all purpose flour
2 bay leaves
sea salt and black pepper
1 batch biscuits

Instructions

1) Preheat oven to 425
2) Add 2 Tbsp olive oil to large saucepan over medium heat, then add onion and garlic and pinch of salt– stir. Cook until soft.
3) Add the flour and stir with a whisk, then slowly whisk in the broth.
4) Add milk, and bay leaves and stir. Simmer until the mixture is thickened (about 10 minutes). If it still appears to thin, scoop out ½ cup of the broth and add 1-2 tbsp more flour and whisk back into the pot to thicken. Wait a few minutes, repeat if necessary
5) While the sauce is thickening, prepare biscuits. Cut out , leave unbacked, and set outside
6) Once the sauce is thickened, add the frozen vegetables and cook for 4-5 more minutes. Taste and adjust seasoning.
7) Discard the bay leaves and divide the mixture evenly between 5-6 lightly greased ramekins or 8×8 baking dish. 
8) Top with biscuits and brush the tops of biscuits with melted butter. 
9) Set your ramekins or 8×8 dish on a baking sheet to catch overflow and bake until the biscuits are golden brown and the filling is bubbly (about 14-17 minutes). Let cool for 5 minutes before serving.



Tater Tot Casserole

admin

10 October 2019

Hi, thank you for coming back for the latest edition of Beyond Primary Cares blog; where I highlight healthy and fun recipes, healthcare news, advice for medical conditions, as well as how membership for care works! Dr. Jeff O’Boyle is the owner of Beyond Primary Care, which is a new approach to family medicine and addiction medicine that creates the time and space your healthcare deserves. Beyond Primary Care is the only Direct Care clinic serving patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County giving families and employers peace of mind with healthcare costs by providing affordable, accessible, and authentic primary care services. 

The primary purpose of the blog is to introduce healthy lifestyle concepts and answer common questions I receive from patients that I believe are important. I want to start discussions that will help educate, benefit, and improve your well-being. 

This featured recipe is a Tater Tot Casserole. These recipes are my attempt, in a way, to bridge that Doctor’s adage of “Eat Better & Exercise More.” In this post, I will showcase a healthy meal made on a budget, my pictures are pretty decent, and that is how I got into this food endeavor.

Tater Tot Casserole

Adapted from: Emily Bites
Prep Time: 40 minutes
Total Time: 1.5 hour
Serves: 6

Ingredients

1 package (20 oz) frozen tater tots
1 lb (99% lean) ground turkey breast
6 slices bacon
2 tbsp butter, unsalted
1.5 tsp salt, divided
1 tsp black pepper, divided
1 tsp thyme
½ tsp crushed red pepper flakes, divided
1 tsp sage
¼ tsp ground nutmeg
8 oz, cheddar cheese, shredded
12 large eggs
½ cup milk
¼ green onion

Instructions:

1) Preheat oven to 350 F. Spray a 9×13 baking dish with cooking spray.
2) Place a nonstick skillet over a stove with low-medium heat. Melt the butter. 
3) In a mixing bowl, combing turkey, ¾ tsp salt, 1/2 tsp pepper, sage, thyme, nutmeg, and ¼ tsp crushed red pepper. Stir until the turkey is well combined with the seasoning. Add to skillet.
4) Break up the turkey with a spoon or spatula, cook until turkey is cooked through.
5) Pour frozen tater tots into the casserole dish and arrange into a single layer. 
6) Once the turkey is cooked, spread the mixture on top of the tater tots.
7) Add the bacon back to the skillet, turn the heat to medium. Cook until crisp. Once done, remove to a layer of paper towels, pat dry and crumble the bacon. 
8) Add the bacon on top of the turkey in the casserole dish. Add the cheddar cheese on top. 
9) In the mixing bowl, combine the eggs, milk, green onions, ¾ tsp salt, ½ tsp pepper, and ¼ tsp red pepper flakes. Beat the eggs and seasoning with a whisk. When beaten, pour the eggs over the top of the cheese layer in the baking dish. 
10) Bake for 50-60 minutes or until eggs are cooked through and a toothpick inserted in the center comes out clean.



High Blood Pressure

admin

8 October 2019

Hi, thank you for coming back for the latest edition of Beyond Primary Cares blog; where I highlight healthy and fun recipes, healthcare news, advice for medical conditions, as well as how membership for care works! Dr. Jeff O’Boyle is the owner of Beyond Primary Care, which is a new approach to family medicine and addiction medicine that creates the time and space your healthcare deserves. Beyond Primary Care is the only Direct Care clinic serving patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County giving families and employers peace of mind with healthcare costs by providing affordable, accessible, and authentic primary care services.

The primary purpose of the blog is to introduce healthy lifestyle concepts and answer common questions I receive from patients that I believe are important. I want to start discussions that will help educate, benefit, and improve your well-being. 

In this blog post, I wanted to talk about hypertension, also known as High Blood Pressure.

You Feel Normal

A person with painful urination is more likely to accept a diagnosis of a urinary tract infection. A child with with wheezing and shortness of breath is more likely to accept a diagnosis of asthma. People diagnosed with high blood pressure are puzzled, saying “How is this something I have” when you don’t feel any different. Symptoms sometimes validate a diagnosis. However, unlike many other illnesses, high blood pressure rarely has identifiable symptoms. As a matter of fact, you may of heard Dr. O’Boyle forbiddingly warn this is the ‘silent killer.

Is High Blood Pressure Dangerous

You may of heard the phrase ‘benign essential hypertension,’ but rest assured, this is an antiquated term. Much like describing a suspicious skin lesion, we use the words ‘benign’ or ‘malignant’ to describe two completely opposite threats. This is not the case when it comes to high blood pressure. 

I mentioned earlier that high blood pressure uses the alias the ‘silent killer’ because if blood pressure is uncontrolled, complications may include heart attacks, strokes, and kidney failure.

It is a very real threat.

What is Blood Pressure?

When I take a patient’s blood pressure, always with an inflatable cuff around your arm, I express the measurement back to you as two numbers. The number on top (systolic) and the number on bottom (diastolic), for example 120/80. The top number indicates how much pressure your blood is exerting against the walls of arteries when the heart beats. The bottom number indicates how much pressure your blood is exerting against your artery walls when the heart is resting between beats. Both numbers matter. 

The difference between a Normal or High Blood Pressure

I adhere to the clinical practice guidelines set forth from the American Academy of Family Physicians. As you can see from the chart above, a normal blood pressure is less than 120 on the top and less than 80 on the bottom. A definition of high blood pressure starts at a top number of 140 or greater and a bottom number of 90 or greater. 

The Odds

Per the Centers of Disease Control (CDC), 1 in 3 adults in the United States will have high blood pressure. This is why I check your blood pressure, a part of what is called ‘vital signs,’ at every visit. 

How Does This Happen?

Knowing the cause of any disease is helpful. Yet for high blood pressure, I rarely find just one cause. In fact, in medical jargon, ‘essential’ as in ‘essential hypertension’ means ‘of unknown cause.’ There are usually multiple factors at work. Some can not be prevented, such as:

  • Genetics
  • Race
  • Age

Genetic risk is complex and various between individuals as some people have protective genes and others don’t. Some ethnicities have high risks of elevated blood pressure (eg- non Hispanic African American people are more likely to have high blood pressure than other races). There is nothing you can do about it. You also can’t stop aging. 

As we age, that doesn’t mean we can’t do anything to tackle modifiable factors, such as:

  • Being Overweight
  • Smoking
  • Lack of Physical Activity
  • Stress
  • Drinking too much alcohol

Testing: Cheap and Easy

You know I check your blood pressure at every visit. But if people had the ability to check more often, the more effectively we could manage this condition. Blood pressure monitors are available at reasonable prices (typically $25-50), and can be done in the comfort and privacy of your own home. Just like our subjective feelings such as happiness, sadness, stress, and restlessness, our blood pressure varies throughout the day too. This is why I recommend monitoring blood pressure at home for at-risk individuals multiple times a day. 

Treatment

Discussing the scope of treatment for blood pressure is extensive and always carries asterisks for certain populations. Just like the causes, I always say treatment is multi-dimensional and must be individualized, your classic N of 1 trial.  Part of that treatment may include:

  • Medications
  • Exercise
  • Naps
  • Smoking cessation
  • Diet modification
  • Relaxation techniques

Naps are for babies, right? I love a good nap when given an opportunity. Research has shown people who sleep for 30-60 minutes, typically after a midday meal, had a 5% lower average 24 hour ambulatory systolic blood pressure than those who did not sleep, even when adjusted for age, gender, BMI, smoking status, salt intake, alcohol intake, exercise, and coffee consumption. Something to dream about.