Category: Health & Wellness

Treating Menopausal Symptoms

admin

19 May 2020

Hi, thank you for coming back for the latest edition of the Beyond Primary Cares blog; treating menopausal symptoms. In my blogs 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 an insurance free, membership based family medicine and addiction medicine clinic. 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’m glad to welcome a guest blogger, my friend Liza Baker. Liza is the owner of Simply: Health Coaching and is a full-time health coach and nonprofit consultant, author, blogger, and podcaster with a soft spot for supporting women in their 40s and above. This is a collaboration blog-piece, where we wanted to educate our patients and the community on treating menopausal symptoms, specifically how role lifestyle and nutrition can positively influence those changes, and what medications can positively influence those changes.

Menopausal, peri-, and post-

First, a little bit of clarity to the menopause timeline:

  • Menopause is defined as the complete cessation of the menstrual cycle for 12 months, after which time it is extremely rare for it to resume. The average age at which menopause occurs in the United States is 52.
  • Peri-menopause is the period of our lives when our bodies (if not our conscious thoughts) begin to move toward the end of our child-bearing years, and it can begin as long as 10 years before the final menstrual cycle—that’s right: you can enter menopause as early as your late 30s to early 40s. And yes, you can still get pregnant during these years! (As we know from the British comedy Sex Education!)
  • Women are considered post-menopausal once they have been cycle-free for 12 months.

Importance of Identifying Menopausal Symptoms

Every woman experiences menopause differently. Some of us reach the end of our cycles almost without noticing; others don’t have a period for some months and then get surprised to find that it was just loitering in there—and then we need to start the countdown over again. Your “regular” periods may have stopped years ago—regular in the sense of timing and in their length and heaviness. 

Like most women, you may have an idea what to expect:

  • Physical symptoms such as hot flashes, night sweats, vaginal dryness, dizziness, nausea, breast tenderness, insomnia, skin changes, abnormal uterine bleeding, urine incontinence, and headaches. 
  • Changes in mood such as increased anxiety, reduced sex drive, memory issues, and fluctuations in mood. 

These symptoms can last months to years, and even post menopause, you can still sometimes “feel menopausal.” These symptoms can be severe, disruptive, and even feel embarrassing at times. 

In a previous blog post, Liza reminds us that it doesn’t help to approach this shift in hormones as a problem, like we are entering this stage of life from the perspective of “we’re broken.” Instead, it’s important to approach this as a woman’s health experience within the context of identifying your own symptoms and getting clarity about possible therapies for treating menopausal symptoms.

Treating Menopausal Symptoms —and causes

You may have mined the women’s health section of your local bookstore looking for informed (dare we say evidence-based) resources to guide you. What you likely found is a broad spectrum of seemingly science-based approaches from “here is why you should be on hormone replacement therapy (HRT)” to “here is why you absolutely should NOT be on HRT!”

Liza is a firm believer that when advice falls on a spectrum (HRT: YES! NO!), the truth likely lies somewhere in the middle. And having learned that many of the top health problems in our country are so-called “lifestyle diseases”—meaning that they can be reversed and/or prevented through our food and lifestyle choices.

Putting Experience Into Practice

Liza’s personal experience with peri-menopause involved a large number of the most commonly recognized symptoms listed above—including raging migraines after decades of their absence and an appearance by anxiety and panic attacks, neither of which she’d ever experienced before.

And perhaps because Liza had been raised with fairly good food and lifestyle choices and began to make even better ones once she had her own family, many of my/her symptoms were quite mild.

That said, as a health coach, her work with clients is based on the principle of bio-individuality: your perimenopause is not my perimenopause; what works for you may not work for me; your kale may be my kryptonite. Dr. O’Boyle explains it this way: “Discussing the scope of treatment … is extensive and always carries asterisks for certain populations…. Treatment is multi-dimensional and must be individualized, your classic N of 1 trial.”

What matters most is that we—as patients/clients and as practitioners—take a holistic approach: yes, it’s about reducing the severity of symptoms—and about taking a longer view of what caused them and how we can shift that in a more positive direction. It’s as much (more?) about prevention as it is about a cure.

And it’s about giving you—the patient—permission to have some agency over your health care. As Dr. O’Boyle says, “Mainstream medicine has a challenge: continue to ignore your story and lose you to a subjective fantasy built on the mistakes of our brain, or join you in your life story ensuring you are taking responsibility for your wellbeing while making you central to the care and cure.”

Treating Menopausal Symptoms with Medications

The stress involved with menopause can be disruptive on many levels. Some women feel awful, and don’t want to be subjected to a physical exam, let alone interact with a physician when they can’t interact with their families, co-workers, and friends in a way that has meaning. At Beyond Primary Care, you can be assured there will be no judgement, no unnecessary physical exams, just compassion and an opportunity to share your story.

At Beyond Primary Care, I use an eclectic and personalized approach—not a “canned” conversation- towards accessing and resolving life changes and stressors. In a thorough health history, I am going to ask about your family, where your quality of life is being most affected, and—most importantly—what you want to do. I find validation of your concerns and education are often powerful methods in support when you are not feeling well. As you read above, some women prefer enhancing their diet and exercise along with support in allowing their symptoms to play out more naturally.

If more holistic approaches of treatment don’t work, I [Dr. Jeff O’Boyle] can get innovative with estrogen and progesterone hormone replacement therapy (HRT), depending on your needs. Getting the dosage right using hormone patches, pills, and creams is always individualized, and I [Dr. Jeff O’Boyle] works with my [his] patients to customize how much or how little may be needed. While HRT is sometimes a last resort for a woman, the relief it gives can be life-changing. Additionally, just like a great chef (shamless cook book plug) with their ingredients, I am constantly measuring and remeasuring your for safety and goal achievement.

Decisions, decisions

Consider this your permission to make a decision about treating perimenopausal symptoms based on what’s right for you—because you do have options!

If you suspect some of what you are experiencing may be due to perimenopause, or if you notice any coworkers, friends, or family members silently struggling, send them a link to this post so that they can join the conversation!

Please share comments and questions below. You can also contact Dr. O’Boyle or Liza Baker directly. We look forward to hearing from you!

What is the Coronavirus? Get Answers Here

admin

27 February 2020

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 an insurance free, membership based family medicine and addiction medicine clinic. 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 the coronavirus, what it is, how is it spread, what are symptoms, and how to protect yourself.

What is the Coronavirus?

Coronaviruses represent a large group of viruses, not just one we are hearing about in the news and media lately. These Coronaviruses are categorized as “Zoonotic diseases,” meaning they are transmitted between animals and people. The Coronavirus this blog is referencing (COVID-19) initially occurred in an animal or seafood market in the city of Wuhan, China. The disease has since spread throughout China and to a number of other countries.

On the ‘skin’ of the Coronavirus are a huge number of spikes (proteins) that give it the appearance of a ‘crown.’ Crown in latin = Corona. Just like the Human Papillomavirus (HPV), which is the causative agent such as non life-threatening conditions like foot (plantar) warts or very dangerous conditions such as cervical cancer, there are many subtypes of Coronavirus. 

Think of subtypes like the seasoning, basil. There is cinnamon basil, Greek basil, lemon basil, well- you get the point.

Some of the subtypes cause respiratory illnesses as minor as the common cold, while others cause pneumonia. These tend to be mild. However, just like HPV, there are some types of Coronavirus that can cause severe disease, such at the China 2019 Novel Coronavirus. This new Coronavirus being spread has not been previously identified in humans.

Situation in the United States

There are 59 total cases of the China 2019 Novel Coronavirus. Eight U.S states have confirmed cases including Massachusetts, California, Washington, Arizona, Texas, Wisconsin, Illinois, and Nebraska. 57 cases have been diagnosed as a result of travel or being evacuated from high-risk countries. 2 cases are believe to have spread person to person within the U.S.

Being present on public transport areas is a major risk factor for transmission. This Coronavirus appears to be spreading easily in China, but not as much in the United States.

The Centers of Disease Control (CDC) states to prepare for the ‘inevitable’ spread of the coronavirus within the United States. 

The CDC calls this Coronavirus “a serious public health concern.” 

The City of San Francisco, despite not having any confirmed cases of the Coronavirus, has declared a local emergency because it is a major travel connection hub. 

How is the Coronavirus spread?

The exact mechanism (as of publication of this blog post) has yet to be discovered. In general, it is thought respiratory droplets – such as what comes out your nose or mouth when you cough or sneeze- or objects that have been contaminated with the virus, are the source of the Coronavirus. 

How does the Coronavirus present?

A number of symptoms can present ranging from mild to severe. Symptoms typically take between 1 and 14 days to appear once the virus is contracted. Mild symptoms include fever (anything over 100.4F), cough, body aches, fatigue, sore throat, cough, and shortness of breath. Severe symptoms include pneumonia, kidney failure, and even death. 

Currently, the only means of diagnosis is testing through a technique called Reverse Transcription-Polymerase Chain Reaction tests that can diagnose the Coronavirus from respiratory samples. This test is currently not available at any outpatient clinics in the United States.

These tests are only at selected U.S. States and local public health laboratories, Department of Defense (DOD) laboratories, and some international laboratories. 

Protect Yourself

Currently there is no specific medication to combat the Coronavirus. Additionally, there is yet to be a vaccine- although these are in development. Treatment if someone is infected is supportive care.

A number of hygiene practices to help prevent the spread of the Coronavirus include covering your mouth and nose when sneezing or coughing (such as the vampire cough depicted above), washing your hands with soap and water frequently, and wearing masks if you could have the virus or around other people you care for who may have the virus.

Fish Antibiotics For Humans

admin

26 January 2020

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 an actual patient of mine about to fish antibiotics for humans, the barriers of obtaining affordable medications, and how to obtain affordable medications.

My Patient’s Fish Antibiotic Story

A kind man in his 30s finds out about my clinic last month saying ‘direct primary care’ is perfect fit because even though he works full time, his employer does not offer him health insurance. He explains his employer is a contractor for a major shipping company (think top 3), but since they are contractors, they are not entitled to the same benefits.

He has been without any healthcare for the past 3 years saying “I can’t afford BlueCross.”

The newly enrolled patient says discovering Beyond Primary Care was serendipitous, because he has been experiencing left ear pain so bad for the past 2 weeks, that he was going to do something about if finally. Curious, I ask what he plan was and he replied he had been reading about ‘fish antibiotics for humans’ on the internet.

Since you don’t need a prescription for that he could avoid the healthcare costs associated with establishing care with a new physician and price of medications at a retail pharmacy.

A Dangerous Idea

Yes, so taking fish antibiotics for humans is a real thing. A quick google search turned up numerous unscientific medical survival guides. I read the reviews for aquarium antibiotics. However, taking medications that are 1) not for humans, 2) not prescribed by a licensed physician and 3) not properly dosed is incredibly dangerous. 

Misuse of any medication can cause serious illness. The medications used for many animals and vertebrates do NOT require FDA approval, so there is no regulation over the manufacturing of the medication that one would take.

I always tell my patients for any medication that they have effects, thus they may have side effects. Additionally, using antibiotics for self-diagnosed illnesses may lead to antibiotic resistance, which ultimately hurts the individual using the medication and society in the larger picture. 

Improving Affordable Healthcare and Transparency

Antibiotics are not necessarily all expensive either. Some large retail pharmacies in the state of Michigan even offer certain types of antibiotics for free (you still need a prescription from a physician). The patient did have an ear infection. Because we are a ‘Direct Primary Care’ clinic, the patient was prescribed AND dispensed the antibiotic from our office at the time of the visit.

The cost of the drug prescribed to this particular patient through Beyond Primary Care was $1.95.

Many of us are accustomed to thinking that we pay health insurance premiums to get access to a lower cost for health care medications — that being the “negotiated rate” or “contracted rate” that the insurance company and the payer agree to in contract talks. But increasingly we are hearing that insured people are paying more than uninsured people.

Additionally, evil organizations out there called Pharmacy Benefit Managers (PBMS- more on them on a later post) are yet another middlemen in our insane medical billing industry that can increase the prices we pay for medications.

No Quick Legislative Road

In late 2019, the current white house administration released new rules requiring hospitals to be more proactive with price transparency by publishing their charges and negotiated rates. Great right? If we go on Amazon, we can see the description, reviews, and price for everything. We expect and demand price transparency with all our other transactions. Same for healthcare now.

However, even within a few weeks of this executive order, hospital systems and insurer across the nation are suing to keep their prices a secret. The hospital systems and insurers know that if their costs become public knowledge, they stand to lose millions of dollars because people will simply shop around for the best market price, something we do for every other service.

Is there an easy solution?

In my opinion, the best advocates for patients to obtain affordable and transparent healthcare are those independent from a large hospital/health system– such as those who operate as Direct Primary Care (DPC) physicians.

Pork Tenderloin

admin

8 January 2020

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 Pork Tenderloin. 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.

Pork Tenderloin with Brussel Sprouts and Butternut Squash

Adapted from Family Circle: Sheet Pan Pork
Prep time: 30 minutes
Total time: 1 hour

Ingredients:

1 Butternut squash
1 lb of brussel sprouts (approx. 4 cups)
1.5 – 2 lb pork tenderloin
Olive Oil
1 tbsp mustard
1 tsp paprika
1 tsp garlic powder
1 tsp salt
1 tsp tumeric
1 tsp thyme
½ tsp pepper

Instructions:

1) Peel and Chop Butternut squash into 1 inch cubes. Trim brussel sprouts as needed. Set aside.
2) Mix Mustard and all spices.
3) Trim silverskin and excess fat from tenderloin. Rinse off and pat dry with a paper towel. Spread mustard mix all over tenderloin.
4) Heat pan to medium-high. Add tenderloin. Brown all sides (6 – 8 minutes, 2-3 per side). Remove from pan and set aside.
5) Add veggies to the sheet pan. Add olive oil, additional salt, pepper, and thyme. Toss to coat. Spread veggies around the perimeter of the pan, leaving room in the middle for tenderloin. Add tenderloin. 
6) Bake at 350 for 25-30 minutes. Give generous drizzle of olive oil over the entire pan. Check the doneness of pork (should be 145 internal temp). Remove pork, wrap in foil, rest for 10 minutes. Turn oven temp up to 400. Return the pan of veggies to the oven for 5-10 minutes until caramelized.
7) To serve sliced pork against the grain and serve up with a scoop of veggies. Drizzle pan juice over top.


Tuscan Tortellini Soup

admin

28 December 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 Tuscan Tortellini Soup. 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.

Tuscan Tortellini Soup

Adapted from Cooking classy
Prep: 10
Total: 35 min

Ingredients

2 Tbsp olive oil
1 ½ cups chopped carrots
1 ½ cups chopped yellow onion
1 cup chopped celery
2 cups chopped green beans, about 1-inch pieces
2 cups chopped zucchini
4 cloves garlic, minced
3 (14.5 oz) cans vegetable broth
2 (14.5 oz) cans diced tomatoes 1 tsp each dried basil and rosemary, crushed
½ tsp dried thyme
Salt and freshly ground black pepper, to taste
1 (9 oz) package refrigerated 3-cheese tortellini
3 cups packed spinach
Shredded Parmesan cheese, for serving

Instructions:

1) Heat olive oil in large pot over medium-high heat. Add carrots, onion and celery and saute 3 minutes.
2) Add green beans and saute 3 minutes longer. Add zucchini and garlic and saute for 1 more minute. 
3) Pour in broth and tomatoes. Add basil, rosemary, thyme, and season with salt and pepper to taste
4) Bring to a gentle boil, then reduce heat to medium and allow to boil, about 8 minutes.
5) Add tortellini and boil 5-7 minutes longer.
6) Stil in spinach and cook 2 minutes longer.
7) Serve warm with parmesan cheese.


Obstructive Sleep Apnea

admin

26 December 2019

Obstructive Sleep Apnea

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 Obstructive Sleep Apnea (OSA).

Your Spouse Says You Snore, a LOT

Everybody snores, right? How bad can it be though? You never hear it.

The changes are gradual, so gradual you may not see the pattern. You finally get tired of the criticism so you make your way to an ear, nose, and throat specialist to tell you have a deviated septum. Maybe they tell you you have a uvula (that dangling skin in your throat) that needs trimming. You consider surgery, but that is a big step. 

Eventually you may start getting depressed. Maybe your personal or work relationships start deteriorating. You start to see a therapist who recommends you back to a psychiatrist, who dutifully puts you on a cocktail of anti-depressant medications. 

At some point you make it back to your primary care physician, where you relay some of this information during a yearly physical. The spouse says they are worried because you seem to stop breathing at night (Apnea), then suddenly gasp for air followed by resuming your slumber as if nothing had happened.

Your physician says your sleep may be a key to your problems.

Other symptoms of Obstructive Sleep Apnea include:

  • Excessive and inappropriate daytime sleepiness
  • Insomnia
  • Problems with memory and/or concentration
  • Impotence
  • Headaches
  • Fatigue

What Causes Obstructive Sleep Apnea

According to the American Academy of Sleep Medicine, Obstructive Sleep Apnea is a sleep-related medical condition that results in an almost complete blockage of airflow despite your body’s effort to breath. This is caused when the muscles in the pharynx (throat) relax during sleep, allowing all the supporting tissues of the throat to collapse and block the upper airway. These apnea episodes, or pauses, can last between 10 and 30 seconds, but some may progress longer. 

This lack of breathing drops your blood oxygen saturation that ultimately sounds an alarm in your brain to cause a temporary arousal from sleep that typically restores normal breathing. This can occur hundreds of time in a single night resulting in poor and episodic sleep quality resulting in the above symptoms.

Diagnosis

You will be advised to undergo a sleep study. This sounds absurd on the face, what doctor would routinely want to observe anyone while they sleep? In fact, you may never see the ‘sleep doctor.’ There are many ‘sleep laboratories’ around the nation, often staffed with sleep technicians where you can have up to 36 separate electrodes placed on you while you are asleep. The laborites sleep technician will likely be helping you with all of this. 

I personally encourage my patients to complete home based sleep studies, as example using Somno Services. With Somno Services, they ship all the necessary equipment to you at your home. This allows my patients to complete the assessment in the comfort of their own homes at a fraction of the cost a sleep laboratory would charge, around $175 versus $1,000+ at a sleep clinic. Following completion, you simply repackage the materials and send it back.

After a few days, the sleep doctor will review the data collected and be able to confirm a diagnosis.

Realistic Treatment Options

CPAP therapy (Continuous Positive Airway Pressure) as pictured below is a standard of therapy. Once you have a diagnosis, you will have to get the proper equipment from a medical supply store. Finding a proper fitting mask is key to this. 

Wearing an oral or dental appliance can be an alternative to CPAP. Oral devices work by holding the tongue in place or by sliding the jaw forward while you sleep. Again, this is a device that may need some fine-tuning by a trained sleep specialist or supply store.

Surgery. Some surgeons may say that corruption of nasal structures or throat structures can reduce or eliminate extra tissues in your throat preventing the collapse that leads to Obstructive Sleep Apnea. While surgery may indeed help in some cases, I encourage all my patients to review the harms and benefits of the surgery vs non surgical options, ask about success rates, and ultimately factor in costs.

Weight loss. I absolutely hate the old doctor’s adage of ‘eat less and move more.’ Weight shaming is not a motivating strategy. Know though, reductions is weight and ultimately body mass can significantly reduce or even eliminate the weight of the tissue pressing onto the airway. Losing weight, like any other medical condition, requires a multi-dimensional approach including potentially mental imagery and therapy, nutritional support counseling, a safe exercise program, and regular biometric feedback.

Roasted Red Pepper Pasta

admin

23 November 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 Roasted Red Pepper Pasta. 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.

Roasted Red Pepper Pasta

Adapted from: LaurensLatest
Prep Time: 10 minutes
Total Time: 30 minutes

Ingredients:

2 tablespoons butter
1 medium onion, diced
5 cloves garlic, minced
2 (12 oz) jars roasted red peppers, drained
1 cup vegetable stock
1 tablespoon fresh basil
½ tablespoon dried basil
½ cup heavy cream
1 cup parmesan cheese, grated, divided
1 (12 oz box) pasta, cooked
Salt and Pepper to taste

Instructions 

1) Preheat skillet over medium heat, melt butter.
2) Saute onion until tender, about 5-10 minutes. Stir in garlic, cook until fragrant. Remove from heat.
3) Pour onions and garlic into blender, add in red peppers, vegetable stock, salt, pepper, and dried basil. Pulse until smooth.
4) Pour back into skillet and stir in cream. 
5) Once pasta is cooked, pour into the sauce along with ½ parmesan cheese and toss.
6) Dish and serve topped with remaining cheese and basil.


Cranberry Orange Bread

admin

16 November 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 Cranberry Orange Bread. 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.

Cranberry Orange Bread

Adapted from: Tasteandtellblog
Prep: 15 min
Total time: 1 hr

Ingredients

2 cups flour
½ cup sugar
1 tablespoon baking powder
1/2 teaspoon salt
Grated zest of one large orange
⅔ cup orange juice
2 eggs, lightly beaten
⅓ cup vegetable oil
2 cups frozen cranberries
½ cup chopped pecans

Instructions

1) Preheat the oven to 350°F and grease a 9×5 loaf tin well.
2) Combine flour, baking powder, sugar, and salt. Sift into a bowl. Add the zest.
3) Make a crater in the middle and add vegetable oil, eggs, and orange juice. Stir gently until combined. Fold in nuts.
4) Pour batter into the tin pan. Place into oven and bake 45 minutes or until toothpick inserted into center comes out clean. Allow to cool for 10 minutes.



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.



High Blood Pressure

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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.