Tag: Family Doctor

Spinach Enchiladas

admin

21 August 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 serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.

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 Spinach Enchiladas. 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.

Spinach Enchiladas

Courtesy of Sadonia2 on Allrecipes
Prep time: 20 minutes
Total time: 45 minutes

Ingredients:

1 tablespoon butter
1/2 cup green onions, chopped
2-4 cloves garlic, minced
2 (10oz) packages frozen chopped spinach, thawed, drained, and squeezed
1 cup ricotta cheese
1/2 cup sour cream
2 cups Monterey Jack cheese
10-15 (6 inch) corn tortillas
1 (19 oz) can enchilada sauce
1 (4oz) can green chilies
1 tablespoon cumin
1 teaspoon salt

Instructions:

1) Preheat oven to 375 degrees F
2) Melt butter in sauté pan over direct heat. Add garlic and green onions cooking for a few more minutes until fragrant, but not brown.
3) Stir in spinach, cumin, green chilies, and salt. Cook for about 5 minutes
4) Warm tortillas one-two at a time in skillet or microwave until flexible, about 15 seconds.
5) Remove skillet with spinach from heat, mix in ricotta cheese, sour cream, and 1 cup of Monterey Jack cheese
6) Spoon about 1/4 cup of spinach mixture into the center of each tortilla. Roll up and place seam side down in 9×13 baking dish.
7) Pour enchilada sauce over the top, and sprinkle with remaining Monterey Jack cheese.
8) Bake for 15-20 minutes, until sauce is bubbling and cheese is lightly browned.

Storytelling in Anxiety and Depression

admin

12 August 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 serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.S

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. 

Storytelling

We talked about what anxiety is in an earlier post. In this post I am discussing something that is important to me in treating any mental health condition- especially anxiety and depression- and that is storytelling.

Why We Listen

Not only is it a way of relaying information about my patients when discussing care (eg- talking to a therapist to find the best medication), but it is an an essential way I continue to learn at work. It has struck me recently that even more than these obvious examples, storytelling has a direct impact on not only how we understand anxiety and depression (or any disease) but the process of healing itself, from the perception and expectations of the patient to the diagnosis and treatment by the physician. One thing I find myself doing on a daily basis as a physician is listening to patient’s stories. I sit down with them, make myself present, and just listen.

Listen For Understanding

Think about any instruction list TELLING you how to do something: 
Step 1: take an anti depressive medication, followed by 
Step 2: get 8 hours of sleep a night, followed by
Step 3: walk 30 minutes each day, and so on. 

People may complete the task, but long term learning for long term success from this method is limited. When someone is stuck in the dark hole that is anxiety or depression, it’s hard enough just getting OUT of bed in the morning, let alone doing any number of tasks. Treating anxiety or any mental health condition is not comparable to assembling a piece of furniture from Ikea.

Now, compare this to learning something from a story, where someone has pushed their own human experience and emotion into those tasks. Hearing the struggles, failures, and successes through story are more likely to shape your ability to learn and cope. Understand there are some conditions that we treat through empathy and ability to get to know people at people at a deeper level. The conversation can lend the support you need as you navigate the ‘hard’ in your own life.

Our Stories Are Ourselves

Sharing your story will help you feel better. Why are you not sharing your story? Perhaps you feel embarrassment, fear, resignation? If you do not share your story then those thoughts and feelings are just randomly going through your mind, and you may only be inclined to be reactive towards them when they do pass through… that is randomly.

We use stories to describe to others our needs, and mental health is no exception. It doesn’t make much difference what we leave in and what we take out, what is important is that we tell the story. There is magic in that. It’s in the listener and storyteller- us. And for each and every ear, it will be different. And it will affect us in ways that we can never predict. From the mundane to the profound. You may tell or hear a tale that takes up residence in your soul, becomes your blood and your purpose. That story will move you and drive you. And who knows what you might do because of it.

The Challenge

The truth is today we are not treating everyone we need to who suffers from anxiety or depression, and can not do so if we continue to insist on one-on-one therapy with only an ‘expert.’ If listening to and sharing stories helps people, how can we withhold it? It will be there, doing its thing, whether you want it there or not. To ignore it seems to me to be the least ethical thing one could possibly do.

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.

Spinach & Artichoke Dip

admin

24 July 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 serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.

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 Spinach and Artichoke Dip. 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.

Spinach-Artichoke Dip

Adapted from: Food Network, Houstons
Prep time: 25 minutes
Total time: 30 minutes

Ingredients:

2 (10 oz) bag spinach, destemmed
1 tbsp butter
2 tbsp onion, minced
2 cloves garlic, minced
3 TB all purpose flour
1 ¼ cups milk
½ tsp lemon juice
1 tsp worcestershire sauce
1 ¼ cups parmesan cheese, grated
¼ cup sour cream, plus more for serving
½ cup white sharp cheddar cheese, shredded
½ cup artichoke hearts, squeezed dry and roughly chopped
Salt
Tortilla chips for serving

Instructions:

1) Bring a large pot of salted water to a boil. Stiri in the spinach and cook until bright green, about 30 seconds. Drain and rinse under cold water; squeeze out the excess moisture, then finely chop.
2) Melt the butter in a large saucepan over medium heat. Add the onion, garlic and ½ tsp salt and cook until the onion is soft, about 2 minutes.
3) Add the flour and cook, stirring, until lightly toasted, about 1 minute.
4) Whisk in the milk and cook, whisking constantly, until thickened, about 1 minute. Remove from the heat. Stir in the lemon juice, worcestershire sauce, parmesan and sour cream.
5) Return the pot to medium heat. Add the spinach, cheddar and artichokes and stir until the cheese melts and dip is heated through. 
6) Serve with tortilla chips, salsa, and sour cream.


Orange Cranberry Scone with Orange Glaze

admin

17 July 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 serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.

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 Orange Cranberry Scone with Orange Glaze. 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.

Orange Cranberry Scone with Orange Glaze

Adapted from: Just a Taste
Prep Time: 15 minutes
Total Time: 1 hr 

Ingredients For Scones:

2 ½ cups all-purpose flour
2 ⅓ teaspoons baking powder
¼ teaspoon baking soda
Pinch of ground nutmeg
½ teaspoon salt
1 cup frozen cranberries
6 tablespoons cold unsalted butter, cubed
¾ cup greek yogurt, plus more for topping
2 large eggs
2 teaspoons vanilla extract
2 tablespoons orange juice
1 tablespoon orange zest

Ingredients For Glaze

1 cup confectioners’ sugar, sifted
1 ½ teaspoons unsalted butter, melted
1 tablespoon greek yogurt
2 ½ teaspoons orange juice
2 teaspoons orange zest

Instructions:

1) Preheat oven to 400 F. Line a baking sheet with parchment paper.
2) In a medium bowl, whisk together all of the dry ingredients of the scones.
3) Grate butter into flour mixture on the large holes of a box grater; use your fingers to work in the butter until mixture resembles coarse meal.
4) Add the cranberries to the flour mixture.
5) In a separate medium bowl, whisk together the yogurt, eggs, vanilla, orange juice and orange zest.
6) Using a fork, stir yogurt mixture into flour mixture until large dough clumps form. Use your hands to press the dough against the bowl into a ball. The dough will be crumbly at first, but as you press, the dough will come together.
7) Place on a lightly floured surface and pat into a 7-inch circle about ¾-inch thick. Use a pizza cutter to cut into 8 triangles; place on prepared baking sheet, about 2 inches apart. 
8) Bake until golden, about 15-20 minutes. Cool for 10 minutes and prepare the glaze.
9) In a medium bowl, prepare the glaze by mixing together all of the glaze ingredients. Whisk until smooth. If glaze is too thick, thin it with extra orange juice. Drizzle over the warm scones and enjoy.

Medicare for All Act of 2019

admin

16 July 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 serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.

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 will not discuss my personal political views nor will I use this as a medium for healthcare horror stories, like this sad story, this sad story, or this frustrating story… because we have heard these before. In this blog I will discuss facts of what I learned from 1) attending the EMU hosted event for ‘Medicare for All,’ and 2) reading through all the pages available online regarding H.R. 1384.

Medicare for All 

I recently attended a town hall hosted at Eastern Michigan University (EMU) on Saturday July 13th where Congresswoman Debbie Dingell (Michigan’s 12th District), Congresswoman Primila Jayapal (State of Washington 7th District), State Senator Jeff Irwin (Michigan’s 18th Senate District), State Representative Yousef Rabhi (Michigan’s 53rd District), State Representative Ronnie Peterson (Michigan’s 54th District), as well as Michigan Nurse Association Vice President Katie Scott were all discussing the ‘Medicare for All Act of 2019.’

They were having a discussion about H.R. 1384, the Medicare for All Act of 2019 which is a bill that would establish a national health insurance program to cover all U.S. residents. Currently (as of 7/15/19) the bill has 117 co-sponsors. 

Speaker Panel Talking Points

To start with the discussion at EMU, I always appreciate an elected officials time (especially on a Saturday night) to discuss what impacts our community. Yes, they did start the panel discussion late, exactly 20 minutes- much like an overfilled physicians waiting room. However, much like those doctors we want to see, we can look past that.

To briefly summarize what they discussed, I felt the panel discussion had an overall vibe of a small group rally for the ‘Medicare for All Act’ with very little substance discussed. To be fair, each speaker only had about 5 minutes. However, 5 minutes should be enough time to pitch something they want to sell. And let’s be honest, our elected officials were trying to sell this bill to the room.

Debbie Dingell

To start with Congresswoman Debbie Dingell’s talk, it was heavy on current healthcare disparity statistics in the US. She did offer some brief talking points such as “We are going to a single billing system that will eliminate a lot of costs.”

The bill claims savings of $500+ billion annually from reductions in costs of billing and administrative costs.

As you can see below of the graph of physicians and administrators from 1970 to 2009, administrative costs are having a major impact on healthcare spending. 

I am curious to see how exactly they will implement this administrative cost savings. Does this mean simply cutting back (i.e.- firing) extra staffing? Those are jobs too. Many physician offices utilize administrative staffing such as front desk receptionists, a dedicated phone staff, nurse triage staff, laboratory staff, billing staff, imaging staff, medical record staff, transcription staff, and office management. 

Primila Jayapal

Congresswoman Primila Jayapal was next. Seattle, you should be proud, you elected a great official. I would be proud to have her represent me if I were there. I was impressed because I felt she actually covered more substance in her discussion than any of the other speakers regarding the ‘Medicare for All Act.’ She states the act will have four components:

  1. Cover Everyone ( Dr. O’Boyle likes this )
  2. No copays or deductibles and be able to go to any doctor or hospital you want to.
  3. Comprehensive coverage including primary care, vision, dental, substance abuse, mental health, maternal care, and more.
  4. Control costs.

Yay! Some material I can work with. Then congresswoman Jayapal says with these ‘controlled costs’ we will pay 14% less then now. WHAT! 14% ?? So that MRI, instead of being $1,400 is now $200 less? That colonoscopy that is billed at $5,000 is now only $4,300. This cost savings is not significant nor will it move the economic needle of medical costs.

Reading through H.R. 1384, I could honestly find only one section (616): Payments for Prescription Drugs and Approved Devices and Equipment that discussed any effort to reduce healthcare expenditure.

Has she heard of Direct Primary Care (DPC)? Does she know I can get a member an MRI for $300, or a colonoscopy for $700? Direct Primary Care is moving the needle on medical cost economics by saving our patients anywhere from 50-90% off of insurance billed costs.

Jeff Irwin

Michigan State Senator Jeff Irwin spoke next. Again, a good speaker. He discussed how doctors are fighting insurance companies over billing and how much a wasteful system this results in. Senator Irwin did say something I believe is important when discussing healthcare: speaking about what people value in their health and healthcare coverage. But, nothing that added any insight on the actual bill. 

Yousef Rabhi

State Representative Yousef Rabhi discussed efforts from a Michigan effort to start universal healthcare plan called ‘MiCare.’ In an acknowledgement of supporting information to Representative Rabhi, he did discuss how he plans to fund MiCare through a vote of the people in Michigan for progressive taxation. Yet, to be fair to the audience, I felt his talk was a bit of a curve ball as all other speakers were focused on the federal bill and not the state bill. 

Ronnie Peterson

State Representative Ronnie Peterson added some personal stories about his history of fighting for racial equality and now fighting for healthcare equality. Again, his talk was touching but added no material onto why or how the ‘Medicare for All Act’ would work.

Katie Scott

The last speaker was Katie Scott, the vice-president of the Michigan Nursing Association. From her talk, I was able to pick out that she was an Intensive Care Unit  (ICU) nurse. Again with the story telling theme of the night, she gave a personal narrative of high prescription drug costs and how that impacted her. 

I absolutely love what nurses do and think their roles are critical towards healthcare. However, ICU nurses and the need they fill are vastly different than what primary care doctors see and what a vast majority of people experience when we think of and utilize healthcare. 

If the elected officials pushing for the ‘Medicare for All Act’ want to be serious, they need to get feedback and collaborate with the primary care providers out there already making changes in their communities. Instead of pushing for town halls on why we need change, Direct Primary Doctors are having town halls in communities on how we are already changing healthcare to improve patient access, improve price transparency, and reduce out of pocket costs on everything from office visits, medications, imaging, speciality care, and laboratory studies.

Guide to Erectile Dysfunction, Beyond Primary Care, Primary Care, Family Doctor

Guide to Erectile Dysfunction

admin

11 June 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 serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.

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. 

Erectile Dysfunction

In this post I am discussing a common condition that I see at my clinic: erectile dysfunction. Let me repeat that last part- a common condition. If you suffer from erectile dysfunction, you are not alone. Those two words can make any man nervous. It affects all men but becomes increasingly prevalent as we age. At least 12 million U.S. men between 40 to 79 years of age have it, but can occur at any age. Older individuals are more likely to experience health conditions that require medication, which can cause or even worsen ED. It is a very emotional and sensitive topic to discuss.

Anatomy & Physiology

The penis consists of two parallel cylinder-shaped tissues called the corpora cavernosa that run the length of the penis, a hollow tube called the urethra that is responsible for expelling urine and ejaculate, erectile tissue surrounding this tube, and various arteries and veins. The process of erection involves increased blood flow and pressure to the penis, and those cylinder-shaped tissues mentioned above become engorged and expand- thus an erection. Erectile dysfunction (ED) occurs when those tissues fail to become engorged or the penis fails to maintain rigidity and resumes a normal shape.

Essential Components for Function

How ED is affecting one male may not be the reason for you. Your doctor will help to differentiate which components are affecting you and this is important in differentiating treatment options.

  • Your interest and desire for sexual activity (libido)
  • Ability to obtain and maintain an erection
  • Ejaculation (orgasm)

Select Causes of ED

Male sexual arousal is a complex subject. Discussing in broad terms, ED can generally be separated into two categories: physical and mental health. Many instances of ED may involve causes from both categories.

Physical Causes

  • Medications: Take a look at your existing medications. Several medications may lead to ED. As example, anti-depressants like SSRIs (citalopram, fluoxetine paroxetine, sertraline) used to treat mental health concerns and Beta-blockers (metoprolol, carvidilol, labetalol)  used to treat blood pressure can cause ED. Review all your medications with your doctor.
  • Smoking: Compared with men who have never smoked, the risk of ED is increased by 51% in current smokers and 20% in ex-smokers. Ask your doctor for help in quitting.
  • Diabetes: If you’ve ruled out other causes, there’s a chance your ED is due to diabetes. Patients with diabetes are three times more likely to develop ED. Review your risk for diabetes or work with your doctor to bring your sugars under control.
  • Low Testosterone: Also called hypogonadism, is a condition that generally occurs to all men as they age. By age 80, 50% of men will have testosterone levels in the low range, however the decline is faster in some men than others. Testosterone levels can affect  a man’s overall health including sex drive and sexual function.

Mental Health Causes

  • Sexual Performance Anxiety: This happens when a man anticipates a problem during the sexual encounter and, as a result becomes anxious while attempting to have sex. Doubt and insecurities may take over your thoughts: “Will I get hard enough?” “Will I maintain an erection?” “How do I compare?” “What if I can’t finish?” These pervasive questions can ruin any performance. Talk to your doctor because once people understand the mental that cause anxiety and how to reduce or eliminate them

Treatment

  • Exercise and Nutrition: A change in eating and drinking habits can potentially reverse the contributing causes.
  • Therapy: Seeing and talking to an accredited sex therapist can lead to an overall happier sex life for men and their partners.
  • Medications: The availability of oral medications such as Viagra, Levitra, and Cialis, make it much easier to treat erectile dysfunction. However, medications should be part of a more comprehensive long-term plan. At Beyond Primary Care, we wholesale generic Viagra 100 mg, 10 pills to our patients for $4.20.
  • Testosterone Replacement Therapy: For men experiencing sexual frustration and have low testosterone, testosterone replacement therapy is a safe and effective way to return T-levels to the normal range.

Banana Bread

admin

4 June 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 serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.

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. 

Banana Bread

This featured recipe is Banana 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.

Adapted from: Allrecipes
Prep time: 15 minutes
Total time:  75 minutes

INGREDIENTS:

2 ripe bananas
⅓ cup melted butter
⅓ cup brown sugar
⅓ cup white sugar
1 egg
⅓ cup plain greek yogurt
1 tsp vanilla extract
¼ tsp salt
1 tsp baking soda
1 ½ cups all-purpose flour

Instructions:

1) Preheat oven to 350. Spray 9×5 loaf pan with non-stick spray.
2) Peel bananas and place into large bowl. Using fork, smash the banana until mushy.
3) Add melted butter and sugars. Stir until smooth.
4) Add egg, yogurt, vanilla, baking soda and salt. Stir.
5) Add flour ½ cup at a time. Batter should be thick but unable to hold a shape.
6) Bake for 50 – 60 minutes.


Ham & Cheese Pot Pie

admin

24 April 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 serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.

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 Ham & Cheese 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.

Ham & Cheese Pot Pie

Adapted from: Philadelphia on AllRecipes
Prep Time: 15 minutes
Total Time: 50 minutes

Ingredients

1 teaspoon brown sugar
10 ounces ham, sliced and cut into cubes
1 cup cheddar cheese, shredded
2 cups frozen mixed veggies (corn, carrots, green beans)
2 green onions, chopped
1/2 cup chive & onion cream cheese
2 cups veggie broth
1/4 cup milk
1/4 cup all purpose flour
1 batch biscuits
3 tablespoons butter

Instructions

1) Preheat oven to 425
2) Add large saucepan over medium heat, then add ham and brown sugar- stir. Cook until browned.
3) Add the flour and stir with a whisk, then slowly whisk in the broth.
4) Add milk 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) Microwave cream cheese spread in microwaveable bowl on for 1 minute or until completely melted, stirring every 15 seconds.
7) Once the sauce is thickened, add the frozen vegetables, shredded cheese, and cream cheese and cook for 4-5 more minutes.
8) Divide the mixture evenly between 5-6 lightly greased ramekins or 8×8 baking dish.
9) Top with biscuits and brush the tops of biscuits with melted butter.
10) 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.


Eggs Benedict with Ham

admin

22 April 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 serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.

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 Eggs Benedict with Ham. 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.

Eggs Benedict With Ham

Adapted from: Self Proclaimed Foodie
Prep Time: 20 minutes
Total Time: 45 minutes
Serves: 4

Ingredients

– 12 eggs (4 eggs yolk separated, 8 for poaching)
– ¼ tsp dijon mustard
– 1 tbsp lemon juice
– 2 tbsp white vinegar
– ½ cup + ½ tbsp unsalted butter, separated
– Salt and Pepper to taste
– 4 slices thick cut shaved ham
– 4 English Muffins, split
– 3 cups Spinach, stems removed

Instructions

1) Set oven to 200F.
2) Put a large pot with at least 4 inches of water over the stovetop and bring to a rolling boil.
3) In a saute pan over medium-low heat, add and melt smaller portion of butter. Add spinach and stir constantly until slightly wilted, remove the spinach from the pan and set aside.
4) Make hollandaise sauce next by adding the egg yolks, dijon, and lemon juice to the blender. Blend for 5 seconds to combine.
5) Melt the ½ cup of butter over the stove in the saute pan or in a microwave safe dish. While blender is running at low speed, add the hot butter. This will thicken the hollandaise. Do not over blend. Add salt if desired.
6) Add the English Muffins to a baking sheet and place into the oven.
7) Using the same saute pan from the spinach, add the sliced ham and return over medium-high heat until warmed. Set aside.
8) To the boiling water, add the vinegar and cover. Reduce the heat so that the water stays as hot as possible without maintaining a boil.
9) Crack an egg into a coffee cup. Gently pour the egg into the water from the cup, holding as close to the water’s surface as possible.
10) Repeat with as many eggs as you feel comfortable cooking or the pot has room for, making sure the eggs don’t touch. Cover the pot.
11) After at least 30 seconds has passed, release any eggs that may be sticking to the bottom of the pot by gently using a spatula underneath.
12) Eggs are done when you use a slotted spoon to lift the eggs to the water’s surface, and the white appears firm but the yolk is still wobbly.
13) Assembly by adding the bottom slice of the English muffin, top with ham, then the poached egg. Spoon equal portions of hollandaise sauce over each egg. Add pepper to taste. Top with top bun slice.


Knee Cap Pain

admin

16 April 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 serves patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne County.

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. 

Knee Cap Pain

In this post I am discussing a common condition that I see at my clinic: knee cap pain. Knee cap pain can present itself multiple ways that may not always be muscular in nature, so you should always check with your doctor before starting any treatment. However, a common reason for knee pain is patello femoral pain syndrome (PFS), where the knee cap begins to increasingly track to the outermost part of the leg bone (femur) with movements such as walking, going up/down stairs, and squatting (pretty much any movement when someone bends their leg). Improper tracking of the knee cap can mechanically be due to a number of problems, and can be years in the making or due to a single traumatic event.

Anatomy

Your quadriceps muscles are key to many movements and activities that you do. The group is made up of four muscles (a “quad”) – rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis obliquus (the VMO). All four then run down to your knee and they join together, becoming a single tendon that surrounds your knee cap (patella). This tendon then continues down to connect to the knee bone (tibia) of your lower leg.

The VMO Connection

The VMO contributes to running, jumping and nearly every other basic movement, because together with your other quad muscles, it’s a powerful knee extensor along with pulling the knee cap to the inside. Anytime you push off the ground, your VMO is involved. It’s also an important knee stabilizer—a critical function that’s often overlooked. The other three quad muscles are either neutral or pull the knee cap to the outside. If you don’t have a developed VMO that can hold its own compared to the other quad muscles, you may experience tracking issues which leads to the vicious cycles of knee pain.

Minimize the Pain and Swelling

Minimizing pain and swelling can be done via an interdisciplinary approach with ice-packs and non-steroidal anti-inflammatory drugs (NSAIDs). Consider using ice-packs over the affected area, fifteen minutes at a time, two to three times a day. No heat, as this only will exacerbate the pain/inflammation cycle. Next, consider NSAIDs as these have anti-inflammatory properties and are used widely for musculoskeletal disorders. Select NSAIDs, such as ibuprofen and naproxen, are available over-the-counter.

Identify your VMO

In a relaxed, seated position with your legs out in front, place a rolled-towel under your knee. Next, feel your VMO by placing your fingers just above your knee cap on the inside aspect of your leg. Extend your leg by bringing your knee cap down into the towel. The extension of your leg should occurring slowly (like 5 seconds), over just a small range. When you do this you should feel the VMO contracting under your fingers. This should be your first exercise. 

Access Range of Motion and Build Flexibility

The first step in improving your situation is going be be determining if you have tight muscles as lack of flexibility can disrupt both the timing and contraction of muscles that will ultimately lead to more pain. From a balance standpoint, a tight muscle may limit the range of motion through which an opposite muscle can move (example of opposite muscles include rectus femoris/glute). Learn what you can about stretching, then find specific flexibility builders such as hip and ankle muscles.

Tape the Knee

Taping the knee is very easy and has been validated by research to help improve the nervous system firing of the weakened VMO muscle. Purchase some athletic or kinesio tape. To apply the tape, place the tape on the outside of the affected knee and pull it across the knee cap inward making sure you have enough pressure that you see a little skin fold crease as you do this. 

Stabilize & Build Strength

Once your swelling has subsided and pain is improving, you need to start with simple non-weighted stability exercises to regain integrity of the joint. Consider one-legged standing exercises. As you progress, start with non weighted strengthening exercises such as lunges, step-ups, and squats. Lastly, if at any point treating your knee becomes too complicated, talk to your doctor about a prescription for physical therapy.