Secure Email

December 21, 2013

TelehealthConnect:  This is my secure email platform, which most of you have not elected to use.  People with Macs have had difficulty using it, and in truth it is cumbersome and expensive (for me).  Fortunately, my electronic health record, Practice Fusion, is currently instituting a secure message system.  It is not quite ready, yet, and I don’t know how well it will function.

To use it, you will have to log onto your patient portal through PatientFusion.com, which I have invited everyone to participate in.  However, I suspect that very few of you have acted on the invitations.  Now, however, I think that it is more important that you do so.

If you didn’t activate your account within 30 days of us giving you a temporary PIN, you will need a new invitation.  Donna can do this for you but you have to let us know that you need it.

While there is no question that regular email has been and will probably continue to be simpler than the secure platforms, if my email every gets hacked (which has never happened so far), then I will have to inform everyone of a potential data breach and possible HIPAA violations, which is a scenario that I most certainly DO NOT want to have to enter into.  Accordingly, I may be forced to change my current policy and to  not respond to regular email with patients.

The office is currently closed until January 2nd, but if you need to be re-invited to PateintFusion, please call or preferably send her an email at donna@drshevin.com and request another invitation.

Influenza again 12/21/2013

Influenza  12/21/2013:

The flu is certainly moving northwards.

As of a week ago (the most recent data available at the time of this writing) Connecticut is marked as showing “local disease” but is “regional” (the next more intense category) in Massachusetts, and “widespread” in New York.

 

 

Fees

December 9, 2013

12/9/2013:

When the recession hit in 2008 I decided to leave my fees unchanged (from their level in 2006) for the duration of economic hardship.  It is now almost 2014 and the prices we all pay have certainly increased.  While the recession is now technically over, unemployment remains high and many are still in distress.

As you know, I like to cover a lot of ground during a consultation, am a good listener, and I analyze a case through several possible “frames of reference” (conventional medical diagnosis and treatment, homeopathic analysis, nutritional status, understanding the interaction of illness and stress, food sensitivities including possible sensitivity to gluten, etc.)  Some of these frames of reference can be summarized under the heading of Functional Medicine.  This takes a lot of time.

I have tried hard to keep my rates at pre-recession levels because so many people have not benefitted from the economy’s “recovery”.  However, as the practice of medicine changes, I now spend much more time that is not face-to-face:  emails, case research, mandatory electronic medical record keeping, telephone calls, coordination of care, etc.  In my continuing efforts to avoid raising rates, I need to be more conscious of time spent, which hopefully will help with your waiting time as well.  I would like to continue to deliver thorough, personalized care under my current fee schedule.  Please see my fees and policies sheet.

Genetics

12/9/2013:

Genetics and basic biochemistry:

Genetic research has mostly focused on finding specific genes for specific diseases, as well as assessing the risks for diseases and drug reactions based on genetic variation.  There are, however, other ways to use genetic knowledge.

“Sequencing” the genome means to find the exact composition of the components of DNA, and to be able to detect any variations in DNA structure which may cause problems of various kinds.

In the autism community, and primarily pioneered by Amy Yasko, this knowledge been used to begin to understand how certain aspects of basic biochemistry are influenced by genetic variations.  The focus of the work in autism has been on “methylation,” or “one-carbon metabolism.”  This takes place in every cell of the body, and problems in one-carbon metabolism are important in many diseases, including autism, autoimmune disease, depression, anxiety and other mood disorders, attention deficit disorders, neurodegenerative disorders, severe allergic disorders, hormonal problems, and aspects of cancer, and probably many more.

A company called 23andme can sequence much of the genome (currently at a price of $99 plus a small shipping fee).  While 23andme.com has just come under restrictions from the FDA, they still provide a list of results in the form of “raw data.”  This can be translated through other websites which report on the variations in the genes of interest.

Based on this knowledge, it may be possible to use targeted nutrition to improve function at the basic biochemical level..  While the combination of variant genes can make the analysis rather complicated, the interventions are safe, and most of them are inexpensive.

Although I have only recently begun using these tools, I am starting to see positive and I am hopeful that I will see more as I continue to treat.  Please feel free to discuss this with me at your next appointment.  I hope to write a longer article as I gain more experience and learn more

Influenza 12/9/2013

12/9/2013:  Influenza season has not really started in New England, it is probably not far off.  “Local” disease has been reported in Massachusetts, an as of Thanksgiving week, flu activity started to pick up in the Southern United States.  Those of you who use the homeopathic preparation Influenzinum should begin (see below).

 

As usual, my policy on flu shots is that I have no objection to them, but since they do not usually offer a high-enough level of protection, especially for people over 60 years of age, there is more that should be done.  The use of the homeopathic “nosode” Influenzinum is one strategy.  We also want to maintain healthy defenses through good nutrition, getting adequate amounts of rest, achieving healthy levels of vitamin D, good hand-washing practices, and the avoidance of crowds during epidemics.  I will continue to send out alerts as the usual epidemic pattern of Influenza develops.  Flu season may not develop until February.

 

If you wish to learn more about Influenzinum, see the following article.

Food 12/9/2013

Food:  In the beginning of the year, I began using a way of eating promoted by Joel Fuhrman, MD, and subsequently revised the “nutrition and homeopathy” article to describe it.

 

This way of eating, termed by Dr. Fuhrman a “nutritarian” diet, is extremely healthy, and has helped many sick people. There is no question that it involves a significant investment of time in shopping, planning, and cooking.  It is ironic that the “conveniences” of modern food supply, preparation, and agricultural practices, not to mention the economics and politics of food, all come at the price of health.  Then the country agonizes over the “cost” of health care…

 

In any case, I would like to report that those of you who have adopted this way of eating have done very well, with significant improvements in well-being and weight loss (where needed).

 

This way of eating is not an “all-or-nothing” approach.  Even a modest increase in high quality food will be helpful.  It should also not be considered a rigid way of eating.  Food sensitivities, individual differences, and logistics may force modifications in the plan.

 

I continue to encourage everyone to read Dr. Fuhrman’s first book, Eat to Live, and to watch the movie “Fat, Sick, and Nearly Dead.”