Primary Care
April 20, 2019
The Measles Outbreaks and You
Measles is making a comeback because of growing failure to immunize all children with the MMR vaccine, which has been available for almost five decades. Measles is serious. We have checked and everyone in Orchard Health Care should be protected.
March 23, 2019
Aspirin Less Helpful Than We Thought for Prevention, More Risky
Low-dose aspirin appears to have little if any benefit in primary prevention of vascular events in older patients while inducing more frequent serious bleeding episodes based on good recent studies. We will advise many (but not all) of you now taking baby aspirin to stop.
October 27, 2018
79,000 Influenza Deaths in 2017. Opioids Close Behind
Influenza killed almost 80,000 people in the US last year, more than opioid overdoses, more than breast cancer, more than car accidents. The flu vaccine works and is benign. Get your flu shot with us before Thanksgiving!
September 4, 2018
Generic Drugs Are the Standard
Generic drugs are equally effective and safe as brand name pharmaceuticals. Prior authorization for expensive brand names is difficult to obtain and hard to justify. If a brand name is desired, the member will be asked to help provide the rationale for the approval process.
September 3, 2018
Premium Hearing Aids at Costco Prices
Hearing aids are essential devices for many older people, but often are not obtained because of the persistently high expense. I recently explored Costco as a source of high-technology major-brand hearing aids at dramatically lower prices.
August 18, 2018
The Valsartan Fiasco
Contaminated valsartan antihypertensive medication was discovered and is being recalled. No one is likely to have been injured by the NDMA contamination, but we intend to switch everyone to irbesartan, a comparable medication in the same ARB class that has not shown any contamination issues.
June 4, 2018
AIMOVIG for Severe Migraines
AIMOVIG is a new monoclonal antibody preventive treatment for chronic and severe episodic migraine that appears to be effective and safe. This is the first new news in a long time in this field.
April 29, 2018
Opioid Contracts and Monitoring
Opioid drugs, also called narcotics, are critical medications for relieving acute pain but more problematic when occasionally used for chronic pain. We describe new state regulations concerning opioid prescriptions and monitoring and how it affects you and our practice.
April 29, 2018
The Zen of Pruning
Spring is here, the apples and peaches are getting ready to blossom. It is pruning time, an exhausting but exhilarating period when I recommune with nature and, indirectly, with my role as caregiver and healer to people in Orchard Health Care.
April 29, 2018
Sweets Are for Treats and Other Nutrition Tips
Many recent articles on nutrition and dieting in various publications echoed what I have advised for several decades. I recap 10 of the major takeaways.
April 29, 2018
In Our 50’s We Become Our Parents
Various conditions that are heavily genetically driven, including high cholesterol, blood pressure, and adult diabetes, typically show up in force after age 50. By 55 we often realize we have biologically become our parents, the bad and the good.
April 29, 2018
Sleeping Pills and Sedatives
Sleeping pills and tranquilizers are commonly requested, used, and appear needed, but there are cognitive and accident risks associated with these drugs. We need to try to find effective but safer alternative therapies.