Finding Your Perfect Geriatrician: The Ins and outs of Senior Healthcare Providers

  Naples Comprehensive Health (NCH) continues to proactively negotiate with Florida Blue Cross Blue Shield (Florida Blue) in an effort to come to a resolution regarding contract terms with the insurance company. Following on-going financial challenges stemming from inflation and external economic factors, the system is seeking fair payment from the insurance company to cover the rising cost of patient care and preserve local access to doctors and vital services for families across Southwest Florida. Florida Blue is the third most profitable Blue Cross program in the nation yet pays NCH a lower rate than other insurers that the community hospital is contracted with, meaning NCH is reimbursed less than other hospitals in the region for the exact same services, even though the cost to provide patient care is similar. NCH is asking Florida Blue to be accountable partners and pay fair rates that keep pace with inflation and prioritize the best interests of patients. If Florida Blue forces NCH out of network and refuses to pay our community hospital fairly, thousands of patients will be without access to local doctors and specialists, said Betsy Brothers, MD, NCH North Hospital Chief Medical Officer and Section Chair for OB/GYN. As the only birthing center in Collier County and the only Comprehensive Stroke Center in Southwest Florida, its critical that Florida Blue recognizes the role NCH plays in community health, and listens to the patients and their customers, who depend on us when they say they want and need to keep their doctors in-network. We hope Florida Blue recognizes that and does the right thing. NCH reached out to Florida Blue months ago to begin negotiations with the goal of coming to a resolution without having to cause concern for, or impact patients. Florida Blue took over three months to respond to NCHs initial proposal. Were disappointed Florida Blue has not shown they share our sense of urgency in reaching a resolution said Jon Kling, Chief Operating Officer for NCH. Were also disappointed they continue to prolong the negotiation and choose to prioritize profit over their members. Florida Blue reported over $14 billion in revenue in the first half of 2023 alone. We know the company can afford to pay our non-profit healthcare system fairly without passing costs to patients. For us, this is about ensuring the health of our organization so we can continue to serve our community and take care of people. If an agreement is not made by September 30, 2024, NCH will be considered out of network for individuals and families with Florida Blue insurance plans. During the negotiation, patients with Florida Blue insurance coverage should continue to access their NCH doctors and services as usual. Community members can learn more at www.standwithnch.com.

As the summer heat intensifies across the country, dehydration becomes a common and potentially dangerous concern. This condition can have severe implications, particularly for seniors who are more vulnerable due to several physiological factors. Seniors face unique challenges, especially when it comes to the impact of their medication on hydration. Why Are Seniors More Prone to Dehydration?Seniors are at an increased risk for dehydration for several reasons:     Reduced Thirst Signal: As people age, their bodies lose their ability to recognize thirst, making it harder to drink fluids.      Lower Body Water Volume: Older adults generally have a lower total volume of body water, meaning they have less fluid to lose before dehydration sets in.      Kidney Function Decline: Kidneys become less efficient at conserving water with age, further contributing to fluid loss.     Chronic Illnesses: Conditions such as diabetes can worsen the risk of dehydration since they affect the body's ability to control water. In addition to these factors, medication plays a significant role in influencing fluid balance in seniors.The Impact of Medication on DehydrationAs a clinical pharmacist, I've seen firsthand how medications can contribute to dehydration, especially in older adults. One of my clients, an active senior, nearly passed out while cycling in the summer. As it turned out, he was on a diuretic medication, commonly referred to as a "water pill." Diuretics are a class of drugs that increase urination, leading to reduced fluid levels in the body. These medications, often prescribed for conditions like hypertension and heart failure, can inadvertently lead to dehydration if fluid intake isn't carefully managed. Some commonly used diuretics include bumetanide, chlorothiazide (Diuril), hydrochlorothiazide, and furosemide (Lasix). But diuretics aren't the only medications that can cause dehydration. Other drugs like these can also affect your body's water balance.     Antihistamines: Often used for allergies, these can cause dry mouth and reduced fluid intake.     Blood Pressure Medications: Certain blood pressure medications can increase urine output.     Laxatives: They can cause fluid loss through increased bowel movements.     Chemotherapies: These treatments often lead to side effects like vomiting and diarrhea, contributing to dehydration.Managing Dehydration RisksIt's important to be aware of dehydration risks, particularly for those taking medications that impact fluid balance. Regardless of whether one feels thirsty, its important to drink water throughout the day. Staying alert to the signs of dehydrationsuch as increased thirst, dry mouth, dark urine, fatigue, and dizzinesscan also help address the issue early. These symptoms are early warning signs that the body may need more fluids.  Finally, anyone concerned about dehydration should consult a healthcare provider. They can adjust medication and advise seniors on managing fluid intake to prevent dehydration.   At Deeper Dive Horizons, one of my priorities is to guide you and your loved ones through the complexities of medication management to improve your well-being. With over 22 years of experience, my goal is to dive deeply into your health and ensure you maintain a balanced and healthy life, even in challenging conditions like extreme heat. Schedule a consultation today to get started 888-984-8895.

Note: this is not medical advice and should not replace a discussion with your own treating physician. This document was created after compiling helpful over the counter and home remedies from patients and colleagues. Winter is a beautiful time of the year, but it also brings along various illnesses. With the constant change in temperature and dry air, it's easy to catch a cold or flu. However, being sick doesn't have to be miserable. Here are some tips to help you through your winter sickness. First off, make sure you are getting enough rest. Your body needs time to fight off the illness, so getting plenty of sleep is essential. Drinking lots of fluids is also crucial to staying hydrated. Warm liquids such as tea or soup can help soothe your throat and loosen congestion. Second, take over-the-counter medication to relieve your symptoms. Decongestants can help relieve nasal congestion, and pain relievers such as acetaminophen or ibuprofen can help reduce fever and body aches. However, be sure to read the instructions carefully and consult with a doctor if you have any doubts. Lastly, try to avoid spreading your illness to others. Cover your mouth and nose when you cough or sneeze, and wash your hands frequently with soap and water. Stay home if you're feeling unwell to prevent spreading the illness to others, and mask up if you need to leave the house. Reminder that we are fortunate enough to have vaccinations against flu, COVID and RSV which cause significant respiratory illness. In conclusion, being sick during the winter can be tough, but with plenty of rest, hydration, and medication, you can make it through. Ive gathered up some of the most common remedies used by myself, my patients, and my followers on social media and shared them below. Remember to take care of yourself and stay warm during the chilly winter weather.STRAIGHT OFF THE SHELFNote: if you take other medications, its important to talk with your physician or pharmacist about how these over the counter meds may interact with your prescribed meds Cough Vicks Vapo Rub on the chest and bottoms of feet Coricidin (good for those with cough and high blood pressure) Delsym Cough Medicine: dextromethorphan containing cough meds help with cough suppression, for dry coughs Zarbees for kids: these come in a daytime and nighttime forms to help with sleep (chamomile) Mucinex: guaifenesin containing meds help to loosen up mucus in your though to help you cough it up, for wet coughs Sudafed: pseudoephedrine is a decongestant and can make you pretty wired/awake. caution if you have high blood pressure Dimetapp for kiddos 6 and older Congestion/sore throat Afrin nasal spray: temporary congestion relief Flonase nasal spray: great for post nasal drip that causes sore throat Saline nasal rinses General cold/flu symptoms Dayquil/Nyquil: remember, these contain acetaminophen aka Tylenol. so dont mix with additional tylenol unless instructed by your physicianKnow your meds! acetaminophen is also known as Tylenol; ibuprofen is also known as Motrin and is the same class of medications as naproxen aka Aleve HOME/HERBAL REMEDIESNote: if you take other medications, its important to talk with your physician or pharmacist about how these remedies may interact with your prescribed meds Nin Jiom Pei Pa Koa-Chinese herbal throat and cough syrup Green tea Ginger tea Boom boom inhaler stickLemon, honey, and chamomile tea Sleep Epsom salts baths Oscillococcinum Black elderberry syrup Raw garlic with honey Mullein tincture Electrolyte rich drinks like liquid IV, LMNT, pedialyte-- monitor sugar content Fermented foods Reishi Ashwaghanda Foods high in vitamin C (citrus!)SOOTHING TEA RECIPEIn a saucepan, bring the following to a boil, then remove from heat and enjoy:8 ox water1 T apple cider vinegar1 T honey1 cinnamon stick1 clove of peeled and smashed garlicsmall  piece of peeled gingerTIPS & TRICKS FROM A PCPafter a viral infection, cough can last 4-6 weeks in some cases. if you have fever with the cough or its getting worse, talk with your doctor as it could indicate a bacterial infection never underestimate the power of sleep and resting your body a fever is technically a temperature over 100.4 degrees F the symptoms of COVID, flu, and RSV overlap significantly. getting tested for these infections may be helpful in determining if you need further intervention your gut health is key to your immune system. you may not be able to fully prevent getting sick, but a healthy mind and body will help you with resilience and recovery. focusing on fiber, mindfulness, sleep and regular exercise can help your gut stay strong! most viral infections last about 5-7 days. but if you are experiencing shortness of breath, chest pain, high fevers, difficulty swallowing, dizziness, or wheezing, contact your physician immediately ask your doctor for their recommendation on checking your childs temperature. they may want you to use a rectal thermometer depending on age