Should You Get the New Shingles Vaccine?

Shingles or Herpes Zoster is a condition that causes pain and a blistering rash over specific parts of the body. It occurs in people who have had “chicken pox” in the past. When a person recovers from “chicken pox” the virus can remain dormant in the body.

If the virus reactivates it can cause Shingles. Postherpetic neuralgia is a result of Shingles and can become a chronic pain problem impacting quality of life. Shingles can be treated with paid medication and antiviral medication, but is preventable by vaccination.

There are two types of vaccinations for Shingles. Zoster Live vaccine and Recombinant Zoster vaccine. The Live vaccine has been available since 2008 but is only about 50% effective against Shingles. It has been indicated for people older than 60 years old, as they are more likely to experience Herpetic Neuralgia.  In the fall of 2017, Recombinant Zoster vaccine became available. It is recommended for patients over the age of 50 and is greater than 90% effective in preventing Shingles and Neuralgia, which is significant improvement over the previous version available. It is not a live vaccine, so it should also be safer than the older vaccine. The Recombinant vaccine requires a series of two injections, given 2–6 weeks apart.

All adults over 50 years old should be vaccinated against Shingles. If you have never had “chicken pox”, you should receive a Varicella vaccine instead of a Shingles vaccine. Your health care provider can test you to determine the correct action if there is a question as to which vaccine is appropriate. Currently it is recommended that anyone over 50 years old who has received the Live Shingle vaccine be revaccinated with the new Recombinant Shingle vaccine (Shingrix).

Please be sure to discuss Shingles vaccine options with your healthcare provider if you qualify.

 

Dr. David Stahura, DO

Do you Wheeze more in the Spring and Fall?

Most of us look forward to spring after hibernating indoors all winter. We enjoy getting out and walking about, enjoying the blooming flowers and budding trees. But if you have asthma or allergies (or both), spring pollen season can take a toll on your lungs. The same goes for ragweed in the fall. Seasonal pollens in the spring and fall can trigger asthma symptoms by increasing airway inflammation causing someone to wheeze more during these peak seasons.

If seasonal pollen is a trigger for your asthma, it is best to stay indoors when pollen levels are high, particularly during the morning hours. Keep windows closed to prevent pollens getting into your home or car. When you have been outside, take a shower and wash your clothes to remove residual pollens once you are back indoors. Most importantly, always remember to carry your rescue inhaler with you should it become difficult for you to breath or you start to wheeze while enjoying the outdoors.

 

Allene Harrison, NP‐C

When is a PAP Necessary?

A Papanicolaou (PAP) test is a screening tool for prevention of cancer. Cervical cancer occurs in the bottom part of the uterus in women. The main symptom is abnormal vaginal bleeding but very often in early stages there are no symptoms. For this reason, screening is important.

Papanicolaou smear (PAP) and the Human papillomavirus (HPV) test are the routine screenings for cervical cancer. These tests are performed by obtaining cells from the cervix using a small brush or spatula during a vaginal exam in the health providers office. It is a quick and painless exam.

The benefit to testing is early detection of cancer as it is generally curable in the early stages. The evidence of benefit is significant in women between the ages of 21 — 65 years old. Potential harms of screening are from false positive test results and over testing, but this is far outweighed by the significant benefits. These recommendations apply to women between age 21 — 65 that have not had a previous cervical cancer diagnosis and are not immune‐compromised.

Currently cervical cancer screening is recommended in women aged 21 — 65 years. For women 21–30, screening should be a PAP test every 3 years. For women 30–65 screening can be done by PAP every 3 years or by PAP test and HPV test every 5 years.

For women less than 21 years or older than 65 years the benefit of screening is unclear and needs to be individualized with your health care provider.

Dr. David Stahura, DO

AbsoluteCARE Achieves HITRUST CSF® Certification to Further Mitigate Risk in Third Party Privacy, Security, and Compliance

HITRUST CSF Certification validates AbsoluteCARE is committed to meeting key regulations and protecting sensitive information.

 

Atlanta, GA, August 1, 2018 – AbsoluteCARE a prominent comprehensive staff model Patient‐Centered Ambulatory ICU Medical Center Company for Members with the most complex chronic conditions, which has locations in Atlanta Georgia, Baltimore Maryland, Greenbelt Maryland and Philadelphia Pennsylvania, today announced the Business Application Servers (Greenway PrimeSuite, Rx30, Updox, eFax, CGM LabDaq, Phreesia, PrimeImage, Fuze VoIP, Sage 300, and Concur), IT Security and Administration Servers, and Domain Controllers have earned Certified status for information security by HITRUST.

 

HITRUST CSF Certified status demonstrates that the organization’s aforementioned systems have met key regulations and industry‐defined requirements and are appropriately managing risk. This achievement places AbsoluteCARE in an elite group of organizations worldwide that have earned this certification. By including federal and state regulations, standards and frameworks, and incorporating a risk‐based approach, the HITRUST CSF helps organizations address these challenges through a comprehensive and flexible framework of prescriptive and scalable security controls.

 

Achieving and maintaining HITRUST CSF is integral for the success and national expansion of our mission to bring our life‐changing healthcare services to the most at‐risk populations that are also the highest utilizers of medical care in the country,” said Alan Cohn, CEO of AbsoluteCARE. “With this certification, our patients and payer partners can be even more confident in our ability to provide privacy and security pertaining to protected health information.”

 

The HITRUST CSF has become the information protection framework for the health care industry, and the CSF Assurance program is bringing a new level of effectiveness and efficiency to third‐party assurance,” said Ken Vander Wal, Chief Compliance Officer, HITRUST. “The HITRUST CSF Certification is now the benchmark that organizations required to safeguard PHI are measured against with regards to information protection.”

Dr. Manasseh Receives “Defying the Odds” Award

Dr. Fredrick Manasseh, our National Director of Pharmacy Services was recently honored by his alma mater, UMKC. He received the “Defying the Odds Award”, which recognizes an alumnus who has achieved professional and personal success despite tremendous obstacles such as financial hardship, lack of or few positive role models, having been raised in an environment or dealt with circumstances that were not conducive to furthering their education. This individual demonstrates outstanding loyalty and commitment to the University or the Alumni Association and has rendered outstanding service to the community.

 

We are incredibly excited to have Dr. Manasseh as part of the AbsoluteCARE team. Congratulations to him on this fantastic achievement!

 

To learn more about Dr. Manasseh’s story, please visit: https://youtu.be/TdnyrLHDueg

The Differences Between Medicare and Medicare Advantage Plans

If you are feeling confused or overwhelmed by your Medicare coverage, please know that you are not alone!  It is, however, important to learn as much as possible so that you can make informed decisions that best meet your specific healthcare needs.

Original Medicare includes Part A (hospitalization), Part B (outpatient medical) and Part D (prescription drug) coverage. If you are enrolled in Original Medicare, your medical benefits are administered directly through the federal government and you have the option of purchasing a separate “stand‐alone” prescription drug plan from a private insurance company. When accessing medical services, beneficiaries are responsible for a deductible and will then pay a 20% coinsurance for the remainder of the year. One major advantage of Original Medicare is that beneficiaries can see any provider who accepts Medicare. They also do not need referrals to see specialists. On the contrary, one major disadvantage is that Original Medicare generally does not cover dental or vision services.

If you opt to get your coverage through a Medicare Advantage Plan, also known as Medicare Part C, you still have Medicare coverage; however, both your medical and (generally) your prescription benefits will be contracted through a private company. You may or may not be required to pay an additional premium for your plan. Patients are usually responsible for a set copay for services, rather than a coinsurance. The coverage varies from plan to plan but all Advantage Plans must, at a minimum, cover the same medical and prescription benefits covered by Original Medicare. They oftentimes offer additional perks such as hearing, dental & vision coverage, transportation to medical appointments, and health club memberships.

It is important to remember that with Advantage Plans, you may be required to choose and stick with a Primary Care Physician. You may also need a referral from your PCP to see a specialist. Provider networks for these plans are more limited then with Original Medicare. You will need to be sure to see providers who are in‐network for your plan or you will likely face higher out‐of‐pocket costs or possibly even no coverage at all.

If you have questions, please contact or set up an appointment with a member of the AbsoluteCARE social work team.

 

Bethany Weikart, Care Manager

AbsoluteCARE Team Members Receive Barbara Vick Impact Award Nominations

Congratulations to Freda, Peer Counselor, and Emily, Director of Community Engagement Initiatives, for their Barbara Vick Impact Award nominations. In addition, we’d like to congratulate Emily on her Trailblazer Award, given for her innovative approach to community engagement and her tireless advocacy on behalf of people living with HIV in Atlanta. We love these ladies and appreciate all of the work they do for AbsoluteCARE, our patients, and the community!

Traveling to India? Be Sure to Obtain Proper Medication.

Malaria is an active disease in India and most travelers should receive medications to prevent them from contracting malaria before travelling.  There are very few areas in India where malaria is not known to occur.  In particular, these are areas above 2000 meters above sea level in the high mountain regions bordering China and Nepal that includes Himachal Pradesh, Jammu, Kashmir, and Sikkim.  All other travelers should see their physician and start medication before travel.  This includes expatriates as well as new travelers, as all are at risk.  While in the country, travelers should cover exposed skin areas by wearing long sleeved clothing and hats.   Liberal use of insect repellent is also recommended to decrease the chance of mosquito bites.

 

Rachna Gadhok, MD

High Cholesterol Doesn’t Always Require Medication

Even if your cholesterol is high, it is possible that a medical provider may suggest not taking a medication for your high cholesterol. Your doctor is taking a number of factors into account, such as which type of cholesterol is high and the calculated risk for a heart attack and/or stroke over the next 10 years.

Let’s look at the two types of cholesterol which are commonly tested:

  • HDL or high‐density lipoprotein — which is “good” cholesterol. A higher level of HDL is actually associated with some protection against heart disease and stroke.
  • LDL or low‐density lipoprotein — the “bad” cholesterol. An elevated LDL level is associated with an increased risk for heart attack and stroke.

So, if your HDL was high, but LDL was normal, then your doctor may not suggest a cholesterol‐lowering medicine. In addition, doctors calculate the risk of having a heart attack based on guidelines from the American Heart Association and American Cardiology Association to further determine the need for a statin (medication which lowers cholesterol). If your risk is low, then you may not need to take any medication.

As always, a healthy lifestyle, including regular exercise, a high‐fiber diet and avoiding tobacco, will go a long way.

 

Rachna Gadhok, MD