Online Chat

Understanding the Basics of Medicare Coverage Live Chat- October 18

medicare-emailJoin us Tuesday October 18 at 12 p.m. EST for an online chat on “Understanding the Basics of Medicare Coverage” with Chuck Chaput of MedicareCompareUSA and Gita Vatave, General Manager Emory Healthcare Network Advantage.  With the annual open enrollment period for 2017 Medicare coverage opening  in a few weeks (Oct. 15), it’s important to know the A,B,Cs and Ds of Medicare. Topics we’ll cover will include:

  • Overview of Medicare Parts A, B, C and D
  • Explaining Medicare Advantage
  • Differences between traditional Medicare and Medicare Advantage
  • Turning 65 and applying for Medicare
  • How Medicare works if you’re turning 65 but don’t plan to retire

You will have the opportunity to ask questions and get real time answers to general Medicare questions.*

*Please note: In this venue, we will not be answering specific questions about benefits of a particular insurance plan.

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Aging Parents and Multiple Health Problems – What Adult Children Can Do to Help

aging-parents-emailAs we age, the likelihood of developing multiple ongoing conditions increases. These problems can include high blood pressure, heart disease, diabetes, chronic obstructive pulmonary disease (COPD) and congestive heart failure, to name a few.

Multiple medical conditions also means multiple prescriptions, therapies and physicians, all of which can become confusing. Sometimes, they might seem at cross purposes as well.

Join us July 27, 2016, from noon to 1 p.m. to chat online with Anthony Nguyen, MD, Emory Healthcare Regional Medical Officer for the Emory Coordinated Care Centers, part of the Emory Healthcare Network Advantage program. Dr. Nguyen works with Emory primary care physicians and Coordinated Care Center staff to deliver continuous coordinated care to older patients.

He will discuss how caregivers – and patients themselves- can communicate with their doctors to help manage health conditions like

  • High Blood Pressure
  • Diabetes
  • Anticoagulation Therapy Program
  • Congestive Heart Failure
  • COPD

He will also explain the therapies, services and treatments offered at the Coordinated Care Centers that can help with this more intensive health management, including:

  • HealthStart assessments
  • Fall prevention
  • Medication management
  • Nutrition advice
  • Smoking cessation programs
  • Behavioral health support

During this chat, you’ll be able to ask questions and get real-time answers from Dr. Nguyen. Register now for our July 27 chat at emoryhealthcare.org/mdchats.

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Takeaways from Dr. Bergquist’s Live Chat on Stress Management

stress-cil-638Thanks to everyone who attended our live chat, “Managing Your Stress,” Tuesday, Dec. 22, with Sharon Horesh Bergquist, MD, who serves as Emory Healthcare Network primary care physician and associate professor with the Emory University School of Medicine.

Dr. Bergquist fielded some great questions on a range of topics, including:

  • Stress and its relationship to autoimmune disorders
  • Stress effects on aging
  • Anxiety attacks
  • Best stress-relieving activities
  • Managing grief during the holidays
  • Good stress and how to make stress work for you
  • The effects of stress on migraines
  • How your primary care physician can help you manage stress

If you didn’t get a chance to join us, read the full transcript from “Managing Your Stress” here.

Two questions didn’t get answered during the live chat, so we’re sharing them here, along with Dr. Bergquist’s responses:

Question: Are other SSRIs as effective as fluoxetine for treating SAD?

Answer: SAD can stand for social anxiety disorder as well as seasonal affective disorder, so I wasn’t sure which one is being asked here.

For social anxiety disorder, the SSRI paroxetine and the SNRI venlafaxine are effective. Older drugs from a family called MAO inhibitors, such as phenelzine can also be used.

Seasonal affective disorder, a seasonal pattern of recurrent depression in fall or winter months, can affect 1.5% to 9% of people. It is typically treated with antidepressants, light therapy or psychotherapy.

There are actually very few high quality studies looking at the best anti-depressant for seasonal affective disorder, and there is virtually no data comparing SSRIs for treating SAD. The data is limited to studies on fluoxetine compared to placebo (in which fluoxetine shows a non-significant benefit) and fluoxetine compared to light therapy (it is nearly equivalent). Other SSRIs are commonly used in practice for SAD but there is little data to know if they are effective.

A recent review on the topic found bupropion XL to be an effective alternative for preventing recurrences of SAD (but even here it was effective at best in a small percent of people, around 20%).

Question: Due to psychoneuroimmunology, if a person has cancer, does distress increase the risk of cancer recurrence?

Answer: A relationship between stress and cancer progression has long been suspected. Recently, through animal cancer models, we are learning that the molecular link between the two may be through the beta-adrenergic signaling pathway which mediates the sympathetic nervous system induced fight-or-flight response.

Stress, through the beta-adrenergic pathway, may contribute to the progression and metastasis of a cancer . (Immune mediated macrophages can infiltrate some tumors such as breast cancer and, like a switch, induce pro-metastatic genes to be expressed.)

The stress hormones epinephrine and norepinephrine can attach and turn on receptors on tumor cells to control a variety of function involved in progression, such as proliferation, migration and invasion. Yet, little research is available to answer the question about whether distress can increase cancer recurrence.

Dr. Bergquist is an Emory Clinic Primary Care Physician and Assistant Professor of Medicine at Emory University School of Medicine. Her expertise includes healthy aging, heart disease prevention and management, women’s health, diabetes, nutrition and obesity counseling and treatment of mood disorders, such as anxiety and depression. She has appeared in over a hundred health segments, including Good Morning America, Fox New Network, CNN and Fox 5, has served as an editorial consultant for WebMD and wrote the TED Ed Lesson, “How Stress Affects Your Body.”

Below we have also highlighted some questions that were asked during our live chat.

Question: It’s been said that a certain amount of stress is good. How does a person maintain a good level of stress without tipping over into chronic debilitating stress?”

Short-term stress is advantageous—not only can it help us perform our best but even supports resilience at a cellular level. Stress becomes debilitating or “toxic” when it is prolonged or recurrent, such as worrying about a sick child or finances. The interaction between stress hormones and the hormones and immune cells, among others, throughout our bodies are responsible for both the good and adverse effects.

Question: How does stress affect aging?

Stress has been associated with decreasing longevity and shortened telomeres. These are the shoelace tips at the ends of chromosomes that allow DNA to get copied every time a cell divides without damaging the cell’s genetic code. With each cell division , telomeres shorten until a cell eventually dies. Stress accelerates this process.

In one study done on mothers who were either caregivers of healthy children or children who were chronically ill, the women who felt the most perceived stress had telomeres that were shorter on average by the equivalent of a decade of aging compared to mothers that felt the least stressed.
How much does exercise really help with stress?

Exercise is one of the most effective ways to manage stress. Exercise can reduce cortisol, which is otherwise known as the “stress hormone”. Exercise can also improve other neuroendocrine changes that take place from chronic stress, and it can reduce the immune system mediated damaging inflammation that occurs from chronic stress.

Question: Mindfulness- what does this mean and what role does in play in stress management?

Mindfulness is actively focusing on the present, and observing your moment to moment thoughts and emotions without passing judgment on them. It’s the opposite of being mindless. Mindfulness has become a widely used way of reducing stress, helping with concentration and focus, increasing compassion and self-awareness, and controlling emotions.

Question: Can a certain diet affect your stress levels?

Omega 3 fatty acids are vital for proper nerve function. A diet that is high in omega-6 to omega-3 fatty acids can exacerbate the chronic inflammation that can be triggered by chronic stress and can adversely affect brain function. . Refined carbohydrates, such as sugar, can cause a spike and then a drop in your blood sugar level. People can feel irritable when their blood sugar drops. B vitamins, zinc, and magnesium are necessary in sufficient amount to support our brain chemicals. There is also a lot of research linking gut bacterial balance and brain health. Fiber rich foods support a healthy gut while sugar, fat, and processed food can disrupt gut bacterial balance.

To view the entire chat transcript click here.

Managing Your Stress Live Chat on December 22nd

stress-chatThe holiday season is in full swing, and there’s no better time to think about stress management. In short spurts, stress is actually helpful and can propel us through a tough situation or help us react quickly to avoid one. However, prolonged or severe stress may trigger physical, psychological and emotional reactions that can lead to health problems or worsen existing ones.

On Tuesday, December 22, 2015 from noon to 1pm EST join Emory Healthcare Network’s Sharon Horesh Bergquist, MD for an interactive web chat on Stress Management. Sign up, send questions and learn about

  • Symptoms of stress
  • Long-term effects of stress on your health and body and
  • Techniques for reducing stress

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About Dr. Bergquist

avatar-horesh-bergquist-sharonDr. Bergquist is an Emory Clinic Primary Care Physician and Assistant Professor of Medicine at Emory University School of Medicine. Her expertise includes healthy aging, heart disease prevention and management, women’s health, diabetes, nutrition and obesity counseling and treatment of mood disorders, such as anxiety and depression. She has appeared in over a hundred health segments, including Good Morning America, Fox New Network, CNN and Fox 5, has served as an editorial consultant for WebMD and wrote the TED Ed Lesson, “How Stress Affects Your Body.”

Posttraumatic Stress Disorder: How It Affects Veterans and Treatment Options That Can Lead to a Better Life Live Chat

ptsd-chat-calloutThough commonly associated with combat experiences, posttraumatic stress disorder (PTSD) can affect anyone who has experienced a traumatic event, be it a near-death experience, sexual violence, or even a car accident. Some common symptoms include upsetting memories, jumpiness, or trouble sleeping. If these symptoms persist, they can cause severe disruptions to daily life. Emory’s Veterans Program offers effective treatment to post-9/11 veterans who may be suffering from PTSD.

Join Dr. Barbara Rothbaum, director of Emory’s Veterans Program and a leading specialist in the treatment of PTSD,  on Tuesday, September 22 from noon to 1 p.m. to discuss PTSD and approaches to treatment. She will be available to answer in-depth questions regarding types of therapy and treatment  methods offered through Emory’s Veterans Program.

Register for the live chat on September 22 at 12pm here.

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About Dr. Rothbaum

Rothbaum_BarbaraBarbara Olasov Rothbaum, PhD, is a professor in the Department of Psychiatry and Behavioral Sciences and director of the Trauma and Anxiety Recovery Program at Emory University School of Medicine.

Rothbaum is a clinical psychologist who specializes in research on the treatment of individuals with anxiety disorders, focusing in particular on Posttraumatic Stress Disorder (PTSD). She is a pioneer in the application of virtual reality exposure therapy to the treatment of psychological disorders.

Rothbaum has served as a Blue Ribbon Panel Member for Pentagon officials since 2009 and serves on the committee for the Institute of Medicine’s (IOM) Study on Assessment of Ongoing Efforts in the Treatment of Post-Traumatic Stress Disorder (PTSD).

Author of over 200 scientific papers and chapters, Rothbaum has published four books on the treatment of PTSD and edited two others on anxiety.  Rothbaum received the Diplomate in Behavioral Psychology from the American Board of Professional Psychology. She has served on the Board of Directors and as past president of the International Society of Traumatic Stress Studies (ISTSS) and served as Associate Editor of The Journal of Traumatic Stress. Dr. Rothbaum is currently on the Scientific Advisory Boards for the Anxiety Disorders Association of America (ADAA), the Obsessive Compulsive Foundation (OCF), the National Center for PTSD (NCPTSD), and McLean Hospital of Harvard University, and on the Board of Directors for ADAA.

Takeaways from Dr. Belagaje’s Stroke Recovery Live Chat

Stroke Recovery ChatThank you to everyone who joined us on May 28, for our live chat on Stroke Recovery. There were some great questions and we hope you found stroke neurologist, Dr. Samir Belagaje’s discussion informative. If you missed the chat, feel free to review the full chat transcript.

There was such a good response, we didn’t have time to address all of the questions you submitted during the chat, so we will answer those below:

Question: What other things can be done besides going to a recovery center?

Samir BelagajeDr. Belagaje: Certainly one can develop a home exercise/rehabilitation plan and continue to work on improving their stroke related deficits in that fashion. However, I strongly recommend that stroke recovery be completed under the guidance of a health care expert in that area or going to a stroke recovery center. They can look at medications which may be adversely affecting the recovery process, start new ones, screen/treat for depression, and provide opportunities to participate in clinical trials which would allow one to get access to latest technology and developments.

Question: Does the brain actually recover from a stroke or are you just ‘retraining’ different parts of your brain? How is it recovering?

Samir BelagajeDr. Belagaje: Great question! People recover from stroke in 3 major ways:

  • Adaptation– In this method, people just “learn to live with deficits” and find ways to adapt or get along with them. Examples would be the use of prisms in eye glasses for post-stroke visual problems or using a cane/walker to help with walking. Another example would be for a person to learn to feed themselves with their opposite hand
  • Regeneration– this involves growing new brain cells and them getting to the area of stroke and repairing that area. This is the way that stem cells and other biotherapeutics may help. It is an exciting area for stroke recovery research.
  • Rewiring– this is probably the major way of stroke recovery in the brain and the mechanism most therapy is geared towards. It is also the way that you are alluding to in your question when you talk about “retraining different parts of the brain”. Most therapy is geared towards getting those undamaged parts of the brain to rewire and take over the function of the damaged portions

Question: My dad lives in the UK and suffered a stroke. What can he do to help himself?

Samir BelagajeDr. Belagaje: Sorry to hear about your father. It really depends how long ago his stroke was and what kind of deficits he has post-stroke. In general terms, he should continue to stay as active as possible and continue to work on his deficits with therapy/rehab team. I would also encourage family and close friends to monitor for post-stroke depression symptoms and alert his health care providers if they notice depression symptoms.

Question: How do you regain normal vision after stroke?

Samir BelagajeDr. Belagaje: Admittedly, post-stroke vision deficits are challenging as we don’t have as good and effective and proven visual rehab therapy/techniques compared to some other deficits. If her stroke is greater than 6 months, I would recommend seeing a neuro-ophthalmologist for possible prisms in the glasses (this would be an adaptation technique I mentioned in an answer to another question). In addition, working with an occupational therapist (OT) may also help to improve visual field deficits and develop compensation techniques.

 

 

 

Stroke Awareness Month Events at Emory Healthcare

Stroke EventsAccording to the American Heart Association, stroke is the leading cause of adult disability in the United States. In recognition of May as National Stroke Awareness Month, Emory Healthcare encourages you to learn the signs, symptoms and risk factors for stroke. Mark your calendar for the following events:

Community Stroke Fair

When: Wednesday, May 13, 2015; 11:00 am to 2:00 pm
Where: Emory University Hospital Midtown Medical Office Tower Lobby
Why:

  • Learn the signs and symptoms of stroke
  • Free blood pressure screening
  • Ask a neurologist about stroke care
  • Hear about stroke rehabilitation programs
  • Speak to a pharmacist
  • Get your BMI checked
  • Free gift bags

5K Scrub Run and Community Health Festival

When: Saturday, May 16, 2015; 8 am to 11am
Where: Emory Johns Creek Hospital parking lot
Why:

  • Learn the signs and symptoms of stroke
  • Free glucose and cholesterol
  • Free blood pressure screening
  • Get your BMI checked

Stroke Awareness Fair

When: Tuesday, May 19, 2015; 10 am to 2 pm
Where: Emory Clinic Motor Lobby between buildings A and B
Why:

  • Learn the signs and symptoms of stroke
  • Understand how to manage blood pressure, exercise properly and maintain a healthy diet
  • Talk with experts about stroke prevention and response for suspected stroke

Stroke LIVE Chat

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 When: Thursday, May 28, 2015; 12:00 pm to 1:00 pm
 Where: Online
 Why:

  •  Learn about stroke recovery and rehabilitation from Dr. Samir Belagaje, stroke neurologist at Emory  University and Director of Stroke Rehabilitation at the Marcus Stroke Center. Dr. Belaje will answer  questions during a LIVE interactive chat.

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Stroke is an emergency. If you or someone around you is experiencing signs or symptoms of stroke, CALL 911 immediately.

Takeaways from Dr. Nahab’s “Stroke Awareness Month” Live Chat

StrokeThank you to everyone who joined us for the live web chat hosted by Emory Stroke Center Medical Director, Dr. Fadi Nahab. Dr. Nahab discussed the signs and symptoms of stroke, as well as treatments, recovery options and prevention.

Get more info and see more of Dr. Nahab’s answers by checking out the chat transcript!

Below are just a few of the questions and answers from the Emory Stroke Center’s live chat:

Question: Are there any preventative measures that you recommend to the general population?

Fadi Nahab, MDDr. Nahab: Definitely! First, if you’re actively smoking, it’s very important to stop as soon as possible. Secondly, dietary factors play a major role in our risk of having a stroke or heart attack. Low salt, limited fried food, high dietary fiber, and nuts can have an important effect. Fish that are high in omega-3 fats, such as salmon or tuna, should be consumed at least two times a week because of its beneficial effects. Limiting sugary beverages (specifically soda and sweet tea) also helps reduce the risk of heart attack and stroke. A third factor is increasing moderate exercise/activity to at least 20 min. daily. 20 min. represents the smallest amount we should be doing for heart attack and stroke prevention. The last four factors include control of blood pressure to a target of less than 120/80, control of cholesterol to a target of total cholesterol less than 200 mg/dl, blood glucose to a target fasting level less than 100, and a target weight using body mass index (BMI) less than 25. Body mass index can be calculated as your weight in kilograms divided by your height in meters squared. A recent study showed that each additional factor you achieve results in an 8% lower risk of stroke.

Question: Do you have advice for preventing hemorrhagic stroke recurrence?

Fadi Nahab, MDDr. Nahab: The best way to prevent a hemorrhagic stroke is to monitor your blood pressure and make sure it’s below 130/80. I often encourage patients to check their blood pressure twice a day, in the morning and evening before meals, sitting down with your arm rested on a table. It’s an important investment to have a blood pressure machine. Without checking your blood pressure, you can miss detecting high blood pressure until it’s too late. For patients who have a hemorrhagic stroke related to a blood vessel problem in the brain, there are very good treatments for reducing the risk of a recurring hemorrhagic stroke. At Emory, we are one of the largest volume hemorrhagic stroke centers in the country and use cutting-edge technology to treat aneurysms and other blood vessel abnormalities.

If you missed this informative chat with Dr. Nahab, be sure to check out the full list of questions and answers on the web transcript. Be sure to visit our website for more information about stroke prevention and treatment at the Emory Stroke Center. If you have any questions for the doctor, do not hesitate to leave a comment in our comments area below.

How Much Do You Really Know About Strokes?

Stroke Awareness ChatMay is National Stroke Awareness Month, making it the perfect time to brush up on your knowledge of the risks, signs and symptoms associated with stroke. According to the Centers for Disease Control and Prevention, someone in the United States dies of a stroke every four minutes. Fortunately, as a Comprehensive Stroke Center, Emory University Hospital is helping lead the way in research efforts that focus on preventing the risk factors that can lead to stroke, as well as new models of stroke care. Emory vascular neurologist Fadi Nahab, MD will be on hand to answer questions such as:

  • What puts someone at risk for a stroke?
  • How can I prevent stroke?
  • How are strokes treated?
  • Why is Emory a great choice for stroke care?

Mitral Valve Disease Chat

Do you know how to recognize stroke symptoms and when to “Act F.A.S.T.“?

Dr. Hart to Host Online Chat on Getting Motivated to Exercise

Dr. Chris HartExercise provides numerous benefits—from reducing cardiovascular disease to fighting depression. While we all know we should exercise regularly, the trick is working up the motivation to start exercising. Overcoming couch-potato inertia can be difficult particularly during the dreary winter months and especially after most of us have spent the holidays celebrating with family, friends—and a lot of comfort food.

Join Christopher J. Hart, MD, Chief of Staff at Emory Johns Creek Hospital and Medical Director of Emory Johns Creek’s Atlanta Bariatric Center, on Tuesday, Jan. 14, 2014 from noon to 1 p.m. as he provides tips and guidance to help you get moving.

Exercise Motivation Chat Sign Up

 

Whether you are simply working toward a healthier lifestyle in the New Year, or you are trying to lose weight for a surgery, Dr. Hart can address issues and questions such as:

  • I really want to start exercising but I can’t seem to work it into my schedule.
  • What if I don’t like to exercise?
  • I can’t carve out an entire hour to exercise. What are my options?
  • What if I can’t afford a gym membership?
  • I’m exhausted all the time, and just the thought of exercising wears me out. How do I get over that mental hurdle?
  • I’ve tried exercising before, but I can’t stick with it. What can I do to stay motivated?

If you’re looking for a good way to get motivated in the New Year, join Dr. Hart for what’s sure to be a great online chat!