The September 7, 2017, chat with GEHA's panel of health-and-wellness experts has concluded. Thanks for participating. If you didn't see an answer to your question, GEHA will be sending you an email in the next several days.

The transcript is available below and will remain online for several weeks.

For more information about GEHA, please visit the GEHA health home page or the GEHA dental home page, or give us a call at .800.821.6136


Moody, Alabama (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): What is biometric screening?
Kipp Wilhoit, RN:

Biometric screenings are short health exams that provide insight into your risk for certain diseases and medical conditions. For example, you may have your cholesterol drawn as part of a biometric screening which would identify if you were at increased risk for a heart attack or stroke.

Typical tests performed during a biometric screening include cholesterol levels, sugar levels, blood pressure, body mass index and waist circumference.


Lizella, Georgia (GEHA Standard Option): Regarding the Health and Wellness aspect, I'd be interested in resources that provide healthy meal plans and weight training plans for women.
Jennifer Jenkins, RN-BC, CCM:

We have a new HealthBalance portal for GEHA medical members that allows for many fun options and activities for getting healthy and exercise.  You can also earn up to $250 in health rewards points!  You can find out the details at https://www.geha.com/~/media/Files/Documents/Health-Documents/Member-Services/healthbalance_quick_start.pdf?la=en.  We would also recommend that you visit your primary care physician to make sure you have no limitations, or conditions that would prevent you from exercising.


Valencia , California (GEHA Standard Option): I am diagnosed with lupus since 2010; I retired in 2007. My specialist is Dr. Yoon Min here in Valencia and my primary doctor is Dr. Gene Dorio, but it has been 2 years already that I haven't seen Dr. Dorio and he seems to be very busy because he has so many patients plus he edits on so many newpapers; I am experiencing headaches but my doctor says it is not related to my lupus and I have to see my primary doctor; so please I need aprimary doctor, can you help me?
Jennifer Jenkins, RN-BC, CCM:

There are numerous choices for a general and/or family practice physicians. Click here for our provider search.

If you want to research more than one type of specialty, you go to the results page and change the specialty very easily. You can also narrow the search by selecting a male or female physician, and one who is accepting new patients. You can look through the results by their star rating as well.

Sometimes family & friends can be really helpful when looking for a new primary care physician.


Aurora, Colorado (GEHA High Option): Regarding IBS symptoms with diagnosed GERD. I was told sometimes mental stress/ anxiety place into the severity or the whole thing in itself. Tried partial dieting and obviously there are certain foods that trigger horrible symptoms. Is there any advice/ guidance on this or anything that hasn't been tried? Or just keep experimenting with what works and what doesn't? Thank you very much for your time.
Teresa Westmoreland, MS, RD, LD:

IBS can be difficult to treat because many times there seems to be no rhyme or reason as to when you will have an attack and symptoms may even seem to change. Here’s a link to a helpful website that offers suggestions depending on the type of symptoms you may have, such as:

  • IBS with constipation
  • IBS with diarrhea
  • Constipated diarrhea
  • Bloating in IBS
  • Nausea and IBS
  • Pain in IBS

In order to gain a clearer understanding of your IBS for you and your MD it is helpful to keep a symptom diary for 2-4 weeks. Keeping a detailed record of diet, medication, stool consistency, pain, emotion status (such as stress/anxiety), and exercise. This can help you identify triggers and help your MD to determine the best treatment plan. You can find a detailed symptom diary here.

Common foods that may cause GERD symptoms:

  • Spicy foods
  • Chocolate
  • Tomato products
  • Citrus fruits/juices
  • Caffeine
  • Fatty or greasy foods
  • Peppermint
  • Raw onion, garlic, pepper
  • Alcohol

Other changes that may help: 

  • Eat smaller meals instead of 3 large meals
  • Avoid laying down 3 hours after eating
  • Consume meals slowly
  • Avoid late night snacking
  • Stop smoking
  • Limit or reduce stress
  • Avoid tight fitting clothes
  • Weight loss if overweight
  • Elevate the head of your bed 6-8 inches

Click for more information.


North charleston, South Carolina (GEHA Standard Option): I have high blood pressure. What can I do or take to bring it down besides prescriptions pills?
Kipp Wilhoit, RN:

Based on the JNC 8 guidelines, lifestyle recommendations that may have an effect on your blood pressure consist of:

1. smoking cessation

2. healthy diet (such as the DASH diet)

3. alcohol use reduction

4. reduce sodium intake to < 2400mg per day

5. 40 minutes of moderate physical activity 3-4 days per week

It should be noted that these modifications may not be enough to sufficiently lower your blood pressure. As high blood pressure is a serious concern for heart attack and stroke, you should speak with your physician about whether prescription treatment may still be needed. Lifestyle modifications can help lower your dose of prescription medications or prevent the need to have additional treatments added on later.


PARSIPPANY, New Jersey (GEHA Standard Option): I am getting waters(tears) in my left eye many times a day, what can I do to stop it
Shauna Todd, RN, BSN, MHA:

Increased tear production can occur for many different reasons; including, but not limited to: environmental factors, irritants, or infections.

I would recommend that you make an appointment with your eye doctor to for evaluation and recommendations based on their assessment findings.


Mesa, Arizona Healthy 84 yr old male (with a lot of home stress as a care giver) has had very few normal BMs in the last several months, however he is having meny false ones that only produce a tablespoon or two of body lubricant (mostly odorless). Is this something to be concerned about?
Kipp Wilhoit, RN: Sounds like you have a lot going on and would benefit from seeing your primary care physician to discuss these symptoms and  possible options for treatment.

Houston, Texas (GEHA Standard Option): What can I do if I think I've been misdiagnosed?
KippWilhoit: Thank you for being proactive with your health care. If you feel that you've been misdiagnosed, you should seek a second opinion from another provider that specializes in that specific area of health care.

Stevensville , Maryland (GEHA Standard Option): I am 77 years old; 5' 5" tall; weight 225 lbs and a vegetarian. No meat,fish or seafood. Where can I find a diet to lose weight?
Teresa Westmoreland, MS, RD, LD:

An appropriate calorie recommendation can be calculated for you based on age, height, weight, and activity level. The correct balance of caloric intake and caloric expenditure from exercise is key in weight loss. A deficit of 3,500 calories at the end of the week is needed for a 1 pound weight loss. The USDA ChooseMyPlate.gov can help you calculate your calorie needs.

After you identify the appropriate calorie level, select the following link to take you to the healthy vegetarian patterns: https://health.gov/dietaryguidelines/2015/guidelines/appendix-5/

Using the patterns, “choose a variety of foods in each group and subgroup over time in recommended amounts. Limit choices that are not in nutrient-dense forms so that the overall calorie limit is not exceeded.”

The patterns are based on evidence of the foods and amounts consumed by vegetarians, in addition to meeting the same nutrient and Dietary Guidelines standards as the Healthy U.S.-Style Pattern.


Stone Mountain, Georgia (GEHA Standard Option): Does GEHA allow Oberra or gastic sleeve surgery? If so what are the requirements? I am currently 5'4" 203lbs and i have tried diet including no meat, exercise, diet pills that made me too jittery and I have only maintained my weight. I see a nutritionist once or twice a month. She recommends a procedure like this because i am able to keep up the lifestyle change. I currently have back, feet, and hypertension issues that she says will be reduced by one of these procedures. Please advise if i would be eligible. Thank you in advance for your time and consideration.
Tori Delana, RN:

Authorization is required for bariatric surgeries. Providers should download a Bariatric Authorization form, complete and fax to 816.257.3255. This bariatric form does include required clinical information required for review. For assistance, call 800.821.6136, Ext. 3100. At prompt, select Option 4.


Woodway, Texas (GEHA High Option): Do you have any resources to help stay on track for healthy eating? I know the types of food I should be eating on a low FODMAP diet but struggle with staying on track - needing help with accountability and maybe a day by day or week by week plan that is written out that i could stick to?
Teresa Westmoreland, MS, RD, LD:

Following a low FODMAP diet can be difficult to follow. In order to stay on track, it is important to be prepared. When you are hungry with no meal plan in mind you are more likely to pick up convenience food that may not be within your guidelines.

First start with making a plan to plan! Look at your calendar for the next few weeks and find the best day to sit down and plan meals for the week. Then create your grocery list. Identify the day of the week that you can grocery shop and do some meal prepping for the week, which will save time when the weekdays get busy.

There are helpful resources coming out that help with following a Low FODMAP diet. I am providing a link to a dietitian who is a low FODMAP diet educator that provides free resources. Following are a few of the free resources you will find on the website:

  • FODMAPS 101
  • Low and High FODMAP diet checklist
  • Low FODMAP grocery list
  • Link to a Low FODMAP diet app
  • Search engine to find a FODMAP dietitians near you

Show Low, Arizona (GEHA Standard Option): I have diverticulitis and was on antibiotics. I have been having severe diarrhea every day and I want to know what I can eat that will slow down the diarrhea or stop it. I am drinking pedialyte with probiotics and been on bland diet.
Jennifer Jenkins, RN-BC, CCM:

This diarrhea can be caused by numerous reasons. It is important that you discuss this problem with the practitioner who prescribed your antibiotics. Diarrhea can be dangerous if not treated in a timely manner.


Kettering, Ohio (GEHA High Option): When older people start to be a little wobbly, is it better to go right away to a wheeled walker? Or should there be interim steps: working on balance strengtheners, using a walking stick or cane, or other possibilities? Does constantly using a walker lessen one's innate sense of balance, or is there no effect? Walking bent over while using a walker all the time cannot be good long-term for either one's stride, posture or balance.
Nicole Doyle, MS, CPT:

Great questions and thoughts! The aging process can affect each person differently. When it comes to mobility, it is important to stay moving! Balance training is super important to practice as we age. There are classes that offer this, and there are resources out there online and otherwise that help you with balance and strengthening core muscles.
 
If one starts to rely solely on another method of balance (walker, cane, etc.) this tends to lessen your own balance/natural stabilizers of the body. Even if you move towards using a walker, I would continue to work on balance movements! Many can be done seated or next to a wall for support and peace of mind.

I would encourage following the American Heart Association’s guidelines for physical activity. Exercise might seem daunting, especially if you are starting to struggle with balance. The guideline suggest: 150 minutes of moderate cardiovascular activity per week, and, two total body strength training sessions. The cardiovascular activity can be walking, biking, etc. Find a type of rhythmic aerobic activity that you enjoy.

Also, keep in mind it only has to be done in 10-minute chunks, so you can do five, 30-minute walks per week, or three 10-minute walks per day (five days a week). The strength training component can also look a variety of ways, from doing basic movements at home with your own body weight or with a resistance band, or finding a class at a gym that works your muscles, two times a week.

Whichever modality you choose, find something fun! You’ll be more likely to stick with it if you enjoy doing it.


Moscow, Idaho (GEHA High Option, Connection Dental Federal (FEDVIP) Standard): Are there benefit options for preventative services (e.g. massage, acupuncture, counseling, etc)? Are there easier, quicker ways to submit medical claims and receive payments?
Jennifer Jenkins, RN-BC, CCM:


Thanks for the question.  There are benefits for many preventative services.  I recommend you go to the online benefit brochure to see a summary of covered services, including acupuncture, chiropractor, & nutritional counseling.  To read the details of the Standard and High Option Medical plan, you can click 2017 plan brochure.

You may also want to consider the preventative benefits of our Health Balance program by earning up to $250 in health rewards points! Click to find out the details

You find info on how to submit your own claims by visiting How to File a Claim. It is much faster to process if we already have the provider loaded into our claims processing system, so you may want to check into that prior to receiving services. Thanks for your continued GEHA membership!


Montrose, Colorado (GEHA Standard Option): I take two medications in the morning before my first meal -- synthroid and lansoprazole. I take the synthroid first thing when I wake up, then wait 30 minutes before taking lansoprazole. After 20 minutes I have my first coffee, than breakfast. Is the timing of taking these two medications acceptable? I've heard one might wait an hour after each but that just seems too long.
Kipp Wilhoit, RN: The recommended administration of thyroid agents is that they be separated from other medications, vitamins and supplements by 4 hours. If you have been consistently taking your medications 30 minutes apart, your Synthroid dose has been adjusted based on this routine and you wouldn't want to change it. Consistency is best.

Midland, Georgia (GEHA Standard Option): What is your opinion on the benefits, if any, of taking vitamin supplements?
Kipp Wilhoit, RN:

For the majority of people, the use of vitamin supplements are unnecessary. The body absorbs vitamins/nutrients best from food. If you are eating a well-balanced diet (full of color with vegetables), you likely do not need additional supplementation.

If you are deficient in a specific vitamin or nutrient, it would be recommended to only supplement that area. If you have concerns, please contact your physician.


Omaha, Nebraska (GEHA Standard Option): are their any cures, etc for neuropathy in legs and feet (tingling feeling and weakness in legs and feet)
Katherine Lurk, PharmD, BCPS:

Thank you for your question.

From a medication perspective, there are no cures for neuropathy, however, there are some treatments that can help reduce your symptoms and make the neuropathy more tolerable. Gabapentin and Lyrica are the most common medications used currently to treat neuropathy, and you may benefit from talking with your health care provider about whether one of these would be safe for you to take. 

Additionally, if neither of those are an option, there are several other prescription medications, including Duloxetine, Venlafaxine, and Amitriptyline, that may provide you benefit.


Florence, Oregon (GEHA Standard Option): I would like a copy of diet recommendations. Thank you.
Teresa Westmoreland, MS, RD, LD:

This excerpt from the 2015-2020 Edition of the Dietary Guidelines for Americans might help:

Consume a healthy eating pattern that accounts for all foods and beverages within an appropriate calorie level. A healthy eating pattern includes:

  • A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other
  • Fruits, especially whole fruits
  • Grains, at least half of which are whole grains
  • Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages
  • A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products
  • Oils

A healthy eating pattern limits:

  • Saturated fats and trans fats, added sugars, and sodium
  • Key Recommendations that are quantitative are provided for several components of the diet that should be limited. These components are of particular public health concern in the United States, and the specified limits can help individuals achieve healthy eating patterns within calorie limits:
  • Consume less than 10 percent of calories per day from added sugars
  • Consume less than 10 percent of calories per day from saturated fats
  • Consume less than 2,300 milligrams (mg) per day of sodium
  • If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.

Visit the link below to find more details and a printer-friendly version of the guidelines listed above:

-Source: https://health.gov/dietaryguidelines/2015/guidelines/chapter-1/key-recommendations/


Pahrump, Nevada (GEHA Standard Option): Hello. I have type 2 diabetes. Recently, I went the local emergency room for chest pains and abdominal pain. I was diagnosed as inflamed pancreas. I refused to be admitted to the hospital simply to be "hydrated" as I can do that at home. I have since had a life style change.... No caffeine, No alcohol, serving of grapes ( anti-oxidants ) a helping of pro-biotic yogurt, Lots of water, and living on chicken. My question is : Does the pancreas heal after this or is it still inflamed. I have only a slight " awareness " under my right ribcage very infrequently. Thank you.
Katherine Lurk, PharmD, BCPS:

Thank you for your question.

Generally, when pancreatitis is treated with hydration and supportive care, the inflammation resolves over time. Depending on how long ago you had the event, you may still be in the healing process. 

Also, keep in mind that once you have an episode of pancreatitis (inflamed pancreas), you are more likely to have recurrent episodes. Your lifestyle changes are excellent and the best ways to prevent another “attack.”  When you notice small flares, consider thinking about what may have triggered it, and try to avoid consuming in the future.


Molalla, Oregon (GEHA Standard Option): How does the caffeine affect the body? Please answer honestly, not just popular speculation. Thank you.
Jennifer Jenkins, RN-BC, CCM:

Caffeine is a central nervous system stimulant. It acts to increase your heart rate, breathing and blood pressure.

You can see a complete list of caffeine side effects at https://www.drugs.com/sfx/caffeine-side-effects.html.


Silverdale, Washington (GEHA High Option): I just had an endoscopy and learned food stays in my stomach and I can't digest it. It makes me nauseated and sometimes I through-up. The Dr. didn't tell me what to do. He said it will just sit there and rot. I really need to know what to do. I also have A-fib and am in 4th stage kidney failure. I am 35. Hope you can help me. Thank-you
Teresa Westmoreland, MS, RD, LD:

Thank you for your question. I recommend you speak with your physician for more guidance on the diet. If gastroparesis has been diagnosed, a health care provider may suggest some of the following tips:

  • 6 small meals instead of 3 large meals allowing the stomach to empty more easily
  • Chew food thoroughly
  • Drink non-carbonated liquids with meals
  • Do not lay down after a meal
  • Avoid high fat foods which slow digestion. For example: French fries, donuts, high fat dairy (whole milk, ice cream, sour cream, etc.), fatty meats
  • Limit raw vegetables and fruits which can be difficult to digest
  • If symptoms are severe, a liquid or pureed diet may be prescribed

If gastroparesis has been diagnosed, it is important to know if Diabetes is part of the cause as this will effect meal planning.

To address the stage 4 kidney disease, lab data is needed in order for the MD or dietitian to recommend an appropriate diet.


Washington, District of Columbia (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): A couple of months ago I sprinted for my commuter bus and thereafter have experienced ongoing pain where my right-side hamstring meets my gluteus maximus. At first I tried stretching, and then ceased any exercise (except for normal walking) that involved that area of muscle. The pain occurs primarily when I stand and walk. I have occasionally felt a bit of temporary numbness in my right foot. I assume that I may have torn some muscle fibers and that the healing process takes a long time. Other than trying to minimize the use the muscles in this area, are there other things that I can do to promote healing? Thanks.
Jennifer Jenkins, RN-BC, CCM:

It sounds like you may want to follow-up with your doctor to make sure there isn’t anything that would need medical attention. I recommend continuing with walking to maintain cardiovascular benefits.

Also, focusing on strength training (movements that don’t aggravate that area) to continue working on muscle tone/strength and maintenance. Using a heating pad might help minimize discomfort, along with taking a warm Epsom salt bath. Self-myofascial release (foam rolling) might also be helpful to try out.

There are many tutorials online that show exactly how to do this process and you can get a foam roller at your local sports’ store. As time progresses you should be able to return to normal activity, barring any major tears/problems.

Sometimes activity will greatly help a problem, sometimes it will aggravate the problem. We recommend that you see your primary care physician to help you determine which strategy best suits the problem you are experiencing.


San Jose, California (GEHA High Option): I hope this is the correct place to ask this question about weight loss. My friend told me that her daughter checks her weight loss based on her heart rate. Today in the gym, I overheard a woman saying that heart rate is what she checks to cause weight loss. Is this true? How does it work?
Dr. Neal Kaufman:

Checking your heart rate before or during exercise may help since your resting heart rate slows over time as you become more fit. During exercise your heart rate increases to help supply blood to your muscles.

Some people find it helpful to figure out their maximum heart rate (220 minus your age in years) and then determine their fat-burning range (60-70% of your maximum heart rate).


Columbus, Ohio (GEHA Standard Option): Does GEHA offer a plan or app for tracking macros? Or do any of the coaching services offer any advice and training on macros?
Kipp Wilhoit, RN:

Thank you for your question. GEHA provides health plan members free access to a wellness portal that does have a food log and a fruit and vegetable tracker. Please register at healthbalance.geha.com to take a look at the resources in the portal. I hope this will be helpful.


St.Louis, Missouri Is the link between HCTZ and high blood sugary levels valid? What alternatives are recommended?
Kipp Wilhoit, RN:

There is a link between the use of thiazide diuretics (such as HCTZ) and an increase in blood glucose levels. The true answer for the question lies in the risk versus benefit of using HCTZ.

Medications such as HCTZ have been proven to reduce the risk of stroke and heart disease in diabetic patients, so your physician would need to balance the benefit of using HCTZ (decreased stroke and heart disease) against the risk of using HCTZ (possible increases in blood glucose).


Farmington, Missouri What is the best oil to fry fish in?
KippWilhoit: Any plant-based oil such as canola, coconut, olive, sunflower, etc. is preferred.

Gerald Morris, Louisiana (GEHA Standard Option): I have moderately arthritic knees. I do not believe they have reached the state where artificial knee joint replacements are necessary. What treatments, drugs and/or exercises should I be using to improve the situation?
Nicole Doyle, MS, CPT:

A visit to the doctor is important to check how your knees are holding up structurally, and to determine if any next steps need to be taken medically.

From a drug perspective, there are a few over-the-counter options, including Acetaminophen (Tylenol), Ibuprofen (Advil), and Naproxen (Aleve).  In addition to pain relief, Ibuprofen and Aleve have the ability to reduce inflammation if that is part of your pain process, and a single dose lasts longer in your system.  There are certain medical conditions that you would want to avoid taking these medications with, so please check with your doctor of pharmacist to ensure it is safe.

There is also a supplement called Glucosamine, that when taken for extended periods of time helps to rebuild the padding in your joints and can provide additional relief.  It generally takes 4 months before you can notice a significant difference.

In addition to these options, there are many prescription medications that can be prescribed for pain relief.  If you feel a stronger medication is needed, please have a conversation with your doctor about the best options for you.

For exercise, I would recommend following the physical activity guidelines prescribed by the American Heart Association, which are: 150 minutes of moderate cardiovascular activity per week, and, 2 total body strength training sessions. The cardiovascular activity can be walking, biking, etc.

Find a type of rhythmic aerobic activity that you enjoy! Also, keep in mind it only has to be done in 10-minute chunks, so you can do 5, 30-minute walks per week, OR, 3, 10-minute walks per day (5 days a week). The strength training component can also look a variety of ways, from using just your body weight and doing basic movements at home, or, finding a class at a gym that works your muscles out, 2 times a week. Whichever modality you choose, find something fun! You’ll be more likely to stick with it if you enjoy doing it.


Grand Rapids, Michigan (GEHA Standard Option): I've been getting brown spots on my upper arms the past year. Could they be age-related? I just had my 92nd birthday the other day.
Shauna Todd, RN, BSN, MHA:

Happy 92nd birthday to you! Darkened patches of skin (age spots) can be normal with age, but you should have your primary care physician or dermatologist evaluate any skin changes.


Springfield, Virginia (GEHA Standard Option): How does taking biotin affect the use of synthroid? What can you advise to treat splitting, breaking nails?
Kipp Wilhoit, RN:

This is a good question. There is no significant interaction noted between the use of prescription thyroid treatments (Synthroid and levothyroxine) and biotin alone. It is important to know that many supplements for "healthy hair, skin and nails" include other agents within the bottle.

It would be advised to discuss the use of these agents with your provider as Synthroid/levothyroxine can interact with certain vitamins/minerals.


Kenner, Louisiana (GEHA Standard Option): What can be done about cramps in my lower extremities at night. Sometimes, my feet curl to the inside, sometimes my calf's cramp and, worst of all, I get excruciating pain in my inner thighs. Sometimes my hands also cramp. This will happen two or three nights in a row and then not occur for a week or so. Thank you and God Bless!
Kipp Wilhoit, RN: The answer is complex because the cramping could be related to multiple things, including you medications, hydration, electrolyte issues, etc. I would encourage you to speak with your physician for evaluation and the opportunity to rule out these possibilities.

Fredericksburg, Virginia (GEHA Standard Option): Through the years, I have read about the value of different vitamin and mineral supplements and have been taking as many as 15 pills or tablets per day. Friends have told me the body can't absorb all that and I should get my nourishment from foods. A doctor actually told me to stop taking all of them. I am 82 years old and in fairly good health, so I have thought perhaps all those supplements have been helping. Do you have any general recommendations about the value of taking supplements?
Kipp Wilhoit, RN:

For the majority of people, the use of vitamin supplements are unnecessary. Although it is an autonomous decision to use vitamins/nutrients, most do not need them. The body absorbs vitamins/nutrients best from food.

If you are eating a well-balanced (full of color with vegetables) diet, you likely do not need additional supplementation. If you are deficient in some vitamin/nutrient, it would be recommended to only supplement that area. If you have concerns, please contact your physician.


Harleyville , South Carolina (GEHA High Option): Which immunizations are covered and is the Zostavax covered? If there is a copay, how much would it be?
Kipp Wilhoit, RN: As per page 87 of the plan brochure, many vaccinations (including Zostavax) are available at your convenience through a participating retail pharmacy. It is recommended that you contact CVS/Caremark at 844-4-GEHARX for coverage benefits.

Atlanta, Georgia (GEHA HDHP Option, Connection Dental Federal (FEDVIP) Standard): What is the easiest way to lose weight, is it cutting calories or exercising. I have been doing both, but my weight lost is minimal.
Dr. Neal Kaufman:

Unfortunately, there is "no easy way" to lose weight. Our bodies are programmed to try to keep whatever weight we are at that time. While eating healthy and being physically active is important to losing weight, what you eat is most important to losing weight and being physically active is important to keeping weight off. 

The best strategy is slow and steady. Each week or two make small but useful changes in what you eat and how active you are. For example, if you drink a lot of sweetened beverages, decrease the amount each day.


Washington, District of Columbia (GEHA Standard Option): I'm a 65-year-old male who recently had a second molar extracted because of resorption. I had a bone graft to help support the adjacent tooth, though I'm not planning an implant. I also recently expelled a black kidney stone. I drink almond milk rather than cow's milk; limit my cheese intake (sadly); include plain yogurt in my diet; and take a daily multi-vitamin. How does one determine an appropriate amount of calcium in the diet, balancing bone growth and strength while discouraging kidney stone formation?
Katherine Lurk, PharmD, BCPS:

Thank you for your question on this complicated and controversial topic.

Based on your age and that you are a male, it is currently recommended that you obtain 1,000 mg of calcium per day. Ideally, most of this calcium should come from your diet while avoiding high doses in supplements, if possible. In addition to calcium, vitamin D is important for the absorption and utilization of calcium, so ensure you are getting around 1,000 units of vitamin D, as well.

With regard to kidney stones, you may consider having them analyzed if you haven't already. Not all kidney stones are made of calcium, and they may be forming from a completely different process. Once you know their make-up, it's easier to identify how to treat or reduce their occurrence.


Tulsa, Oklahoma Have heard that sitting is the new smoking. How often should you get up and move about? How much activity is required each time you get up?
Dr. Neal Kaufman:

"Sitting is the new smoking" is shorthand for the health risks when someone isn't physically active and the benefits when one is active. A good rule of thumb is to have a short (e.g., 5 minute) activity break every hour or so.

Walking is the easiest activity but anything which gets you moving will work. For those who are unable to walk for any reason, doing arm and upper body movement is worth the effort. For example, doing "curls" with water bottles in each hand is one way to be active when walking is hard or painful.


Rochester, Minnesota (GEHA Standard Option): What type of diet and exercise routine should I follow as a prediabetic in order to avoid becoming a full blown diabetic?
Dr. Neal Kaufman:

Great question! By making changes in your diet and getting more active you can help prevent or delay diabetes. Choose foods that are low in fat, calories and added sugar. Select foods high in fiber such as vegetables, fresh fruit and whole grains.

To get started, try making small changes. For example, cut back on sweets; switch from regular soda and juice to water with a squeeze of fresh fruit; start each dinner with a salad of leafy greens.

For some people with prediabetes, early treatment can actually return blood glucose levels to the normal range. Research shows that you can lower your risk for type 2 diabetes by 58% by:

  • Losing 7% of your body weight (or 15 pounds if you weigh 200 pounds)
  • Exercising moderately (such as brisk walking) 30 minutes a day, five days a week
  • Don't worry if you can't get to your ideal body weight. Losing even 10 to 15 pounds can make a huge difference.

- See more at: http://www.diabetes.org/diabetes-basics/diagnosis/#sthash.irPSxNyi.dpuf

You also might want to check out GEHA's free-to-the-member, year-long, digital weight loss program called Virtual Lifestyle Management.  It has been quite effective, especially for people like you. It isn't specifically a diet or exercise program.  Rather, it is a program that helps overweight and sedentary adults overcome their barriers to being more active and eating better.  You will be assigned to your own coach who will be there to help you on  your journey.  You will have access to lessons, goal setting, and tracking of your progress. You can go to www.geha.com/active to learn about the program and to sign-up if you want to enroll.



Frederick, Maryland (GEHA Standard Option, Connection Dental Federal (FEDVIP) High): Can I use Silver Sneakers with GEHA?
Kipp Wilhoit, RN:

Thanks for your question. We have researched Silver Sneakers. Compared with other options, it is not currently a cost-effective choice for our membership. In part, this is because our national membership is so large. As with all benefits, we look for good value while also working to control costs and the premiums members pay. We will continue to look at this option in the future.

All GEHA health plans include our Connection Fitness® program by GlobalFit at no additional cost to our members or their covered dependents. With Connection Fitness you receive discounts at more than 10,000 gyms, including 24-Hour Fitness, Gold’s Gym, Curves and more. You can shop for your new gym with a free Guest Pass to try participating clubs before joining. Click to learn more about the Connection Fitness program.


Clinton, Maryland (GEHA Standard Option): I keep getting information in my email about the medication "METFORMIN" stating you should not be taking it. I do not go back to my doctor until two months, is this medication something I should be concerned about?
Kipp Wilhoit, RN:

Metformin is the gold standard of therapy for altered blood sugar levels and is backed by strong research and literature. The benefits of using metformin usually far outweigh any risks.

You are encouraged to speak with your physician, in person or by phone, about your concerns.


Edmond, Oklahoma (GEHA High Option, Connection Dental Federal (FEDVIP) Standard): Is there a concern about getting LDL cholesterol too low while on a statin drug?
Dr. Neal Kaufman:

The concern is generally not that the LDL will get too low, but to get to a low enough value to improve outcomes there will be side effects of the medication.

Work with your health care provider to determine your cardiovascular risk and aim for a dose of medication (and a healthy diet) to attain an LDL that has been shown to lower the risk in people like you.

The higher the cardiovascular risk, the higher the dose of medications, and the higher the tolerance of side effects.


Anaheim, California (GEHA Standard Option): When treating high uricacid reading in blood test, is Uloric (high cost) significantly better than Allopurinol? Had one Gout attack two years ago. Doctor just prescribed Uloric last week.
Kipp Wilhoit, RN: Thank you for your question. Although Uloric is a newer agent in the gout arena, allopurinol remains the "tried and true" therapy. If you feel that your symptoms are not severe/recurrent and have concerns with the cost of Uloric, you are encouraged to speak with your provider about switching to a more affordable agent. Allopurinol would be significantly cheaper based on your benefit.

Washington, DC (GEHA Standard Option): Starting from my hip, my left leg (sometimes, my right leg too), I experience excruciating pain all over, down at my fingers, I feel numbness and cold, under my feet, I feel burning, I can't stand long without pain and on the top, it itches and nibbling. It's has been going on for a long time, but now progressing. I exercise at the gym, I use electrical feet warming, I massage them. But nothing seemed working.
Jennifer Jenkins, RN-BC, CCM:

Thanks so much for the question. Pain signals are generated by our bodies for numerous reasons, and it's important to investigate what those reasons are. We recommend that you see your primary care physician to help you determine your next step.

Sometimes activity will greatly help a problem, sometimes it will aggravate the problem. It is important for you to have an opinion as to which strategy best suits the problem you are experiencing.

I hope we answered your question and assisted you today.


Saint Louis, Missouri (GEHA High Option, Connection Dental Federal (FEDVIP) High): I have Self Plus One High Option in FEHB and FEDVIP. Can my husband get the free biometric screenings at Quest Lab as well?
Jennifer Jenkins, RN-BC, CCM:

Up to two members, 18 years or older, of GEHA's FEHB medical plan per household can receive a free biometric screening.

You may also want to learn how to earn up to $250 in health rewards points. Here’s the information on our HealthBalance Quick Start flyer.

Thanks so much for your great question.


Billings, Montana (GEHA Standard Option): I am an active healthy woman. I exercise regularly and am of average weight. I have struggled with sciatica (or something like it) pain for many years now. I just do my best to stretch and ignore it. I have seen friends spends thousands of dollars trying to get relief and in the end the doctors tell them to do stretching exercises. Do you recommend a visit to the doctor, or just keep moving stretching and ignoring the pain as best I can?
Jennifer Jenkins, RN-BC, CCM:

Great question! Sciatica and similar types of pains can be really tough to live with, let alone learn how to manage. There are many "remedies" described when you begin to research this subject, and finding what works for you, specifically, can be frustrating.

I would recommend a visit to your doctor, just to rule out anything that can be done medically, and to get some guidance/advice from your medical team, to be on the safe side.

Also, physical activity and stretching is a great way to stay mobile, as long as your body is allowing you to tolerate some forms of movement. I always recommend gentle walking and stretching, up to what your body can handle (low-impact aerobic movement, and stretching either with a band or just with your own body weight).

Focusing on improving core strength would also be beneficial, to help stabilize your lumbar/core region.


Woodinville, Washington (GEHA High Option): Good morning. I want to see a doctor for general checkup and tests that are age-appropriate (I'm a 56 year old female). I'm not sure what specialty to choose from. There is family practice, adult practice, general practice, etc. Which specialty should I choose?
Jennifer Jenkins, RN-BC, CCM:
Great question. There are numerous choices for a general and/or family practice physician. Physicians can choose from several different board certifications, and specialties that can be confusing to consumers.

Any of the above options would be a good choice for you to start your search with. You can also choose a specialty of internal medicine to add even more variety.

If you want to research more than one type of specialty, you go to the results page and change the specialty easily. You can also narrow the search by selecting a male or female physician, or one who is accepting new patients. You can look through the results by their star rating as well.

Sometimes family and friends can be really helpful when looking for a new primary care physician. Hope this answered your question.  


Sneads Ferry, North Carolina (GEHA Standard Option): Do you support the stool sample mail in program for colon cancer, and if so, where do I get the package?
Jennifer Jenkins, RN-BC, CCM: Yes we do. You can get this test done for free at any participating Quest Diagnostic Center with a doctor's order. It is called the Insure FIT test. Call 866-908-9441 to schedule an appointment with Quest. 

New Market, Maryland (GEHA High Option, Connection Dental Plus, Connection Dental Federal (FEDVIP) Standard): How can I lose weight in the waist line? Thank you.
Jennifer Jenkins, RN-BC, CCM:

We have a new HealthBalance portal for GEHA health plan members that allows for many fun options and activities for losing weight and getting healthy. You can also earn up to $250 in Health Rewards points! You can find out the details at geha.com/rewards.



N. Las Vegas, Nevada (GEHA HDHP Option): What is the best exercise to relieve back pain?
Nicole Doyle, MS, CPT:
Back pain is a significant problem that many people face. Movement is a great way to keep back pain at bay.

Walking, stretching, warm water soaks, balance exercise, and strength training are great ways to help alleviate body pains/aches. Working on core strength is also a great way to help strengthen the abdomen, therefore helping to stabilize the lumbar/low-back region of the body.

I would recommend following the physical activity guidelines prescribed by the American Heart Association, which are: 150 minutes of moderate cardiovascular activity per week, and, 2 total body strength training sessions. The cardiovascular activity can be walking, biking, etc. Find a type of rhythmic aerobic activity that you enjoy! Also, keep in mind it only has to be done in 10-minute chunks, so you can do 5, 30-minute walks per week, OR, 3, 10-minute walks per day (5 days a week).

The strength training component can also look a variety of ways, from using just your body weight and doing basic movements at home, or, finding a class at a gym that works your muscles out, 2 times a week. Whichever modality you choose, find something fun! You’ll be more likely to stick with it if you enjoy doing it.

Be sure to consult with you physician before starting any new exercise program when you have back pain.

Atlanta, Georgia (GEHA Standard Option): What is the best natural way to get rid of parasites (Giardia lamblia) from your intestines. How will you know when they are gone?
Kipp Wilhoit, RN: Per the Centers of Disease Control (CDC), some episodes of parasitic infection (such as Giardia) are self-limiting and will correct on their own. For many, symptoms persist or there is fear of spreading, so prescription treatment will be needed in order to eradicate. Please discuss options with your physician to see what the best route is for your treatment based on your medical history and current symptoms.

Denton, Texas

How can someone overcome sundowning dementia?

Tori Delana, RN:

According to Mayo Clinic, some tips for reducing sundowning are:

  • Try to maintain a predictable routine for bedtime, waking, meals and activities.
  • Plan for activities and exposure to light during the day to encourage nighttime sleepiness.
  • Limit daytime napping.
  • Limit caffeine and sugar to morning hours.
  • Keep a night light on to reduce agitation that occurs when surroundings are dark or unfamiliar.
  • In the evening, try to reduce background noise and stimulating activities, including TV viewing, which can sometimes be upsetting.
  • In a strange or unfamiliar setting, bring familiar items — such as photographs — to create a more relaxed, familiar setting.
  • Play familiar gentle music in the evening or relaxing sounds of nature, such as the sound of waves.

Talk with your loved one's doctor if you suspect that an underlying condition, such as a urinary tract infection or sleep apnea, might be worsening sundowning behavior, especially if sundowning develops quickly.

Source: http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-answers/sundowning/faq-20058511


Durham, North Carolina (GEHA Standard Option): How can I tell if acupuncture is covered on my plan? Thanks.
Kipp Wilhoit, RN: As per page 49 of the online brochure, alternative treatments such as acupuncture are covered by the High Option benefit. Sessions are limited to 20 visits per calendar year. For a preferred provider, the member would pay 10% of the plan allowance. For non-preferred providers, members would pay 25% of the plan allowance and any difference between GEHA's allowance and the billed amount.

St. Petersburg, Florida What are possible causes of loss of taste and smell and what possible remedies are there?
Kipp Wilhoit, RN: There are many causes for loss of taste and smell. Some culprits could be the use of dentures, sinus issues/infections, sinus polyps, medication side effects, etc. It is best to discuss your concerns with your physician to rule out common causes and decide if you may need a referral to a specialist.

Rockville, Maryland (GEHA Standard Option): I am 62 years old. My doctor wants to put me on statins for high cholesterol (270). He is recommending a new generic for Crestor. He said if I prefer Atorvastatin (generic for Lipitor), he would do that, but he believes new generic for Crestor is "more bang for your buck, i.e., lower dosage gives better results than Atorvastatin. What do you advise about Crestor generic versus Lipitor generic?
Kipp Wilhoit, RN:

The answer lies in that statin medications are not direct in comparison when it comes to strength.

For example, the equivalent dose of Lipitor 20mg per day is Crestor 5-10mg per day. This is not due to effectiveness, it is due to the drug chemical.

So, yes your physician is correct that you will be able to use a lower dose of Crestor compared to Lipitor. This doesn't mean that one is superior to another as both will adequately lower your cholesterol.


grand junction, Colorado (GEHA High Option): Can I add my mother to my insurance?
Jennifer Jenkins, RN-BC, CCM: Enrollment rules are mandated by OPM on behalf of federal employees. Parents are not currently allowed on a family policy.

Arvada, Colorado (GEHA High Option): I normally get my flu shot at the clinic, but this year they are not available there until October. Will GEHA pay for me to get the shot now at the Safeway pharmacy?
Tori Delana, RN:

GEHA health plan members can go to a participating retail pharmacy to receive certain vaccinations. Influenza vaccine is commonly administered by retail pharmacies.


Members may call CVS/caremark at 844-4-GEHARX or 844-443-4279 or visit caremark.com to identify a participating vaccine pharmacy and for coverage benefits. GEHA members should check with the retail pharmacy to ensure availability of a pharmacist who can inject vaccines and availability of the vaccine product before going to the pharmacy.GEHA members should also ask retail pharmacies if there is an age requirement for vaccines that can be administered at that pharmacy.



Belleville, Illinois (GEHA High Option): I keep seeing how drinking vinegar and lemon juice will help with losing weight faster. Some of them say to take garcinia. Is this a safe way to lose weight? Any known side effects?
Kipp Wilhoit, RN:

Thank you for your question. The weight loss claim from consuming apple cider vinegar and lemon juice comes from the belief that it will help lower blood sugar, increase satiety and improve digestion. Overall, the benefits seem to be minimal and are not fully backed by science. It would not be recommended to use garcinia as these supplements are not evaluated by the FDA for safety and efficacy and may be harmful.

Side effects associated with ingestion of apple cider vinegar and lemon juice mainly consist of increased acid intake that may lead to health problems, such as reduction in potassium within the body.


San Diego, California (GEHA Standard Option, Connection Dental Plus, Connection Dental Federal (FEDVIP) High): For nocturia, my doctor prescribed Tamsulosin which does not work except to lower my blood pressure. What other options are reasonably available? Are there any homeopathic remedies that might work? I am trying to avoid surgery. My age is 80+
Kipp Wilhoit, RN:

The assumption in this answer is that your nocturia is caused by an enlarged prostate (BPH). If this is the case, you may ask your physician about increasing the tamsulosin dose or adding on another agent to help with symptoms.

Lifestyle and home remedies include limiting beverage intake in the evening, limiting caffeine and alcohol and limiting the use of decongestants (pseuophedrine) and antihistamines (allergy medications).


Pataskala, Ohio (GEHA Standard Option): Is the IUD birth control covered under this policy?
Kipp Wilhoit, RN: This is a good question. Per page 40 of the online brochure, IUDs are covered under the Standard Option benefit plan. For preferred providers, there is no charge and no deductible. For non-preferred providers, the member is responsible for 35% of the plan allowance and any difference between the GEHA allowance and the billed amount.  

Charleston, Tennessee (GEHA Standard Option): Some health plans pay membership fees to local YMCA's and other health improvement facilities. Does GEHA have this benefit?
Kipp Wilhoit, RN: All GEHA health plan options include our Connection Fitness program by GlobalFit at no additional cost to our members or their covered dependents. Through Connection Fitness you have access to discounts on gym memberships. To see if YMCA is a participating facility, visit globalfit.com/geha.

Los Angeles, California (GEHA High Option): What medications are approved for allergic rhinitis and allergic conjunctivitis?
Kipp Wilhoit, RN:

Thank you for your question. Unfortunately, allergic rhinitis and allergic conjunctivitis do not have a cure, but they can often be controlled by over-the-counter or prescription agents. Staying ahead of the allergy is very important. Taking medication daily for prevention is a better than only using allergy medications when symptoms arise.

There are over-the-counter and prescription medications (ex. Allegra, Claritin, Flonase, Nasonex, etc.) that may help with your symptoms. Please check with your health care provider before taking these medications.


Vancouver, Washington (GEHA Standard Option): Is it best to drink only a small amount of water with a meal? How does a large quantity of water drunk with a meal affect digestion?
Teresa Westmoreland, MS, RD, LD: One or two 8-ounce glasses of water should not interfere with digestion. Having water during a meal can actually aid the digestive process and may help you feel more satiated. Discuss this with your health care provider since in some cases, such as after gastric surgery, it is not recommended to have liquids during your meal.

York, Pennsylvania (Connection Dental Federal (FEDVIP) Standard): How often should you have a colonoscopy if you had benign polyps in your colon when you were 33? I am 67 now. Should it be every 5 or 10 years?
Shauna Todd, RN, BSN, MHA:

The U.S. Preventative Services Task Force recommends screening for colorectal cancer starting at age 50 and continuing until age 75. There are various screening methods available. The frequency and screening method for you should be determined by your primary care physician, taking into account your individual risk factors.