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.
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.
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.
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.
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
- Tomato products
- Citrus fruits/juices
- Fatty or greasy foods
- Raw onion, garlic, pepper
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
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.
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.
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.
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.
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
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.
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.
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!
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.
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.
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
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:
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.
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.
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.
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.
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).
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.
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).
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.
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.
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.
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.
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.
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.
"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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
How can someone overcome sundowning dementia?
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.
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.
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.
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.
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).
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.
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.