Empty Nest - April 2024

Your Local Broker for Medicare Insurance Needs

Jay Looft Owner/Agent

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Does having Medicare insurance limit my access to healthcare?

highly rated and you can’t use them.

When you are a Medicare insurance beneficiary, it can limit which doctors and hospitals you are permitted to see under your plan. Let’s dive into the details!

In general, most hospitals and doctors are willing to accept Traditional Medicare.

From my experience, those doctors who do not accept Medicare AT ALL are usually in the Primary Care Physician field and are typically independent doctors. This is a small percentage of doctors, not the majority.

Many doctors that accept Medicare insurance will put a limit or “cap” on the amount of Medicare insurance patients they will see. This is because they want to reserve space for patients with employer coverage, and other coverages which can pay them more for their services. When you encounter a doctor with a Medicare patient “cap”, don’t take it personally, it’s a business decision. I do understand it can be frustrating, especially when they come

On the other hand, if you are on a Medicare Advantage plan, your access to healthcare depends on the list of contracted doctors and hospitals- called a network. The doctor and hospital network can and will vary per Medicare Advantage carrier and plan. HMO networks are local geographic networks, whereas PPO networks are national networks. This network design should be a consideration when choosing a plan.

Medicare Advantage networks have come a long way over the past decade and are now widely accepted among doctors and hospitals, but your list of providers should be analyzed prior to enrolling into a plan.

When you need help combing through the details of the doctor and hospital networks, or would like help choosing your next Medicare insurance plan, turn to SeniorSource Medicare Solutions. We offer our Medicare insurance expertise at $0 cost to you and would be delighted to be your Medicare insurance broker. Give us a call today at (770) 913-6464.

Brought to you by – Jay Looft, Senior Source Medicare

Why do some tumors track along nerves?

At a recent conference, an outstanding lecture by Dr. Scott Lester of the Mayo Clinic, Rochester, provided insight into the question of why tumors exhibit “perineural invasion” – the behavior of tumors wrapping around and travelling along nerves. The answer is another example of how nature and biology never cease to surprise.

In medical school, one of my favorite professors loved to say, “50% of what you are going to learn during these four years will ultimately be proved wrong.” As I sat in my hard wooden chair taking notes on apparently error-ridden knowledge, I hoped that the 50% that was misinformation was at least not the half that mattered.

As it turns out, one of the pieces of misinformation apparently concerned perineural invasion. In medical school, I was taught that some tumors track along nerves because nerves are convenient highways to other parts of the body. This was the “path of least resistance idea.” Professors also posited that some of the vessels and lymphatics running along with the nerve are an additional reason for tumor growth along nerves – essentially the idea that tumors spreading along nerves is really just tumors spreading along the surrounding lymphatics and blood vessels – “business as usual.”

Several recent studies presented by Dr. Lester have provided data that sheds new light on this subject:

In one experiment, scientists placed a nerve next to but well apart from a tumor growing in a petri dish. The tumor extended a strand of cells in the direction of the nerve and grew toward the nerve. This challenges the idea that perineural tumor growth in patients is simply cancer extension along nerves already touching a tumor. Then, the scientists tested proteins found in the nerve and found that the entire nerve did not have to be present in the dish to attract tumor growth. When scientists put a small amount of a nerve protein called GDNF (glial derived neurotrophic factor) in the dish, the tumor grew towards the GDNF. Apparently, proteins in the nerve attract tumor growth. So nerves are not just highways: some tumors seek out nerves by growing towards proteins that nerves produce.

In another experiment, scientists placed pancreatic cancer cells next to the sciatic nerve inside of a live rat. Predictably, the cancer grew and invaded the sciatic nerve. The muscles relying on the sciatic nerve were unable to function which caused partial paralysis. However, when the scientists delivered radiation to the rat’s sciatic nerve

BEFORE implanting the pancreatic cancer, the tumor grew but paralysis did not occur upon tumor implantation against the nerve. Nerves that had received radiation produced less GDNF.

We have long thought of radiation as primarily working by killing cancerous cells because radiation is known to cause breaks in cancer cell DNA resulting in cell death. But these studies led Dr. Lester, a radiation oncologist, to ask if radiation therapy’s effect on healthy tissue is just as important to its success as its effect on cancer cells themselves. Perhaps in some cases, radiation’s effect on growth factors in healthy nerve tissue is critical to preventing cancer recurrence.

As many questions as answers are raised by these studies. Will we one day have medicines that treat perineural tumors by inhibiting neurotrophic factors? For tumors that do not track along nerves but that invade muscle, bone or other tissue, will medicines increasingly target growth factors in these tissues to prevent spread? Already, medicine that targets “vascular endothelial growth factor” is being used to treat certain cancers. Perhaps one day a local injection of a medicine that blocks neurotrophic factors will be used to help treat perineural tumors.

As a Mohs surgeon, I took interest in these studies because many skin cancers track along nerves and because identifying perineural invasion under the microscope is an important part of my job. When I find significant perineural invasion, radiation therapy after surgery is an option I discuss. I hope that I might one day be able to offer a targeted pill or injection as an alternative to radiation.

However, I thought that these studies are of broad general interest because they are an intriguing example of how the obvious or intuitive answer so often is not the correct answer when biology is involved. Tumor growing along nerves is not just a case of taking the path of least resistance. So much of what we assume or are taught does not turn out to be the whole story. Nature is always more complex than we imagine, and new discoveries provide opportunities for medical advancement.

If you or a loved one struggles with skin cancer or any dermatologic complaint, consider Premier Dermatology and Mohs Surgery of Atlanta. Dr. Brent Taylor and Kathryn Filipek, PA-C are delighted to help you achieve your skin health goals. Dr. Taylor is a Harvard-graduate, a board certified dermatologist and vein care expert, and fellowship-trained Mohs surgeon. Kathryn Filipek has greater than 15 years of dermatology experience with expertise in medical, surgical and cosmetic dermatology including fillers, Botox®, and sclerotherapy.

Insist

Dr. Brent Taylor is a Board-Certified Dermatologist, a Fellowship-Trained Mohs Surgeon, and is certified by the Board of Venous and Lymphatic Medicine in the field of Vein Care.

He is an expert in skin cancer and melanoma treatment, endovenous laser ablation, minimally invasive vein procedures and cosmetics procedures such as Botox and injectables.

Kathryn is a certified physician assistant with over 18 years experience as a Dermatology PA. We are excited to welcome her, as she brings with her experience in general dermatology and cosmetic dermatology.

Her specialties include general dermatology such as acne, eczema, rashes, hair loss, full body skin exams, abnormal growths etc. Kathryn also specializes in cosmetic dermatology including lasers, injectables, micro-needling, PRP, facial peels, sclerotherapy for spider veins and at home skin care.

Kathryn Filipek, PA-C

Brought to you by – Dr. Brent Taylor, Premier Dermatology and Mohs Surgery of Atlanta

How to build your child’s self-esteem Does having Medicare insurance limit my access to healthcare?

Brought

to you by –

Jay Looft, Senior Source Medicare

When you are a Medicare insurance beneficiary, it can limit which doctors and hospitals you are permitted to see under your plan. Let’s dive into the details!

In general, most hospitals and doctors are willing to accept Traditional Medicare.

From my experience, those doctors who do not accept Medicare AT ALL are usually in the Primary Care Physician field and are typically independent doctors. This is a small percentage of doctors, not the majority.

Many doctors that accept Medicare insurance will put a limit or “cap” on the amount of Medicare insurance patients they will see. This is because they want to reserve space for patients with employer coverage, and other coverages which can pay them more for their services. When you encounter a doctor with a Medicare patient “cap”, don’t take it personally, it’s a business decision. I do understand it can be frustrating, especially when they come

highly rated and you can’t use them.

On the other hand, if you are on a Medicare Advantage plan, your access to healthcare depends on the list of contracted doctors and hospitals- called a network. The doctor and hospital network can and will vary per Medicare Advantage carrier and plan. HMO networks are local geographic networks, whereas PPO networks are national networks. This network design should be a consideration when choosing a plan.

Medicare Advantage networks have come a long way over the past decade and are now widely accepted among doctors and hospitals, but your list of providers should be analyzed prior to enrolling into a plan.

When you need help combing through the details of the doctor and hospital networks, or would like help choosing your next Medicare insurance plan, turn to SeniorSource Medicare Solutions. We offer our Medicare insurance expertise at $0 cost to you and would be delighted to be your Medicare insurance broker. Give us a call today at (770) 315-8145.

Your Local Broker for Medicare Insurance Needs

Paige Gorman Agent

A child’s self-esteem begins with a positive self-identity, which is critical for building a foundation for confidence, happiness, and emotional well-being. When children have a positive self-identity, they can navigate through life with a sense of purpose and feel like they belong. These children gain confidence and can persevere when facing challenges in school and all areas of their lives. A strong sense of self-identity and self-worth also drives children to confidently pursue their passions without giving into self-doubt, which can hinder personal and academic growth. The mission for parents and mental health professionals is to help nurture and develop a child’s positive self-identity; so they can reach their full potential and lead meaningful and productive lives.

Step 1: Encourage your child to embrace their unique qualities (i.e., race, culture, spiritual beliefs, sexual orientation, talents, etc.).

Step 2: Celebrate your child’s accomplishments often, using positive affirmations.

Step 3: Teach your child healthy coping skills (i.e., mindfulness, deep breathing, positive self-talk, guided imagery, etc.).

Step 4: Expose your child to various extracurricular activities.

Step 5: Provide your child with a safe and supportive environment.

Step 6: Help your child to develop healthy relationships with their peers and family members by

utilizing assertive communication skills and reinforcing the use of “I” statements.

Step 7: Teach your children the S.M.A.R.T. goal setting strategy by encouraging them to set specific, measurable, attainable, realistic and timely goals for themselves.

Step 8: Teach your child to use a strength-based approach to problem-solving.

Step 9: Help your child to recognize their negative thoughts and inner dialogue.

Step 10: Provide your child with positive modeling of self-esteem and expose them to positive mentors.

The Summit is offering a wide range of summer groups for elementary, middle, and high school students. Registration closes on May 10th. Financial assistance is available, and groups are FREE for students that attend any of our partner schools. Visit our website at summitcounseling.org to learn about summer groups, our school partnerships, and other services available for children, teens, and adults.

Brought to you by – Charles Smith, MS, LAPC, NCC | Summit Counseling Center

It’s allergy season in Atlanta!

Brought to you by – Comprehensive Internal Medicine

What are allergies?

Allergies are your body’s reaction to a foreign particle, usually a protein. These proteins can come from pet dander, molds, pollens, or from trees and grasses. If you develop an allergy to a particular protein, your body’s defense system (immune system) reacts to it and the allergic reaction creates allergy symptoms.

What is an allergic reaction?

An allergic reaction is the way your body responds to an allergen, usually a protein.

You may feel itchy, watery eyes, a runny nose, sinus or ear fullness, a hoarse voice, a scratchy throat, or trouble breathing. You may even develop a skin rash.

These symptoms can be treated with over the counter or prescription allergy medication or immunotherapy (allergy shots) can be tailored specifically for you.

What is allergy testing?

To perform allergy testing, small pinpricks or scratches are made in the

skin and a very small amount of allergen is placed to test your body’s response. If you react to the allergen, we have identified a trigger that is causing your allergy symptoms.

What is immunotherapy?

Immunotherapy is a treatment used to desensitize your body to the allergy trigger.

In this treatment, the results of your allergy testing are used to create a very personalized formula of medicine that is used to slowly treat your immune system in a way that stops reacting to your allergy trigger. Immunotherapy medicine is given by injection (allergy shots) and is administered twice weekly. The first injection is given in the doctor’s office. Comprehensive Internal Medicine uses an advanced formulation and instruction that allows you to then give the injections at home. This saves the twice-weekly visits to the doctor’s office. You return to Comprehensive Internal Medicine every 6 weeks to progress the therapy and at the end of one year, allergy testing is repeated. Often, a second year of treatment is advised, following which, most allergies are cured.

Providing Medical Care Including the Prevention, Diagnosis and Treatment of Diseases

Comprehensive Internal Medicine has been serving the Alpharetta community for 20 years, celebrating this milestone anniversary in 2023. The medical practice offers a very comfortable environment and serves a medical home where patients are seen for their wellness examinations (checkups) and for the management of multiple medical problems. Same-day appointments are always available.

We welcome new patients, take most insurance plans and discounts for self-pay patients.

Jeffrey Obiora, M.D.

Dr.

In addition, he brings

Jacqueline T. Pearson, M.D., M.S.

Anju Bhushan, M.D.

Arezou Fatemi, M.D.

Ryan Bozof, M.D.

Shima Mansouri, P.A.-C

Laurae Carpenetti, M.D.

Carol Hector, M.D. Sumera Pervaiz, M.D. Sudeshna Nandi, M.D. Petula Gunn, APRN

Common questions for the dermatologist

Q&A with Dr. Radhika Trivedi of Epiphany Dermatology

What factors contribute to acne?

Acne is influenced by a combination of factors, including genetics, hormonal changes, excess oil production, and the presence of acne-causing bacteria on the skin. Lifestyle factors like diet, stress, and certain medications can also play a role. Understanding these factors is crucial in developing an effective acne management plan.

How can I treat my acne?

Treating acne involves a multifaceted approach. Over-the-counter products with ingredients like salicylic acid or benzoyl peroxide can help, but for more severe cases, consulting a dermatologist is essential. Dermatologists can prescribe topical or oral medications tailored to your skin’s specific needs. They also provide personalized advice on skincare routines and may recommend procedures like laser therapy or chemical peels for more severe cases. Partnering with a dermatologist ensures that your treatment plan is effective, minimizing the risk of scarring and promoting long-term skin health. It’s a collaborative effort to find the most suitable solutions for your unique skin conditions.

ALPHARETTA-ROSWELL

Delivering Readers Award-Winning Newspapers

2023 Georgia Press Association

1st Place – News Photograph

1st Place – Feature Writing

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1st Place – Serious Column

1st Place – Food Ad

1st Place – Newspaper Promotion Ad

1st Place – Classifieds Section/page

2nd Place – Page One

2nd Place – Lifestyle Coverage

2nd Place – News Photograph

2nd Place – Local News Coverage

2nd Place – Business Writing

2nd Place – Lifestyle/Feature Column

2nd Place – Food Ad

2nd Place – Newspaper Promotion

2nd Place – Signature Page 2nd Place – General Excellence 3rd Place – Page One 3rd Place – Lifestyle Coverage

3rd Place – Feature Writing

3rd Place – Breaking News Writing

3rd Place – Local News Coverage

3rd Place – Serious Column

Place – Feature Article Layout 1st Place – Self Promotion Classifieds 2nd Place – Educational Column

2nd Place – Entertaining Column

2nd Place – Self Promotion Own Publication