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September: Mother Nature Brings Us Together
As if to send a strong message to the
Divider-in-Chief
and his isolationist followers, Mother Nature has sent the oval office a strong missive to close ranks. Natural disasters of unprecedented magnitude have struck North America including Houston, Florida, the Keys, Mexico City, and Puerto Rico. Like you, I have friends, family, colleagues, and loved ones in at least two of these places and have struggled to find out if they are safe. Having suffered the dire consequences of Super Storm Sandy, I am experiencing
post-traumatic stress disorder (PTSD)
for the first time. And because the
World Trade Center Twin Towers
also fell in September, it has been a double whammy. But here's the question: The
Trade Tower disaster
brought us together, made us stronger and more united. Will we approach these recent natural disasters with the same integrity? Our resolve for a unified nation, one for all and all for one, is being tested. Remember that the citizens of Puerto Rico are also citizens of our United States. They therefore deserve our full and unflinching support. Please consider on-line contributions to the
American Red Cross
and
Catholic Relief Services
, both of whom are straining to provide services to these severely distressed areas. For those of you who are victims of these hurricanes and are in need of tax relief or government aid, you may find the newsletter on the subject from
McCarthy & Company, PC helpful.
John A. Schmidt, MD
Internist
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The Public Health Consequences of Rescinding Deferred Action for Childhood Arrivals (DACA)
Imagine being brought to the United States by your undocumented parents before you could pronounce your name. You master the English language, attend school, and enter the work force. Some say you are a living example of the American Dream
. Others say you are an imposter and deserve to be deported.
The Gospel on Sunday, September 24, was one of the most difficult for me to accept. The owner of the vineyard paid the same wage to those who worked a full day, a half day, or a quarter day. Clearly those who worked fewer hours should be paid less. Except the owner of the vineyard disagreed and paid all the same wage. Hmmm... Clearly the vineyard owner did not attend business school. Will he no longer be able to attract full-time laborers or will he be flooded with grateful, talented, and committed workers to make his vineyard the best in the land? I suspect he didn't care. His only goal was to give his workers a living wage so they could survive long enough to show up the next day. Charity? Enlightened self-interest? You decide. But know this. The
stress put on the Dreamers
by the Divider-in-Chief will have consequences for our health care system in general and our mental health care system in particular. Read the editorial published online in the
New England Journal of Medicine
on September 13 for more. As your physician, I am interested in your blood pressure, not your immigration status. Doctors' offices, hospitals, and clinics are, by definition, sanctuaries.
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Chimeric Antigen Receptor T-cell (CAR-T) Therapy: A Major Advance in the Battle Against Cancer!
You and I count on our
immune systems
to destroy invaders, including cancers. As discussed in previous newsletters, cancers have developed elaborate mechanisms to keep our immune systems in check. Fortunately, medical investigators have now found new ways to empower our immune systems to target and destroy the cancers that would prematurely end our lives.
The pharma industry is criticized for profiteering and rightly so. This, on the other hand, is a genuine advance born of decades of painstaking research. Read the inspiring account in the September 17 online issue of the
New England Journal of Medicine
of how a five-year old, Emily Whitehead, was saved and is a thriving, tumor-free 12-year-old today.
The immune system, once unleased, is a powerful warrior. CAR-T is not for the faint hearted. The potential for collateral damage is considerable. As discussed in the article, the future success of CAR-T depends, in part, on minimizing damage to normal cells. Fortunately, progress has been made in this area as well.
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Patients with Mild to Moderate Chronic Obstructive Pulmonary Disease (COPD) Benefit from Daily Tiotropium
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Kidney Function in the Systolic Blood Pressure Intervention Trial (SPRINT)
SPRINT showed that
cardiovascular events
and, all-cause mortality was significantly lower in the aggressive treatment group. I agree with the SPRINT authors when they conclude that an elevation in creatinine is
benign
when compared with heart attack, stroke, or death. This is yet another example of how doctors and patients need to pay more attention to clinical outcomes than laboratory data.
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Medicare Part D Open Enrollment
All Medicare patients are required by law to purchase medication coverage (Part D). Unfortunately, many of my Medicare patients opt for cheap plans and then end up paying large out-of-pocket sums for the medicines they deserve. October 15th
marks the beginning of Medicare Open Enrollment. I advise all Medicare recipients to visit
Medicare.gov
and click on the part D tab. Enter your zip code and medications and sign-up for the plan that best meets your needs and your pocketbook!
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Medication Reconciliation (Med-Rec)
Perhaps the greatest challenge I face is knowing what medicines you are taking, when you are taking them, and how often. Most patients find this odd. They say: "You prescribed them, so you must know." Well, in some cases that is true. However, most of my patients are also taking medicines prescribed by other physicians, nurses, and clinics. Some pharmacies provide a "fill history," but most, unfortunately do not. Thus, the only foolproof way for me to know what medicines you are taking is to read the labels of your medication bottles. So please, please, please bring ALL of your medication bottles to each and every visit.
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Patient Portal
We are now showing a short tutorial video in our waiting room describing our free online
Patient Portal
called "Follow My Health." Please look up from your magazine and see how a few minutes of your time can improve your health care!!
Morgan, Valerie, Ms. Clark, and I wish you a wonderful autumn and a quick recovery from the recent storms!
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Board Certified Internist
Dr. Schmidt is one of the leading internists in Monmouth County offering
Medical Home
services.
He is an attending physician at Jersey Shore University Medical Center.
Dr. Schmidt is enrolled in the Maintenance of Certification Program of the American Board of Internal Medicine
Feel free to share this newsletter with your family and friends.
Register to receive our monthly newsletter
today!
Click here to learn more about the benefits of our
Follow My Health Patient Portal
and register today! You can make appointments and get your lab results on the portal. Simply ask Valerie to send you an invitation. Call 732-282-8166.
"A good government may, indeed, redress the grievances of an injured people; but a strong people can alone build up a great nation."
- Thomas Francis Meagher
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