Where Am I?

Hello again. Jill here, your faithful receptionist. For those not in the know, we (and by "we" I mean our valiant medical assistant Donna, our beautiful office manager Sherry, and their spouses) moved the Hoffman Estates Office from Algonquin to 1585 Barrington Road, St. Alexius Doctor Building #2 Ste. 601. And believe you me, a lot of people are having a really hard time finding it.

Last Friday we made one of our poor patients literally drive around in circles as we rattled off directions from where we thought she was, and she found us despite our best efforts to get her seriously lost. Poor thing, took her almost two hours to find us, but she claims it was worth it. She also had Mapquest to aid her, but Mapquest (and most GPS machines) only leads people to an approximation of where St. Alexius is.

When patients finally do arrive, they find parking to be somewhat less than pleasant. Parking spaces are not always to be had in front of the building, but there is additional parking to the side. It is quite a walk. If that is unappealing, I suggest stalking patients as they come out of the building to their cars and attack for a space. Adds some excitement to the day! As one of my favorite patients related to me: "I fought a handicapped woman for the spot I found. We faced off and I knew she was going down. 'Mine!' And boom. Down she went." I was very proud of her.

The end effort is worth it. The office here is really beautiful and just being here makes you feel more relaxed. There's a huge tank with fish swimming, marble floors, a television, and water. Also a great view...of the parking lot. Now you can see all the spaces that aren't available!

So when coming to see us for the first time in our new (and really nice) digs, try leaving yourself a lot of time if you're coming from further away. Otherwise you might have to face down old ladies for prime parking and deal with our horrific direction giving. If that sounds like fun for you than I don't want to take that away from you. ^_^

Gone Fishin'

“If I get hungry when I have to wait for you, I’m going to bring my fishing gear and catch something from your fish tank.”

This was one of the ironic comments that one of my less reverent patients made in our new office surroundings. Some exciting things have been happening with our practice lately and we’d like to share them with everyone.

For one, we’ve moved our Hoffman Estates office. We formerly had been at 1626 W. Algonquin Rd., which is in the middle of a Strip Mall with no other medical practices or facilities in the area. On one side of us was a hair salon, and on the other was a restaurant. The restaurant used to be a bar when I was shown the property by a real estate rental agent, at 9:00 A.M. on weekday it was a nice quiet location. I have Tuesday night hours and that was when I discovered the walls were paper thin as the bar music regularly drowned out any conversations that I could have with a patient.

The old location was pretty isolated and we had prospective patients that could never find it. One common problem is that they would go to 1626 East Algonquin Rd which apparently is a Mexican restaurant in Arlington Heights. When the aforementioned bar next to us went out of business it was replaced by yet another Mexican restaurant. This made for some amusing but frustrating scenarios where patients who had gone to 1626 East Algonquin Rd would be calling and saying that they were at the Mexican restaurant and couldn’t find us. Jill thought they meant they were at the restaurant next door and told them to walk over.

Our new digs are at St. Alexius Hospital (Doctor Building Two). We are sharing space with a plastic surgery group (Dr. Frank Madda is named several times as a top plastic surgeon in the Chicago Magazine Poll). Dr. Madda apparently is a tropical fish lover and we have a nice tank in the waiting room, leading to my irreverent patient’s comment.

The main reason that I am excited by the move is that it puts us at a major medical center! This is useful for many reasons but the one that I like the best is that it reinforces that we are a medically based weight loss program. When you come to our office you will see a physician every visit, one that has been highly trained in weight loss medicine. We treat obesity like a disease, the same way we treat diabetes, hypertension, sleep apnea, heart disease, arthritis, and all the other diseases
that are caused by obesity. We figure out how many calories you need, devise a diet to help you lose, offer medication to help if you need and want it, and try to assist in treating the other medical problems linked to obesity.

Obesity is a medical problem, after all. Sometimes the seriousness of that message could get lost when we were in a less than serious location, like a suburban strip mall.

SAD

It is January here in Chicago. The holidays are past and we seem to be perpetually buried in snow this year. Although I have many items on my agenda I just don’t seem to be able to muster any enthusiasm for doing any of them.

I’m beginning to wonder if I don’t have a small case of Seasonal Affective Disorder (SAD). This is a Psychiatric condition where the affected person becomes sad and lethargic in the winter months. It is thought that the lack of sunlight during the short winter days causes a chemical imbalance in the brain, and that the condition resolves as the days grow longer.

Looking back at my life, it does seem that when I have accomplished major goals--including dieting--, it is more likely to have occurred in the warmer months. I do seem to have more energy and need less sleep then. A few of my kids have also noticed that the cold Midwestern winters seem to affect them emotionally, although they aren’t necessarily averse to doing cold weather events such as skiing.

Many people have this issue. Many try to overcome some of the blahs with food.
Over the years I’ve noticed that most patients in my internal practice will put on several pounds in the winter months and lose it in the summer. They blame it on the lack of activity during the winter. I’m sure that is a part of the story, but I think the more likely explanation is that we tend to eat a lot of comfort food during the dreary winters.

I’ve been musing about this because there is also the well known phenomenon of people wanting to start diets after the holidays, the “New Years Resolution” phenomenon. It seems like the worst time to attempt such a feat, but perhaps it makes sense, since the willpower is being ratcheted up during a time when one is otherwise most likely to gain weight. If we succeed in the winter, hopefully in the summer we won’t need so much will power because our natural tendency is to eat less anyway.

Anyway, I guess that I should say this is a good time to come to our office for a free consultation. We have all kinds of weight loss plans and I know that we can help you. If nothing else it will get you out of the house.

Pediatric Obesity

The patient (let’s call him Jake) had been referred to me by his local pediatrician. He was 17 years old and weighs 497 pounds. He came with his father who must have weighed at least 400 pounds.

There was a lot going on here and the family dynamics could be the subject of another blog entry. However, after they left, I couldn’t help reflecting. I’m 50 years old; did I ever know families like this when I grew up?

I remember the heaviest kid in our class when I was growing up. He was the target of endless abuse. His last name started with the same first five letters as mine; I tended to sit next to him because we were frequently assigned seating alphabetically. This included gym class, which meant that I had to sit next to him in the locker room. He was terribly ashamed of his body. I felt sorry for Larry, who was a gentle soul, and tried to act as if his corpulence didn’t exist, while many others would taunt him. I remember trying to avoid looking at his body while we undressed or showered in gym, both to save him further embarrassment but also because I was repelled by his rolls of fat.

For some reason, they once weighed us all in gym--publicly. I was 6’3” and 155 lbs., and Larry was 5’8” and 240 lbs. He was devastated because he hadn’t known how much he weighed.

Yet for all his corpulence, I believe Larry wouldn’t even stand out compared to what I see in adolescents today. 17% of our teenagers are obese. And to be considered an obese teenager you have to be pretty big. A child isn’t considered obese until he or she is above the 95th percentile for height and weight. Between the 85th and 95th percentile considers are classified as “overweight” and “at risk” for Obesity. Even by this incredibly lax standard, about 1 in 6 kids today is obese.

Furthermore, these kids already have the adult illnesses that accompany obesity. The rates of diabetes in children are at alarming levels. 10% of the kids in our country already have liver disease. Hypertension in kids is skyrocketing. It isn’t unusual for kids under 20 to be having heart attacks and strokes.

Despite all these health issues, the biggest issue still troubling these kids is what most bothered Larry--peer rejection. Despite the fact that they are now much more numerous, they still feel ostracized and very self conscious of their body image.

The biggest predictor of whether a child will become obese is if they have obese parents. Think of that the next time you evaluate your weight and health. Parents that make the time and effort to control their weight are the best role models for these children.

I last saw Larry over 10 years ago, at our 20th High School reunion. While he was still struggling with his weight he probably hadn’t gained more than 20 pounds since then. Meanwhile it was shocking to see how many of our classmates had overtaken him. I remember one of his worst tormentors, who was a small wiry kid. He now was a policeman somewhere in Florida and must have weighed 300 pounds. I remember the look on both of their faces when they greeted each other. Larry was too polite to say anything but one didn’t need to be psychic to know what he must have been thinking.

Gottlieb Lecture

Hey, Jill here again. I meant to post about this on my patient blog but kept forgetting to do so. So, since this hasn't been updated in a while, I thought I'd do it here.

Dr. Finegold gives a lecture at Gottlieb Hospital (and will be starting this at Prairie Stone as well) about the weight loss program. I was dragged into helping with this when one of our MAs couldn't make it because her daughter was getting married. I was prepared to hear everything I'd heard before and quite frankly to be bored out of my mind.

I was so very, very wrong. Now, understand that Dr. Finegold is indeed a man I've known all my life, and consider him to not be the most charismatic person I've ever been around. Despite that, he makes an excellent public speaker. I was truly inspired to renounce fast food (something I hold near and dear to my way of life) and to get to a frickin' gym and work out. I hate gyms and working out. But this lecture made me quit dragging my feet and contact the gym for a personal trainer, and I've been happier ever since. It actually scares me how well this talk worked.

He brings up some interesting points on how as a species we evolved to be a hunter/gatherer biology and how modern convience goes against this. We used to have to physically hunt our meat and live off of berries/roots/fruit/etc. We were lean, mean, low I.Q. machines. Culture wasn't at its height, but physically we were awesome. Technology and civilization has served to work against our natural physiology. Think about it: we no longer traverse the land on our own two feet but use cars to get places, even if it's five minutes away. Food is readily available in the supermarket, pre-killed (and packaged!) for us--or worse, we can get it "freshly prepared" in front of us in five minutes in a fast food line. Yet our biology is still rigged to the early days of hunting with sharpened sticks after lean deer or foxes or whatever-four-footed creature you could catch. Or fish. Or whatever. Anyway, he tells this better than I do. And with slides and pictures!

Next lecture is November 12th at Gottlieb Hospital. It should start at seven at night...though I'll double check that.

"Does My Insurance Cover This?"

Hey, Jill here again.



I get asked this question a lot. Half the calls made to the office are potential patients who won't consider coming in until they have this question answered. So I finally decided to post about it.



The answer is this:

It depends on your insurance plan. So there. Whatever your insurance, Blue Cross Blue Shield, Humana, Cigna, HMO, PPO, whatever--sometimes it's covered depending on what you're paying for.

So give them a call. The number is on your card somewhere. I know it is. All you have to do is muster the courage and patience to sit through the automated system until you talk to a real person. It's annoying, I realize that. That's part of life.

So does your insurance cover this? I don't know. But ask yourself this instead: "Can I afford to keep living the way I do now for much longer? Or will my health begin to deteriorate faster?"

Oh yeah, we don't take Public Aid. Everything else (HMO sites have to be Gottlieb West Town site 133) is acceptable. So you guys can relax about that, at least.

I will say most insurances do cover us, though. We have a small percentage of patients who aren't covered who never come back, but about 94% are.

So please, if you're going to call us, at least think of a creative way to phrase this question. I like creative thinkers. ^_^

I Can't Afford to Lose Weight Right Now

I was talking with Gloria, the manager of the Gottlieb Health and Fitness Center. GHFC partners with Chicago Weight Control in the near western Chicago suburbs. For the last two years we have had a highly successful comprehensive weight loss program. She was concerned about an alarming, if understandable, trend. Perhaps due to our current uncertain economic climate, people think that they cannot afford the program

Our program is called comprehensive because we attack the weight loss issue on every front. For three months people get:

• Appointments with physicians certified in weight loss medicine (bariatric medicine)
• They have their metabolism tested (indirect calorimetry)
• Two sets of blood chemistry
• A health club membership with 12 personal training sessions
• A meeting with a registered dietitian seven times
• Three group counseling sessions led by a professional psychologist.
  

The program does cost $2500, which initially seems like a lot of money. Insurances don’t cover it, although some of our patients have been able to get up to $600 back from their insurance companies.

I realize that $2500 sounds terribly expensive. However, let’s look at that a bit.

First off, what is the value of the services. The physician component, including the indirect calorimetry and the two sets of blood work, is worth about $1100. The 7 meetings with the dietitian are worth $600. The personal training is worth around $900. The health club membership is about another $500, and the three sessions with the psychologist are worth $300. That is roughly $3500 for $2500; it just isn’t possible for us to discount the service to any additional degree.

Secondly many of the patients are taking multiple medications. When they lose weight and no longer require these medicines, they are saving a fortune. Many patients can be on three medicines for diabetes, three for their blood pressure, one or more cholesterol medications, arthritis medications, etc. Even patients with insurance have costs for these medications. One of our patients who has lost more than 200 pounds states that in the past twelve months his savings on his insurance co-pays have already paid for the cost of the program.

The unfortunate truth is that being unhealthy is expensive. Not only are there medication expenses, but there are physician visits, medical equipment (wheelchairs, insulin pumps, walkers...the list goes on and on) that people have to pay for. Insurances are covering less and less of this, and as the economy falters, they will shift more of those costs to the patients.

From a financial planning perspective, one of the best investments that you can make is to protect your health. I would argue that money invested in our program will probably save you several times your initial investment. I would also argue that given the unreliability of every other investment vehicle out there, that if you need our program, investing in it is a lot more reliable investment than most other options.

All of the above is looking at this strictly from a financial planning standpoint. Finances alone are not the whole story. Can we put a price on being healthy enough to keep up with our grandchildren? Or being able to have children in the first place? How about living long enough to see our children raise their own children? At the risk of sounding like a Master Card commercial, there isn’t any price too high to pay for all of that.

I know that in times of great uncertainty, our program looks too steep. Honestly, I don’t think people can not afford our program. It is the best investment for both your health and finances that you could make.