February 14, 2026 • 42 mins
- Listen Saturday mornings at 8 as Dr. Msonthi Levine discusses medical issues and takes your calls on News Talk 560 KLVI. Dr Levine is board certified in Internal Medicine and Geriatrics. His office is located at 3080 Milam in Beaumont, Texas. He can be reached at 409-347-3621.
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Episode Transcript
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Speaker 1 (00:00):
All right, welcome Southeast Texas Internet radio listeners. Is Doctor Levine,
your weekly host of the Doctor Levine Medical Hour. Thank
you for joining me on the edition of the show
here every Saturday morning between eight and nine. We're trying
to help you figure out what is good for you
and your family to stay alive and stay out of
(00:20):
the doctor's office as frequent as possible, keep your medication
list to a minimum, and stay out of the hospital
as much as possible. Sometimes it's hard to avoid, but
certainly there are things that you can do on a
regular basis to keep yourself alive and healthy. And this
is what we're here to do to discuss those things
(00:42):
that you can do. Because it's not one little magic
pill or one little magic liquid or whatever you've come
up with, that one little thing that will save you
and keep you from going to the doctor's office or
avoid this certain thing. It's a few things that you
(01:05):
have to do, not one thing, but a few things. Yes,
it's a little bit time consuming, but man, it pays
off in the future by keeping out of the hospital,
keeping you alive, keeping you healthy. And that's what we're
here to discuss, and thank you for joining us on
the edition of the show. Phone lines are open eight
(01:25):
nine to six klv I one one hundred and three
three zero klv I. We'd love to hear from you.
Happy Valentine's Day to all those listeners out there, and
happy Valentine's Day to my wife. She texting me this morning,
as you know, she was here last week and we
had a great conversation talking about various topics. We try
(01:47):
to pull in some of the admin side to healthcare delivery.
As you know, that's just this whole other side of
healthcare delivery that we don't really talk about too much,
but you're familiar with it when you try to get
your mad's refilled, or you need to get a referral somewhere,
or you're just trying to decide which insurance package to get,
(02:10):
or you're in the hospital and you're trying to get
something accomplished and there was some fine details of the
contract that you signed up for that you don't remember
or that you weren't exposed to be kind of tricky,
and so we bring her on and discuss some of
those topics. Remember, if there's any topic you like me
(02:31):
to talk about, just call the radio show, or you
can call my office, you can call the station and
drop off a little note, and we can certainly get
into it and talk about it whatever you'd like to discuss,
because it's confusing out there even for doctors sometimes to
figure out what is the right thing to do. Things
(02:51):
are always changing, and you just always hear so much
about do this, do that, don't do this, don't do that.
It's it's just maddening. All the information that you're getting
exposed to. You just don't know what to do. So
this is what we are here to try and figure
out to help your particular situation. The weather it's outside
(03:15):
is not terrible, a little overcast. Maybe our winter season
is over with, maybe I don't know. We're getting into
the middle part of February. It's normally sort of a
colder month for us, and then March April is right
behind us on deck. Those are our warmer months, or
(03:37):
at least it starts to get warm. So not much
of a winner at this time. As you know, I
typically like this time of year, and we certainly have
seen our spike of our usual respiratory illnesses. Those viruses
are always circulating out there, especially the flu was bad,
bad this year. Necessarily COVID. Didn't see a ton of COVID.
(04:02):
To be honest with you, it was more of a
flu season this year. And again we're always harping to
you about getting these flu vaccines and we want to
try and improve compliance to one hundred percent, but that
is hard to do because we live in this country.
(04:23):
We are free thinkers and we certainly want to pursue
our own thoughts and if we don't want to do something,
we don't want to be forced to do that. That
is the nature of our our organization, nature of our industry,
so that not everyone wants to do that, and they don't,
(04:46):
so we don't get one hundred percent. We, like I said, Mike,
get seventy eighty percent and that's pretty good. But it
was more of a flu season this year. And thankfully
we do have medications that are available for flu sufferers.
Tammy flu has been out for a long time, and
sometimes patients will get various other additive medications to their
(05:08):
list of medications by their healthcare professional, you know, maybe
something for cough, maybe something for nasal drainage. But the
medications are pretty good, and then we do have that
medication for the COVID virus, the pax slovaed pax lviid,
which in my experience works pretty well. And again just
(05:30):
have to take it within the first couple of days
of onset of the symptoms, but sometimes I'll even give
it a little a few days beyond that, just again
because I feel like it does make a difference in
cutting the severity down and the length of time that
you have the infection. So I do like the product,
and again just remind everyone vaccines are there to provide
(05:53):
some protection, but again it's not one hundred percent, meaning
you still can get the infection if you get the vaccine.
It's just there to sort of boost the immune system
and be there to be on deck if you will,
ready for this active infection to come about so that
you're not as vulnerable if you've never had exposure to
(06:15):
a remember, exposure is everything. We want to get you
exposed to the virus so that you can be ready
to defend yourself. The viruses help produce antibodies. Antibodies or
those little proteins that sort of float around in your
bloodstream scouting out the system and if it sees an
invader or some sort of organism, that's not supposed to
(06:36):
be there. Then it sort of attacks and mounts an
immune what we call it an immune reaction. I mean
you feel it as fever, achiness, maybe your temperature goes up,
your heart rate goes up. We call that stepsis sepsis.
Most people are becoming familiar with that term, and it
(06:57):
is starting to strike fear in a lot of patients
when they hear that term sepsis, which we try to
explain to patients, it really just is a medical term
that explains what happens when you get an infection. You
don't necessarily need to be hospitalized for sepsis. It doesn't
mean that you will perish hearth, that it's going to
(07:21):
kill you. I mean, sepsis can kill you, But for
the most part, most patients who have sepsis do well,
especially if they go in and get properly treated with
appropriate antibiotics and appropriate medical therapy. Maybe there's an abscess somewhere,
or an infected oregan somewhere like a gallbladder or an appendix.
(07:43):
Those are very common infections as one gets older, and
as long as they come into the hospital and they
get their antibiotics and they get their surgery, a lot
of times they do very well and they recover and
they get out of the hospital pretty quickly. As you
may or may not know, a lot of patients who
are older, we sort of hear this refrain all the time.
(08:06):
They were doing so well two days ago, and now
they're in the hospital and they're fighting for their lives.
And this is a common situation. Unfortunately, as you get older,
your body's just not as strong, it's not as resilient,
doesn't have as much physiological metabolic reserve to fight these
(08:28):
sort of infections and the acute medical crises that you're
going through. We talk so much about heart attacks and
strokes and cancer. Most people are familiar with that. I
don't think we spend enough time talking about infections, which
is super common as you get older. Again, because the
immune system is not functioning as well. It's programmed into
(08:52):
us to start wearing out. It's not as efficient, so
we become what we call immuno compromise. Right, it's not
one hundred percent working, and so several different types of
organisms can start to cause infection. So the skys that
live in to be honest with you, again, we just
(09:15):
don't think about it as much. As we need to,
but it is causing a lot of harm or biddity
mortality as one gets older. It's infections, So there certainly
are things you can do to boost your immune system.
We talked about vaccines. That's one major major way to
do that, and it's getting easier to get vaccines and
(09:39):
doctors offices have them, pharmacies have them, so just be
sure you're up to date with that. If you're not
quite sure which ones you need, you can certainly probably
look online, or you can go back to your pharmacy
wherever you get your vaccines and they can run down
your record to see which ones you need. But really
just being healthy and general helps keep your immune system up.
(10:03):
If you are being unhealthy, if you are abusing your
body in some way, then it does suppress your immune
system and that person is add more risk for these
common infections that we do see that can lead to
sepsis and a hospitalization. And again sometimes the episode of
(10:25):
sepsis can be fairly severe to the point that you're
unable to recover from it even though you are getting
proper treatment. Again, this is what we see in the
hospital and just puzzling to patients' families that they're in
a hospital, they're seeing doctors or sing nurses, they're getting
the x rays, they're getting the antibiotics, and patients are
(10:48):
just not getting better, which again sometimes happens, especially if
you're older and you have heart failure, kidney failure, your
lungstone work as well. Maybe you're on and I mean
no suppressants because you have rheumatard arthritis or you have lupus.
You're sort of a vulnerable person and so you sort
(11:10):
of have to live in a bubble if you will,
to try and cocoon yourself, protect yourself from getting infections,
and other than vaccines, just being healthy is the biggest
way to do that. And as you know you listen
to my show and a big believer in this. You
gotta put the right fuel, got to put the right
(11:31):
fuel in your mouth. You have to drink the right
fuel as well. And yes, it can be a little
bit complicated. It's not something they really teach us from
day one. If you just sort of do what you
were taught when you're in high school and middle school
(11:52):
and all the messages that you hear and read, I
mean you're sort of eating all day, you're drinking all
these wonderful beverages. But again you have to really keep
in mind that most of these food items, these beverage
items that are so popular that taste so good, are
just not healthy for it, and you really have to
sit down and figure out what is going to work
(12:14):
for you. Yes, it is time consuming. You might be
a busy person with all these different things you have
to do. Maybe your a mother with several kids, you
have jobs, you have a husband, and you just can't
really get to your own health just because so many
things are distracting you and you sort of just keep
kicking the can down the street. As they say, you
(12:36):
never quite figure out what it is for you, and
you're sort of eating and drinking without really thinking about
it until you have your major crises and then you
really have to prioritize that. But certainly, as I mentioned,
it starts with the food, and we want those vegetables
at a high priority list. I mean, this is the
(12:57):
beginning of the year, so most people are sort of
thinking about their health and trying to figure out what
works for them. It's that food that you are putting
in your mouth. That is what a lot of times
generates disease or health. And it's also the beverages that
we drink all the time that is a lot of
(13:18):
times what can cause disease and illness. So you want
to get away from those sugary beverages as much as possible.
I know that the big smoothie movement was very popular.
All these machines that have come to the market that
can blend and pulverize your food. You grab all these
ingredients like a cake, and you just throw it in
(13:41):
this container and you just grind it and pulverize it,
and you drink this sort of super concentrated liquid with
all these different ingredients and wilae. You know you're done
for the day. You've done your part. You're a good person.
You're going to live forever because you're doing what you
(14:01):
were told to do by eating and drinking all these superfoods,
if you will, and I pulverize it, and I just
got it in right now in the morning. It's just
that a lot of experts have raised the awareness and
the concern that eating and drinking food in a very unnatural, pulverized,
(14:25):
super concentrated manner is a very very unnatural way to
digest your foods. Foods and your body really have not
been designed to work that way. So it's better if
you just try to eat whole foods in its most
natural state, the way it comes right from the counter,
(14:47):
or the way you buy it from the supermarket. It's
sort of a lot of times already ready to eat,
just maybe have to peel it or clean it up
and you start eating it. You don't necessarily have to
put it in a grind under or blender and just
pulverize it and drink it that way unless you really
like that. But I didn't want anyone to think that
(15:08):
that is the best way to consume that or if
you do it that way versus the other person, that
you're going to live longer than the other person who
doesn't do that. So try to again give yourself the
right fuel every day so that your body can operate.
That means your immune system so that you don't come
(15:29):
into the hospital with stepsis and have to be there
for a week and then, as you know, if you've
ever gotten sick, your body just feel terrible when you
have these infections, and it takes sometimes a week or
longer a month to sort of recover from an acute
(15:49):
infection like stepsis, or you're in a tract infection or pneumonia,
which we see every single day. It can really drag
you down very rapidly, where you need to go to
a rehab facility are what we call a skilled nursing
facility to get back on your feet from this infection.
And again, it all starts with that food. So eat
those vegetables as much as possible, stay away from that sugar,
(16:11):
and keep yourself out of trouble. Phone lines are open
eight on six Kalvy one hundred three three zero ko via.
We're going our first break, be back in two minutes.
(16:34):
All right, welcome back to the doc Lavine Medical. Our
phone lines are open eight nine six Kalova one hundred
three three zero ko for I welcome to the show.
And we're sitting here chatting about the diet and trying
to reduce our chances of going to the hospital for
sepsis or infection. And one thing that's popular right now,
(16:55):
which I certainly endorse, are these GLP one agonist that
very popular right now. These originally came out as diabetic medications,
but again, it's so hard to go through the day
without just munching and eating and drinking with all the
food items and beverage items that are around that are
just easily available. You work out at the plants and
(17:17):
you know there's just food out there, or you work
at a facility where there's just snacks available, crackers, cookies, drinks.
They're just sitting around at your disposal. Whenever you get hungry,
you can munch on these things. And you know, if
you're in a place where there's a lot of activity
and a lot of distraction, hey, you're gonna snack on
that stuff. Or it's late at night, you're at home
(17:39):
and you had a hard day, and that ice cream
is sitting in there, those chips are sitting in the kitchen. Man,
it's hard to say no popcorn, whatever your snack item is.
Even though you're not really burning a lot of calories
every day, it just adds up over the day. We
need help out there. Just like a lot of times,
if you're smoking, you're in your fifties, maybe you had
(18:02):
your first heart attack or a stroke, and you gotta
stop smoking. You can't expose your body to more tobacco.
But it's hard to quit. It really is. It's a habit.
That's ingrained into your mind and your body, and just
to stop overnight can be challenging to a lot of patients,
and we need help to make it easier to do
(18:26):
and make us more successful. And with the act of
eating and the weight gain that comes with eating. These
g LP one agonists you know as those zimpic or
zep bound with gov Trulicity, Moonjaro, they just have several
of these products that are now available for patients. And
(18:48):
it's easier certainly if you have diabetes because the insurance
companies are buying into paying for it if you have diabetes.
But other than that, if you're just overweight, you're eating poor.
The medicines can be very expensive and hard to afford
just because the prices are super super high. But the
(19:10):
pharmaceutical companies are trying to reduce the price and sort
of find that halfway spot, that halfway medium such that
they don't necessarily need a lot of money. Hello, what
are you doing here? I just had to I guess
I'm struggling this morning, Like, let me come help you out.
(19:32):
You're struggling out there. Oh my god, you're making all
this noise.
Speaker 2 (19:35):
Good morning.
Speaker 1 (19:35):
I just couldn't resist being away from the stage.
Speaker 2 (19:39):
No, it's Valentine's Day.
Speaker 1 (19:41):
We have to rename this show now.
Speaker 2 (19:43):
Huh No, it's Valentine's Day. And I felt really bad
for you to be by yourself. I'm going to be
working all day. You're going to be working all day.
So and you were talking about cooking and vegetables, which
is really much am.
Speaker 1 (19:56):
It's like, we're going to just struggling out there. Let
me come help you.
Speaker 2 (20:00):
You're just happier when I'm here and it's happy Valentine's Day.
Speaker 1 (20:04):
Yeah, absolutely, welcome missus Lavigne, the admin extraordinaire who runs
the admin's side of the office, as you know. So
we need folks like her to help us figure this out.
Just like when you go to the doctor's office and
you have some medicine that like a golp wan agonist
you want to know if you can afford it. And
(20:25):
a lot of times patients think, naturally, we understand what
the insurance company will do in terms of cost, what's affordable,
what's available, who's in their network. They sort of think
that physicians naturally know, and a lot of times we
don't know that information, and we need folks like you
admins to be on that side that can use your
(20:48):
processes to look that stuff up and just figure out
exactly who is a network and what medications are available
and affordable. You were talking that we had an update
on the computer system, and I guess that was some
part of it where doctors can kind of see if
the medicine, which one was it available, or if it's generic,
(21:11):
or the cost or what part of it was available. Now,
do you remember.
Speaker 2 (21:16):
It's a platform when you're there prescribing a medication. Excuse
me that when you choose what medication you want, it's
supposed to pop up and give you all the other
classes that are in that same or the medications that
are in that same class. It'll tell you the one
that you're choosing, it'll let you know if it requires
(21:36):
a PA, it'll give you the authorization. If you want
that medication, you're like, you know, this is the best
thing for my patient. I want this medicine. Then you
just start the prior authorization and that sends that message
to Kayla. Kayla then starts the process and sometimes the
patients when they walk out of the office to check out,
we already have it processed and ready for them to
(21:57):
pick up at the pharmacy.
Speaker 1 (21:59):
Okay, perfect, And so let's say for medications in general,
or I was mentioning doctors. They want to know if
once some doctors in the network, there's normally a number
that a patient can call. Is that correct to answer
some of these questions as a representative for their insurance
that can answer questions like who's in the network, or
(22:23):
if there's a medication that they cannot afford, what's the alternative?
Is that true? Or yes? I mean that's what I
recommend to patients. I thought that was the case. Is
that not the case? Or do you know?
Speaker 2 (22:34):
For general questions, they can usually always call a number
on the back of their card and they can ask
if there's a particular physician that they're wanting to go to,
they can see if that doctor's in the network before
they make the appointment or before they initiate anything else.
As far as medications, I think probably before they see
that physician, they're not going to know right what medications
(22:56):
that doctor's going to prescribe. I'm not quite sure if
they could call a pharmacist, you know, if that patient
is you know, a customer at that pharmacist, they could
call and maybe ask them, Hey, I'm wondering about this
particular medication, because all pharmacies can check medication benefits just
like we check patient's insurance benefits.
Speaker 1 (23:18):
So can they call the insurance company though.
Speaker 2 (23:22):
They can also call the insurance company.
Speaker 1 (23:24):
Is maybe there's a website they can go to and
it can sort of list some of these alternatives. They
don't really have to talk to anyone. They can maybe
put a name of a medication in it spits out
some alternatives or I mean, I don't know, I'm just
asking this qu this is what I tell you.
Speaker 2 (23:41):
So there's there's on the back of everybody's card, there's
a number for Member Services. Member Sir, they are the member,
we are the provider. So there's a provider number, there's
a member services number, and they could call that Member
services number and then just go from there and see
how it goes.
Speaker 1 (23:58):
Right, same thing with if they need a referral to
get an X ray, or if they need a referral,
like you say to a doctor, they can kind of
look into these sorts of things. It's a little cumbersome
for the doctor's office to do all these tasks just
because it's time consuming and if you add that up,
it's overwhelming, to be honest with you, so we do
(24:20):
at our office we do ask patients sometimes to do
some of that legwork for us, just because it's time
consuming to try and talk to all these representatives and
get all these.
Speaker 2 (24:32):
I can simplify this for you.
Speaker 1 (24:34):
Go ahead.
Speaker 2 (24:35):
If a patient has an HMO not a PPO. We've
talked about this in the past.
Speaker 1 (24:40):
I think we need to talk about it again though,
because I forget sometimes HMO versus PPO.
Speaker 2 (24:45):
Well, you forget because it's not really important to what
you do exactly. So that's why.
Speaker 1 (24:50):
I'm important to the listeners right Just these terms are
confusing and it's not natural terms. It's sort of these
industry terms that they originate or come up with your
after years, so it can be a little confusing PPO
versus HMO.
Speaker 2 (25:05):
What I guess would say, so HMO is just a
managed care plan, so they have so much money in
their bucket to manage that patient, and those are all
going to require a referral because they want to know
how much is this patient costing, where are they going,
and is what the doctor is wanting to order? Is
it necessary? If they don't think it's necessary, then it
(25:27):
goes to peer to peer and.
Speaker 1 (25:28):
You love those absolutely the best.
Speaker 2 (25:32):
So so if you have a PPO, that means that
you're in a non managed plan and you can really
you have the freedom to do what you want. Some
do you require a referral just because referrals to another doctor.
They want to know why you're going, what is your
(25:52):
diagnosis that you know your primary is thinking, and what
is going to be happening at this person or this
physician's all of us that requires a referral. They normally
ninety nine percent. You know, prove it if it's medical necessary,
and they'll give you, you know, six months of visits,
a year of visits, and you move on. HMOs are
(26:13):
a little bit more difficult to deal with, but that's
because they're managed.
Speaker 1 (26:18):
Yeah, they're just trying to manage the flow, yeah, of healthcare.
And again that can be a tough situation as well.
Patients come to the office even though they have HMO
and they want to see a certain doctor. I might
not necessarily agree with it, or I don't think it's
necessary honestly, which is.
Speaker 2 (26:35):
What you should do. So you're doing what's best for
your patient.
Speaker 1 (26:39):
Yeah, that's what I'm saying. It's not really I think
the whole topic of gatekeeping and we're going to restrict
the flow of healthcare delivery. I think it was an
ideal and maybe a good concept, but on a day
to day basis, I think it's hard to implement that.
Just good patients are concerned about their health and they
may want a second opinion, and if you listen to
(27:01):
the show, you know that's built into our healthcare system,
getting a second or even third opinion. And yes, that
would require a referral. I might not agree with it.
I might not think they need to see another doctor,
but they would like to see another doctor, and I've
run over the years that's always a better way to go.
And so again it's sometimes hard to control that in
(27:25):
terms of what the desire of the patients are paying
a lot of money for their health care and they
sort of want what they want from the healthcare system,
and if they need want a referral, not that doctor
Lavine wants a referral, well then we're going to send
the referral, right Because we want our patients to be happy.
We want them, we don't want them to be concerned
that something's being overlooked. And yes, sometimes a fresh pair
(27:46):
of eyes can really see something that we can't see.
And at the end of the day, we just want
them to be taken care of. And so in my opinion,
it's an ideal or an idea, but on a day
to day basis, I don't think it works out very well.
I mean again, even with medications, patients are advertised certain medications,
(28:06):
certain procedures, certain devices, and so they come in with
desires and wants that maybe I don't think they need,
but they want it right, they're paying for it. I'm
just their a healthcare professional. I'm just trying to help
them feel better and get what they feel like they
need to protect themselves and their family. And you know
who am I to get in the way of that?
(28:27):
Does that make sense so well?
Speaker 2 (28:29):
I wanted to Also, there's two types of referrals. Sometimes
your insurance does not require referral, but the doctor that
they're wanting to go to does. Yeah, and it's just
a doctor's.
Speaker 1 (28:42):
Office is based on the insurance.
Speaker 2 (28:45):
It is based on the insurance, but it's more based
on the doctor who's going to be the consultant as
far as they just want to know that you the
primary sent your patient to them, so that patients that
are out there that don't require referrals aren't making their
own appointments.
Speaker 1 (29:03):
And I thought that was just based on the fact
that when they build insurance company, the insurance company says, hey, where's.
Speaker 2 (29:11):
The referral if they're insurance No, based on that, So
again there's an insurance referral, and then there's a doctor
to doctor referral.
Speaker 1 (29:20):
Okay, understood. Yeah, that's something that does that change every
year or has it been like that for a long time.
Speaker 2 (29:27):
It's been like that since I've been doing this for
twenty years.
Speaker 1 (29:30):
Twenty years anniversary, twenty years.
Speaker 2 (29:33):
Our twentieth year anniversary.
Speaker 1 (29:35):
Where's my patch? Phone lines are open eight nine to
six kal Hey, I one one hundred and three zero
kale here. I'll be back in two minutes. Hey, welcome
(30:03):
back to the doctor Vine Medical Ower Film lines or
open eight nine six Scalva one hundred and three three
zero Kovia. We have Erica from Orange. How can we
help you?
Speaker 3 (30:12):
Oh?
Speaker 4 (30:12):
Yes, sir, I caught the tail end of your talk
about sepsis, and I don't know if you I don't
know if you touched on the answer I'm looking for.
But I have a daughter that's handicapped and she's wheelchair bound,
and so she gets regular ladder checks, you know, her
(30:32):
urine culture and it always comes back with bacteria. But
she sees a spina BIFFI a doctor and her nurse
practitioner regular physician is always whenever she has that kind
of result, she orders a an eibiotic. But the spina
(30:57):
biff of the doctor that she sees says that with
her conditions, it's normal for her to have that tear
in her urine, and she would only treat it if
she's symptomatic, which she's never been. You know, she's been fine,
no other symptoms with it. So I just wanted to
get your opinion. And the reason why she says they
(31:19):
do that is because if she's always on antibiotics, she's
going to get resistant, where when she does get symptomatic,
if she has an infection that's more involved with her body,
that she'll be resistant and then she won't be able
to respond as well with what would typically work. I
(31:41):
wanted to get your opinion.
Speaker 1 (31:43):
Yeah, Erica, thank you for that question. That's a good question,
by the way, and yes, I agree with the physician
on this particular topic we call that. Urinary colonization is
what we call that, and that just means that the
bladder and the urine continual contain bacteria, but it's not
generating an infection. We have bacteria on our body all
(32:07):
the time and our nose, throat, our skin, our gas,
intestinal system, and yes, sometimes the bladder system chronically contains
bacteria such that if you check it with the urine
analysis and a culture of something will grow. Absolutely in
certain conditions like spinabifida and other metabolic, medical neurological conditions
(32:29):
will cause the bladder to malfunction or dysfunction, and so
it just harbors bacteria all the time, and so when
you check it, it's there. And yes, whatever reason, if
you expose the body to multiple different antabotics, the bacteria
and the bladder tend to develop resistance over time such
(32:51):
that they get pretty nasty. And yes, if an infection
does happen, it requires ivy. Antibiotics on the tablets just
don't work because the body has had exposure. The bacteria's
had exposure over and over again, and the bacteria learn
how to defend themselves, especially in the genital urinary system
(33:12):
or the bladder systems. So I would agree with the
doctor on this point that you want to try and
limit the exposure of antibiotics if you can avoid it.
And yes, doctors will ask if there are any symptoms
of active infection, which I just mentioned, fever, maybe a
high heart rate, maybe low oxygen level, achiness. For urinartract infections,
(33:38):
we want some change in the urinary experience, so blood
in the urine, frequent urination, lower abdominal pain, cloudy urine,
something like that. In conjunction with these physical symptoms. We
then take that information and say, yes, you have an
active infection and you need antibiotics. But if we don't
(33:59):
have the presence of that, and all we have is
a positive urine culture and bacteria in the urine analysis,
we would then say it's probably colonization and does not
require antibiotics out of the interest of not developing these
resistant organisms. So I agree with that wholeheartedly. That is
(34:20):
a hard topic though, for a lot of families and
a lot of patients when they see that on the
urine culture report, this nasty organism and it's in staring
in their face, they just want to quote get rid
of it, and so they call their healthcare professional, and
just in a busy day with all the decisions you
have to make, a lot of times, there's a knee
(34:40):
jerk to just go ahead and prescribe the antibotic again,
because we want the patience to feel good about their health,
and we want them to feel good about our decision making,
and we're just trying to help them out. And so yes,
a lot of times we will give an antibotic even
though we don't feel like they really need it. The
same thing with upper rest return infections out of that
all the time. So it's a tough topic, but I
(35:03):
would agree.
Speaker 4 (35:04):
With that one, okay. And then I guess it's a
personal call if they have because it's not unusual for
her to maybe not have a clear maybe a little
bit cloudy in her urine right, and then also a
white blood cell correct, But I haven't, so you kind
(35:24):
of have to call it from there.
Speaker 1 (35:27):
I think the history would be very helpful in that situation.
If you know all the history and you know that yes,
my daughter always has a cloudy urine, it always grows something,
then that will help their provider to understand that it's
a chronic issue and then there's no need to prescribe anabiotics.
I think if she just shows up to some er
(35:49):
or some monecare, no one knows her history, and they
check a urine and it shows all that. Yeah, they're
going to give her antibotics, no question, just because you
you sometimes can't wait to get that information. So if
you're not there, yes, they're probably going to get her
and give her some antabotics, rightly, so, just because sometimes
you don't have time to guess, and you want to
be as aggressive as possible as it pertains to sepsis,
(36:13):
just because there's a clock that is ticking behind and
you got to get the antibiotic on board as fast
as possible if they do have true sepsis, so that
the patient doesn't get worse. And all emergency departments are
judged on how fast they can get those antibotics on
board if someone has sepsis. So there's a lot of
pressure in American hospitals and ers and mine cares to
(36:36):
start the antibotic as soon as possible without asking any questions.
So if you're not there, yes, probably she's going to
get that antibiotic. All right, Gail, All right, let's Gil
hung up. And that was a very good question, missus Charlotte,
just because man, we battled that all the time, especially
at the nursing homes. We get that all the time,
(36:58):
and it's a frustrating topic for me and a frustrating
issue with me. I've tried to battle that over the years. Againness,
you blew up, You blew up your microphone.
Speaker 3 (37:13):
All right, Hello, this is Gail. We got disconnected.
Speaker 1 (37:16):
Yeah, go ahead, gil.
Speaker 3 (37:19):
Okay. Uh I turned on my radio in the middle
of your discussion with the lady about UH calling in
to find out about the price of your prescription and
if your prescription, uh, if it costs too much, can
you get prescribed a different one with your insurance company?
(37:41):
H I personally, Uh, I think it probably has to
do with who your prescription carrier is. Uh. I live
in Louisiana, and my insurance company, the person who handles
our prescriptions is overscript and a couple of times the
(38:02):
last couple of years, a prescription that my doctor has written,
they would not cover. So, like the lady said, there's
a number on your card that you can call, And
when I called, I said, y'all didn't cover my prescription.
And I asked, do you have a suggestion what you
(38:24):
would cover instead, And the lady on the phone I
was talking to looked it up and she gave me
a couple of extra a couple of suggestions on what
would be what they would cover that would be appropriate substitutions.
(38:46):
And she even told me a couple of them were
asthma medications, and she said, and this one would even
be cheaper than that one. She even told me price ranges,
and she said, so she said, Now this was this
particular company. She said, so you may when you call
(39:07):
call back to your doctor to give him these suggestions,
you might ask him if he would prefer if it
would be okay to you know, you might suggest the
insurance company said this one was cheaper, So if it's
okay with you, I'd prefer this one. But you know,
it's up to the doctor which one he wanted. But
(39:29):
this particular company was willing to give me suggestions on
prescriptions they would would cover.
Speaker 1 (39:39):
Okay, Well, good, Yeah, so that system works. And that
was my thinking all along. I just wanted to make
sure that that is what is out there. You can
call a number and that can help us figure out
what medicines are available. And a lot of times. Yes,
there are different options and for the doctor we like
certain medications, but yes it is an expense issue. We
(40:03):
want you to be able to get the medication. If
you can't afford it, then let's try something that you
can't afford. So well, appreciate that that comment, Gale. Anything
else today.
Speaker 3 (40:12):
Let you know what they will cover and what they
want you know.
Speaker 1 (40:17):
Awesome, Well, I'm glad the system works finally. All right, Gil,
thank you for that. And phonein's open eight one six KALV.
I want to hundred three three zero kyo Via. I'll
be on the last break. All right, welcome back to
(40:38):
Doctoravine Medical. Our phone ones open eight nine to six K.
I want to hundred three three zero k via. Did
your mic work?
Speaker 2 (40:44):
Let me see? Oh yes, summer I'm back on yeah Sureleye.
Speaker 1 (40:50):
Anyway, thank you for joining for the edition of the show.
Remember you can call the radio station, call my office
if you have a topic. And yes, we're always enjoyed
miss being coming on it a little bit late this morning,
but you did.
Speaker 2 (41:02):
I wanted to surprise you, yes.
Speaker 1 (41:04):
A big surprise. Happy Valentine's Stay too, all the listeners
out there, Happy Valentine's Stay. To you as well.
Speaker 2 (41:11):
Thank you Happy Valentine's Stay to you as well. Yes, absolutely,
my number one Valentine.
Speaker 1 (41:16):
And my number one fan over there.
Speaker 2 (41:18):
Seriously, I listened to him every Saturday morning and sometimes, no,
I never sleep and sometimes I'm texting him. Sometimes I
text him answers and opinions and hey, think of this
or think of that. So honestly, I'll listen to you
because I don't get to see that side of you
because I'm your wife, so I don't get to really
(41:40):
see you in that role. So that's what I enjoy.
Speaker 1 (41:45):
Okay, I guess, I guess you can follow me at
the office here, no wonder, you can just follow me around.
Speaker 2 (41:50):
I'm good.
Speaker 1 (41:51):
You have things to do.
Speaker 2 (41:52):
I have lots to do.
Speaker 1 (41:53):
You had some comment on the infections at the nursing homes.
Speaker 2 (41:57):
Yeah, I mean yeah, I feel like at one minute, okay,
I feel like because they they're not walking around, there's
trapped heat. They're laying in the bed. You know, what
do you think about that just trapped heat?
Speaker 1 (42:13):
No, I think that there's a lot of risk factors
for the harboring of bacteria in the bladder as one
gets older. But like I said, it's sort of a
chronic condition, meaning we can give them antibiotics, but as
soon as the antibotics stop, guess what, the bacteria is
going to come back. The body defends itself. Remember we
do have an immune system that defends us.
Speaker 2 (42:33):
And but you have to be careful with over prescribing
antibiotics because of the resistance, no.
Speaker 1 (42:39):
Question, but I'm just saying it's it's hard when you're
interacting with families and they're concerned about certain things and
they want certain things. It's it's tough out there. Sometimes
you have to make some comfromise. Anyway, phone, thank you
for joining for Oinician of the show.
Speaker 2 (42:53):
Eat your vegetables, drink your water, don't drink and drive
All right, welcome Southeast Texas Internet radio listeners. Is Doctor Levine,
your weekly host of the Doctor Levine Medical Hour. Thank
you for joining me on the edition of the show
here every Saturday morning between eight and nine. We're trying
to help you figure out what is good for you
and your family to stay alive and stay out of
(00:20):
the doctor's office as frequent as possible, keep your medication
list to a minimum, and stay out of the hospital
as much as possible. Sometimes it's hard to avoid, but
certainly there are things that you can do on a
regular basis to keep yourself alive and healthy. And this
is what we're here to do to discuss those things
(00:42):
that you can do. Because it's not one little magic
pill or one little magic liquid or whatever you've come
up with, that one little thing that will save you
and keep you from going to the doctor's office or
avoid this certain thing. It's a few things that you
(01:05):
have to do, not one thing, but a few things. Yes,
it's a little bit time consuming, but man, it pays
off in the future by keeping out of the hospital,
keeping you alive, keeping you healthy. And that's what we're
here to discuss, and thank you for joining us on
the edition of the show. Phone lines are open eight
(01:25):
nine to six klv I one one hundred and three
three zero klv I. We'd love to hear from you.
Happy Valentine's Day to all those listeners out there, and
happy Valentine's Day to my wife. She texting me this morning,
as you know, she was here last week and we
had a great conversation talking about various topics. We try
(01:47):
to pull in some of the admin side to healthcare delivery.
As you know, that's just this whole other side of
healthcare delivery that we don't really talk about too much,
but you're familiar with it when you try to get
your mad's refilled, or you need to get a referral somewhere,
or you're just trying to decide which insurance package to get,
(02:10):
or you're in the hospital and you're trying to get
something accomplished and there was some fine details of the
contract that you signed up for that you don't remember
or that you weren't exposed to be kind of tricky,
and so we bring her on and discuss some of
those topics. Remember, if there's any topic you like me
(02:31):
to talk about, just call the radio show, or you
can call my office, you can call the station and
drop off a little note, and we can certainly get
into it and talk about it whatever you'd like to discuss,
because it's confusing out there even for doctors sometimes to
figure out what is the right thing to do. Things
(02:51):
are always changing, and you just always hear so much
about do this, do that, don't do this, don't do that.
It's it's just maddening. All the information that you're getting
exposed to. You just don't know what to do. So
this is what we are here to try and figure
out to help your particular situation. The weather it's outside
(03:15):
is not terrible, a little overcast. Maybe our winter season
is over with, maybe I don't know. We're getting into
the middle part of February. It's normally sort of a
colder month for us, and then March April is right
behind us on deck. Those are our warmer months, or
(03:37):
at least it starts to get warm. So not much
of a winner at this time. As you know, I
typically like this time of year, and we certainly have
seen our spike of our usual respiratory illnesses. Those viruses
are always circulating out there, especially the flu was bad,
bad this year. Necessarily COVID. Didn't see a ton of COVID.
(04:02):
To be honest with you, it was more of a
flu season this year. And again we're always harping to
you about getting these flu vaccines and we want to
try and improve compliance to one hundred percent, but that
is hard to do because we live in this country.
(04:23):
We are free thinkers and we certainly want to pursue
our own thoughts and if we don't want to do something,
we don't want to be forced to do that. That
is the nature of our our organization, nature of our industry,
so that not everyone wants to do that, and they don't,
(04:46):
so we don't get one hundred percent. We, like I said, Mike,
get seventy eighty percent and that's pretty good. But it
was more of a flu season this year. And thankfully
we do have medications that are available for flu sufferers.
Tammy flu has been out for a long time, and
sometimes patients will get various other additive medications to their
(05:08):
list of medications by their healthcare professional, you know, maybe
something for cough, maybe something for nasal drainage. But the
medications are pretty good, and then we do have that
medication for the COVID virus, the pax slovaed pax lviid,
which in my experience works pretty well. And again just
(05:30):
have to take it within the first couple of days
of onset of the symptoms, but sometimes I'll even give
it a little a few days beyond that, just again
because I feel like it does make a difference in
cutting the severity down and the length of time that
you have the infection. So I do like the product,
and again just remind everyone vaccines are there to provide
(05:53):
some protection, but again it's not one hundred percent, meaning
you still can get the infection if you get the vaccine.
It's just there to sort of boost the immune system
and be there to be on deck if you will,
ready for this active infection to come about so that
you're not as vulnerable if you've never had exposure to
(06:15):
a remember, exposure is everything. We want to get you
exposed to the virus so that you can be ready
to defend yourself. The viruses help produce antibodies. Antibodies or
those little proteins that sort of float around in your
bloodstream scouting out the system and if it sees an
invader or some sort of organism, that's not supposed to
(06:36):
be there. Then it sort of attacks and mounts an
immune what we call it an immune reaction. I mean
you feel it as fever, achiness, maybe your temperature goes up,
your heart rate goes up. We call that stepsis sepsis.
Most people are becoming familiar with that term, and it
(06:57):
is starting to strike fear in a lot of patients
when they hear that term sepsis, which we try to
explain to patients, it really just is a medical term
that explains what happens when you get an infection. You
don't necessarily need to be hospitalized for sepsis. It doesn't
mean that you will perish hearth, that it's going to
(07:21):
kill you. I mean, sepsis can kill you, But for
the most part, most patients who have sepsis do well,
especially if they go in and get properly treated with
appropriate antibiotics and appropriate medical therapy. Maybe there's an abscess somewhere,
or an infected oregan somewhere like a gallbladder or an appendix.
(07:43):
Those are very common infections as one gets older, and
as long as they come into the hospital and they
get their antibiotics and they get their surgery, a lot
of times they do very well and they recover and
they get out of the hospital pretty quickly. As you
may or may not know, a lot of patients who
are older, we sort of hear this refrain all the time.
(08:06):
They were doing so well two days ago, and now
they're in the hospital and they're fighting for their lives.
And this is a common situation. Unfortunately, as you get older,
your body's just not as strong, it's not as resilient,
doesn't have as much physiological metabolic reserve to fight these
(08:28):
sort of infections and the acute medical crises that you're
going through. We talk so much about heart attacks and
strokes and cancer. Most people are familiar with that. I
don't think we spend enough time talking about infections, which
is super common as you get older. Again, because the
immune system is not functioning as well. It's programmed into
(08:52):
us to start wearing out. It's not as efficient, so
we become what we call immuno compromise. Right, it's not
one hundred percent working, and so several different types of
organisms can start to cause infection. So the skys that
live in to be honest with you, again, we just
(09:15):
don't think about it as much. As we need to,
but it is causing a lot of harm or biddity
mortality as one gets older. It's infections, So there certainly
are things you can do to boost your immune system.
We talked about vaccines. That's one major major way to
do that, and it's getting easier to get vaccines and
(09:39):
doctors offices have them, pharmacies have them, so just be
sure you're up to date with that. If you're not
quite sure which ones you need, you can certainly probably
look online, or you can go back to your pharmacy
wherever you get your vaccines and they can run down
your record to see which ones you need. But really
just being healthy and general helps keep your immune system up.
(10:03):
If you are being unhealthy, if you are abusing your
body in some way, then it does suppress your immune
system and that person is add more risk for these
common infections that we do see that can lead to
sepsis and a hospitalization. And again sometimes the episode of
(10:25):
sepsis can be fairly severe to the point that you're
unable to recover from it even though you are getting
proper treatment. Again, this is what we see in the
hospital and just puzzling to patients' families that they're in
a hospital, they're seeing doctors or sing nurses, they're getting
the x rays, they're getting the antibiotics, and patients are
(10:48):
just not getting better, which again sometimes happens, especially if
you're older and you have heart failure, kidney failure, your
lungstone work as well. Maybe you're on and I mean
no suppressants because you have rheumatard arthritis or you have lupus.
You're sort of a vulnerable person and so you sort
(11:10):
of have to live in a bubble if you will,
to try and cocoon yourself, protect yourself from getting infections,
and other than vaccines, just being healthy is the biggest
way to do that. And as you know you listen
to my show and a big believer in this. You
gotta put the right fuel, got to put the right
(11:31):
fuel in your mouth. You have to drink the right
fuel as well. And yes, it can be a little
bit complicated. It's not something they really teach us from
day one. If you just sort of do what you
were taught when you're in high school and middle school
(11:52):
and all the messages that you hear and read, I
mean you're sort of eating all day, you're drinking all
these wonderful beverages. But again you have to really keep
in mind that most of these food items, these beverage
items that are so popular that taste so good, are
just not healthy for it, and you really have to
sit down and figure out what is going to work
(12:14):
for you. Yes, it is time consuming. You might be
a busy person with all these different things you have
to do. Maybe your a mother with several kids, you
have jobs, you have a husband, and you just can't
really get to your own health just because so many
things are distracting you and you sort of just keep
kicking the can down the street. As they say, you
(12:36):
never quite figure out what it is for you, and
you're sort of eating and drinking without really thinking about
it until you have your major crises and then you
really have to prioritize that. But certainly, as I mentioned,
it starts with the food, and we want those vegetables
at a high priority list. I mean, this is the
(12:57):
beginning of the year, so most people are sort of
thinking about their health and trying to figure out what
works for them. It's that food that you are putting
in your mouth. That is what a lot of times
generates disease or health. And it's also the beverages that
we drink all the time that is a lot of
(13:18):
times what can cause disease and illness. So you want
to get away from those sugary beverages as much as possible.
I know that the big smoothie movement was very popular.
All these machines that have come to the market that
can blend and pulverize your food. You grab all these
ingredients like a cake, and you just throw it in
(13:41):
this container and you just grind it and pulverize it,
and you drink this sort of super concentrated liquid with
all these different ingredients and wilae. You know you're done
for the day. You've done your part. You're a good person.
You're going to live forever because you're doing what you
(14:01):
were told to do by eating and drinking all these superfoods,
if you will, and I pulverize it, and I just
got it in right now in the morning. It's just
that a lot of experts have raised the awareness and
the concern that eating and drinking food in a very unnatural, pulverized,
(14:25):
super concentrated manner is a very very unnatural way to
digest your foods. Foods and your body really have not
been designed to work that way. So it's better if
you just try to eat whole foods in its most
natural state, the way it comes right from the counter,
(14:47):
or the way you buy it from the supermarket. It's
sort of a lot of times already ready to eat,
just maybe have to peel it or clean it up
and you start eating it. You don't necessarily have to
put it in a grind under or blender and just
pulverize it and drink it that way unless you really
like that. But I didn't want anyone to think that
(15:08):
that is the best way to consume that or if
you do it that way versus the other person, that
you're going to live longer than the other person who
doesn't do that. So try to again give yourself the
right fuel every day so that your body can operate.
That means your immune system so that you don't come
(15:29):
into the hospital with stepsis and have to be there
for a week and then, as you know, if you've
ever gotten sick, your body just feel terrible when you
have these infections, and it takes sometimes a week or
longer a month to sort of recover from an acute
(15:49):
infection like stepsis, or you're in a tract infection or pneumonia,
which we see every single day. It can really drag
you down very rapidly, where you need to go to
a rehab facility are what we call a skilled nursing
facility to get back on your feet from this infection.
And again, it all starts with that food. So eat
those vegetables as much as possible, stay away from that sugar,
(16:11):
and keep yourself out of trouble. Phone lines are open
eight on six Kalvy one hundred three three zero ko via.
We're going our first break, be back in two minutes.
(16:34):
All right, welcome back to the doc Lavine Medical. Our
phone lines are open eight nine six Kalova one hundred
three three zero ko for I welcome to the show.
And we're sitting here chatting about the diet and trying
to reduce our chances of going to the hospital for
sepsis or infection. And one thing that's popular right now,
(16:55):
which I certainly endorse, are these GLP one agonist that
very popular right now. These originally came out as diabetic medications,
but again, it's so hard to go through the day
without just munching and eating and drinking with all the
food items and beverage items that are around that are
just easily available. You work out at the plants and
(17:17):
you know there's just food out there, or you work
at a facility where there's just snacks available, crackers, cookies, drinks.
They're just sitting around at your disposal. Whenever you get hungry,
you can munch on these things. And you know, if
you're in a place where there's a lot of activity
and a lot of distraction, hey, you're gonna snack on
that stuff. Or it's late at night, you're at home
(17:39):
and you had a hard day, and that ice cream
is sitting in there, those chips are sitting in the kitchen. Man,
it's hard to say no popcorn, whatever your snack item is.
Even though you're not really burning a lot of calories
every day, it just adds up over the day. We
need help out there. Just like a lot of times,
if you're smoking, you're in your fifties, maybe you had
(18:02):
your first heart attack or a stroke, and you gotta
stop smoking. You can't expose your body to more tobacco.
But it's hard to quit. It really is. It's a habit.
That's ingrained into your mind and your body, and just
to stop overnight can be challenging to a lot of patients,
and we need help to make it easier to do
(18:26):
and make us more successful. And with the act of
eating and the weight gain that comes with eating. These
g LP one agonists you know as those zimpic or
zep bound with gov Trulicity, Moonjaro, they just have several
of these products that are now available for patients. And
(18:48):
it's easier certainly if you have diabetes because the insurance
companies are buying into paying for it if you have diabetes.
But other than that, if you're just overweight, you're eating poor.
The medicines can be very expensive and hard to afford
just because the prices are super super high. But the
(19:10):
pharmaceutical companies are trying to reduce the price and sort
of find that halfway spot, that halfway medium such that
they don't necessarily need a lot of money. Hello, what
are you doing here? I just had to I guess
I'm struggling this morning, Like, let me come help you out.
(19:32):
You're struggling out there. Oh my god, you're making all
this noise.
Speaker 2 (19:35):
Good morning.
Speaker 1 (19:35):
I just couldn't resist being away from the stage.
Speaker 2 (19:39):
No, it's Valentine's Day.
Speaker 1 (19:41):
We have to rename this show now.
Speaker 2 (19:43):
Huh No, it's Valentine's Day. And I felt really bad
for you to be by yourself. I'm going to be
working all day. You're going to be working all day.
So and you were talking about cooking and vegetables, which
is really much am.
Speaker 1 (19:56):
It's like, we're going to just struggling out there. Let
me come help you.
Speaker 2 (20:00):
You're just happier when I'm here and it's happy Valentine's Day.
Speaker 1 (20:04):
Yeah, absolutely, welcome missus Lavigne, the admin extraordinaire who runs
the admin's side of the office, as you know. So
we need folks like her to help us figure this out.
Just like when you go to the doctor's office and
you have some medicine that like a golp wan agonist
you want to know if you can afford it. And
(20:25):
a lot of times patients think, naturally, we understand what
the insurance company will do in terms of cost, what's affordable,
what's available, who's in their network. They sort of think
that physicians naturally know, and a lot of times we
don't know that information, and we need folks like you
admins to be on that side that can use your
(20:48):
processes to look that stuff up and just figure out
exactly who is a network and what medications are available
and affordable. You were talking that we had an update
on the computer system, and I guess that was some
part of it where doctors can kind of see if
the medicine, which one was it available, or if it's generic,
(21:11):
or the cost or what part of it was available. Now,
do you remember.
Speaker 2 (21:16):
It's a platform when you're there prescribing a medication. Excuse
me that when you choose what medication you want, it's
supposed to pop up and give you all the other
classes that are in that same or the medications that
are in that same class. It'll tell you the one
that you're choosing, it'll let you know if it requires
(21:36):
a PA, it'll give you the authorization. If you want
that medication, you're like, you know, this is the best
thing for my patient. I want this medicine. Then you
just start the prior authorization and that sends that message
to Kayla. Kayla then starts the process and sometimes the
patients when they walk out of the office to check out,
we already have it processed and ready for them to
(21:57):
pick up at the pharmacy.
Speaker 1 (21:59):
Okay, perfect, And so let's say for medications in general,
or I was mentioning doctors. They want to know if
once some doctors in the network, there's normally a number
that a patient can call. Is that correct to answer
some of these questions as a representative for their insurance
that can answer questions like who's in the network, or
(22:23):
if there's a medication that they cannot afford, what's the alternative?
Is that true? Or yes? I mean that's what I
recommend to patients. I thought that was the case. Is
that not the case? Or do you know?
Speaker 2 (22:34):
For general questions, they can usually always call a number
on the back of their card and they can ask
if there's a particular physician that they're wanting to go to,
they can see if that doctor's in the network before
they make the appointment or before they initiate anything else.
As far as medications, I think probably before they see
that physician, they're not going to know right what medications
(22:56):
that doctor's going to prescribe. I'm not quite sure if
they could call a pharmacist, you know, if that patient
is you know, a customer at that pharmacist, they could
call and maybe ask them, Hey, I'm wondering about this
particular medication, because all pharmacies can check medication benefits just
like we check patient's insurance benefits.
Speaker 1 (23:18):
So can they call the insurance company though.
Speaker 2 (23:22):
They can also call the insurance company.
Speaker 1 (23:24):
Is maybe there's a website they can go to and
it can sort of list some of these alternatives. They
don't really have to talk to anyone. They can maybe
put a name of a medication in it spits out
some alternatives or I mean, I don't know, I'm just
asking this qu this is what I tell you.
Speaker 2 (23:41):
So there's there's on the back of everybody's card, there's
a number for Member Services. Member Sir, they are the member,
we are the provider. So there's a provider number, there's
a member services number, and they could call that Member
services number and then just go from there and see
how it goes.
Speaker 1 (23:58):
Right, same thing with if they need a referral to
get an X ray, or if they need a referral,
like you say to a doctor, they can kind of
look into these sorts of things. It's a little cumbersome
for the doctor's office to do all these tasks just
because it's time consuming and if you add that up,
it's overwhelming, to be honest with you, so we do
(24:20):
at our office we do ask patients sometimes to do
some of that legwork for us, just because it's time
consuming to try and talk to all these representatives and
get all these.
Speaker 2 (24:32):
I can simplify this for you.
Speaker 1 (24:34):
Go ahead.
Speaker 2 (24:35):
If a patient has an HMO not a PPO. We've
talked about this in the past.
Speaker 1 (24:40):
I think we need to talk about it again though,
because I forget sometimes HMO versus PPO.
Speaker 2 (24:45):
Well, you forget because it's not really important to what
you do exactly. So that's why.
Speaker 1 (24:50):
I'm important to the listeners right Just these terms are
confusing and it's not natural terms. It's sort of these
industry terms that they originate or come up with your
after years, so it can be a little confusing PPO
versus HMO.
Speaker 2 (25:05):
What I guess would say, so HMO is just a
managed care plan, so they have so much money in
their bucket to manage that patient, and those are all
going to require a referral because they want to know
how much is this patient costing, where are they going,
and is what the doctor is wanting to order? Is
it necessary? If they don't think it's necessary, then it
(25:27):
goes to peer to peer and.
Speaker 1 (25:28):
You love those absolutely the best.
Speaker 2 (25:32):
So so if you have a PPO, that means that
you're in a non managed plan and you can really
you have the freedom to do what you want. Some
do you require a referral just because referrals to another doctor.
They want to know why you're going, what is your
(25:52):
diagnosis that you know your primary is thinking, and what
is going to be happening at this person or this
physician's all of us that requires a referral. They normally
ninety nine percent. You know, prove it if it's medical necessary,
and they'll give you, you know, six months of visits,
a year of visits, and you move on. HMOs are
(26:13):
a little bit more difficult to deal with, but that's
because they're managed.
Speaker 1 (26:18):
Yeah, they're just trying to manage the flow, yeah, of healthcare.
And again that can be a tough situation as well.
Patients come to the office even though they have HMO
and they want to see a certain doctor. I might
not necessarily agree with it, or I don't think it's
necessary honestly, which is.
Speaker 2 (26:35):
What you should do. So you're doing what's best for
your patient.
Speaker 1 (26:39):
Yeah, that's what I'm saying. It's not really I think
the whole topic of gatekeeping and we're going to restrict
the flow of healthcare delivery. I think it was an
ideal and maybe a good concept, but on a day
to day basis, I think it's hard to implement that.
Just good patients are concerned about their health and they
may want a second opinion, and if you listen to
(27:01):
the show, you know that's built into our healthcare system,
getting a second or even third opinion. And yes, that
would require a referral. I might not agree with it.
I might not think they need to see another doctor,
but they would like to see another doctor, and I've
run over the years that's always a better way to go.
And so again it's sometimes hard to control that in
(27:25):
terms of what the desire of the patients are paying
a lot of money for their health care and they
sort of want what they want from the healthcare system,
and if they need want a referral, not that doctor
Lavine wants a referral, well then we're going to send
the referral, right Because we want our patients to be happy.
We want them, we don't want them to be concerned
that something's being overlooked. And yes, sometimes a fresh pair
(27:46):
of eyes can really see something that we can't see.
And at the end of the day, we just want
them to be taken care of. And so in my opinion,
it's an ideal or an idea, but on a day
to day basis, I don't think it works out very well.
I mean again, even with medications, patients are advertised certain medications,
(28:06):
certain procedures, certain devices, and so they come in with
desires and wants that maybe I don't think they need,
but they want it right, they're paying for it. I'm
just their a healthcare professional. I'm just trying to help
them feel better and get what they feel like they
need to protect themselves and their family. And you know
who am I to get in the way of that?
(28:27):
Does that make sense so well?
Speaker 2 (28:29):
I wanted to Also, there's two types of referrals. Sometimes
your insurance does not require referral, but the doctor that
they're wanting to go to does. Yeah, and it's just
a doctor's.
Speaker 1 (28:42):
Office is based on the insurance.
Speaker 2 (28:45):
It is based on the insurance, but it's more based
on the doctor who's going to be the consultant as
far as they just want to know that you the
primary sent your patient to them, so that patients that
are out there that don't require referrals aren't making their
own appointments.
Speaker 1 (29:03):
And I thought that was just based on the fact
that when they build insurance company, the insurance company says, hey, where's.
Speaker 2 (29:11):
The referral if they're insurance No, based on that, So
again there's an insurance referral, and then there's a doctor
to doctor referral.
Speaker 1 (29:20):
Okay, understood. Yeah, that's something that does that change every
year or has it been like that for a long time.
Speaker 2 (29:27):
It's been like that since I've been doing this for
twenty years.
Speaker 1 (29:30):
Twenty years anniversary, twenty years.
Speaker 2 (29:33):
Our twentieth year anniversary.
Speaker 1 (29:35):
Where's my patch? Phone lines are open eight nine to
six kal Hey, I one one hundred and three zero
kale here. I'll be back in two minutes. Hey, welcome
(30:03):
back to the doctor Vine Medical Ower Film lines or
open eight nine six Scalva one hundred and three three
zero Kovia. We have Erica from Orange. How can we
help you?
Speaker 3 (30:12):
Oh?
Speaker 4 (30:12):
Yes, sir, I caught the tail end of your talk
about sepsis, and I don't know if you I don't
know if you touched on the answer I'm looking for.
But I have a daughter that's handicapped and she's wheelchair bound,
and so she gets regular ladder checks, you know, her
(30:32):
urine culture and it always comes back with bacteria. But
she sees a spina BIFFI a doctor and her nurse
practitioner regular physician is always whenever she has that kind
of result, she orders a an eibiotic. But the spina
(30:57):
biff of the doctor that she sees says that with
her conditions, it's normal for her to have that tear
in her urine, and she would only treat it if
she's symptomatic, which she's never been. You know, she's been fine,
no other symptoms with it. So I just wanted to
get your opinion. And the reason why she says they
(31:19):
do that is because if she's always on antibiotics, she's
going to get resistant, where when she does get symptomatic,
if she has an infection that's more involved with her body,
that she'll be resistant and then she won't be able
to respond as well with what would typically work. I
(31:41):
wanted to get your opinion.
Speaker 1 (31:43):
Yeah, Erica, thank you for that question. That's a good question,
by the way, and yes, I agree with the physician
on this particular topic we call that. Urinary colonization is
what we call that, and that just means that the
bladder and the urine continual contain bacteria, but it's not
generating an infection. We have bacteria on our body all
(32:07):
the time and our nose, throat, our skin, our gas,
intestinal system, and yes, sometimes the bladder system chronically contains
bacteria such that if you check it with the urine
analysis and a culture of something will grow. Absolutely in
certain conditions like spinabifida and other metabolic, medical neurological conditions
(32:29):
will cause the bladder to malfunction or dysfunction, and so
it just harbors bacteria all the time, and so when
you check it, it's there. And yes, whatever reason, if
you expose the body to multiple different antabotics, the bacteria
and the bladder tend to develop resistance over time such
(32:51):
that they get pretty nasty. And yes, if an infection
does happen, it requires ivy. Antibiotics on the tablets just
don't work because the body has had exposure. The bacteria's
had exposure over and over again, and the bacteria learn
how to defend themselves, especially in the genital urinary system
(33:12):
or the bladder systems. So I would agree with the
doctor on this point that you want to try and
limit the exposure of antibiotics if you can avoid it.
And yes, doctors will ask if there are any symptoms
of active infection, which I just mentioned, fever, maybe a
high heart rate, maybe low oxygen level, achiness. For urinartract infections,
(33:38):
we want some change in the urinary experience, so blood
in the urine, frequent urination, lower abdominal pain, cloudy urine,
something like that. In conjunction with these physical symptoms. We
then take that information and say, yes, you have an
active infection and you need antibiotics. But if we don't
(33:59):
have the presence of that, and all we have is
a positive urine culture and bacteria in the urine analysis,
we would then say it's probably colonization and does not
require antibiotics out of the interest of not developing these
resistant organisms. So I agree with that wholeheartedly. That is
(34:20):
a hard topic though, for a lot of families and
a lot of patients when they see that on the
urine culture report, this nasty organism and it's in staring
in their face, they just want to quote get rid
of it, and so they call their healthcare professional, and
just in a busy day with all the decisions you
have to make, a lot of times, there's a knee
(34:40):
jerk to just go ahead and prescribe the antibotic again,
because we want the patience to feel good about their health,
and we want them to feel good about our decision making,
and we're just trying to help them out. And so yes,
a lot of times we will give an antibotic even
though we don't feel like they really need it. The
same thing with upper rest return infections out of that
all the time. So it's a tough topic, but I
(35:03):
would agree.
Speaker 4 (35:04):
With that one, okay. And then I guess it's a
personal call if they have because it's not unusual for
her to maybe not have a clear maybe a little
bit cloudy in her urine right, and then also a
white blood cell correct, But I haven't, so you kind
(35:24):
of have to call it from there.
Speaker 1 (35:27):
I think the history would be very helpful in that situation.
If you know all the history and you know that yes,
my daughter always has a cloudy urine, it always grows something,
then that will help their provider to understand that it's
a chronic issue and then there's no need to prescribe anabiotics.
I think if she just shows up to some er
(35:49):
or some monecare, no one knows her history, and they
check a urine and it shows all that. Yeah, they're
going to give her antibotics, no question, just because you
you sometimes can't wait to get that information. So if
you're not there, yes, they're probably going to get her
and give her some antabotics, rightly, so, just because sometimes
you don't have time to guess, and you want to
be as aggressive as possible as it pertains to sepsis,
(36:13):
just because there's a clock that is ticking behind and
you got to get the antibiotic on board as fast
as possible if they do have true sepsis, so that
the patient doesn't get worse. And all emergency departments are
judged on how fast they can get those antibotics on
board if someone has sepsis. So there's a lot of
pressure in American hospitals and ers and mine cares to
(36:36):
start the antibotic as soon as possible without asking any questions.
So if you're not there, yes, probably she's going to
get that antibiotic. All right, Gail, All right, let's Gil
hung up. And that was a very good question, missus Charlotte,
just because man, we battled that all the time, especially
at the nursing homes. We get that all the time,
(36:58):
and it's a frustrating topic for me and a frustrating
issue with me. I've tried to battle that over the years. Againness,
you blew up, You blew up your microphone.
Speaker 3 (37:13):
All right, Hello, this is Gail. We got disconnected.
Speaker 1 (37:16):
Yeah, go ahead, gil.
Speaker 3 (37:19):
Okay. Uh I turned on my radio in the middle
of your discussion with the lady about UH calling in
to find out about the price of your prescription and
if your prescription, uh, if it costs too much, can
you get prescribed a different one with your insurance company?
(37:41):
H I personally, Uh, I think it probably has to
do with who your prescription carrier is. Uh. I live
in Louisiana, and my insurance company, the person who handles
our prescriptions is overscript and a couple of times the
(38:02):
last couple of years, a prescription that my doctor has written,
they would not cover. So, like the lady said, there's
a number on your card that you can call, And
when I called, I said, y'all didn't cover my prescription.
And I asked, do you have a suggestion what you
(38:24):
would cover instead, And the lady on the phone I
was talking to looked it up and she gave me
a couple of extra a couple of suggestions on what
would be what they would cover that would be appropriate substitutions.
(38:46):
And she even told me a couple of them were
asthma medications, and she said, and this one would even
be cheaper than that one. She even told me price ranges,
and she said, so she said, Now this was this
particular company. She said, so you may when you call
(39:07):
call back to your doctor to give him these suggestions,
you might ask him if he would prefer if it
would be okay to you know, you might suggest the
insurance company said this one was cheaper, So if it's
okay with you, I'd prefer this one. But you know,
it's up to the doctor which one he wanted. But
(39:29):
this particular company was willing to give me suggestions on
prescriptions they would would cover.
Speaker 1 (39:39):
Okay, Well, good, Yeah, so that system works. And that
was my thinking all along. I just wanted to make
sure that that is what is out there. You can
call a number and that can help us figure out
what medicines are available. And a lot of times. Yes,
there are different options and for the doctor we like
certain medications, but yes it is an expense issue. We
(40:03):
want you to be able to get the medication. If
you can't afford it, then let's try something that you
can't afford. So well, appreciate that that comment, Gale. Anything
else today.
Speaker 3 (40:12):
Let you know what they will cover and what they
want you know.
Speaker 1 (40:17):
Awesome, Well, I'm glad the system works finally. All right, Gil,
thank you for that. And phonein's open eight one six KALV.
I want to hundred three three zero kyo Via. I'll
be on the last break. All right, welcome back to
(40:38):
Doctoravine Medical. Our phone ones open eight nine to six K.
I want to hundred three three zero k via. Did
your mic work?
Speaker 2 (40:44):
Let me see? Oh yes, summer I'm back on yeah Sureleye.
Speaker 1 (40:50):
Anyway, thank you for joining for the edition of the show.
Remember you can call the radio station, call my office
if you have a topic. And yes, we're always enjoyed
miss being coming on it a little bit late this morning,
but you did.
Speaker 2 (41:02):
I wanted to surprise you, yes.
Speaker 1 (41:04):
A big surprise. Happy Valentine's Stay too, all the listeners
out there, Happy Valentine's Stay. To you as well.
Speaker 2 (41:11):
Thank you Happy Valentine's Stay to you as well. Yes, absolutely,
my number one Valentine.
Speaker 1 (41:16):
And my number one fan over there.
Speaker 2 (41:18):
Seriously, I listened to him every Saturday morning and sometimes, no,
I never sleep and sometimes I'm texting him. Sometimes I
text him answers and opinions and hey, think of this
or think of that. So honestly, I'll listen to you
because I don't get to see that side of you
because I'm your wife, so I don't get to really
(41:40):
see you in that role. So that's what I enjoy.
Speaker 1 (41:45):
Okay, I guess, I guess you can follow me at
the office here, no wonder, you can just follow me around.
Speaker 2 (41:50):
I'm good.
Speaker 1 (41:51):
You have things to do.
Speaker 2 (41:52):
I have lots to do.
Speaker 1 (41:53):
You had some comment on the infections at the nursing homes.
Speaker 2 (41:57):
Yeah, I mean yeah, I feel like at one minute, okay,
I feel like because they they're not walking around, there's
trapped heat. They're laying in the bed. You know, what
do you think about that just trapped heat?
Speaker 1 (42:13):
No, I think that there's a lot of risk factors
for the harboring of bacteria in the bladder as one
gets older. But like I said, it's sort of a
chronic condition, meaning we can give them antibiotics, but as
soon as the antibotics stop, guess what, the bacteria is
going to come back. The body defends itself. Remember we
do have an immune system that defends us.
Speaker 2 (42:33):
And but you have to be careful with over prescribing
antibiotics because of the resistance, no.
Speaker 1 (42:39):
Question, but I'm just saying it's it's hard when you're
interacting with families and they're concerned about certain things and
they want certain things. It's it's tough out there. Sometimes
you have to make some comfromise. Anyway, phone, thank you
for joining for Oinician of the show.
Speaker 2 (42:53):
Eat your vegetables, drink your water, don't drink and drive
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