Promote Your Wellness with Preventive Services

appleheartInsurance companies cover a visit with your healthcare provider—whether it’s with a doctor, physician’s assistant, or nurse practitioner—once a year at no cost to you.

Although there are plenty of negatives to groan about in healthcare these days, this is a win! Doctors worked with legislators and for the past ten years, preventive services have been covered. At the Downtown Doctor, we invite you to take advantage of this. That’s right, you don’t have to be sick or have a medical issue or problem to see us. Bring in your supplements, vitamins, and list of questions. Together we can promote YOUR wellness.

It can get confusing and frustrating, so let me clarify why sometimes this visit incurs a copay/cost. Say you come in for the annual wellness/preventive visit. You and your provider review immunizations, order labs/other tests based on your age/risk factors (colonoscopy/mammogram/other), review medications, supplements, answer general wellness questions—that’s covered!  However, if a medical problem is introduced, assessed, and managed, that’s when you could be billed.  

For example, if you have a sore knee and want the physician to examine it, that isn’t preventative; this is a medical issue which requires assessment and a plan. Insurers use the term “separately identifiable” to describe this kind of problem. Your provider will make a list of future visits to schedule, each one focused on a problem. If patient and provider agree to evaluate and treat a problem on the same day as the preventive visit then there would be a copay/charge. That is because the problem is in addition to the preventive visit.

Clear as mud? We are used to navigating the choppy waters of healthcare so please ASK for clarification.

The Downtown Doctor is accepting new patients and most insurance plans, including Medicare and Tricare. Please call to see if we accept your plan and schedule that annual visit. Together let’s PREVENT a problem!

For women, this visit is in addition to your covered annual gynecological visit which may include a pap smear.

Other covered visits (may vary depending on your plan so, again, please ask your insurance company and us) are for screening of sexually transmitted diseases, evaluation of contraception options, school physical, and work physical.

S.H.I.T. Happens!

Let’s Talk about our Sex Hormones In Transition!  

Screen Shot 2017-02-23 at 5.58.41 PMAs we hit our mental and professional peaks in life, our fabulous bodies that have served us well start to change. Starting in the late 30s and early 40s, both male and female sex hormones will start to decline. This can show up as a multitude of symptoms that we don’t attribute to menopause.  Yes—I said it—the dreaded word, menopause.

And particularly for women, menopause has unfortunately become synonymous with getting old. Know that this is not true; you are still a vibrant woman, whether you’re conquering the world or your child’s homework (both equally important). The transition to officially defined menopause can last from four to eight years. As the hormones change, we start to have symptoms that we may or may not attribute to menopause. The reason we tend to overlook the possibility is because we are still menstruating and we are still young—it couldn’t be menopause!

Perimenopause
-Having your period in the previous three months with no changes in menstrual regularity in the past year.

Early Perimenopause
-Menstrual cycle in previous three months with changes in the regularity in the past year.

Late Perimenopause
-No menstrual cycle in previous three months but having your period in the past eleven months.

The transition through these phases is often and erratic and unpredictable process. This is a result of the hormonal roller coaster of constantly fluctuating sex hormones.

Symptoms of Perimenopause
-Menstrual Changes
-Vasomotor symptoms
-Hot flashes
-Night sweats
-Vaginal dryness, painful intercourse
-Mood alterations
-Infertility
-Declining bone mass
-Increase risk for cardiovascular disease
-Difficulty sleeping
-Urinary incontinence/frequent urination
-Anxiety
-Hair growth on face
-Loss of sexual interest
-Memory lapse
-Weight gain

O.K., so you looked at the symptoms, and you have to admit, this may sound a little like you. What now?

Yes, there is a lot of information floating around out there. And no, you don’t have to tough it out. Everyone’s body and health history is different, so it’s important to talk with your healthcare professional about what options are best-suited for you and your symptoms and for your safety. Here at my practice, Downtown Doctor, we pride ourselves on this kind of care and assessment.

 

Non-Hormonal Options

Mood Changes/Depression/Anxiety: Regular exercise, relaxation techniques, B-Vitamin replacement, or antidepressants.

Urinary Incontinence/Frequent Urination/Bladder Infections: Stay well hydrated, drink plenty of water. Avoid caffeine and foods high in acidic content. Practice your pelvic floor exercises to strengthen the pelvic floor muscles. Explore antimuscarinics (overactive bladder medications) with your healthcare provider.

Night Sweats/Hot Flashes: Dress in thin layers (wicking fabrics), layer bed covers, sip cold water, place ice pack under pillow at night and down at feet.

Trouble Sleeping: Go to sleep and wake up at consistent times (even on weekends), avoid caffeine, avoid blue light before bed (that means turn off the cell phone, iPad, computer), develop a relaxation-promoting bedtime ritual, keep the bedroom for bedroom activities (sleeping and sex only).

Sexual Discomfort/Vaginal Dryness: Use vaginal moisturizers (i.e. Replens,K-Y Long-lasting Vaginal Moisturizer), water-based vaginal lubricants (Astroglide, Moist Again, and Silk-E), and have sex—it promotes vaginal health by promoting blood flow.

 

Now, you tried all of the above and you’re still miserable. What are your options?

Hormone Replacement Therapy (HRT)

HRT is the replacement of the declining female hormones that cause the symptoms of perimenopause, such as hot flashes, night sweats, fatigue, brain fog, vaginal dryness, and the prevention of osteoporosis. The hormones replaced by HRT are typically estrogen, progesterone, and testosterone.

Based on your symptoms and your hormone levels obtained through lab work your medical doctor may recommend you starting either one hormone replacement such as Estrogen or a combination of hormones (estrogen, progesterone & testosterone). These hormones can be taken orally, topically, or by injection.

Progesterone: Helps promote sleep, calming, acts as a natural diuretic, increases one’s metabolic rate and works as an antidepressant. Bio-identical progesterone has been shown to decrease breast cell growth, decrease the bad cholesterol, decrease blood pressure, and decrease the buildup of plaque in your arteries, thus reducing your risk for heart attacks and strokes.

Estrogen Replacement: Helps with vasomotor symptoms of menopause, reduces vaginal dryness and improves skin texture.

Testosterone: Helps increase sexual interest, promotes a sense of emotional well-being, necrosis muscle mass and strength. Improves sagging skin, decreases excess body fat, helps maintain bone strength and reduces brain fog.

 

Synthetic vs Bioidentical

Synthetic hormones are manmade often conjugated equine estrogens, which will breakdown into 45 percent estrone sulfate and 55 percent various equine estrogens. Bioidentical Hormones are derived from plant sources and are modified to replicate the structure of human hormones.  These most closely mimic natural human physiology. Most healthcare providers believe treatment with bioidentical hormones is the safest and some will not even prescribe synthetic hormones to their patients.

Is HRT safe?  
As you might recall around 2002, news spread that HRT caused cancer. This was a result of the Women’s Health Initiative Study that reported an increased risk of breast cancer associated with the use of Premarin and Prempro (both synthetic hormones). No study has associated bioidentical hormone replacement with increased cancer risk. So, as you may suspect, women around the world grew concerned and stopped HRT. The current consensus of the medical community based on evidence is when bioidentical progesterone and/or estrogen were prescribed together the risk for cancer and heart disease was decreased. In general, women can reduce their risk by initiating HRT in perimenopause and early menopause. The risk increases as the time from menopause increases and with increasing age.

Any type of HRT—including birth control pills—has been found to have a slight increase in risk for blood clots, which in turn does increases ones risk for stroke and heart attack.

Is the risk worth the benefits? 
Each individual woman is unique in their own right. For this reason, it is important to visit a healthcare provider such as Downtown Doctor who can evaluate your symptoms, medical history and risk ratio. You and your healthcare provider can then devise an individual approach to treating your symptoms that works for you and your lifestyle.

What should you expect at your appointment?
During your visit, your medical professional should take a complete history including your current symptoms, past medical history, and family medical history. They will examine you and may perform a gynecological exam, pap smear, mammogram, bone density screening and a colonoscopy depending on your age and when your last screening for these things was. Your healthcare provider will also send you for basic lab work and check your hormone levels. Once your screening is completed and you and your medical provider have decided on the type HRT to start, you will follow up with your medical provider regularly to evaluate effectiveness and recheck your hormone levels. We here at Downtown Doctor would love to have the opportunity to discuss this and any of your other medical concerns with you.

Please feel free to visit our website at www.freemanmedicalclinic.com or give us a call at 512-391-9400 to schedule an appointment.

 

BY LEAH C. HUGHES, ACNP—DOWNTOWN DOCTOR

Originally published on Austinfitmagazine.com

Dr. Freeman visits Studio 512: Tips for Making a First Aid Kit

Whether you require an urgent care walk-in visit or you want to schedule an appointment for Botox and fillers, the Downtown Doctor has you and your family covered. They can also make sure we know exactly what our first aid kits need,in case we need to do a little at home mending and medicating. Downtown Doctor is located at 1611 West 5th Street #180, Austin, Texas 78703. They have a Walk-In urgent care and easy free parking. You can call 512-391-9400 to make an appointment or go to FreemanMedicalClinic.com for more information.

Sponsored by Freeman Medical Clinic. Opinions expressed by guests on this program are solely those of the guest(s) and are not endorsed by this television station.

Originally posted by WXAN

Baby, It’s Cold Outside….

sunscreenAlthough the weather is getting (somewhat) cooler, the sun is still shining bright here in Austin. However, even on overcast days, don’t forget about the importance of quality sunscreen during the winter.

Not all sunscreens are created equal:

When we talk about sunscreens, there are 2 main categories to think of – chemical and physical. Chemical sunscreens are found in most makeups, moisturizers, and foundations these days. They work by absorbing or scattering the sun’s rays. These take about 20 minutes to absorb into the skin to be effective and can be made of a number of different chemicals. Physical sunscreens, on the other hand, create a physical barrier on your skin to block the sun’s rays and are effective immediately after application. Physical sunscreens are made of titanium dioxide and zinc oxide. Each one of these ingredients is not completely effective without the other, but together, they give you protection against both UVA and UVB rays from the sun.

What’s the best sunscreen for me?

That’s easy – a physical sunscreen that protects against both UVA and UVB rays from the sun. A GREAT option is SkinCeuticals Sheer Physical UV Defense SPF 50. This sunscreen is great for all skin types, is lightweight, water-resistant, and has a universal tint that works with all skin tones. It provides broad-spectrum protection with transparent titanium dioxide and zinc oxide to help protect you from the sun’s rays that can contribute to premature aging of the skin and skin cancer. This retails for just $34 and is available without appointment from the Downtown Doctor clinic in downtown Austin.

Remember sunscreen is just one component to your daily skincare routine. Don’t forget about your daily moisturizer and antioxidant serums as well!

We want you to look and feel your best all winter long – try it out today! Also makes great gifts!

Do you have time for the flu?

Blowing NoseFlu season is upon us! Check out these flu facts to help keep you and your loved ones well this flu season. If you suspect that you are ill with flu, please call for an appointment at Downtown Doctor, a family medicine clinic in the heart of downtown Austin!

  • The influenza “flu” virus is seasonal. The typical flu season runs from October to May, usually peaking between December and February.
  • Symptoms of the flu may include:
    • Fever, Chills, Body aches, Cough, Runny Nose, Headache, Fatigue, Sore throat  
  • What can I do to help prevent the flu?
    • Flu Vaccine!
    • Wash your hands or use hand sanitizer
    • Cover your cough/sneeze
    • Regularly sanitize countertops, door knobs, and other frequently contacted locations in your home
  • What flu vaccine is available at Austin family practice clinic Downtown Doctor?
    • Quadrivalent (protects for 2 Flu A & 2 Flu B viruses), preservative free
    • High Dose (recommended for age 65+ and those with chronic illness)
    • These are NOT a live vaccines and can NOT make you sick!
  • What to do if you suspect you may have the Flu?
    • Schedule an appointment at Austin family practice clinic Downtown Doctor to be seen for your symptoms, there is a rapid influenza test that can confirm the presence of the influenza virus.
    • Flu virus is treated with symptomatic treatment, fluids, and rest.
    • There are antiviral medications (ex: Tamiflu) available that can help your body fight off the virus but should be started within the first 48 hours of symptoms.
    • Since flu is a virus, antibiotics are NOT helpful

Shout OUT: Georgeanne Freeman

Original article posted on TheAustinChronicle.com and written by Blake McCoy

A photo of Dr. Georgeanne Freeman in the procedure roomName: Dr. Georgeanne Freeman
Status: Austin, TX homegrown (originally from Houston)
ID: Ally
Queerly Quotable: “I tell my patients, you’re like a… little lotus blossom, really. I’m just going to get to watch you do this: [uses hands to imitate a lotus blossom opening].”

Few of us can truly appreciate the painstaking process that is transitioning, aside from the person going through this feat, and, of course, their doctor. Dr. Georgeanne Freeman‘s clinic,Downtown Doctor, offers hormone-replacement therapy to transitioning Austinites. “I feel like I I’m doing my little part,” Dr. Freeman says, recalling the story of how she came to offer bioidentical hormone treatment in her scope of services.

“I was a fourth year medical student, doing my role rotation in Beebe, Arkansas. My friend and [at the time] attending physician is extremely religious. He felt that it was against his religion to do hormones. He had this patient, and said, ‘I can’t see this patient anymore.’ So I went in, did the history – a girl who felt trapped in a boy’s body. The mother was there and was just super clear: ‘This child was never a boy,’ she said. ‘He has boy parts, but this, this is a girl.’ And that was my first… You’re in a room with a family, and this is happening. It had a big impact on me.”

Inside Scoop: Originally from Houston, Freeman spent eight years in the Ozarks where she worked until moving to Austin. She enjoys taking a rejuvenating swim at Barton Springs in her free time and says the weirdest thing she’s ever eaten is deer heart, which might be why she has so much heart.

For more on the Downtown Doctor, follow Dr. Freeman on Facebook or Twitter @DowntownDr.

ACL + Texas = Hydrate! Learning to have fun and be safe all in one!

Austin is known for many things! Unique eats, staying weird and music festivals are among the top attractions! With ACL upon us we wanted to take a minute to remind everyone about Hydration! Being outside for hours in the infamous Texas heat along
with indulging in adult beverages can lead to dehydration. Not something you want to experience! Before your lineup stop in and Hydrate yourself- it will help your body throughout the day and we definitely want you to keep your strength so you don’t miss your favorite performance!

All About Transgender Services

Here at Downtown Doctor, we pride ourselves in treating everyone in our community-and have a zero tolerance policy for discrimination of any kind.

Today we discuss the services we offer our transgender population!

We offer a “full-spectrum of care” for our transitioning patients:

  • full physical exams
  • ordering labs (hormones and basic wellness labs like cholesterol and electrolyte levels)
  • sick visits (*sneeze*)
  • cosmetic procedures (Botox and other cosmetic fillers)
  • consultations (pre-op, hormone discussions/changes, ect.)
  • referrals (plastic surgery, voice therapy, ect.)
  • advice (excellent reads, changing gender marker legally, coming out, ect.)

The question we get most is if we will see a transitioning patient who wants to start hormone therapy.  ABSOLUTELY.  The physicians at Downtown Doctor will want to know if you’re hooked up with a therapist in your transition process, and would like to get a consultation letter from your therapist if you are already seeing one.  If you aren’t with a therapist–that’s okay!  We will still see you in the office-just be aware that the physicians will refer you to a therapist so you can seamlessly continue on your journey.

We hope you’ll come visit the physicians and staff at Downtown Doctor for all your healthcare needs-and know we are here FOR YOU!

 

-KS

 

Are you getting enough Vitamin D?

Are you getting enough vitamin D? The answer is most likely no.  Though studies are still underway to determine optimal blood levels, recommended daily amounts, and the full role it plays in the human body; there is growing data from studies of youth, young adults, and elderly persons that vitamin D is an unrecognized and prevalent health problem. It has been reported that vitamin D deficiency rates are 36% in otherwise healthy young adults and up to 57% in general medicine inpatients in the United States. Rates of inadequate vitamin D are even higher among dark-skinned individuals, those who are overweight or have low HDL (good) cholesterol, and during the winter.

Vitamin D is manufactured by the skin in the presence of sun exposure. Though no one is exactly sure why vitamin D deficiency has become so prevalent, many postulate that it is due to our vigilant use of sunscreen and spending too much time indoors. High rates of obesity likely contribute as well.

Current research indicates that the consequences of vitamin D deficiency go far beyond inadequate bone development and excessive bone loss that can result in fractures. Every tissue in the body, including the brain, heart, muscles and immune system, have receptors for vitamin D, indicating that the nutrient is needed for these tissues to function well.

Studies have found associations between low levels of vitamin D and increased incidence of cardiovascular disease, osteoporosis, autoimmune disorders such as multiple sclerosis and type I diabetes, the common cold and flu, some types of cancers, and low levels of testosterone.

What are the symptoms of vitamin D deficiency?

Fatigue
General muscle pain and weakness
Muscle cramps
Joint pain
Chronic pain
Weight gain
High blood pressure
Restless sleep
Poor concentration
Headaches
Bladder problems
Constipation or diarrhea

Since vitamin D is synthesized by the skin via exposure to sunlight, a brief period of sun exposure (approximately 5-30 minutes depending on skin tone between 10am and 3pm) at least twice weekly is helpful in increasing blood levels. Further, oral supplementation is also prudent. Although the recommended daily allowance for vitamin D is 200-400 international units per day, this doseage may not be effective depending on your individual blood level. At Downtown Doctor, we recommend having your vitamin D level checked to ensure proper supplementation in order to optimize your health and energy levels.

Meet Your Weight Loss Goals in 2013!

At Downtown Doctor, our passion extends beyond healing the sick.  We want to partner with you to reach a state of optimal health and wellness. One component of this is reaching a healthy weight.  The New Year is the perfect time to take action towards this goal, but in order to be successful you need the proper tools.

  • Write your goals down.  Putting a pen to paper sets your goals in motion.  Journals, food diaries, and to-do lists are extremely important to your weight loss plan.
  • Set a definite date.  Mark your calendar for a certain date for each goal that you want to achieve.
  • Remove temptations.  Remove all bad foods from your refrigerator and pantry (this includes cakes, pies, cookies, bread, sugar, sodas, and generally all processed foods and sugars).  Stock up on colorful vegetables, lean meats, poultry, fish (especially salmon, cod, halibut), fruits (primarily berries), and raw nuts such as almonds.
  • Meet mini-goals.  Make small changes every week, and they will add up in time.  This gain in momentum is what personal finance guru Dave Ramsey calls the ‘snowball method’.  After all, it’s easier to move little pebbles than an entire mountain.
  • Bring a friend along for the ride.  Tell your friends and family what you want to accomplish and tell them how they can help you.  Telling someone else your goals holds you more accountable to reaching them.  Who knows, maybe you’ll inspire a friend to make the journey with you.
  • Document everything.  Keep a detailed account of your weight loss, dietary intake and how you’re feeling.  By keeping a record, you will be able to see what you’re consuming, where your problem areas lie, and how your physical and emotional state is doing.
  • Photograph yourself.  Pictures don’t lie, but sometimes scales do.  Even though your scale may read that you’ve gained 2 pounds in the last 3 weeks, this could very well be 3 pounds of lean muscle–a tissue that will not only get you looking toned but will also speed up your metabolic rate and make it easier to shed fat.  By taking photos of yourself, you will be able to reference your physical appearance from week to week.
  • Set realistic goals.  Remember, it took time to gain the weight and it will take time to lose it.  It’s a marathon, not a sprint and this mindset will enable you to create new healthy habits that will last a lifetime.
  • Employ the proper tools.  There are tools available to help you meet your weight loss goals.  Downtown Doctor recommends the dietary supplement Slim as a way to encourage weight loss, increase energy, and better control your appetite and blood chemistry.  Please see below for further information about Slim.

Overview
Slim is a clinically proven dietary supplement formulated to help your body burn fat and support healthy cholesterol levels. Derived from natural ingredients, the proprietary blend in Bios Life Slim is a safe and simple way to encourage weight loss, increase energy, and better control your blood chemistry.

Part of a complete approach to health from the inside out, taking Bios Life Slim twice per day helps control the rate your body absorbs the food you eat. Instead of experiencing an energy rush just after eating, the proprietary fiber blend in Bios Life Slim helps spread that energy across several hours – eliminating the need to snack between meals.

A diet is something you do to your body; Bios Life Slim is something you do with your body. It doesn’t just assist with weight loss; it helps reduce your appetite and decrease leptin resistance, in addition to helping you maintain healthy triglyceride and cholesterol levels.

Many people start seeing results within six weeks, and some start experiencing benefits even sooner. So order Bios Life Slim today and be on your way to improved health.

 

How it Works
At the heart of Bios Life Slim is its proprietary fiber blend. By increasing your fiber intake 10 to 15 minutes before a meal, you help offset what is entering your body.

When you consume food, your body increases its insulin and glucose levels; its goal is to take advantage of all the energy you’re providing. The problem is, you’ll sometimes provide more than your body needs at that moment; that leftover energy is stored as fat.

Bios Life Slim helps in two ways. One, Bios Life Slim will slow the rate of absorption; this is especially significant for high-carbohydrate meals. Carbs are great sources of energy, as long as they’re used relatively quickly. But if they’re not used, these carbs are converted into fat. By slowing the absorption rate, Bios Life Slim helps your body utilize those carbs over a longer period of time – eliminating the need to store them as fat.

The other way Bios Life Slim helps is by creating fat-burning zones between meals. Utilizing the 4-4-12 principle (where you wait at least four hours between breakfast, lunch, and dinner, and 12 hours between dinner and breakfast the next day) it allows your body’s glucose and insulin levels to return to normal. You won’t have to eat between meals because the fiber in Bios Life Slim will be providing ongoing energy form the carbs you’ve already eaten, and if you do need more energy your body will have a reason to burn the fat reserves it already has.

In the end, Bios Life Slim not only helps curb hunger, but it helps your body burn the fat it already has – all without the confusion, hunger, and mediocre results of other weight loss products and programs.

 

Nutritonal Information
For the best results take Bios Life Slim twice daily, 10 to 15 minutes before your largest meals. Mix each packet with eight to ten ounces of water, milk, or juice, or compatible beverage. Mix vigorously and drink immediately. Bios Life Slim may be taken at any time, with or without food.

Ingredients: Biosphere FiberTM (Guar Gum, Gum Arabic, Locust Bean Gum, Citrus Pectin, Oat Fiber, Maltodextrin, Beta Glucan ), Unicity 7xTM (Proprietary blend of plant derived polysaccharides, Orange Juice powder flavor blend, Citric Acid, Calcium Carbonate), Bios Cardio MatrixTM (Phytosterols, Chrysanthemum, Morifolium, Policosanol), Bios Vitamin ComplexTM (Calcium Carbonate, Vitamin C (ascorbic acid), Chromium, Vitamin A (Beta Carotene), Vitamin E (d-alpha-tocopheryl acetate), Niacinamide, Zinc, Vitamin B6 (Pyridoxine Hydrochloride), Vitamin B12 (cyanocobalamin), Vitamin B2 (Riboflavin), Folic Acid, Vitamin B1 (Thiamin HCI), (Biotin), Orange Juice Powder, Citric Acid, Sucralose.

Bios Life Slim is a dietary supplement and a food. Medication that can be taken with food may be taken with this product. This product contains chromium, which can help maintain healthy blood sugar levels. This is a vegetarian product. This is also a natural product; therefore, color may vary from lot to lot and some ingredients may not dissolve as rapidly as other natural ingredients.

Bios Life Slim is derived from natural ingredients. Do not use if contents are damaged and be sure to store in a cool, dry place.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, or prevent any disease.