Those seeking viable  “remedies” to age well by altering consumption of specific foods to increase their antioxidant free radical scavenging capacity (ORAC), are off to a good start. But that is basic old school of antiageing news, especially to those who have been experimenting with the scientific fountain of youthful ageing. The latest meaningful antiageing news addresses the dietary effect of nutrition on your genes. Nutriogenomics.

1) Genomics: The growing field of nutriogenomics entails selectively picking what you eat to turn on the genes expressing the antiageing capabilities of your genetic makeup. Foods grown organically are different. They are natural. Genetically modified organisms (GMO) foods are altered and have not been tested on humans but causes sterility in hamsters. Consider that food labels do not require GMO facts. When you go shopping for food, if it does not say organic or non-gmo on the label, that food may very well be genetically modified.

The latest genetic antiageing product I have located is TA-65, a telemerase activase.  The product is a specific concentrated extract of the astralgus plant. Consider the science of TA-65, to protect and slow the ageing process by selectively decreasing the rate of degradation of the human telomere, the antiageing gene.

2) Ginger:   In Ayurveda, ginger is portrayed as vishwabhesaj, or “universal medicine.” The essential oil of ginger, for example, is a wonderful remedy for headaches and migraines. The Chinese have used it traditionally for male balding and as an aphrodisiac. A recent study describes using the essential oil of ginger as a method for tapering off antidepressant medications. The mechanism of action may be due in part to the serotonin neurotransmitterreceptor strengths of the sesquiterpenes found in oil of ginger.

Carbon dioxide distilled oil of ginger (Zingiber officinale Roscoe, Zingiberaceae) contains potent phytomolecules, as [6]-gingerol and [6]-paradol, which also have antitumor promotional and antiproliferative effects of abnormally dividing cells. Specifically, the transdermal application and nasal inhalation of vapors of 10% CO2 extracted essential oil of ginger Zingiber officinale can be a safe and effective addition to the medical management for the prevention and treatment of complications of nausea and vomiting associated with general anesthesia.

3) Green Tea: The wellness properties provided by the major antioxidative polyphenols and epigallocatechin-gallate (EGCG). The epigallocatechin gallate, a major antioxidative green tea polyphenol, exerts striking inhibitory effects on diverse cellular events associated with multistage carcinogenesis. In addition, these phytomolecules have the ability to suppress proliferation.

4) Ginseng: This all healing panacea, Panax, ginseng is an awesome adaptogen, raising the quality of life by increasing bodily ability to cope with stress. Source of supply of this adaptogen matters because American ginseng is Yin keynoting circulation. Eastern ginseng keynotes Yang effects. Take your Ginseng  in the morning to create a less stressful and energized day.

5) Ginkgo: An is herbal supplement with mixed efficacy findings. Recently, the United States Institute of Medicine has determined a link between Agent Orange and hypertension, and has recommended that the VA cover hypertension as well as the current list of diseases caused by the toxin. The Federal Govt. determines disability through the VA system, using a “means test” for exposure to Agent Orange in Vietnam which has to meet the standard of “at least as likely as not” in order to be considered the cause of physical disability.

This means testing phrase appeals to me but not the FDA, as a means of evaluating experimental studies of supplements. Rather than casting aside many supplements for not providing big pharma designed statistically significant results, perhaps a more reasonable method of analysis could be that supplements, like Ginkgo, are “at least as likely as not” the reason for improved health and ageing benefits.

Your ageing decision tree: you study this Input, you work the Process, you make your Decisions and hopefully your Result in this experiment will be that, over time, you will look and feel younger than your actual age.

Wellness wins over the long haul. AKEA

James Geiger MD
Chief Wellness Officer of oilMD.com
Promoting Wellness through nature since 2004

The Fountain Youthfully Ageing

I got this special alert describing the congressional approach to paying doctors for their work.  Basically, decrease pay by more than 21% and hold those payment  for several weeks to discuss it some more.  Maybe the bill will be repealed.  Maybe not.

Special Alert on Obamacare

Official CMS announcement regarding April claims processing
CMS continues to work with Congress towards possible legislative action to extend the zero percent update for the Medicare Physician Fee Schedule.  The zero percent update expired on March 31, 2010.
We are hopeful that Congress will take action in the next few days.
Until now, CMS has been holding April 2010 date-of-service claims, anticipating congressional action.  But that has not occurred.
Therefore, under current law, Medicare contractors will begin processing claims with dates of service April 1 and later at the negative update rates.  This will begin as soon as systems are fully tested to ensure proper claims payment.  And, Medicare contractors will pay these claims on a first in – first out basis.
If subsequent congressional action extends the zero percent update retroactive to April 1, 2010, Medicare will reprocess those claims at the higher rates.  Claims with submitted charges at or above the higher rates will be able to be automatically reprocessed without further action.
Providers have the option of holding their affected claims until the legislative landscape becomes clearer.
Claims with dates of service prior to April 1, 2010, are not affected and will continue to be processed under normal procedures at the rates in effect on the date of service.

The Centers for Medicare and Medicaid Services (CMS) just released the official announcement (above) regarding the processing of claims in light of Congress’ failure to extend the freeze on Medicare physician payments.
The Senate continues to debate an amended version of H.R. 4851, the Continuing Extension Act of 2010, legislation which would continue the payment freeze at its current level through May 31. Once the Senate completes action on this bill, it will return it to the House for their consideration. Since this version of the extension legislation is different than the version passed by the House on March 17, the House must approve this Senate-passed version before sending it to the president for his signature. Yesterday, the House Rules Committee approved a rule allowing for swift consideration of this amended version of H.R. 4851. The House is expected to act on this legislation this week.

James Geiger MD

As you know, last week, the Senate failed to pass a series of extensions that included a temporary halt to the 21.2 percent cut in Medicare physician payments. As a result, the cut went into effect on March 1st.  It does appear that Congress will extend current rates — hopefully this week — but we expect the extension to only provide temporary relief.  This pattern of short-term patches has created a crisis that will have negative and far-reaching impact on providers, patients and the health care delivery system and violates one of the College’s core principles — access to care, enabled by an adequate surgical workforce. We share your concerns about the long-term viability of your practices and your ability to continue providing quality surgical care to patients.

The American College of Surgeons has always maintained that access to medical care is essential.  We also recognize that the instability and uncertainty of the Medicare payment system will make it impossible for some of our fellows to provide the quality of care that our patients deserve.  With that in mind, we feel it is important we inform Fellows with factual information on your available options as a practicing surgeon.

We hope the information below serves as a useful tool for you and your practice. We urge you to carefully digest and consider the information about the available options and proceed thoughtfully when selecting your Medicare participation status.  In the coming days and weeks, the College is committed to providing all Fellows with the most up-to-date information on Medicare physician payments so that you can make an informed decision about your participation with the Medicare program.

Sincerely,

Brent Eastman MD, FACS, Chair of the ACS Board of Regents
LaMar McGinnis, MD, FACS, President of the American College of Surgeons
Andrew Warshaw, MD, FACS, Chair of the ACS Health Policy and Advocacy Group
Michael Zinner, MD, FACS, Chair of the ACS Board of Governors
David Hoyt, MD, FACS, ACS Executive Director
Christian Shalgian, Director, Division of Advocacy and Health Policy

Medicare Participation Status Information

Physicians have until March 17 to change their Medicare participation or nonparticipation status for this year. Fellows wishing to change their participation status can do so by supplying written notification to their Medicare contractor. The decision will be retroactive to January 1, 2010 and is binding through the calendar year, unless CMS reopens the enrollment period or the physician qualifies for an exception such as relocation to a different geographic area or to a different group practice.

Below is a brief overview of Medicare contractual options available for physicians. The College is not recommending or offering legal advice on any of the three options discussed below and we recommend that Fellows consult with an attorney to ensure full compliance prior to making a status change decision.

There are three Medicare contractual options for physicians: participating (PAR), non-participating (non-PAR) and private contracting.  Physicians considering a change in status should review any current contractual agreements with hospitals, health plans or other entities that require them to be PAR physicians.  In addition, some states have laws prohibiting physicians from balance billing patients.  Please click here for an example of how the Medicare fee schedule breaks down under each option.

Medicare Participating (PAR) Physician

PAR physicians agree to accept assignment on all Medicare claims, which means that they must accept Medicare’s approved amount (80 percent paid by Medicare plus the 20 percent patient copayment), as payment in full for all covered services for the duration of the calendar year. The patient or the patient’s secondary insurer is still responsible for the 20 percent copayment, but the physician cannot bill the patient for amounts in excess of the Medicare allowance. While participating physicians must accept assignment on all Medicare claims, Medicare participation agreements do not require physicians to accept every Medicare patient who seeks treatment from them or their practice.

Medicare Non-Participating (non-PAR) Physician

Physicians may elect to be a non-participating (Non-PAR) physician, which permits them to make assignment decisions on a case-by-case basis and to bill patients for more than the Medicare allowance for unassigned claims.  Non-participating physicians agree to accept 95 percent of the Medicare approved amounts for services provided.  Non-participating physicians may charge more than the Medicare approved amount, but are limited to 115 percent of the Medicare approved amount for non-participating physicians.  Since approved amounts for non-participating physicians are 95 percent of the rates for participating physicians, the 15 percent limiting charge is effectively 9.25 percent above the participating approved amount for services provided

Private Contracting

Physicians may privately contract for health care services, agreeing to bill patients directly and forego any payments from Medicare to their patients or themselves.  However, private contracting decisions may not be made on a patient-by-patient basis. To become a “private contracting physician,” a physician must first opt-out of the Medicare program.  Once a physician has opted out of Medicare, they cannot submit claims to Medicare for services provided to any Medicare patients for a two-year period.  To privately contract with a Medicare beneficiary, a physician must enter into a private contract that meets specific requirements and file an affidavit that also meet certain requirements.  There is a 90-day period after the effective date of the first opt-out affidavit during which physicians may revoke the opt-out and return to Medicare as if they had never opted out of the Medicare program.

Even if a physician has opted out of Medicare, as long as the physician has not been excluded from participation in Medicare by the Office of Counsel to the Inspector General (OIG) based on convictions for program-related fraud and abuse, licensing board actions, or defaults on Health Education Assistance Loans he/she may order, certify the need for, or refer a beneficiary for Medicare-covered items and services, provided the physician is not paid, directly or indirectly, for such services (except for emergency and urgent care services). For example, if a physician who has opted out of Medicare refers a beneficiary for medically necessary services, such as laboratory, DMEPOS or inpatient hospitalization, those services would be covered by Medicare. For more information about exclusions: http://oig.hhs.gov/fraud/exclusions/authorities.asp.

Emergency Services Furnished by a Privately Contracting Physician

Physicians who have opted-out of Medicare under the Medicare private contract provisions may furnish emergency care services or urgent care services to a Medicare beneficiary with whom the physician has previously entered into a private contract so long as the physician and beneficiary entered into the private contract before the onset of the emergency medical condition or urgent medical condition. These services would be furnished under the terms of the private contract.

Physicians who have opted-out of Medicare under the Medicare private contract provisions may continue to furnish emergency or urgent care services to a Medicare beneficiary with whom the physician has not previously entered into a private contract, provided the physician submits a claim to Medicare in accordance with both 42 C.F.R. part 424 (relating to conditions for Medicare payment) and Medicare instructions (including but not limited to complying with proper coding of emergency or urgent care services furnished by physicians and practitioners who have opted-out of Medicare) and collects no more than the Medicare limiting charge, in the case of a physician (or the deductible and coinsurance, in the case of a practitioner). A physician who has been excluded from Medicare must comply with Medicare regulations relating to scope and effect of the exclusion (42 C.F.R. § 1001.1901) when the physician furnishes emergency services to beneficiaries, and the physician may not bill and be paid for urgent care services.

Can aging be slowed down or even reversed? The first decade of the 21st Century has provided insight into the age old search for the fountain of youth. The various schools of thought and practice exploited by longevity experts remain unproven.

Decrease Oxidative Stress to Age Well

Is that all there is to staying young? Chemical stresses due to dietary and environmental factors have negative effects, notably, acceleration of aging (Bonnefoy, 2002). As we age, body tissue, including fat, is oxidized by free radicals, which basically are chemicals with unpaired electrons exerting oxidizing, rustlike damage at the cellular level (Barja, 2004). The aging reaction of the body as a result of these combined negative energies is called “oxidative stress.” Antioxidants protect the over eighty trillion body cells from oxidative stress by scavenging free radicals and binding them to render them harmless.

Supplementing with antioxidants,essential oils,vitamins, specific dietary foods, juice therapy,hormones or extremes of surgical procedures and genetic engineering have all been suggested as the possible tools of aging meaningfully.

The aged population of the notable blue zones of planet earth have been consulted and studied. The centenarians (>100 years of age) prescription for successful aging is based on certain key principles.

What really works?  The centenarians reveal the secret significant adaptations which have  contributed to their process of  growing old gracefully. Their secrets are found in these four powerful and yet simple topics.

• What to do

• What to think

• How to eat

• How to build social relationships

The details of this prescription for successful aging will be one of  the foundational topics of this blog throughout 2010.

James Geiger MD
the oilMD

Ideal Brain Exercise

Although plenty of studies describe the ideal workout, little data defines the ideal workout for the brain. Exercise for many people often stops permanently when it is no longer required as part of physical education class in school, contributing to the obesity epidemic of Americans.  Certainly most people realize that the better quality foods you eat and the more you exercise throughout all the decades of life, the more benefits you will gain from those endeavors. Not just in building muscles but in preventing medical and emotional heart failure and brain failure.

In the previous century, a basic concept of human physiology stated that the brain (i.e., the central nervous system, or CNS), did not regenerate when damaged, destroyed, or lost due to the aging process. Current research has shown that CNS cells can regenerate. Stem cell research using various tissues, like skin cells and umbilical cord blood  is accelerating worldwide. A little known area of research has shown that the smell cells of the nerve sheath of the first cranial nerve for olfaction have totipotent stem cell ability when surgically implanted into the spine.

New research on brain-derived neurotrophic factor (BDNF) shows why physical exercise is important to the brain. Scientists have made powerful observations that new nerve cells can be grown in the human brain simply by putting subjects on a three-month aerobic workout regimen. Exercise treats depression effectively as well. A pill could be developed that simulates the effects of exercise.

Physically and mentally challenging activities are currently approved prescriptions for health and wellness.

Psych yourself up to exercise with scientifically blended essential oils. Aromatherapy is more than just the nose. Topical application of oils is a time honored athletic practice.

Get pumped up with Sports Perfomance Enhancer by the oilMD

James Geiger MD

the oilMD

The AMA has given support to the Affordable Heath Care bill despite the loud protests of many physicians.

AMA conflict of interest is called in question here on several counts.

This conflict if interest is true in part because the billing codes for ALL medical billings are controlled by the AMA which does not include billing codes for the vast majority of complementary/alternative medicine practices. The codes for C.A.M. services  should be incorporated into the US health care system in order to implement the integration of preventative health care practices. Doctors Weil, Oz, Ornish and Hyman testified before the U. S Senate committee on Health and agreed that the US system of health care would be much more effective if preventative measures were implemented as Health Care reform.

I agree.

James Geiger MD

Host Ann Butenas  interviewed  Dr Geiger, a board certified anesthesiologist and clinically certified aromatherapist.

The doctor’s new book The Sweet Smell of Success: Health and Wealth Secrets promotes medical aromatherapy research in the 21st Century

and a whole lot more secrets revealed.

Consider this……..if an anesthesiologist found novel wellness information that was so new and exciting to him,  shouldn’t you think it is worth checking out as well.

Available for interviews in 2010.

Dear Dr. Geiger,

Sincerely,
Brent Eastman, M.D., FACS, Chair of the ACS Board of Regents
LaMar McGinnis, M.D., FACS, President of the American College of Surgeons
Andrew Warshaw, M.D., FACS, Chair of the ACS Health Policy and Advocacy Group
Thomas R. Russell, M.D., FACS, Executive Director of the American College of Surgeons

There is no shortage of emotions when your child is sick. Especially in light of the recent statistics documenting the increased trend in this point of the pandemic of deaths of children from Swine Flu. Although the CDC has verified that the deaths were among children with serious chronic illnesses like diabetes, asthma and immune compromised patients, that is not comforting to parents of well children. Nonetheless, during this H1N1 Swine flu pandemic there are pre-existing conditions which the CDC has identified and publicized which must be considered when making medical care decisions for special groups, such as pregnant women, children and the elderly. These emotions and conditions may generate considerable questions which must be answered by the patient’s parents and doctor prior to initiating any treatment.That process is known as obtaining  informed consent.

A virus does not need consent to infect a child but a doctor must obtain the informed consent of the parent or guardian in order to vaccinate a child or initiate treatment for an infected child.

What constitutes informed consent?

According to the FDA, it is the process of obtaining a patient’s permission for a procedure after the patient and doctor have discussed the risks, benefits, and alternatives of the procedure and the patient understand them.

For example, as an anesthesiologist, the process of obtaining informed consent prior to surgery involves a discussion of both allopathic and integrative medical methods of administering an anesthetic. Intravenous medications such as propofol and inhaled anesthetic gases are administered to keep a patient asleep throughout surgery. A potential anesthetic complication often discussed before surgery is the patient’s fear of having nausea and vomiting while  recovering from anesthesia. I obtain consent to use essential oil of ginger as an integrative medicine technique as well as intravenous medications like ondansetron, to prevent and treat post-op nausea and vomiting (PONV).

The topics surrounding the  Swine flu pandemic are so complex and emotions are so high during this season of national debate on health care reform, that one would be  hard-pressed to say they are truly informed . Especially, when you are in line of people waiting to get immunized by a caregiver at a  minute clinic. Our government has spokespeople saying the flu vaccinations are necessary and safely tested. Some lawgivers have written into law that all health care providers must be vaccinated. There are numerous opponents making claims otherwise.

Say your doctor recommends the live, attenutated virus intranasal vaccine (LAIV),  for your child. Are you one of the 27% of parents who say they will not allow their child to be vaccinated?  Are you informed enough to ask the doctor if the vaccine will harm an unborn child if my child sheds virus for the next 21 days around me? Is the clinic where you are seeking treatment aware that your child has asthma and is therefore not a recommended candidate for FluMist? If your child gets a complications of the vaccine are you aware  that the manufacturer is protected from lawsuits. You can apply for government assistance to cover the added medical expenses if it is determined that the complications are indeed from the vaccine.

What is a person to do? Do your due diligence. Seek help using online digital triage.

Be as informed as you possibly can while adopting safe practices. Besides watching Sesame Street videos with your kids to teach them the proper techniques of sneezing and handwashing, one could adopt natural methods of boosting immunity. Using food as your medicine, consider that mangosteen, acai, garlic, olive, onion, ginger, echinacea, cat’s claw, shiitake & maitake & reishi mushrooms, lomatium dissectum, lemon balm, St John’s wart, vitamin C, vitamin D, zinc and probiotics are known traditional remedies with anti-viral and immune boosting function.

Have you heard of Inhalational Therapy? Then stay tuned. Breathing the vapors of essential oils distilled from plants is wonderful.

Be proactive and stay informed.

The oilMD

James Tad Geiger MD