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Residents of Idaho seeking a non-hormonal contraceptive option might find the CAYA diaphragm to be an excellent choice. This guide outlines the steps and state-specific requirements to help you obtain the CAYA diaphragm in Idaho.
To get the CAYA diaphragm in Idaho, start by scheduling an appointment with a licensed healthcare provider. Idaho law requires a prescription for the CAYA diaphragm, so you'll need a healthcare professional to assess your suitability for this contraceptive method. During the consultation, your provider will review your health history and explain how the CAYA diaphragm works.
In Idaho, obtaining the CAYA diaphragm requires a prescription. Once your healthcare provider determines that the CAYA diaphragm is suitable for your contraceptive needs, they will issue a prescription. If your usual provider is unfamiliar with the CAYA diaphragm, you may seek out a clinic or provider specializing in non-hormonal contraception within the state.
With your prescription, the next step is finding a pharmacy in Idaho that carries the CAYA diaphragm. Not all pharmacies stock it, so calling ahead or searching online for availability is recommended. You can also opt to order the CAYA diaphragm from an online pharmacy that ships to Idaho.
Idaho health insurance plans, including those under the Affordable Care Act, often cover contraceptive devices like the CAYA diaphragm. Before purchasing, confirm with your insurance provider if the device is covered. If you're uninsured, Idaho's Medicaid program or other state-assisted health plans may cover the CAYA diaphragm.
Using the CAYA diaphragm correctly is essential for its effectiveness. Your Idaho healthcare provider should offer you detailed instructions on how to use the CAYA diaphragm, and online resources are available to help ensure proper usage for maximum contraceptive benefits.
My Virtual Physician offers telehealth appointments for patients interested in the CAYA diaphragm. Schedule your appointment with us today! BOOK HERE
The Covid-19 pandemic and technological advancement in healthcare delivery have introduced telemedicine in prenatal care. It might seem that telemedicine is here to stay and in a few years, will become a major approach in delivering health care to pregnant women.
With telemedicine, expecting mothers receive consistent and necessary care via videoconferencing, at-home monitoring, and consultation with remote specialists. These were said to improve health outcomes while allowing for less frequent antenatal visits.
However, certain challenges may affect the use and outcome of telemedicine to provide care to patients. Below are perceived barriers to telemedicine in prenatal care.
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Several factors affect the use and health outcomes of telemedicine. Patients and healthcare providers alike play a significant role in the provision and delivery. However, other non-human factors exist which may affect the successful outcome of virtual visits and at-home monitoring.
The following are perceived barriers to telemedicine in prenatal care:
Poor internet connection and slow speed result in loss of connection, poor audio and video quality, hence affecting the smooth interaction between patients and providers. Due to poor signal, online consultations can experience multiple interruptions leading to frustration, low patient satisfaction, and reduced use of the virtual approach to healthcare delivery.
In some cases, factors such as weather conditions, living in rural areas, and home interior can affect the network service in homes and workplaces, hence reducing the frequency, duration, and efficiency of virtual visits for healthcare delivery.
Lack of technological knowledge and skills is a challenge to the use and success of telemedicine in prenatal care. Unfamiliarity with communication technology is common to both patients and providers.
Healthcare providers who have little to no knowledge on how to use communication technology may not want to take up online consultations.
Likewise, patients may find it difficult to install and navigate the telemedicine software on their digital devices. In other cases, patients lack knowledge and training on how to use certain monitoring devices. Hence, they may find it difficult or impossible to interact and provide adequate information during online consultations.
The lack of certain equipment and instruments poses a challenge to the success of telemedicine in prenatal care. Some patients may not have certain instruments such as a fetoscope, weighing scale, sphygmomanometer, amongst others, resulting in non-availability of data to work with.
Consequently, this can lead to poor monitoring which may affect health outcomes of prenatal care via telemedicine.
While patients may enjoy convenience at home, they may be faced with discussing health concerns at the risk of being heard by family members and friends.
In-person visits provide the privacy of the doctor's office which may not be possible with audio and video calls from the homes of patients. This may affect the use of telemedicine in providing and accessing prenatal care.
In other cases, the patient may feel their conversations are being recorded and hence, lose trust in both the service and the healthcare provider.
Telemedicine switches up the order of the conventional hospital visit. The presence of family members, children, colleagues, and other persons may make engagement difficult. Activities in the background may cause distraction during virtual visits.
On the other hand, certain patients may feel disconnected due to a lack of social presence and physical contact with their healthcare provider. The online interaction may be alien to some patients and affect their ability to bond with their healthcare provider.
Nonverbal communication is as effective as verbal communication and in some cases, more. Virtual visits limit communication with body language and facial expressions. Healthcare providers can read these cues during in-person visits and act accordingly.
While telemedicine might be said to save cost, it does not come cheap. Patients may lack the financial ability to buy smartphones, airtime and data, and instruments and equipment.
Unfortunately, patients may not have insurance, or their insurance companies may not cover telemedicine healthcare services.
Healthcare providers are not left out as they also need airtime and data to call and interact with patients.
Telemedicine is a novel approach to access and delivery of prenatal care. Like the conventional in-person approach of care, it has its pros and cons.
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At My Virtual Physician, our team is committed to ensuring that patients get the best of health care as needed. We provide virtual care at any point in your pregnancy while you await your appointment with your local OB doctor. We are in network with many insurance health plans including Medicaid, Medicare, United HealthCare, and Blue Cross.
Every woman desires to have a healthy pregnancy and birth without complications. Prenatal care helps improve an expecting mother's chances of a healthy pregnancy and birth. In prenatal care, a pregnant woman visits a health care provider at intervals to assess and monitor her health and that of the growing baby.
Prenatal care, also known as antenatal care, is the health care a woman receives during pregnancy. Accessed by 4 million women every year, prenatal care is one of the most common preventive health services in the United States.
Prenatal care involves regular checkups with your healthcare provider and routine testing to ensure you are healthy throughout your pregnancy and have a complication-free birth and a healthy baby. During these appointments with your healthcare provider, you get to ask questions and report any complaints you may have. A doctor, nurse, or midwife provides answers to these questions, advice, and possible treatments for whatever complaint you report.
Appointments during prenatal care depend on the age of your pregnancy and your risk for complications.
Telemedicine is simply the use of technology to access and provide health care remotely. The Covid-19 pandemic made healthcare less accessible and unsafe for both healthcare providers and patients. However, with telemedicine, pregnant women and their families could access healthcare without being physically present. Information such as readings and test results could be exchanged via videoconferencing, voice calls, text messaging, and other formats on mobile devices and computers.
Hence, telemedicine has made healthcare more accessible, cost-effective, and convenient with patients receiving care from the comfort of their homes. Consequently, telemedicine has reduced the number of ER visits and the workload at hospitals.
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Although telemedicine is not new to the healthcare system, its use in prenatal care is low. In prenatal care, telemedicine provides an avenue for pregnant women to keep appointments and receive care via apps and other software on digital devices. These apps provide opportunities for home monitoring of vital signs including temperature and blood pressure, fetal heart rate, blood sugar, and weight amongst others. Besides having routine appointments with their general physician, pregnant women can book consultation sessions with specialists such as Obstetricians, Psychiatrists, Genetic Counselors, and Lactation Consultants.
With telemedicine, you can have your appointment from the comfort of your home. The physicians at My Virtual Physician are there when you have concerns, issues, and questions that do not require hands-on physical examination. Hence, we supplement the care you will receive from your local Obstetrician.
You can book an appointment or call for an appointment with our Obstetric and Gynecology specialists. To book your appointment, we will collect some data such as your name, address, and date of birth. You will be asked to specify the reason for your visit, your preferred day of the week, and your preferred time frame.
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During the video call, we will collect confidential medical, obstetric, and gynecology history. Privacy is very important and we adhere to all ethical rules binding that. We will ask you to agree or "consent" to the terms and conditions of the telemedicine visit.
During the video visit, we will ask you for other data such as vital signs including weight, temperature, and blood pressure. We will ask about medications you're using, allergies, diet and food cravings, complaints, and other important information. The data collected inform what action of care will be provided.
A visit to us helps you get your prenatal care started while you await your appointment with your local OB doctor. Your virtual physician can help to electronically order prenatal care labs and/or send an order to the nearest radiology facility for you to get an ultrasound.
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At My Virtual Physician, we are available to help guide you through your pregnancy and answer any questions that may arise. We are in network with many insurance health plans including Medicaid, Medicare, United HealthCare and Blue Cross.
This past year tested many young businesses. Telemedicine is not new. But the My Virtual Physician (MVP) business model is. The virtual doctor practice offers the best in online doctor services as a direct-to-consumer multi-specialty provider licensed in multiple states. Regardless of 2020's challenges, the MVP virtual doctor team didn't slow down. They focused on their path to becoming the #1 online doctor and forged ahead.
Over the last 12 months, MVP worked hard to bring high-quality medical care into homes in 15 states. They now offer online pediatric, gynecologic, and primary healthcare services for patients of all ages. Plus, they provide same-day scheduling for online physician appointments, some in-network insurance benefits, and five-star customer service.
As the #1 online healthcare provider, MVP doctors get to know their patients. Quality care is emphasized, and they aim to provide the best patient satisfaction in telemedicine. Here’s what patients are saying about MVP's online doctors:
“I would give My Virtual Physician more stars if I could”
“Dr. Howard has the best personality and is very friendly.”
“The future of medical visits; what better way to social distance.”
“A+ would recommend to everyone.”
Since their launch, MVP has opened new offices and added service lines such as nutrition and diabetic care. The practice has partnered with more online doctors and added office staff. Just this Spring, MVP enhanced their patient portal for self-scheduling, and integrated a program to trend patient reviews.
This one year anniversary milestone is cause for celebration. It is exciting, and this is only the beginning. Despite any challenges that lie ahead for this medical practice, their progress shows that the future is very bright for My Virtual Physician.
Congratulations to Dr. Howard, Dr. Masghati, Dr. Ayyagari, and all of the My Virtual Physician Staff.
Stefanie:
Welcome, everyone! Thank you for joining us today.
My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states.
It is Talk Tuesday and we are back with our weekly educational series, talking with our experts, exploring some common healthcare concerns that we see, and hopefully answering some questions you may have.
Today our physician expert is Dr. Daniel Kessler, Primary Care Physician, and one of our telemedicine providers. We are talking about a topic affecting one in ten Americans, Diabetes.
Dr. Kessler, thank you for joining us today.
Stefanie:
Let’s start by talking about Diabetes statistics. According to the American Diabetes Association, in 2018, 10.5% of Americans were estimated to have diabetes and about one-fifth of those were undiagnosed. Those are pretty significant numbers. Should people be concerned about diabetes?
Dr. Daniel Kessler:
Well that depends. We know about risk factors that can increase the likelihood of getting Type II diabetes. The CDC says you’re at risk for developing type 2 diabetes if you:
If you have non-alcoholic fatty liver disease you may also be at risk for type 2 diabetes.
So for individuals with risk factors, there should be some concern or at least awareness.
Stefanie:
So let’s talk about early detection. Why is it important? Why is early detection key in diabetes?
Dr. Kessler:
Early detection is key in diabetes because early treatment can prevent or at least slow serious complications. When a problem with blood sugar is found, doctors and patients can take effective steps to prevent irreparable damage to the heart, kidneys, eyes, nerves, blood vessels, and other organs.
An article in the Current Opinion in Endocrinology, Diabetes and Obesity journal recognized that there are many reasons why earlier detection of diabetes could be of benefit to the individual and the healthcare system, because it creates the opportunity to treat the high blood sugar.
Furthermore, undiagnosed diabetes is often associated with potentially-preventable, costly complications. ER visits and hospital stays can be expensive!
The base estimated cost of living with diabetes is around $9,600 per year. This includes prescription medications, diabetic testing supplies, doctors appointments, and routine care. This cost will be higher for uncontrolled or unmanaged diabetics who more care, more medications, more doctors appointments. Early detection can save thousands of dollars.
Stefanie:
So Dr. Kessler, for our listeners who may not be familiar with diabetes, can you tell us what a diagnosis of diabetes means? What is diabetes?
Dr. Kessler:
Sure, Diabetes is a metabolic disorder in which your body is not able to efficiently turn the food you eat into energy, leaving sugar to build up in the bloodstream. This creates two problems: the cells are not getting the sugar energy they need, and the sugar is accumulating in the blood. High blood sugar, known as hyperglycemia, causes damage to many tissues and organs of the body. This is why diabetes is a serious condition that can be dangerous.
Normally when you eat, your body breaks food down into glucose. As your blood glucose level rises, the pancreas releases insulin. Insulin is a hormone that tells body cells to let the glucose inside.
In diabetes, either your pancreas does not make insulin correctly, or your body cells do not react to the insulin the way they should. This means that the glucose stays in the blood, which is why diabetics experience high blood sugar, also known as hyperglycemia. Over time, hyperglycemia can damage nerves and blood vessels.
Stefanie:
I understand. And how do doctors know that the pancreas is not making insulin right or the body cells not reacting to the insulin?
Dr. Kessler:
Well, a blood test can determine if a person has diabetes. There are two tests commonly used.
A glycated hemoglobin test, known as a hemoglobin A1c (HbA1c) test, measures the glycated form of hemoglobin to determine the three month average of blood sugar. This blood test takes about a minute to perform, and results are generally available in two to three days. A normal HbA1c is below 5.7%. Prediabetes is 5.7 to 6.4%. A result of 6.5% or more is classified as diabetic. Another test doctors use to detect diabetes is a fasting blood glucose, or fasting blood sugar (FBS), test. This blood test measures the basal (base) sugar levels of the blood. Testing is usually performed in the morning after the patient has had nothing to eat or drink for eight hours or more. This test may take around ten minutes and results can be immediately available. A normal FBS is 70-100 mg/dl (3.9 - 5.6 mmol/L). An abnormal fasting blood sugar test may be repeated by the doctor or additional tests may be performed for confirmation of the abnormal blood sugar reading.
Stefanie:
And what these tests find, high blood sugar, can it go away? Can diabetes go away, or can early diabetes be cured?
Dr. Kessler:
Diabetes is a chronic condition which means it may not go away. It is possible, however, to reverse some of the effects of diabetes, and to even go into a remission state for those with Type II Diabetes. Remission in diabetes means that your blood sugar levels are within the normal range and you have not required medication to manage your blood sugar for six months or more.
Lifestyle changes like a healthy diet, daily exercise, and weight management can improve the way your body uses insulin, and can improve the prognosis for someone diagnosed with diabetes.
Stefanie:
Thank you Dr. Kessler, you have definitely helped me to understand diabetes better and how important it is for individuals to know their risk and talk to their physician to prevent problems and even get diagnosed and treated early!I appreciate you joining us for Talk Tuesday and telling us what we need to know about early detection in diabetes. For everyone else joining us as well, this has been Talk Tuesday with MyVirtualPhysician. If you would like to talk with one of our board-certified physicians about diabetic screening or your risk, you can check out our website at www.myvirtualphysician.com. We look forward to talking with you again, and we hope you have a great week.
It affects up to one in five adults, and it is a common ailment diagnosed by primary care physicians and specialists. Moreover, it can be a real pain in the neck, or chest rather. I'm talking about gastroesophageal reflux. This big word does not have to be a big deal. Simple lifestyle changes and, in some cases, medication can treat it. So just what is gastroesophageal reflux?
Gastroesophageal reflux is the backflow of acid and other contents from your stomach into the tube the connects the stomach to your mouth, called the esophagus. This reflux can occur naturally on occasion, but when it happens frequently, it can cause problems.
When the backwash of acid and undigested food particles flows back out of the stomach, it can damage the lining of the esophagus. You see, the stomach has a protective lining inside that protects the underlying tissues from the strong stomach acid and other substances that you may eat. Unfortunately, the esophagus does not have that same protection. The harsh back-flow can eat away the esophagus' smooth muscle tissue.
There is a valve at the bottom of your esophagus where it connects to the stomach. It is called the lower esophageal sphincter, or LES. This LES closes after food enters the stomach to prevent it from coming back up. Additionally, your diaphragm is a muscle above the stomach that also helps to support the valve. Sometimes the sphincter relaxes, and stomach contents can escape.
Normal reflux can occur after meals and does not last long. This event rarely occurs when lying down or during sleep.
Abnormal reflux lasts longer and causes troublesome symptoms. Many report feeling discomfort at night when they lay down, rather than just after meals. Chronic reflux causes damage to the digestive system tissues.
If you suspect that you have abnormal reflux or gastroesophageal reflux disease, read on to learn what you can do about it and where to find a quiz to see if you might have reflux.
Gastroesophageal reflux disease (GERD) is caused by the reflux of stomach acid and contents into the esophagus. This condition is related to several factors:
Proton pumps in the stomach wall create enzymes which make stomach acid to break down the food we eat. When they overproduce, reflux is more likely to occur. Coffee is known to increase stomach acid production. Stress also increases stomach acid production. Therefore these can be risk factors for GERD.
The lower esophageal sphincter (LES) closes off the bottom of the esophagus to prevent back-splash. When the muscle tone is relaxed, then the door is not fully closed, and juices can seep back out of the stomach. Smoking and drinking alcohol and caffeinated beverages both contribute to decreased LES tone. These are also risk factors for GERD.
Furthermore, chocolate and mint are known to relax the lower esophageal sphincter.
Moreover, pregnant women have increased progesterone levels. This hormone affects the LES as well.
Two factors that cause increased intra-abdominal pressure are obesity and pregnancy. These both put pressure on the abdominal organs and can lead to gastroesophageal reflux.
An article published in the Gastroenterology Clinics of North America found that obesity, defined as a BMI > 30, was a significant risk factor for reflux and esophagitis (inflammation of the esophagus). The study showed that over one-fourth of participants had weekly reflux symptoms.
A recent study on GERD in pregnancy showed that over 50% of women report reflux symptoms while they are expecting. This can be related to hormonal changes in pregnancy slow digestion and delay stomach emptying.
Reflux can be aggravating and cause symptoms such as:
Less likely but possible signs and symptoms include:
Knowing what we know about reflux and how it happens, there are some simple lifestyle changes you can make if you are suffering from GERD signs and symptoms.
Choose small proportions. Avoid high-fat meals because the fats require the stomach to produce more acid and take longer to digest. Spicy foods (like tomatoes and oranges) can also aggravate reflux.
Maintain a healthy weight.
Sleep habits: Firstly, also avoid eating within three hours of bedtime. Do not lie down after eating. Give your body time to digest the meal.
It can also be helpful to raise your head while resting to let gravity keep the stomach contents down. You can use extra pillows or even raise the head of your bed six to eight inches with bed risers or blocks.
Avoid toxins that could be aggravating your digestion, such as nicotine, alcohol, or excessive caffeine]
Over the counter proton pump inhibitors (PPIs) decrease stomach acid production and may provide some relief. Available options include:
Warning: Do not take these for more than 14 days without talking to your doctor.
There are some urgent signs and symptoms that warrant immediate medical attention. You should call your doctor or seek urgent care for these:
Less serious signs and symptoms that could be related to reflux but should be checked out by a doctor include:
Now that you know what is gastroesophageal reflux, you can make an informed decision about when it is time to talk to your doctor. If you would like to see if you might be suffering from GERD, take this online quiz by the American College of Gastroenterology.
If you still have questions or you would like to discuss your problem with a top-rated doctor, click to schedule an appointment. My Virtual Physician treats conditions, including heartburn, upset stomach, and more. And if you have any suggestions for additional topics that you want to read about, please let us know! And don’t forget to check out our podcasts for more! Share and follow us on social media.
Chang, P., & Friedenberg, F. (2014). Obesity and GERD. Gastroenterology clinics of North America, 43(1), 161–173. https://doi.org/10.1016/j.gtc.2013.11.009
Ramya, R. S., Jayanthi, N., Alexander, P. C., Vijaya, S., & Jayanthi, V. (2014). Gastroesophageal reflux disease in pregnancy: a longitudinal study. Tropical gastroenterology: official journal of the Digestive Diseases Foundation, 35(3), 168–172.
You’ve heard it said "the only thing constant is change.”
Healthcare is no different. Similarly, it continues to evolve as time goes on. Telemedicine is a great example. Patients now have convenient access to doctors and specialists in the privacy, safety, and comfort of their homes. Another example is the field of integrative holistic medicine. You might be asking, just what is integrative medicine? And how is it a change for the better?
Integrative holistic medicine, or just integrative medicine (IM), is a specialized approach that looks at the whole person. It is a different way to treat what ails us. This medical subspecialty takes into account the "whole body" and the many influences that affect a person's health. For example, these can include physical, mental, social, and spiritual factors.
This movement in healthcare combines conventional schools of mainstream medicine with alternative medicine. That is to say, it focuses on a holistic view of the patient which makes care personalized. Doctors in IM choose therapies that work best for each person and can be linked to better outcomes. Here are some basic principles of IM that they follow.
The doctor-patient relationship is collaborative. In other words, the two partners work together to achieve an outcome. Practitioners spend time with the patient to get to know about them. IM doctors may ask questions to learn more about the origin of symptoms. Likewise, they will explore the background behind the illness or injury.
This practice of spending more time to understand the root problem is helpful. Firstly, patients are empowered by information. Secondly, understanding the "why" behind their problems gives them hope.
Patients are considered more than just human bodies. Similarly, wellness and illness are more than the physical functions of the body.
Symptoms can be complex. For instance, they can involve physical, social, psychological, and spiritual manifestations. IM takes into account the whole body, mind, spirit, and community. Providers do this by working to understand how a person’s experiences may have caused illness. They are able to devise an effective treatment plan as a result. Importantly, they seek to treat the person and not just the illness.
Also, lifestyle and stress play a huge role in illness, health, and healing. Integrative holistic doctors understand this relationship and try to help patients manage their stress.
In the IM field, doctors seek the most natural path. This is to say that they prefer minimally invasive treatment. In IM, traditional western care is blended with more eastern philosophies to treat and manage a variety of conditions. For example, non-invasive therapies that may be recommended include yoga, meditation, and herbs.
The goal of integrative care is optimal wellness for the client. Prevention is key. This means that there is an emphasis on health, rather than on the illness.
The IM field focuses on what works for the patient. For example, care may include an evaluation of genetic factors that could be contributing to the current health status. The provider and patient then work together to sort out what might be causing illness. Providers try to figure out where the patient is coming from. With this more patient-centered approach, patients are often motivated to make changes and work towards the goals they set.
There are many benefits to choosing a provider with integrative holistic medicine expertise.
Studies show patients working with IM providers report improved mental and emotional wellbeing. This could be related to symptom relief and improved disease management that are reported also.2
IM treatment involves a customized regimen tailored to the individual. The doctor spends time getting to know the patient, and he or she feels more valued. A study on IM in pain management found that an individualized, relationship-centered approach, meeting the patients where they are, can help determine which modalities may be used synergistically3, optimizing the outcomes.
The IM field continues to evolve. Therefore, there are more clinical trials and research studies going on to examine some of the non-traditional approaches. You can trust that there will be good evidence-based study behind the treatment plan you are participating in.
Patients have more options working with an integrative holistic care provider. This is because non-traditional therapies give doctors and patients more tools to work with. By using treatments such as massage, biofeedback, or sound therapy, patients have access to more choices in their treatment.
In conclusion, this valuable care model has many benefits for patients. The integrative holistic medicine approach is a change in how some doctors are addressing patient care.
Highly personalized treatment and a focus on prevention are beneficial to patients. Additionally, the use of minimally invasive and natural therapies makes this field stand out from more traditional approaches.
IM does not exclude traditional methods, however. Think of it as an "add-on" to increase the success of treatment and increase benefits. Get away from the adage "a pill for the ill." Replace it with "medicate and meditate."
As times change and healthcare evolves, doctors must continue to meet the demands of today's patients. The future of medicine must recognize the complexity of the social, physical, developmental, and genetic influences on health and disease.1
Dr. Daniel Kessler of MyVirtualPhysician is double board-certified in Family Medicine and Integrative Holistic Medicine and holds full certifications in Functional Medicine. Dr. Kessler and other doctors are available for consultation. MyVirtualPhysician treats conditions including allergies, earaches, cold and flu symptoms, and more. If you want to schedule an appointment with our integrative holistic care practitioner at MyVirtualPhysician, you can click the buttons below to book an appointment. If you have any suggestions for additional topics you want to read about please let us know! Don’t forget to follow us on social media.
