Renaissance Health News

New Renaissance Health website launched!

We're pleased to announce the launch of our new website. Please have a look around, and let us know what you think!

The Kitty Hawk Project

Watch this space for more information about the exciting launch of the Kitty Hawk Project, working with the most progressive employers and health systems to re-imagine how we deliver care for all.

Spring into Summer of Wellness

We are pleased to introduce our first Spring into Summer Fitness program, which will run for 14 weeks over this spring/summer. Participants are invited to join us for a one hour fitness walk followed by a light supper and lecture series/discussion group. The fitness walk will leave from our office at 61 Massachusetts Avenue where we will return for the post-walk lecture series (starting at 7pm) outlined in the calendar below:

Tue 5/24 -Healthy Eating Patterns
Wed 6/1 -Building Blocks for Weight Loss
Wed 6/8 -Getting Started with Exercise
Tue 6/14 -Low carb vs. Low fat
Wed 6/22 -Book Club: Eat, Drink, and Be Healthy by Walter Willett, MD
Tue 6/28 -Quick Healthy Meals
Wed 7/6 -Ready*Set*Go: A Coach Approach to Health and Fitness
Tue 7/12 -Movie Night: Supersize Me
Tue 7/19 -Book Club: Strong Women Stay Young by Miriam Nelson, PhD
Tue 7/26 -Healthy Eating on a Budget
Tue 8/2 -Learn more about Yoga and Pilates
Wed 8/10 -Vitamins and Supplements
Tue 8/16 -Book Club: Minding the Body, Mending the Mind by Joan Borysenko
Tue 8/23 -Maintaining an active lifestyle

Sat 8/27 -Wrap up event: MassBike Festival Ride to Verrill Farms in Concord

The program is open to all who are interested. It is free to Renaissance Health members. For non members, we charge $10 for an individual session, $100 for the entire series, and $25 for just the book clubs.

Please contact us by phone or email by 3pm the day prior to each session if you are interested in attending. Please also plan to arrive 5-10 minutes early so we can start the walks on time, and wear appropriate clothing (comfortable shoes and loose clothing, and rain gear for inclement weather, and sunscreen and hat for warm sunny days).

To learn more, email us at info@renhealth.net, or call us at 781-643-6080.

Advance Directives

Over the past few weeks the news has been filled with the controversy over Terri Schiavo. Clearly this has been a painful situation for her husband and family and a thought-provoking issue for the entire country. The important lesson to be learned is that this situation is now largely avoidable for those who have planned ahead and prepared the appropriate legal documents.

An advance directive is a legal document that helps to ensure that your health care wishes will be respected if you become unable to speak for yourself. There are two basic types of advance directive: a living will and a health care proxy. A living will documents your personal wishes about end-of-life medical treatment. A health care proxy, or durable power of attorney for healthcare, appoints someone else to speak for you if you are unable to speak for yourself. While these forms may seem redundant, it is useful to have both.

Making decisions about end-of-life care are difficult and can be even more difficult when these decisions are put in the hands of someone else. The Massachusetts Medical Society has created a discussion guide to help patients and their proxies formulate these decisions. The following questions are taken from that guide:

1. What makes life meaningful or good for you now?

2. What, if any, religious or personal beliefs do you have about sickness, health care decision-making or dying?

3. Can you imagine any circumstances in which life would be so unbearable for you that you would not want medical treatments used to keep you alive?

4. If your spokesperson ever had to make a medical decision on your behalf, are there certain people you would want your spokesperson to talk to for advice or support?

5. Is there anyone you specifically would not want involved in helping to make health care decisions on your behalf?

6. Should financial or other family concerns enter into decisions about your medical care?

7. How closely would you want your spokesperson to follow your instructions about care decisions, versus do what they think is best for you at the time decisions are made?

We would recommend a thoughtful consideration of these questions and then discussion with your family and health care agent to ensure that you are all in agreement.

Each state has its own regulations regarding these forms. Massachusetts state approved health care proxy forms can be downloaded for free on their website.

Every person over 18 is entitled to fill out these forms. In the past, the medical establishment only encouraged the elderly or terminally ill to fill out these forms, but we have learned from situations like Terri Schiavo’s that they can be beneficial for everyone. Like a last will and testament, changes can be made to these forms at any time. It is recommended to keep a copy of these forms in a secure, but accessible, location as well as to provide copies to us (your primary doctor), your family and your health care agent. You may also wish to provide a copy to your lawyer.

As always, please let us know if you have any questions or concerns.

Boston Globe Op-ed

The Boston Globe recently published an op-ed piece by Renaissance physician Rushika Fernandopulle about the need for innovation in health care. In it he wrote, "Even though we have made amazing strides in technology (such as new drugs, surgeries, and tests), we deliver this care to patients using a 19th-century delivery model. For instance we put up many barriers to patients communicating with providers; our care is largely reactive and not proactive; we focus too much on treatment and not prevention, and too often fail to use even simple information technology to make care safer and more effective." We hope our practice is a first step to fixing this broken model. To read the entire story, click here

C-Reactive Protein

Many of you may have read reports in the popular press about a new cardiac marker called C-reactive protein (CRP). Two studies published in the New England Journal of Medicine earlier this month showed that lowering the levels of CRP in some patients can reduce their risk of getting heart attacks and of dying of heart disease. These effects seem to be additive to those gained by lowering LDL (the bad sort) of cholesterol.

CRP is a marker of inflammation in the body. It is made in a number of places in the body, including the liver and in the coronary arteries themselves when there is inflammation. It has been known for years that levels of CRP rise when people get heart attacks, and it is postulated that inflammation plays an important role in causing blockages of the coronary arteries.

So should you be tested for CRP, and should you do anything different if it is too high? Like many emerging medical areas, the answers are not entirely clear. The studies published this month only looked at people who already had significant coronary disease and were already on high doses of statins to reduce their cholesterol. It is not clear whether these results will apply to people who are at lower risk. It also must be noted that both teams of researchers who published these studies have received significant funding from drug companies that make drugs that can be used to lower CRP, and that one lead author actually makes money from each CRP test performed.

All that said, the data is suggestive that people with histories of heart disease ought to have their CRP measured and those with high levels, even if they have normal cholesterol numbers, ought to be treated with aggressive statin therapy. A trial is now underway to see if treating low risk patients with normal cholesterol values but high CRP will be of benefit. For the time being we recommend only those at higher risk of coronary disease consider checking and treating a high CRP. As always, if you have any questions, please give us a call or email.

New Year's Resolutions

It's January, the time of year when resolutions are made and, unfortunately, often broken. Perhaps the most common resolutions have to do with leading a healthier lifestyle: losing weight or simply eating healthier, exercising more regularly, quitting smoking, cutting back on alcohol intake, etc. These may also be the most easily broken. One of our goals at Renaissance Health is to help you keep those resolutions and make them a reality. One of the ways in which we plan to do that is by checking in on you throughout the year to ensure that you are making progress with your goals. For now, here are some tips and tricks on successful lifestyle changes:

Set realistic goals. For example, if your goal is weight loss, keep in mind that it is unrealistic to expect to lose more than 1-2 pounds per week. Or if you've been a couch potato, don't resolve to run the Boston Marathon. Start slowly and gradually build up.
Track your progress. If your goal is centered around diet, keep a food diary as well as a weight log. This will allow you to assess where you might be falling short of your goals and enable you to make subtle changes which can lead to success. If your goal is exercise, log how many times a week you did a certain activity, how long you did it for and the intensity at which you were exercising. You should find that with time you can increase the intensity, duration and sometimes even the frequency with which you exercise.
Reward yourself. Set interim goals and when you reach them reward yourself with something you'll enjoy and that will reinforce your progress. For example, a new article of clothing when you reach a certain weight goal, or a massage when you've achieved an exercise goal.
Don't give up. Remember that lifestyle change is difficult. Don't beat yourself up too much for one little slip. Try to get back on track.