Health Matters is a weekly radio show by the Medicine Center Pharmacy on WHBC 1480 AM in Canton, Ohio. This episode pharmacists Brad White and Paul White discuss Health Insurance mysteries and how to save money on healthcare expenses with Rick Pipes of Pipes Insurance in New Philadelphia, Ohio.

You can find all our Health Matters Podcasts here: iTunes Google Play Stitcher

A recent study showed that only 4% of Americans understand the key terms that are necessary to understand their health insurance. The four key terms identified to understand your health insurance policy are:

1. The deductible

2. The copayment

3. Coinsurance

4. Maximum out of pocket

Understanding these terms unlocks the mysteries of your health insurance and they are the key to reducing your out of pocket expenses and saving money. This morning, we're going to talk with Rick about saving, money reducing out of pocket medical expenses, and using our health insurance wisely. We'd like to remind our listeners that you can subscribe to you podcast on your smartphone. Just look for health matters with the Medicine Center pharmacy in the app store and you can take any of our programs with you anytime. If you have any questions like addressed today, you can post them up on our live Facebook feed. [00:43]

What is copayment?

On a traditional Preferred Provider Organization plan, which is a PPO, all those components exist. Most the time the people don't see their deductible, we'll talk about that in a second. They have what are called copays. Copays are literally just a flat small dollar amount that they pay for certain types of procedures; for example, you go to your general practitioner, you just pay on average $25 to $60, depending upon the type of provider that it is. They don't see their deductible, it helps with their cash flow. So they're not having that larger expense, as well with prescriptions as you well know, there's tiers of copays that exists, whether it be generic type drugs, name brand type drugs, non formulary, these range anywhere from $10 up to $300, depending upon the type of prescription. There's copays for urgent care visits, those are the non-emergency room, private facilities typically that range at about a $50 to $75 copay. And then, of course, emergency rooms if you have to go typically do have a copay as well. They're getting higher and higher because the cost of the emergency room averaging about $150 to $300 as a copay. [02:25]

What is a deductible?

Now, so when do we see our deductible? What is a deductible? Your deductible is basically for the larger expenses. Typically, we're talking outpatient services, inpatient services, diagnostic testing, perhaps even durable medical equipment. At that time you have an amount of money that you spend before the insurance starts to pay from January to January that doesn't include those copays. The range is that your deductible, ranges from $500 all the way up to larger deductibles of $5,000. And that's how much you spend before the insurance pays. [03:37]

What is coinsurance & MOOP?

After your deductible, at that point you share with the insurance company the cost, i.e., the coinsurance you're speaking of. You've probably heard of “80-20”. 80-20 means that I will pay 20% of the bills after my deductible, the insurance company will pay 80% of the bills after my deductible. This will continue on and on until you hit your annual maximum out of pocket. In our business we call it “the moop”. Sometimes employees like that term better than moop. But when you hit that the plan will pay 100% of the cost. So, if you're paying your 20% after deductible, that will go to a certain point. The highest that the government allow us to have, if you're using network doctors and hospitals, is $8,150 for one person, and double that for family, as a deductible as a maximum out of pocket, deductibles would be lower than that. [04:10]

What is Consumer Driven Health Care?

Well, it started in 2004. Basically, what happened is the republicans at that time under President George Bush thought that their answer to health care would be, “You know what? Let's make people better consumers.” If you have a $25 copay, as we mentioned, or a prescription copay of $10, you don't know that that cost of service or that cost for prescription may be $80, or maybe $150, or frankly, could be $400. We don't know. So, what they did is they created some vehicles and tools in the health care that allow the consumer to see those costs with a higher deductible and then have those copays so that they can make better decisions as consumers; thus, consumer driven health care. When you shop for a vehicle, when you shop for anything, you compare, you don't go out and buy. The expensive Porsche we just spoke about, you do some comparative shopping and that was the purpose behind consumer driven health care. [06:52]

HDP vs HSA vs HRA

I just mentioned in 2004 that is when consumer driven health care, that is when HSA’s came out and what they are, is: first of all, you have to have a High Deductible health Plan (HDP) that qualifies by the IRS to have a Health Savings Account. The deductible, the richest HSA or Health Savings Account plan you can have with the High Deductible health Plan starts at $1,400 for single and $2,800 for family, that would be the absolute richest, most of them are much higher. At that point in time on these plans, other than preventative care, because that's always covered 100%, you are not allowed to have those first dollar benefits as copays. So, everything's under your deductible. But what you do get is you get to open up this account at a bank that is specifically for Health Savings Account money, that is guided and monitored by the IRS. Now, the employer or the employee, or both can now put money into this account, completely tax free. They use this money then to pay their higher deductible, as well as the IRS let’s them to use this money for other items such as dental and vision, long term care premium, LASIK eye surgery, orthodontia, I got $9,000 in my boy’s teeth. So, all these things qualify from your account but what really makes them unique is: I tell people, this is kind of your healthcare retirement, because this money; you can put $3,550 in a single or $7,100 a family, more than your deductible at times, and then it carries year after year and the interest is tax free as well. So, hopefully I'm accumulating money so that when I retire, I can use this money towards other health care expenses at age 65 I could take it out and pay taxes but most of the time we'll just spend it down. Now, in contrast to that, so, I mentioned the High Deductible health Plan and the HSA. [08:14]

Health Reimbursement Account (HRA)

The difference between that is: that is employer money, that when you show those same types of expenses that qualify by the IRS, the employer can reimburse you for them. But if you don't use those expenses, the employer retains the money. So, it's only spent if you have those expenses where the Health Savings Account, once it's in their account, they personally own it just like they own their 401k, and you can't take it away from them. [10:09]

Having HSA and HRA both at the same time

Well, actually, you could have them both, but you have to start with the HSA and the minimum levels of deductibles, then you could have an HRA on the backside of that. [10:44]

Why care about cost when I have insurance? 

One of the things I hear all the time is these insurance companies are making all kinds of money. The reality is under the Affordable Health Care Act, they limited how much an insurance company can retain. Anywhere from 15 to 20% after claims paid, they actually have to return it, if they collect too much. So, it is not necessarily the insurance companies and I know I will get looked at unfavorably for that because people want to blame them. But the costs keep rising, and so when the costs rise, what happens to you as an employer who's offering health insurance is: a great portion of your increases relative to your claims specifically as to your group's health conditions. Average renewals are anywhere between 10% and 20%. Most employers can't afford that type of increase, especially when they can't increase their goods and services by the same amount. Therefore, they have two options:

1. They either increase what the employees are paying from their paycheck to accommodate the premium increase, or

2. They adjust their plans so that there's higher deductibles, higher maximum out of pockets and hit the employees who are using the plan.

For these reasons, I feel that the employees need to be as engaged as the employer and it is a team approach. It's not one of the others, not the employees against the employer. I've worked very hard at trying to get within the employee population and educate them with certain seminars and tools that will probably talk about today. So, that they help make good decisions, realizing they are part of how that renewals going to look and what their contributions are going to be next year. [14:42]

How can I save money on medical costs? 

Well, you need to question things, you know, it's not natural for us to ask our doctor a lot of questions. They're in a hurry, sometimes they obviously are working on their flow of patients, but we have to stop and start asking questions, including of our physician. So, find a doctor that is willing to talk to you. If they're ordering a slew of tests, ask about those tests as to the cost of those tests. For example, I heard a statistic a long time ago that a PET scan is within 5% of what maybe an MRI could show you versus maybe 85% of what an X-ray could show you, and they're not all created equally, but sometimes the X-ray may present the right solution before the MRI or before the pet and the cost difference is anywhere from $185 up to $3,000 up to $6,000. So, again, education, not questioning our doctor per se, but working with them on solutions and uncovering all of the answers that you need to listen to. [17:56]

What are the tools that can help save medical costs?

Well, right now insurance companies have been becoming pretty creative to help their constituents save on costs. So, for example, there's not a carrier out there right now that if you go to their online site, doesn't matter if it's Blue Cross Blue Shield, Medical Mutual, AultCare, any of the carriers, they have a cost comparison system. So, if I'm getting a knee surgery done, I can say, “Listen, I'm getting the knee surgery, here's my doctor,” but they can work out of several hospitals. I put those hospitals in. I put the procedure in, and they'll literally tell me what the cost of that is, at each one. Now, more importantly, they also have quality ratings. I don't necessarily want to go have a colonoscopy, but I want to go to somebody that actually has a good success rate and a good cost. So, that gives me that information as well. In addition, one of the newest things too, that insurance companies are providing is “telemedicine”. This is not in lieu of your general practitioner. I don't wish to offend any of my doctor friends, but it is in addition, it's something that they can access quickly. I mean, literally within 10 to 20 minutes a licensed physician will typically call them. They're trained in telemedicine, and if we're talking rashes, light colds, allergies, things that are minor, they can treat you telephonically over Skype, over FaceTime, and then through that they could call a prescription into the Medicine Center Pharmacy, you can fill that within a relatively quick period of time, and that person's up and running and never left their home in a short period of time. The cost of that literally is $45 to $49 if you were to build the entire cost. So, it's very affordable and they'll communicate to your general practitioner, so they have that information on your health history. [19:59]

Again, I don't want to replace the general practitioner, but at times we can't get to see them in a timely manner. So, telemedicine can help with that and it depends on the severity, but for sure on sinus infections, light colds, allergies, rashes, those things that you probably know the answer to in advance but maybe also need a prescription the remedy. [21:52]

Cost difference between Teladoc, Statcare, and emergency rooms

Definitely pricing is the first issue but, obviously, severity of the medical needs at hand, dictates where we go as well. So, we talk about Teladoc a little bit; for sure, the quickest; for sure, the most economical $45 to $49 as mentioned, but they can't do everything. They're not going to be able to take an X-ray, do stitches, take your blood pressure. [26:31]

There's packages now tied to Teladoc, within school systems they has a nurse practitioner with a station to telephonically electronically sending the information to the doc for diagnostics. So, it does exist. [27:07]

So, let's say my son's played soccer, both of them had injuries in soccer; you don't know if it’s a break, if it's a sprain, if it's that type of thing. Well, you can't do an X-ray over Teladoc. So, that is a perfect example of when an urgent care would come in handy. That's not the emergency room. It's usually a privately owned urgent care. At that time you go there's a physician on hand if the hours are appropriate, and they can do an X-ray. Cost of this is on average between $300 to $600 depending on how much the imaging is on the total visit. And again, closer to the $300, depending upon if they are doing imaging or not. But you get in, it's not as crowded. You get there quickly. It's a lower costs than going to the emergency room. [27:30]

When do I go to an  emergency room?

Oddly enough, emergencies are coded from 1-2-3-4. 1 and 2, you never need to go to emergency rooms, so those are the people that probably shouldn't be there. 3 and 4, you should. So, based on symptoms, which could be life threatening, and that's diagnostic symptoms, that's not actually what's happening, chest pains, those types of things, then you should go to the emergency room, that's what they're for and they do it well. Just realize, if it's non-emergent, you will be in that waiting room for a long time with a lot of other sick people. On average, if you're there for 4 hours, which is not that long emergency room, the costs going to be about $1,200. So, again, I wouldn't know why people would want to be there if it's not emergent, and now there's a lot of options that they can go to besides the emergency room. [28:15]

How can I save money at the pharmacy? 

I truly tell every associate and I do group meetings and have done group meetings for thousands of employees to form a relationship with their local pharmacy and specifically, I do say the Medicine Center. I encourage them to first thing go to you or somebody like you, make sure that they are giving that prescription regimen to that pharmacist and doing a few things. I've seen way overprescribing from different physicians, there's no continuity. You guys can say that this works with this. This doesn't work with this. You talk to their doctor on their behalf, make sure that they're not getting overprescribed and things are working together. Just as important the cost of those drugs as we mentioned, they may be on the newest name brand drug, they cost 10 times as much as the laboratory that's been out forever and has a low cost. You can help them with those decisions. And as important over the counter medication, they now are coming in either or which over the counter prescriptions may save their money, easier access to, on your shelves, already flu shots, which you can do in house, all these things lined itself and you work with their doctor. So, often I tell people, you want to keep the relationship with your doctor, but sometimes you need to let your pharmacist work with your doctor on your behalf to help you to keep you healthy and to help you save on costs. [32:23]

Preferred Pharmacy

I obviously have a passion for health care what I do, and part of why I have such a passion is I always want to pull back the curtain and see what the wizard’s got going on back there. And one of the biggest mysteries and non-disclosed is what we call the PBM’s, the Pharmacy Benefit Managers that are basically the conduit between the pharmacy companies and the insurance companies and yourself. So, what they do, the big boys, is that pricing on that drug may not necessarily be at a lower cost to that insurance company that they're calling a specialty, but on the back end, that overpricing of that prescription, they give out and hand out what's called “rebates”. That rebate may go to or for sure goes to the PBM, the Pharmacy Benefit Manager. Sometimes goes back to large employers, and most of time is shared with the insurance company that's telling you to go to that specialty prescription program. So, if that drug internally is more expensive, even though they're paying a lower copay, they may hit that doughnut hole that they would not hit normally in a quicker fashion, and then they have this large cost to them on a drug that they thought they're saving money. [37:09]

What Medicare plan should I pick?

Every Medicare Part-D plan has its own list of prescriptions that may or may not accommodate the patients you're working for. So, I guess my advice would be, first of all, that person work with you in conjunction with a consultant that's independent. We do have two in our office, and I say independent not working directly for the advantage plan, but they have two choices:

1. They can get a Medicare Advantage plan, or

2. Medicare supplement plan.

They have six months from the time they turn 65 to do that, without any issues, after that they have that open enrollment period that they have to go to, in order to get on board. There's a slew of options, and unfortunately, that population sometimes just get overwhelmed and does not want to make a decision that may be best. So, I say, seek trusted advisors yourself, along with somebody that understands the plan side, understands their health needs. So, they're not just looking at price, but they're looking at coverage, because coverages are not all built equally. Advantage plans are managed care, and they do have gaps and holes that may not accommodate that patient. So, you want somebody that understands that language to work in conjunction on their situation. [43:32]

The medicare supplement, when you're talking A through F, they're identical, just different carriers. But when you talk about advantage plans, managed care, they go from no premium, because they're paying part of your part B but those are really scaled back coverages, to a lot higher premium for better coverages, and those are the ones with the open enrollment on an annual basis. [45:07]

How Pipes can help?

We've been there since 1974. There's over 20 Associates working for Pipes insurance service and map investments. We do all types of insurance investment products. Of course, I do focus on the employee benefits, but that's one division. We also do commercial property and casualty insurance. We also do individual property and casualty, your home, your auto. We've talked about senior products, we have specialists in that. Individual health insurance, and again, we have another company called map investments that can help with investments, as well as life, annuity, disability, those types of things. [46:03]

We're located on West High Avenue in New Philadelphia. Our phone number is 1-888-328-8958. Our website is simple, it's pipesins.com, and if you want to email me with questions or if you have any thoughts that you'd like to talk about, it's rick@pipesins.com. [46:47]

Summary 

Since most people are insured through their employer, don't look at your employer as the enemy. Where I’ve seen success, and I've literally seen a lowering in claims year to year, is on those cultures that take time to happen. Where the employees are working with the employer. They're creating plan designs that cater to good consumerism, consumer driven health care. They're giving them tools to stay healthy. In some cases, they're even getting the medical care, but they're working together. There's benchmarks in place. They all realize they're in this problem that health care inflation is a national problem, it is not the employer problem, and what can they do as a subculture to control those costs and work together. [47:28]

This episode is sponsored by Mercy Medical Center and Studio Arts and Glass.

Introduction

We've had a lot of questions about CBD in the pharmacy and as you drive around town and see signs everywhere from on telephone poles to gas stations and video stores. It's kind of make you wonder, “Okay, what's the deal with CBD?”. So, we're going to talk about CBD this morning and we're going to talk about what kind of product it really is, what you should be looking for and why it's important to find a source that's of high quality to get benefits for the body that you want. So, just as a reminder, you can subscribe to our podcast; you go to your smartphones app and you can look for our podcast Health Matters with the Medical Center Pharmacy. Please subscribe to us and we'd love to have you join us each week. [00:41

What is CBD oil?

CBD is Cannabidiol. It's a non-intoxicating cannabinoid found in cannabis. It has many potential therapeutic benefits including anti-anxiety, anti-inflammatory and anti-seizure suppression properties. It comes from a plant it called hemp, and it does not have psychoactive properties, which means CBD is not the same thing as medical marijuana. So, CBD has a profile cannabinoids in it that can help support the body's endocannabinoid system, but medical marijuana actually has high THC levels which is the psychoactive product which can get you high or hallucinogenic effects. So, they are two separate products even though they come from a very similar plant. [01:27]

Why does CBD belong in a pharmacy?

CBD currently is not recognized as a medical treatment or a drug. The FDA allows it to be sold in the US. It's basically sold as a dietary supplement but there are many therapeutic benefits which make it really belong in a pharmacy as far as I'm concerned, and the reason I feel it belongs in a pharmacy is because there are a number of different drug interactions that are possible. [03:48]

Uses of CBD

There are some studies and research that shows there's possibility that CBD could be supportive of anti-inflammatory processes and anti-anxiety effects. [04:25]

How does it work?

We have a series of receptors in our body that are part of what we call the endocannabinoid system, and when CBD stimulates these receptors, there is a potential for modulation of inflammation and pain, and also anti-anxiety properties based on how it affects your neurotransmitters; dopamine and glutamate releases. [04:45]

There's significant study that's been done on marijuana in proper for years back into the 60s and 70s, and one of the things that has been discovered are the CB1 and CB2 receptors, where both THC, and now CBD have influence on. And I'd like to give the analogy at the seminars that I've been giving in the last six months that a receptor in the body is kind of like a keyhole, and drugs or prescription drugs often affect receptors. And so in this case, CBD is a supplement or a natural product that has a key like shape that when you put it next to this lock, which is the receptor, it doesn't necessarily perfectly unlock the lock, but everybody probably has a key at home that's really worn down and you can kind of stick it in a lock it doesn't belong in and jiggle it and you sometimes can open that lock. [05:54]

Well, CBD and THC both have effects on receptors and as a result, they get a response in the body and that's where we believe that some of these anti-inflammatory and possibly anti-anxiety effects can happen. [06:52]

What is endocannabinoid system?

We have this whole system in our body, you're familiar with the respiratory system, or your digestive system, or your cardiovascular system. Well, we have what we call an endocannabinoid system, and it's this giant system of receptors in our body that can be stimulated by CBD, and also by medical marijuana or THC. [07:27]

What types of CBD are there?

There are a number of different forms. There are tinctures which are like an oil product where you'd administer it in a dropper under the tongue. There are capsules which you'd swallow orally, and there's topicals, creams, salves, lotions, ointments, and there's even inhaled smoke products which I can't get real excited about given some of the dangers we've learned about vaping lately, but there are inhaled products out there too. So, those are some of the forms and they can be used for different reasons. [09:47]

Other Keynotes

●      Brad explained full spectrum, isolate, and broad spectrum CBD. [16:05]

●      Discussion on dosages of different types of CBD. [17:54]

●      CBD for pets and it helps with anxiety in pets. [26:17]

Upcoming Seminars for LDN and CBD Oil

We've had some really exciting seminars over the last six months, and the next one is coming up on February 6th, at 6:30pm. It's at the Hampton Inn meeting room in New Philadelphia, Ohio at 1299 West High Avenue. It's right off the interstate there at 77 and West High in New Philadelphia, and we've been talking about Low-Dose Naltrexone and CBD products. So, if you want a more in-depth see discussion, we're going to talk more on that Thursday evening in February about that. But Low-Dose Naltrexone is an interesting product because it also has uses that complement CBD in a fashion where they could even be used together. Low-Dose Naltrexone actually is an immune system modulator, and it helps with autoimmune conditions through a couple different mechanisms in the body and helps modulate the immune system, and it also helps reduce inflammation. To learn more about LDN benefits join us on February 6th or check out additional resources on our site.[34:30]

Flu and Shingles Vaccine

Well, I'm looking at the CDC’s season week one ending map on their website, and their week one ended on January 4th and this is the 17th. So, the data is a little bit behind, and almost the whole country is red for high flow activity except for little Ohio and Illinois. Ohio is on the minimal side, and Illinois is on the low side. So, it's there, it won't be long for us. There's a couple ways, if you haven't gotten a flu shot yet, get it today, I mean, today, because it's going to take a week or two to build up and you're running out of time. We have flu shots available, walk into any pharmacy and we'll fix you up. On the flip side, we do have the ability to give you flu or strep tests. [40:59]

So, don't be afraid to think of the Medicine Center if you need a strep test or a flu test, and, of course, if you don't test positive, that's great, but we can maybe recommend some over the counter medications for you to help you deal with those symptoms you're suffering with. [42:47]

Shingles is probably one of the biggest questions I get from patients that come in the pharmacy. There have been enough TV ads and enough stories from family members, loved ones or friends that people have shared some pretty frustrating experiences about having Shingles and people don't want it, and I don't blame them. Numerous vaccine came out a few years ago called Shingrix and it has extremely high effectiveness and activity for duration of use, and as a result, the demand has been so high, it's been very difficult for us to keep up pace. [43:18]

Medication Compliance with Easy Dose Packs

So, it's slick because one of our most popular requests in the pharmacy is, “How can you help me figure out how to keep my medication organized?” and when you start to take two and three and four medications a day, and you got to take one in the morning, and one at noon, and one at 4pm, and one at bed time. It gets to be a lot, we're all busy, we're all trying to keep track of things. So, the neat thing about these is it's nice little strip pack and they're customized by dose. So, if you're going to go off to work, you can take off Friday's pack and it might have your morning dose, and lunch dose, and afternoon dose. You don't have to take all your bottles with you to work, it's no sweat. So, it can be really flexible. We have patients that are in assisted living facilities or senior living that use these in own residence. We have truck drivers that drive across the country and they take their seven day strip pack and take it with them. They like it because it's easy, it's labeled and it's totally functional. So, it's something that we can even deliver to your home if you live in the community. So, if you're not able to get out, our home delivery service is available. [46:30]

●      Summarization by Brad [48:35]

This episode is sponsored by Mercy Medical Center and Studio Arts and Glass.

Cardiothoracic surgery, also known as thoracic surgery, is the field of medicine involved in surgical treatment of organs inside the thorax.  The thorax is what we refer to as our chest.  Generally, this would include treatment of conditions of the heart and lungs.  This episode we will talk with Dr. D’Agostino about heart and lung surgery as well as screenings.

You can find all our Health Matters Podcasts here: iTunes Google Play Stitcher

According to the latest polling data available, 45% of Americans resolved to lose more weight and get in shape in the New Year.  For those of you in that 45% or considering weight loss we want to share information with you today about the Mercy Weight Management Open House on Monday, January 13 from 3:30 PM to 6:00PM.  This week’s podcast we will learn more about the open house and the program Mercy offers.

With Mercy Medical Center’s experienced weight-loss physicians and registered dietitians, you can choose from three medically safe options that will be customized for your health needs and goals. Each program includes weekly support, accountability, lifestyle education, exercise guidance, and maintenance programs to help you break negative eating patterns, lose weight safely and effectively, and keep it off!

This podcast has a special guest with an inspiring success story.

You can find all our Health Matters Podcasts here: iTunes Google Play Stitcher

Today we will talk again with our friends from the Great Start for Great Futures Coalition about each of our roles in helping the children of Stark County realize their potential for a Great Future. Don’t miss Part 1, Part 2, and Part 3 here.

You can find all our Health Matters Podcasts here: iTunes Google Play Stitcher

This installment Jen Griffing and Krista Allison discuss how critical it is for all of us to work together to nurture children in the 2000 days they have before they go to kindergarten.

What is Your Role at Home and in the Community?

It is important for families to understand they have what it takes to be their child’s first and most important teacher.

As a community, understanding that to build strong literacy skills we all need to begin modeling behavior that can nurture our youth. There are a number of ways that you can contribute to the success of children around you by initiating responsive interactions.

Here are 5 elements of responsive interactions:

1. Tuning-In : Tuning in is paying attention to every attempt a child makes to communicate. Eye contact is critical as is waiting and acknowledging sounds, coos and babbles as a young child’s means of communicating along with recognizing how children are moving, responding if they seem unsettled and ensuring they can rest, eat or play in a comfortable way. An ongoing lack of tuning in has been shown to cause a disruption in the developing architecture of a child’s brain. Children CRAVE these positive, responsive interactions and truthfully they are essential for ALL healthy human relationships.

2. Facial Expressions : Using your face to express yourself is another great way to build a relationship and in addition helps children learn what a word means. They will soon learn whether a word is positive or negative, what communicates an emotion or indicates a place or time of day. This all comes together later as children understand the words you are using and can take ownership of those words as their own. A great resource to illustrate how critical facial expressions are to young children is the Still Face Experiment , which you can find online.

3. Touch: Touch is another great way to communicate responsively. Pairing a light touch with talking increases learning as it stimulates multiple pathways in a growing brain to support stronger connections.

4. Gestures: Using gestures, along with words, also helps children understand the meanings of words. In the everyday this might look like, up, under, so big, bye-bye and blowing a kiss.

5. Child-directed Speech: This is the loving, sing-song, high-pitched joyful voice that children love to hear! In child directed speech, you stretch out words and repeat sounds so children start to recognize different sounds and hear the rhythm of language. It's important to note that in this case, we aren’t referring to baby talk, but rather the

What is the State of Ohio Doing?

The state of Ohio has what’s called the Third Grade Reading Guarantee (TGRG). Ohio's Third Grade Reading Guarantee is a program to identify students from kindergarten through grade 3 that are behind in reading. Schools provide help and support to make sure students are on track for reading success by the end of third grade. The point of the guarantee is to ensure a solid literacy foundation is established for each child by the end of the third grade and in many respects become an additional influence in closing the achievement gap.

While we know that there are potentially additional opportunity gaps that may exist to hinder a child’s learning progression, reading closing the reading gap is critical to a child’s life long success because children who start off behind; stay behind. Unfortunately, this trajectory can lead to dropping out of school (signs that are evidenced in the 6th or 9th grade).

What Resources are Available Locally in Stark County?

There is a strong family and community partnership element and that’s where Talk First Stark really comes in to provide support and include all of the adults who impact all of our children.

We believe that awareness + advocacy= advantage.

Awareness, which means not only being aware that we must make an early investment in our youngest citizens AND

we need to Advocate, meaning using our knowledge to act intentionally on their behalf so that they will have every advantage and opportunity afforded to them to create a positive trajectory for success. Which is back to the heart of our coalition, Great Start for Great Futures.

If you are a caregiver or community member and you are interested in learning more or having us come to your location for an awareness or advocacy training, Please visit the Stark Education Partnership’s website and look for the Early Childhood drop down icon for contact information for scheduling a Talk First Stark session.

Talk First Stark is about leveraging the power of language to ensure that all families and community members have the tools they need to nourish the growing brains of our children. We know that whatever your role is, you are a powerful partner in impacting the life of a child. It starts with you. It continues with us.

“We work collaboratively with multiple stakeholders engaging and collaborating with education, business, civic and community stakeholders to drive sustainable improvement and innovation from our youngest citizens to our college and career-minded young adults to ensure life-long success”

— -Krista Allison, Stark Education Partnership

A plastic surgery practice specializes in treatments for skin malignancies, breast cancer and complex wound reconstruction, as well as non-surgical and surgical cosmetic procedures.  We will talk with Dr. Khan about the procedures offered at Aultman Medical Group as well as advancements and new techniques in the field.

Dr Khan covers questions about reconstructive surgery from injury, trauma, as well as cosmetic procedures. Patient safety is also a concern and patients should seek out trained professionals for Botox and filler procedures. Enjoy this week’s show!

The human brain grows and develops at its greatest rate at the beginning of life, which is why ensuring proper nutrition is key. However, it can be challenging for growing children and adolescents to meet their nutrient needs. The truth is, lack of nutrition during the developing stages of life can have profound effects on growth and the structural development of the brain.

DHA, one type of omega-3 fatty acid, is necessary for healthy brain function as it is a principal structural component for proper brain function and development.

This essential fatty acid is found at high levels in a limited number of foods such as fatty fish and marine algae, which many children do not regularly consume. Supplementing with an omega-3 fatty acid that is DHA dominant can ensure children are getting the necessary fats they need for healthy brains.

Health Matters is a weekly radio show sponsored by the Medicine Center Pharmacy on WHBC 1480 AM in Canton, Ohio. This episode pharmacists Brad White and Paul White discuss Omega 3 supplementation and Brain Health with Bryce Wylde, functional medicine expert.

Introduction

The brain is made up of specialized cells called neurons. You've got 86 billion of them. They work together to process and transmit electrical and chemical messages that enable you to function. Their magic lies in their ability to help connect each other to form neural networks; just like people do to form social networks. If you'd like to, please subscribe to our podcast; you can search for Health Matters with the Medicine Center in your favorite podcast app and take our show with us wherever you go each week. If you have questions you'd like to post up today, post them up to our live Facebook feed. [00:55].

Below are experts from this podcast episode:

Bryce Wylde is an alternative medicine expert, clinician, television host, educator, author and philanthropist.   

Dietary Sources of Omega 3 Fatty Acids

So, first of all, if you'll let me indulge the backdrop, people are really confused, I believe, about even what Omega 3’s are? Where they come from? It's well talked about, it's one of the most researched evidence-based ingredients; actually, second only to aspirin. In the world, over 21,000 human clinical trials and publications have been made for Omega 3’s, but as it released the supplements market -- First of all, there's all types of sources in our diet. So, this is the stuff that can come from:

1. Nuts

2. Seeds

3. Plants, like Echium and Ecchi flower; those are actual ingredients and supplements on the market as well

4. Seaweed

5. Algae, we use that at Brain Armor

6. Algo, and we'll perhaps talk about all the reasons why we source vegan

7. Fish, of course, is some of the highest levels

8. Grass fed beef

But, by and large, when people think Omega3’s, they think about fish boil. But, in this day and age, the bottom line with our SAD diet (Standard American Diet). We simply aren't achieving a high enough amount of these Omega 3’s. So, there's all sorts of Omega 3’s available in the supplement market, which include:

1. Flax

2. Fish

3. There's a lot of vegan sources

4. Algal sources

5. There's even plant and seed sources called Echium and Ecchi flower; that sounds like sushi, it’s not. Ecchi flower is simply a weed, Boraginaceae is the Latin name.

So, you can get Omega 3’s from all kinds of sources; however, and this is something I hope it will clarify today, there's really only one best source, and that is, in fact, as it turns out: Algal. It's very, very sustainable and it's very, very useful for the body in the format that it's already in as it pertains to the most bioavailable or readily available to the body. [04:34]

Functions of Omega 3 in Maintaining Health 

So, Omega 3’s are, otherwise, also considered essential fatty acids. That's because specifically they are essential to get from our diet, our body can't make it on its own. So, it turns out that, based in genetics, some of us are actually better than others, but at the end of the day we don't really make enough of a particular essential fatty acid known as DHA as well as EPA by simply consuming what we get in our diet. In fact, consuming more Omega 3 had a huge consequence in the evolution of the size and the function of our brain. This is only about 50,000 years ago where we actually began to cook to use fire, allowing us to digest outside of our body and allowing us to do a lot more than just forage all day, hours of the day. So, growing this bigger brain was actually less of a liability, but simultaneously, this is where it's really interesting. There's a mutation in a gene called FADS2, and this gene encodes for a really crucial enzyme that's necessary to convert Omega 3’s in the body. This enzyme is called Alpha60 saturates. It's critical for brain function. However, it still doesn't do a good enough job on its own drawing from nuts and seeds. We really have to eat quite a lot of fish to get the optimal levels of these Omega 3 essential fatty acids. In this day and age, again, that SAD diet that we're consuming, we are way over consuming grain, and proinflammatory foods, refined carbohydrates, and we refer to this as the starch and the sugars, cakes, cookies, muffins, overconsumption of bread etc. That's shoving us over toward an Omega6 saturation in our systems, and that's actually proinflammatory, where the Omega 3s EPA and DHA are anti-inflammatory. So, our body doesn't make omega threes effectively. However, about 50,000 years ago, we did have this gene mutation in our population which allowed us to do a little bit better a job, and in this day and age, we kind of reverted back to a situation where we, not only don't get enough in our diet, but we over consume something competitive to the benefit of Omega 3, and that's the Omega6. So, actually, historically, evolutionarily we used to be more of a 1:1 ratio of Omega 3 to Omega 6, and this day, we're 26:1 Omega 6 to Omega 3, pushing ourselves into, what we affectionately refer to as proinflammatory. Inflammation is a medical buzz term of the day for a good reason, it really is what causes at the molecular level all disease is inflammation. [06:38]

Types of Omega 3 Fatty Acids

The we really should pay attention to are about four. It's a biochemical cascade essentially stepwise in all the cells of our body that we take an Omega 3 called ALA (Alpha Linoleic Acid). ALA, then in the body turns into SDA (Stearidonic Acid), and then that turns into EPA, and then eventually EPA turns into DHA. Once again, though the body doesn't do a great job, it does a little bit of this converting, women actually do a little bit better than us for that matter, but ALA into SDA into EPA to DHA. Those are four essential omega three fatty acids. DHA, ultimately think of that as brain juice, that is the most important brain Omega 3 essential fatty acid. [09:54]

DHA, Brain Juice, and it’s importance

So, DHA downstream, it’s just alluded to the furthest downstream, the closest axonal gases. This is the most important brain nutrients scientists have discovered, literally. It fuels the cells, so, think of the cells of our body, red blood cells are the most sort of commonly thought of illustrations we've gotten our head, as the cylindrical sort of half circular cells with a membrane around them to keep inside things like iron, oxygen carrying capacity, hemoglobin, etc. So, all the cells of your body, whether it's a red blood cells, skin cells, or even a neuron in the brain have a membrane, and that membrane is there purposely to allow things in and outside of the cell. The membrane is made up of fats, phospholipids, they're called, and they've got a hydrophilic and hydrophobic and one side doesn't like water, one side likes water, and that's how the cell ultimately keeps integrity. Ourselves really require a high percentage and particular neurons, brain active thinking cells require quite a high percentage of DHA and Omega 3 fatty acid as well as EPA known to sort of quell and manage inflammation, but DHA and that integrity, high percentage of DHA in the brain, we refer to it effectively as “brain juice”, is going to allow neurons to connect and communicate with each other better. We're fatheads, our brains are made of 60% or more fat and the most important fat is that DHA. [15:37]

Brain Armor and Algae Based Omega 3

So, the differentiator is that most importantly work derived from algae, not fish or algal oil. Here's the key to understand: fish do not enhance EPA and DHA, they ingest this from algae to begin with. So, what they do is bioaccumulate it, so this is part of their food chain. They consume the algae and then they saturate their bodies, their meat, with EPA and DHA, and what we know is to get the purest, the most potent form of EPA and DHA, we can actually simply go straight to the source by bypassing further processing that fish undergo. We can acquire these healthy fatty acids from the same natural route that fish do, right from algae and processes in very controlled environments. When it comes to fish, we're a little concerned this day and age with bioaccumulation of other things like dioxins, and heavy metals, these are all quite toxic. So, that requires a purification process when it comes to fish before their oils can be sold. Often, this process involves so much converting and reconverting of their oils that we're concerned about things like rancidity, not even to mention sustainability. So, here's the other important thing is that during the fermentation process that our product goes our algae, algal cells are only fed pure nutrients of certified quality. So, our Omega3’s come from these microalgae fermenters, imagine these massive fermenters that look like what you find in the beer industry, and they rely on this pure, these natural ingredients, so that the finished product is 100% free of toxins, unlike the fish oil industry. All components that we're using, this is in the mix, it's very simple, they need a little bit of energy, a little bit of food, and some care and they just blast out all kinds of DHA and EPA. We know that basically everything that goes into the algae, so that we can be very confident about everything that comes out. So, essentially, brain armor is all of that it's pure, it's sustainable, because that's important, we have to consider sustainability we're not raking the ocean floor for these algae because that's also an unsustainable process. Vegan and keto friendly at the same time. It's all GMP (Good Manufacturing Practices), credibly evidence-based ingredients. This is a DSM ingredient with many, many hundreds of human clinical trials, and then we have a very clean label. So, another differentiator is there's no sugar, obviously no gluten, artificial flavors, artificial sweeteners, very clean label. So, that would be ultimately how we differ. We're also NSF and NSF certification in particular for sport is very important because this means that it's actually safe for athletes who are constantly tested for any impurities or sport enhancers, they can feel comfortable taking this product as well. [17:31]

Benefits of EPA DHA Supplementation

I think what we have to do is, first visit what is cognitive ability and certainly it's not just your IQ ranking, or your recall ability, for that matter I’ve recently in been interviewing, what are known as memory champions, memory athletes didn't even know until recently these guys existed, but they have legitimate games in which they are challenging their brains on a regular basis and train their brains, for that matter, to become the best at recall, but it's simply not cognitive abilities, not just recall, it's not just IQ. It's a whole bunch of other things. So, what is it? And what do we do to improve it? So, first of all, neurogenesis. Neurogenesis is the generation of new neurons in various brain regions. Neuroplasticity is our ability to have a plastic or malleable brain and that is to say, nerve connections are constantly being made and they're constantly being paired back, learning things, unlearning things, and then to increase neurotrophins; these are a type of hormone found in our brain that increases neurogenesis and neuroplasticity. So, ultimately, what we want with a healthy diet and lifestyle is we want to boost all of these factors and the good news is that we can. So, I'm always telling things like consuming more healthy spices, mustard, for example, a teaspoon of that every day, curcumin, these have ingredients in them that boost neurotrophic activity. Lots of green tea, I'm drinking some right now, with EGCG, very potent antioxidants. We know about cardiovascular exercise, we're meant as humans to push, pull, jump, squat, lift. These are things we don't do enough of, that’s one of those important things to boost brain activity and cognitive ability. I'm a huge advocate of taking contrast showers that's turning the dial really hot, almost to feverish point; you don't want to burn yourself, of course. And then spend a minute on the opposite end of the dial, freezing cold. You do that back and forth for a bit that's actually going to boost these neurotrophins, which is going to boost neurogenesis and boost neuroplasticity. So, all kinds of things, we talk about sleep hygiene; keeping a really dark cool room, turns out that that is key for glymphatic. So, we know about lymphatics; draining toxins out of our system in the periphery, but there's no lymph in your brain. They're called glimp or glial cells; these are the non-thinking neurons that help to clean up the mess. They only really work at night, in deep sleep, when it's cool and dark, and getting that, not just ours clock on the pillow, but deep restful sleep. [31:49]

But, probably the most important thing, is when we come full circle, is supplementing with DHA and EPA. So, DHA has been known to boost certain neurotrophins, to boost neuroplasticity, and to boost neurogenesis. So, all of these things, probably most importantly, something so easy everyone can do, to supplement with Brain Armor is going to affect, and in a positive way, cognitive ability. [34:53]

The Living Brain Project

Thelivingbrainproject.com is where you can learn about case studies done by Brain Armor with a variety of participants.  Participants that supplemented their diet with Brain Armor EPA:DHA formula at the recommended dose for 90 days saw the following results:

Every patient demonstrated an increase in the Omega 3 Index (O3i)  

Baseline Omega6:Omega3 ratio was reduced from 7.35:1 to 4.5:1 (close to an ideal range of 3:1)

AA:EPA Inflammatory Marker ratio reduced by 51%

You can get your Omega 3 Index (O3i) tested at the Medicine Center Pharmacy. Check out our Events page for the next in pharmacy health screening event.

What is BDNF?

So, I sort of spoke briefly about neurogenesis, neuroplasticity and the neurotrophins, NFL (NeuroFilament Light). BDNF is probably the most important neurotrophins to know about Brain Derived Neurotrophic Factor. So, it's an acronym that stands for the production of that particular neural hormone. And it's responsible essentially, for new nerve growth and nerve connectivity. So, it's responsible, essentially for neurogenesis and neuroplasticity. In fact, there's also a gene called BDNF, and that's responsible for how well each of us individually do this. Good news is regardless as to the variation genetically that you might have, a brain derived neurotrophic factor, we can improve it, we can boost it, and DHA is one of those things. [39:40]

Can we grow new nerve cells?

So, the best information that came down the pipe in the last less than a decade, in fact, it's really only been the last few years neuroscientists have realized that we can grow new neurons and new nerve cells. We don't do that in an astronomical number. You mentioned in the top, in the intro, we've got 86 billion neurons, we're only doing a few thousand more a day. So, and that's only if you're treating your brain right by taking things like brain armor and engaging a healthy diet and exercise. But, the fact of the matter is certain regions in our brain and particularly hippocampus, where we form memories and consolidate memories at night when we sleep well, in other parts of our brain, we can grow new neurons and new nerve cells when we treat our brain well, that's the bottom line. [44:49]

How to Treat the Brain Well?

Anything you can do to boost that neurogenesis, neuroplasticity, BDNF, taking saunas every day, engaging in high intensity exercises like hit, training, cardiovascular exercise, improving social networks, drinking green tea. Thinking about ingredients like curcumin from turmeric, more spices in your diet, and of course, taking brain armor, literally consuming that daily is improving your brain health and growing new nerve cells. [45:46]

The Medicine Center Pharmacy is your local resource for Brain Armor Omega 3 Supplements.

If you commit to improving your brain health & performance we are committed to you.

That's why we created a 40-day Test Pack including Brain Armor Brain Nutrient Formula and 2 Omega-3 Index Testing Kits. Baseline your current Omega-3 Index, Omega-6 to Omega-3 ratio and your AA:EPA inflammatory markers on day 1 and then re-test after supplementing with Brain Armor for 40 days. You will see the difference and feel the difference. Clinician Reference Sheet

ACTIVE INGREDIENTS (per serving - 10 mL):

TOTAL OMEGA-3s - 2,292 mg
DHA : EPA - 1,250 : 625 mg
VITAMIN D3 - 1,800 IU
VITAMIN E - 45 IU
Medium Chain Triglycerides - 4,500 mg

Below is a sample of NFL Pro Football and Brain Armor case studies.

You can find additional case studies here.

After dosing with Brain Armor - Omega-3 Index increased over 72%

AA: EPA Inflammation decreased over 77%

See Kyle's full results and Video Story here

After dosing with Brain Armor - Omega-3 Index increased over 31%

AA: EPA Inflammation decreased over 45%

See 'Zay's full results and Video Story Here

After dosing with Brain Armor - Omega-3 Index increased over 61%

AA: EPA Inflammation decreased over 70%

See Don's full results and Video Story Here

After dosing with Brain Armor - Omega-3 Index increased over 31%

AA: EPA Inflammation decreased over 72%

See Steve's full results and Video Story Here

After dosing with Brain Armor - Omega-3 Index increased over 120%

AA: EPA Inflammation decreased over 78%

See Jeff's full results and Video Story Here

After dosing with Brain Armor - Omega-3 Index increased over 84%

AA: EPA Inflammation decreased over 63%

See Derek's full results and Video Story Here

Special Guest: Nicole Selinsky, Diabetes Educator and Licensed Dietician, at Mercy Medical Center

Diabetes is a challenging disease to manage successfully. From medication to monitoring and from exercise to diet there is a lot to coordinate, understand and manage. Although the care regimen is complex, patients with good diabetes self-care behaviors can attain excellent control. Patients do best when they understand what they need to do, when they feel empowered to affect a change in their life and when they believe the benefits exceed the costs. Today Nicole will share her knowledge and tips to help you or your loved ones understand how to manage diabetes.

Understanding your A1C

Hemoglobin A1C is a test that measures your average blood sugar levels were over the past three months. The A1C test can also be used for diagnosis by your physician and it can also be used as a benchmark to evaluate blood sugar control over a period of three months.

Your A1C test result is given in percentages. The higher the percentage, the higher your blood sugar levels have been:

• A normal A1C level is below 5.7 percent

• Prediabetes is between 5.7 to 6.4 percent. Having prediabetes is a risk factor for getting type 2 diabetes. People with prediabetes may need retests every year.

• Type 2 diabetes is above 6.5 percent

• If you have diabetes, you should have the A1C test at least twice a year. The A1C goal for many people with diabetes is below 7. It may be different for you. Ask what your goal should be. If your A1C result is too high, you may need to change your diabetes care plan.

Source: NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Monitoring your blood sugar on a daily basis combined with exercise and a healthy diet plan go a long way to controlling your diabetes. Diabetes Self Management Training by a Certified Diabetes Educator (CDE) and a Registered Dietician (RD) can provide you with valuable information to take control of managing your diabetes.

im·bue botanicals truly believes that centuries-old botanicals can have a profound impact in improving our lives, and those of our pets. To that end, we grow the finest organic Colorado hemp, process it under the most stringent conditions, and produce an extensive line of premium CBD products, including tinctures, capsules, and topical lotions and salves, all available in multiple strengths… for both people and pets. Their premium Colorado grown hemp products are non GMO, cruelty free, vegan and contain no added flavorings or sugars.

With nearly three decades of experience, the founders of im·bue botanicals are passionate about utilizing their expertise and know-how to deliver exclusive, proprietary products, designed and envisioned to provide outstanding results. The “Earth First” approach to business as well as consumer wellbeing is fundamental to all that they do.

im·bue botanicals carefully formulate our products for optimal concentrations. The unique, low pressure and temperature processing ensures that their product is fully-infused. It’s what we call Full Spectrum, and it’s designed to provide outstanding benefits. And at im·bue botanicals, all of our products are batch tested by independent laboratories prior to shipment to ensure quality and consistency. We currently provide several distinct products, designed for differing requirements. Our proprietary liquid product utilizes all-natural, pleasant tasting organic vegetable glycerin as the base. This ensures a pleasant taste, without any unhealthy additives. And our exclusive capsules provide a convenient alternative when a higher, more sustained dose is preferred.

We also offer our unique topicals, em·body lotions and salves. These soothing, restorative, all-natural products provide exceptional comfort restore and vitality to areas where applied.

Additional Product Information: It’s a good idea to always consult your physician or veterinarian when adding to your or your pet’s diet. These products are not intended to diagnose, treat, or cure any disease, and no claims regarding such are made.

This episode of Health Matters we talk with special guest Chris Fankhauser, Executive Director Mercy Hospice.

Did you know that 90% of American’s want to age in their home and that home health care is the preferred method of health care delivery for the aged, dying and chronically ill? Home care workers provide care to over 5 million American’s on an annual basis and the workers who care for them travel 8 billion miles on an annual basis to provide that care. Please join us as we honor and celebrate these tireless workers who provide an invaluable service and make a difference every day in the lives of the patients and families they serve. Tune in to this week’s podcast and learn how Mercy Hospice provides care for patients and families.

Today we will talk again with our friends, Krista Allison and Jen Griffing from the Great Start for Great Futures Coalition about each of our roles in helping the children of Stark County realize their potential for a Great Future

Evidence indicates that both the quantity and quality of words spoken to a child in the first 3 years of life predict a child's language and emerging literacy skills more strongly than socioeconomic status, parent level of education, and race/ethnicity (Dickinson and Porche, 2011, Hart and Risley, 1995, Hoff, 2003, Hoff, 2013, Hurtado et al., 2008, Huttenlocher et al., 2010, Rowe, 2012, Weisleder and Fernald, 2013).

From a research perspective, we know that the higher the number of words spoken to a child the greater increase in vocabulary development, enhanced language and speech processing, and improved literacy outcomes. (Hoff and Naigles, 2002, Hurtado et al., 2008, Huttenlocher et al., 1991, Weisleder and Fernald, 2013, Zimmerman et al., 2009).

What that means from a practical perspective is that our relationships and the ways we interact with children are the necessary foundation for language development.  Parents and family members can develop meaningful context that others cannot.  They know cries, facial expressions, interests and behaviors, and how their children communicate their needs...and of course their wants!

It may sound simple, but the most important way to help children develop language is to build relationships! We know that children are practicing to respond before we can actually see and hear them responding.  So, responsive interactions, back and forth turn taking while talking, are the best way to enhance your relationships with children, while at the same time building their language foundation.

Some of these strategies are very natural and are not even related to WHAT we say but HOW we say it. Again, these tips are free. They don’t require any special planning or materials and can be done anytime or anywhere.

 Here are 5 elements of responsive interactions:

 1. Tuning-In: Tuning in is paying attention to every attempt a child makes to communicate. Eye contact is critical as is waiting and acknowledging sounds, coos and babbles as a young child’s means of communicating along with recognizing how children are moving, responding if they seem unsettled and ensuring they can rest, eat or play in a comfortable way. An ongoing lack of tuning in has been shown to cause a disruption in the developing architecture of a child’s brain. Children CRAVE these positive, responsive interactions and truthfully they are essential for ALL healthy human relationships.

 2. Facial Expressions: Using your face to express yourself is another great way to build a relationship and in addition helps children learn what a word means. They will soon learn whether a word is positive or negative, what communicates an emotion or indicates a place or time of day. This all comes together later as children understand the words you are using and can take ownership of those words as their own. A great resource to illustrate how critical facial expressions are to young children is the Still Face Experiment, which you can find online.

 3. Touch: Touch is another great way to communicate responsively. Pairing a light touch with talking increases learning as it stimulates multiple pathways in a growing brain to support stronger connections.

 4. Gestures: Using gestures, along with words, also helps children understand the meanings of words. In the everyday this might look like, up, under, so big, bye-bye and blowing a kiss.

 5. Child-directed Speech: This is the loving, sing-song, high-pitched joyful voice that children love to hear! In child directed speech, you stretch out words and repeat sounds so children start to recognize different sounds and hear the rhythm of language. It's important to note that in this case, we aren’t referring to baby talk, but rather the way we say real words to get high engagement from a young child, using the speed and tones of our voice.

We always like to encourage the idea of “Strive for 5,” that being 5 back and forth responsive interactions.  When you have at least 5 serve and returns in your conversation “my turn, your turn.”

“Serve and Return” is back-and-forth communication, or adult speech followed by a child's vocalization within 5 seconds or vice versa. Conversational turns invite children into the conversation regardless of whether they are able to communicate verbally or through nonverbal signals and provide children with the opportunity to build their communication skills in the context of an engaged social relationship (Kuhl, 2007, Zimmerman et al., 2009)]

The brain has the opportunity to be nourished with language and to develop those critical patterns and pathways. It gives you both quantity and quality of words all while growing your relationship as well!

The last strategy around the 5 pertains to the 5 senses (sight, hearing, smell, taste and touch)

 Our five senses are a powerful tool in helping us learn about the world around us.  As we experience our environments, we can use what we see, smell, hear, touch and taste to give our children lots of words to build their vocabulary and grow strong brain connections.

If we use our 5 senses to enhance our language experience and nourish the relationship and responsive interactions within a group it will make those connections even stronger.

Don’t miss Part 1, Part 2, and Part 4 here.

You can find all our Health Matters Podcasts here: iTunes Google Play Stitcher 

This week on Health Matters our guest, Ron Grey, Consultant with 21st Century Vitamins.

Early reports indicate the flu season will be particularly heavy this year and it is also expected to be early.  Besides getting a flu shot you might be wondering the best way to increase your immunity and stay healthy.  This episode we will discuss vitamins and supplements with our friend, Ron Grey.

The LDN Research Trust released a documentary earlier this month that provides education for patients that are suffering from chronic pain and are dependent on opioid prescription medication.

At the Medicine Center Pharmacy we strive to help educate patients and the medical profession to use an alternative, inexpensive, effective treatment. Watch Pain Specialists talk about using Ultra and Low Dose Naltrexone to treat their patients with Chronic Pain. Our thanks to the speakers in alphabetical order: Asher Goldstein MD, John Kim MD, Neel Mehta MD, Norman Marcus MD, Pradeep Chopra MD, Samyadev Datta MD. This program is not sponsored by any pharmaceutical manufacturer, it is funded by donations to the LDN Research Trust which has been a driving force in providing LDN education and research around the world.

You can learn more about low dose naltrexone at one of our monthly patient education seminars or by contacting the pharmacy. You can register here for the next seminar: Register Here

Did you know that your oral health offers clues about your overall health — or that problems in your mouth can affect the rest of your body? This morning we will talk with Dr. Garrett Heck, Chief Resident at Mercy Dental Services. We hope you will protect yourself by learning more about the connection between your oral health and overall health.

Both CBD oil products and LDN have prompted many questions at our pharmacy and we are happy to share experiences and feedback with you. We will provide accurate information regarding the potential benefits of LDN and CBD oil from the experiences of our own patients, as well as to provide a forum to connect with others dealing with the difficulties of autoimmune and chronic pain disorders. 

As you drive around town you will probably see signs advertising CBD Oil everywhere. From gas stations to video stores, how are you supposed to know if CBD oil is right for you? How are you supposed to separate the low quality brands from the reputable? Your Medicine Center Pharmacist is the most accessible health care professional to answer your questions.

What is CBD?

CBD is the abbreviation for cannabidiol. It is one of over 100 cannabinoids that are found in the hemp plant. You will not get “high” from CBD Oil as there is no more than 0.3% THC present.

What is the difference between industrial hemp and marijuana?

Hemp and marijuana are the same plant, cannabis sativa. The difference is that hemp is cultivated for significantly lower amounts of THC (tetrahydrocannabinol), less than 0.3% by dry weight. Industrial hemp also has more fibrous stalk and grows taller than marijuana which tends to grow bushy. Marijuana is cultivated to contain much higher percentages, often as high as 10-12% of THC, for psychoactive purposes.

What Kind of CBD Oil Should I Use?

CBD oil products available in the marketplace today can vary in a variety of strengths, ingredients, and dosage forms. CBD oil is available in both oral and topical forms. Oral forms include tinctures and capsules. Topical lotions, salves, lip balms, and massage oils can be applied directly to areas of concern on the skin. The form of CBD Oil you choose would depend on the intended use.

Is CBD Regulated in the USA?

While CBD is not currently regulated by the FDA there are many reputable companies that are setting standards to assure a quality product by testing purity, potency, and safety. The best products are full spectrum, Colorado grown, organic, gluten free, Non-GMO, vegan, cruelty free, highly bioavailable, and undergo independent laboratory testing. The most reputable companies control the process from “seed to sale” meaning that they control the entire chain of command process of planting, growing, harvesting, extracting, and botting. Look for documentation on product packaging for production tracking of testing and certificates of analysis.

Why Do Prices of CBD Vary So Much?

Be wary of lower quality vendors selling cheap CBD products sourcing hemp raw material from China, where growing standards are questionable. These products are often only isolates of CBD and not full spectrum and will not have certificates of analysis available. Higher quality products that have had independent testing and chain of custody documentation will command a higher price, but also have the potential to provide a better therapeutic outcome due to the integrity of the product.

Why Full Spectrum CBD Oil?

Utilizing over 100 of the active ingredients from the hemp plant, the entourage effect is a proposed mechanism by which CBD compounds act together to modulate the receptors in the endocannabinoid system.

Hemp has both terpenes and cannabinoids and plays a role in the expression and flavor of the product.  Terpenes can be damaged in extraction if you are not careful. 

Will CBD Oil Interact With My Prescription Medication?

Cannabidiol is metabolized in the liver by the P450 system and it is possible that CBD Oil could interact with prescription medication metabolism and as a result alter the intended outcome in the body.

How Does CBD Work?

When you ask a pharmacist this type of question you get a technical answer, so here is the technical answer:

The main actions of CBD are centrally; acting on the Endocannabinoid system -specifically the CB1 and CB2 receptors.

• Activates TRPV-1, modulating body temperature, the perception of pain and inflammation.

• Activates Adenosine receptors, promoting anti-anxiety and dopamine/glutamate release.

• Inhibits FAAH (fatty acid amide hydrolase) enzymes, leading to the modulation of the endogenous CB1 receptor.

The simple answer is that this seems to help reduce peripheral pain and inflammation.

Very few licensed drugs act on these receptor groups directly.

• Rather than getting you high, CBD actively blocks the neurological effects of THC (the component removed from all CBD products).

Will CBD Affect My Job or Cognitive Ability?

• CBD has no measurable effect at all on reaction time and can be safely taken when used in our commercially available formulations in recommended doses. It can be taken safely when driving and operating machinery.

• It is possible that you could test positive in a drug screen if you use CBD Oil products for a long enough period of time or in higher doses.

What Medical Conditions Are Patients Treating?

Please consult a health care professional when treating any disease/condition. We are seeing CBD Oil products provide support for the following common conditions:

• Anxiety

• Chronic Pain

• Eczema

• Migraines

• Muscle Pain

• Neuropathy

• Psoriasis

• Sleep Disorders

Have you used CBD Oil and benefited from the therapy? Please share your experiences below so we can all learn together.

CBD Oil In the News:

Arthritis Foundation Statement on CBD Oil 

Are you one of the 9 out of 10 Americans who wish to Age in Place?  Or, maybe you are helping care for a parent or loved one who requires assistance in their home or is considering assisted living.  Estate Planning is ideal for those who want to get a head start on protecting family assets and laying the groundwork for their financial legacy.  It is a uniquely personal process and can be highly individualized based on a person’s desires or needs – and it’s never too late to seek help.  This morning we will be talking with Jim Contini from Krugliak Wilkins.  Jim specializes in both Estate Planning and Elder Law. 

Health Matters with the Medicine Center Pharmacy welcomed our guests Jen Griffing and Krista Allison, members of the Great Start for Great Futures Coalition to discuss Brainology.

One step builds on another. The progress in language development made during the first five years of a child’s life is extremely predictive of future school successes and struggles. Kindergarten readiness predicts 3rd grade reading achievement, which predicts 8th grade math achievement, which predicts high school graduation, which predicts postsecondary attainment. Ninety percent of a child’s brain development occurs by age five. Birth to age three is the fastest rate of brain development across his or her lifetime. 

Today’s consensus in the fields of neuroscience, education and developmental psychology reveal that a child’s experiences between birth and age five have an enormous impact on the ability to thrive throughout life; from academic achievement, to health, to future earnings as an adult.

On this podcast we will talk with our friends from the Great Start for Great Futures Coalition about each of our roles in helping the children of Stark County realize their potential for a Great Future.

What is Great Start for Great Futures 

 Formed in December 2016, The Great Start for Great Futures (GSGF) Coalition is a countywide collective comprised of early education providers, agencies, advocates, and community leaders who collaborate to design and implement initiatives to close the early learning gap in the Stark County community.

The Goal of Great Start for Great Futures Coalition

To ensure all children have access and opportunity to high-quality early education to ensure kindergarten readiness in all (early learning) educational domains

One key point we want our community to remember is that:

You don’t begin at 3~

You don’t begin at 5~

You begin before birth.

So therefore, under our theory of change, we actually have an advantage in closing the achievement and opportunity gap in the areas of literacy, numeracy and social-emotional development for children before birth to age three.

 We know that if take advantage of the “advantage” we will see kindergarten readiness and create a solid foundation for academic growth. It’s all about language nutrition.

What is “Language Nutrition”?

Words truly build our brains. Just like our bodies need nourishing foods and clean water, our brains NEED language. They need words to build strong, healthy connections. These connections grow stronger and stronger for children by hearing LOTS of words! Words that are given to them by caring people in the context of their day around things that have the most meaning to them. For example: meal time, riding in the car, playtime, nature, bath time and bedtime….just to name a few. The more meaningful words and conversations the more healthy and stronger connections we create to build our children’s brains. That’s brainology.

Brainology 101 Overview?

 Let’s go a little deeper into the term “language nutrition” and brainology. Now we have disclaimer alert- we not medical professionals, but we are educators, parents and community members and we’ve looked at the research behind the connections between early childhood and education. 

Here’s what we learned over the last 25 years as a result of research by various scholars in early childhood development in health/medicine, education, economics, 

• Early childhood is a critical period for developing language skills (listening, speaking and understanding) (Shonkoff & Phillips, 2000)

• Language enables a child to communicate with others which builds both social and cognitive development which is a prerequisite of school readiness and literacy (Dickinson and Porche, 2011, Forget-Dubois et al., 2009, Hart and Risley, 1995, Rowe et al., 2012, Weisleder and Fernald, 2013).

• The basic architecture of the brain is constructed through an ongoing process that begins before birth and continues into adulthood.  (The Science of Early Childhood Development- Harvard)

• Babies are able to perceive and react to sound as early as at 24 weeks gestation and begin to learn language in utero by 35 weeks gestation, suggesting that newborn infants' brains are primed to learn language (Kisilevsky et al., 2009, Perani et al., 2011)

• Similar to the construction of a house, the building process begins with laying a foundation (The Science of Early Childhood Development- Harvard)

• Through this process, early experiences create a foundation for lifelong learning, behavior, and both physical and mental health. A strong foundation in the early years increases the probability of positive outcomes. (The Science of Early Childhood Development- Harvard)

 It starts with you. It continues with us.

 If you are a parent, talking with your child every day, throughout the day, is one of the most important gifts you can give to ensure healthy growth and development.  You are absolutely your child’s first and most important teacher. No one knows or can connect with your child better than you!

It’s in these day to day interactions that children receive the most powerful language nutrition.

Being intentional about using language as a tool to help children grow strong, healthy brains isn’t optional, but necessary for helping children prepare not only to read but to be able to communicate and connect as they develop.  Because as we mentioned, we know that the difference in early language exposure really is the beginning of the achievement gap and we can work as a community to proactively address this.

Talk First Stark is about leveraging the power of language to ensure that all families and community members have the tools they need to nourish the growing brains of our children. We know that whatever your role is, you are a powerful partner in impacting the life of a child.

Other Links Of Interest

The Power of Language Nutrition for Children’s Health and Academic Development

The Science of Early Childhood Development

How does nutrition affect the developing brain?

CDC’s Developmental Milestones

Don’t miss Part 1, Part 3 and Part 4 here.

You can find all our Health Matters Podcasts here: iTunes Google Play Stitcher 

Recently, NBC News released a report by Dr. Rudi Tanzi, from Massachusetts General Hospital. He has discovered inflammation kills millions of nerve cells, shutting down the area responsible for thinking and memory. Could this be link be a between nervous system inflammation and memory play a factor in Alzheimer’s Disease? If it is true, then treating inflammation could lead to a viable approach to addressing the symptoms of Alzheimer’s. 

This link to neuroinflammation could lead to many new treatment options for patients that suffer from autoimmune diseases like alzheimer’s.

If you would like to learn more about how the mechanism of action of low-dose naltrexone mechanism may affect inflammation in the central nervous system through action on the microglial cells.

“We review the evidence that LDN may operate as a novel anti-inflammatory agent in the central nervous system, via action on microglial cells. These effects may be unique to low dosages of naltrexone and appear to be entirely independent from naltrexone’s better-known activity on opioid receptors.”

— Jarred Younger & Luke Parkitny & David McLain Clin Rheumatol (2014) 33:451–459

Learn more about low dose naltrexone and at our next public seminar.

A recent article published by NPR does a fantastic job of providing legitimacy to a therapy that has been very popular at our compounding pharmacy, low dose naltrexone (LDN). The volume of scientific information is expanding at an enormous pace, and as a result it is challenge to be aware of all the cutting edge therapies, so it is great when the press helps to raise awareness.

The good news is that the research is there, but often takes time to trickle into the mainstream standard of care. This NPR article relays the experience of living with chronic pain from the “other side" of the story, the non-research side, from the point of view of patients.

The article tells the history of LDN, why it's so promising, and the fact that ONLY compounding pharmacies have the ability to prepare this medication in custom dosage forms to meet patients needs.

Patients and providers can quickly read (or listen) to this news story and understand now low dose naltrexone works and it provides legitimacy in coming from a national news source such as NRP

Dr. Bruce Vrooman, an associate professor at Dartmouth's Geisel School of Medicine, was an author of a recent review of low-dose naltrexone research.

The full text of the NPR News story can be found here: In Tiny Doses, An Addiction Medication Moonlights As A Treatment For Chronic Pain

The compounding pharmacists can assist you with your questions about LDN, for more information contact the pharmacy here or call us at 330-339-4466.

Our next public information session on LDN will be October 3rd, 2019 at 6:30pm at the Hampton Inn Meeting Room 1299 West High Avenue New Philadelphia, Ohio 44663.

Do you have experience with LDN you would like to share?

Most people who experience mental health problems recover fully, or can live with and manage them, especially if they get help early on.

But even though so many people are affected, there is a strong social stigma attached to mental ill health, and people with mental health problems can experience discrimination in all aspects of their lives.

We will talk with Chris Fogarty, Psychiatric and Mental Health Nurse Practitioner at Mercy Medical Center about mental health initiatives in our community and reducing the stigma attached to mental health conditions.

YOU ARE NOT ALONE.  These are powerful words.  It’s important to measure how common mental illness is, so we can understand its physical, social and financial impact — and so we can show that no one is alone.

1 in 5 U.S. adults experience mental illness each year
1 in 25 U.S. adults experience serious mental illness each year
1 in 6 U.S. youth aged 6-17 experience a mental health disorder each year
Suicide is the 2nd leading cause of death among people aged 10-34

Community Resources:

Mental Health First Aid Training

Mercy Medical Center Plain Chris Fogarty Psychiatric and Mental Health Nurse Practitioner