Prepare to have your health questions answered here on Safe, Effective, Natural Solutions
with Dr. Todd Binkley, owner of Binkley Healing Center in downtown Ventura.
Now, here's Dr. Todd.
Good afternoon.
I'm Dr. Todd Binkley, board certified non-force doctor of chiropractic and practitioner of
functional medicine.
February is Heart Disease Month.
We talked last week about how to reduce plaque formation, a simple way to think of the three
most important ways to prevent heart disease and keeping in mind that heart disease is
the number one cause of death in America and around the world.
Three things to remember, keep the pipes clear, keep the pressure low, and keep the pump strong.
So we talked a lot about how to keep the pipes clear by reducing and reversing plaque formation.
Next week, we'll get to how to keep the pressure low in this show.
But first, I mentioned last week a couple of great studies and I want to make sure to
have time to get to those now.
Listen to this headline.
Why are we letting insurers dictate patient care?
Prior authorization is wreaking havoc on patient health.
This is an article that just came out in the medical literature written by Barbara Jung,
MD, and Deborah Dazeer, MD.
Jung is a gastroenterologist.
Dazeer, Dr. Dazeer is a rheumatologist.
Here's what they say.
When patients are suffering from life-threatening illnesses or debilitating health conditions,
the only thing that should matter is delivering appropriate evidence-based treatments in a
timely manner.
Before that, patients rightly turn to us, their trusted physicians, for expert guidance
on the best course of action.
Yet all too often, insurers insert themselves into the equation.
As a result, restrictive policies like prior authorization can interfere with patient care
and lead to dangerous and painful outcomes.
Listeners to this show will have heard me talk about this a lot.
I am a practitioner of functional medicine.
I'm sorry I don't quote take any insurance because they don't actually pay anything for
the services that I offer, unfortunately.
With one proviso, if you can get your insurance doctor to order the tests I need, then your
insurance will pay for the tests.
But for my expertise, for my consultations, for my review of your tests and recommendations,
you do have to pay out of pocket.
But it's less expensive than you might imagine, especially when you factor in the angst of
waiting and deductibles and copays, etc.
I recommend, while we're on the subject, that everyone get a high deductible plan with a
medical savings account or a health savings account and spend that money on your health
instead of waiting until you're forced to spend it on disease treatment.
Functional medicine is the process of identifying earlier signs of stress on all of your organs
and tissues so that you can reverse disease that's beginning or prevent it from happening
in the first place, as contrasted with conventional medicine practice by 99.9% of doctors, which
is just treating disease that you already have.
So this article goes on.
As you already likely know, prior authorization allows insurers to review doctor's orders
and decide whether they will cover prescribed services.
Such policies were initially established to help reduce health care costs by controlling
patient access to more expensive or investigative medications, treatments, and therapies.
But insurers have taken it too far, overruling physicians' recommendations and defaulting
to rejection of routine, evidence-based, and often life-saving care to prevent any expenditures.
Today, prior authorization has become one of the most widespread challenges in medicine,
drastically impacting our two specialties, gastroenterology and rheumatology.
Again, this is an article in the medical literature written by Barbara Jung, MD, and Deborah Dyett
Dazir, MD, a gastroenterologist and rheumatologist, lamenting the extreme restrictions that insurance
companies impose on their ability to do their job.
Each of these doctors goes on to present an example of how this affects their practice
in real life.
She says, to fully understand what this means to our patients, consider a case of a patient
that I have who takes a medication to manage Crohn disease.
This patient typically suffers from breakthrough symptoms before her next infusion is due,
so we asked for authorization from her insurer to increase her dose.
The insurance company required several letters to document and justify this change, which
resulted in a one-and-a-half-month delay before she could access the medication she needed
to effectively manage her disease.
This patient is 44 years old and works as a gardener, so while she waited for prior authorization
and continued to experience GI gastrointestinal and musculoskeletal symptoms, pain in her
gut, pain in her muscles, her condition impacted her ability to perform her job and enjoy her
life.
That experience is the antithesis of patient-oriented care, yet it's representative of all too many
gastrointestinal patient experiences nationwide.
The rheumatologist author of this article goes on to describe a patient who has systemic
lupus erythematosus.
This is an autoimmune condition that causes multiple symptoms.
A 62-year-old patient who, after taking medication for 10 years, experienced flare-ups that exacerbated
her incurable rheumatic disease.
During the medication was no longer working, the rheumatologist switched her to FDA-approved
treatment that her insurance company denied because the patient didn't have a specific
antibody test required for that particular medication.
So now the patient's on an inferior medication that provides less benefits and is enduring
multiple rounds of more dangerous treatments just to keep her pain under control.
Quoting the authors, continuing with this article, the state of play for prior authorization
puts the insurer, not the physician, in the driver's seat for patient care, and that is
wreaking havoc on patient safety and well-being.
I'm going to say that again.
This is two physicians practicing in the real world, talking about their experiences about
why insurance is wreaking havoc on patient care.
The state of play for prior authorization puts the insurer, not the doctor, in the driver's
seat for patient care, and that is wreaking havoc on patient safety and well-being.
The article continues, unfortunately these examples are just a drop in the bucket of
frustrating insurance barriers.
According to a 2022 American Medical Association survey, virtually all physicians report prior
authorization delays to access necessary care for their patients.
Four out of five doctors report that burdensome, lengthy prior authorization processes sometimes
or often lead to patients abandoning their prescribed treatment.
Additionally, one-third of physicians reported that the process has led to a serious adverse
health event for patients, events including extreme pain by not being able to receive
the right medication or hospitalization to a flare-up of an inflammatory bowel disease.
Recently, the article goes on, a Kaiser Family Foundation report found that approximately
60% of insured adults experience issues when using their insurance coverage.
This includes 16% who face problems with prior authorization, particularly among Medicaid
recipients, high needs patients, those needing emergency services, and diabetes and mental
health patients.
These figures underscore the serious threat that prior authorization poses to patient
outcomes.
This is particularly true for patients struggling with rheumatic diseases like arthritis, which
is a leading cause of disability in the U.S., as well as a range of gastrointestinal diseases
such as Crohn's disease, ulcerative colitis, and colon cancer, the second most common cause
of cancer death in the U.S.
For these vulnerable patients, delaying or denying access to care often leads to the
disease getting worse.
If you've just tuned in, these are not my words.
I've been reading a article that just came out in the major medical press by Barbara
Young, MD, president of the American Gastroenterological Association, and Deborah Diet DeSere, MD,
president of the American College of Rheumatology.
They can't say things like this in the article, but if you didn't catch it, that last part
clearly has implications for severe pain for these patients and even early risk of death
from lack of access to insurance coverage, insurance that you've paid good money for,
and it's just frustrating for me as well, but it's the reality of the situation.
If you want to get something other than what most medical insurance offers, there's no
such thing as health insurance.
It's medical insurance.
It doesn't cover anything to keep you healthy.
It only covers medical treatment.
You've heard me say this before.
I'm never going to stop saying it.
There's no such thing as medical insurance.
If you want to restore health, if you want a fighting chance, if you want to give your
body a fighting chance to discover a condition early enough that you can completely eliminate
it or discover it early enough that you can reverse it or to identify earlier stresses
on your various parts of your organs and systems that can usually be fixed, even in severe
cases, oftentimes there's a way to provide adequate nutrients for your body to heal itself
like it was designed.
I'm Dr. Todd Binkley.
You're listening to Safe, Effective, Natural Solutions to Almost Any Health Challenge.
Here's another study I'm really excited to tell you about that just came out in the mainstream
medical literature about the importance of vitamin D. I tell all of my patients, people
who I don't even test, who just want to find out how to stay healthier, there's three things
everyone can do to give your body a fighting chance to stay healthy.
And that is to take three supplements that most people, thousands of people that I've
tested, tens of thousands if not hundreds of thousands of people, my colleagues have
tested around the country.
These three things are always deficient and people don't realize that until they test
vitamin D, fish oil, and minerals.
So you need to take a good multivitamin, which is a long conversation.
It's on some of my previous episodes.
One a day multivitamins are useless, a good multivitamin has to be at least three or four
capsules to have minerals in it that your body can absorb.
Fish oil, fish oil is really important to control inflammation, to help with all kinds
of joint conditions and a whole host of other things that involve inflammation throughout
your body.
But if you pressed me, put a gun to my head and said, okay, I just want one pill, what's
one vitamin that I could take that would improve my health?
That's an easy answer, vitamin D. Vitamin D is mostly important for your immune system.
People know it more for bone health, a few other things, but it's really important for
basically every part of your body.
So I love this study.
This is February, this is cardiovascular disease awareness month, so says me.
And here's a study in young people.
It's a study from Spain, 177 healthy sedentary adults, ages 18 to 25 years old, 65% women.
They're all white people from Granada, Spain.
They were non-smokers, they led a sedentary lifestyle and did not have any history of
chronic disease or cardiovascular disease.
And so they did a whole bunch of measurements on them and they tested their vitamin D levels.
And here's a really important takeaway too.
I'm always telling people if you hear slam pieces on nutrients that say, oh, this vitamin
doesn't work for this and this vitamin doesn't work for that.
Well, it's usually because they don't use enough or proper forms of the nutrients to
achieve the desired effect.
And so this is kind of an interesting illustration of that as well.
So their measurements were your vitamin D level was declared deficient if it was less
than 20 and it was declared normal if it was above 30.
Well, that's still way too low.
The healthy range for vitamin D is between 50 and 90.
When you do the standard vitamin D test, there are three major types of vitamin D tests.
But if you just go to any doctor and say, I want my vitamin D levels checked, they're
going to do the 25 OH vitamin D serum concentration.
That is the standard vitamin D test.
And the number and don't say, don't ask them if it's OK, ask them what the number is.
You want your vitamin D level to be between 50 and 90.
But this test only measured difference between people whose vitamin D was less than 20 or
30 or above.
And this is interesting because the normal level for vitamin D on most lab tests used
to be 20 and they've only recently raised it to 30.
A few years from now, they'll eventually figure out that you should raise it.
The normal range should be between 50 and 90.
But the standard practice of medicine does not do that yet.
But this is a really interesting study because it compares just that range between 20 and
30.
So the people with vitamin D levels below 20 had higher fat mass index, higher body
mass index, higher systolic blood pressure, higher serum glucose and higher insulin and
higher insulin glucose ratio.
They also used a model of insulin resistance, a measure, a way to measure risk of diabetes,
which was also higher with the lower vitamin D level.
And again, it was only a little bit lower than the what everyone should be getting and
is super easy to get with one single little supplement.
The takeaway results go on to mention that markers for serum glutamyl transferases and
alkaline phosphatase, these are two standard liver inflammation markers, which are often
increased when people have diabetes, but also increased when people have any stress on their
liver or their pancreas were elevated in the people with slightly lower vitamin D levels,
as well as an anti-inflammatory marker into LUCN4.
So body mass index, waist hip ratio, fat mass index, blood pressure, levels of glucose,
insulin, triglycerides and liver markers were higher in all the participants with vitamin
D deficiency versus those with what they called normal vitamin D levels.
And again, they called vitamin D deficiency less than 20 and normal vitamin D above 30.
Imagine what the results would have been if they had actual functional levels of vitamin
D, which are between 50 and 90.
And just in case you haven't heard me talk about this before or any other functional medicine
practitioner, no one gets that level of vitamin D in their bloodstream from sun exposure.
Walking around in the garden in short pants and short sleeves will never give you a vitamin
D level of 50 to 90.
The only way to achieve functional, healthy levels of vitamin D is to take supplements.
Yes, our bodies are designed to make vitamin D from the sun, but you have to expose your
entire torso to the skin several days a week.
And even that only works in the summer in Southern California.
So that's the short way.
If you want to know more, email me.
But basically everyone needs to, all adults need to supplement around 5,000 units of vitamin
D a day if you want to have a healthy immune system and prevent your risk of heart disease,
the number one cause of death in America and around the world.
So what can you do to prevent or reduce your risk of heart disease?
This is a continuation of what I started talking about last week.
I like to explain it in three simple ways.
Keep the pipes clear, keep the pressure low, and keep the pump strong.
This is from a lecture I've done many, many times over the past, I don't know, 20 years
probably at Community Memorial Hospital at St. John's Hospital at several service clubs
around Ventura County, people seem to find it really effective because it keeps it simple.
Keep the pipes clear, keep the pressure low, keep the pump strong.
Last week we talked about many, many ways to keep the pipes clear.
That's the thing that most people focus on.
Most people think the only way to do that is to lower your cholesterol levels.
That is not true, refer to last week's episode to hear more about that.
But it is really, really important and people do ignore this all the time.
It's really important to keep the pressure low.
The only way you know if you're keeping your blood pressure low is to check it.
If you have any family history of heart disease, if you have any stress in your life, check
your own pulse.
If you have rapid heart rate, ask your spouse, ask your family members, do you seem like
a high stress person or someone who is under stress?
If any of those things are true, then you should spend 40 bucks at your local pharmacy
or on Amazon on a blood pressure monitor to use at home.
OMRON, O-M-R-O-N is the standard.
They're probably not the only good one, but they're widely available, they work.
I continually compare the results of the easily push one button OMRON blood pressure cuff
I use in my own office with the more standard old style stethoscope and sphygmometer that
doctors use.
It doesn't really matter, an OMRON blood pressure cuff works just fine as long as it's one that
goes around your arm.
Don't get the ones that go around your wrist.
They're okay for certain circumstances and easier to use.
You want a regular blood pressure cuff that goes around your arm.
OMRON is a good one.
There's probably other good ones.
Just get one.
The nice thing about them is if you're willing to take a few minutes to program them, set
the time and the date, then they'll even check, they'll keep a log of all your readings for
you.
But if you're like me and you don't feel like messing with anything that's a pain to program,
just write down your own numbers.
Just take your blood pressure every day for a few weeks and write down the numbers and
take it at different times of the day.
Take it at 10 o'clock in the morning and 4 o'clock in the afternoon and right before
bed.
It is normal for your blood pressure to be high first thing in the morning.
When you wake up, part of the reason you wake up when you wake up is because your adrenal
glands pump out a hit of cortisol to make you go from sleeping to waking and that will
increase your blood pressure.
Temporarily, it's a normal thing.
It's nothing to be worried about.
But it is good to measure your levels at different times throughout the day and write the numbers
down.
It does not matter what one blood pressure reading is.
If it's really high one time or three times in a week, it doesn't matter.
Don't worry about it.
Your blood pressure goes up and down all the time.
What matters is the average for a week.
That's why you want to keep a log.
If you have any risk factors or even if you've just never checked and you have stress, then
you should monitor your own blood pressure.
Get a blood pressure monitor, check it yourself, write the numbers down every day.
And then here's the most important thing.
Ignore any readings that you're worried about and instead get the average for a week.
So at the end of a week, you've got 30 readings because you checked it three times a day plus
a few extra times.
Or if you've got 10 readings, however many numbers you have written down, add up all
of those numbers and divide by the number of entries that you have.
And there you've got your average blood pressure for a week.
Your average blood pressure for one seven day period is what really matters.
It goes up and down all the time.
But if your average is below 130 over 80, then you don't have high blood pressure.
And there are conditions where people have low blood pressure too and that's important,
but it's just much less frequent.
So call me if you have low blood pressure.
That is usually an adrenal issue.
I've helped lots of people with low blood pressure.
If you faint, feel like fainting when you stand up, then you probably have low blood
pressure.
But most people are worried about high blood pressure.
That is one of the main contributors to heart disease.
So you want to keep the pressure low.
And the way to do that is by first knowing what your pressure is and not what it is one
day to, you know, just again, I can't stress enough.
Don't worry about one high reading.
Do the average for a week because then you can gain awareness and control and make changes.
I'm Dr. Todd Bankley talking about how to prevent heart disease.
And one of the main changes you can make to reduce your blood pressure is just to notice
when you're stressed and checking your blood pressure is one way to do that.
But sometimes you become aware of it in other ways.
And anytime you're stressed, a simple thing that anyone can do is simply lie on the floor,
not in bed.
You need to be on a firm surface, but lie on the floor or a table with a mat, just something
firm.
A bed is too squishy.
You need a firm surface for your muscles in your ribs to push against.
And simply lie on the floor and take deep, long, deep breaths.
Deep breath in, hold, deep breath out, hold and repeat.
And by that, I mean, inhale to a count of four or six or eight.
Breathe in as slowly as you can.
Hold for a count of one or two and then breathe out to the same count that you breathe in.
For example, breathe in to a count of six, hold for a count of one or two, breathe out
for a count of six or longer.
Try to make the exhalation take longer than the inhalation whilst lying on a firm surface.
This is profoundly relaxing and you can check your blood pressure before and after doing
this.
And if you do it for 10 or 15 minutes, you'll see when you have a high blood pressure reading,
you can lower it by 10, 15, sometimes 30 points.
I'm Dr. Todd Binkley.
You've been listening to Safe, Effective, Natural Solutions.
I look forward to the opportunity to help you prevent heart disease.
Email me anytime with your questions.
Tune in next Friday at 4 p.m.
Have a fantastic weekend.
You've been listening to Safe, Effective, Natural Solutions with Dr. Todd Binkley.
If you have a health question you want discussed on the show, email your health questions to
drbinkley at binkleyhealingcenter.com.
Take advantage of this opportunity to ask questions for yourself and for your loved
ones because our health matters.
Join him next Friday at 4 p.m. for Safe, Effective, Natural Solutions right here on 98.3 The Word,
KDAR.