Personal Physicians Newsletter Archive

David Katzman, MD, Jennifer DeLaney, MD

& Jacqueline Fairchild, MD

Internal Medicine Specialists

Know of anyone looking for a doctor who will provide personalized and compassionate care? Please have them call our office to meet Dr. Jacqueline Fairchild. She is fantastic and currently accepting new patients.

Holy Grail or Not Ready for Prime Time?

David Katzman, MD

A blood test to detect early cancer has long been an appealing idea to cure cancer before it spreads. While previous tests have checked for proteins made by cancer (PSA for prostate cancer, CEA for Colon Cancer, CA-125 for Ovarian cancer etc), a new approach looks at Cancer DNA in the blood. Given that cancer is caused by mutations in DNA, and cancer cells turn over rapidly and “spill” some of this DNA into the blood stream, we can now look for this altered DNA in a blood test.

You may have heard about the Galleri test that attempts to do this. It is able to detect the DNA from most cancers (not skin or brain and less reliably for prostate and kidney). Given that this technology is in its infancy, it is not a perfect test. In one study, a positive test led to an eventual (average 57 days) diagnosis of cancer in 38% of a higher risk population (prior history of cancer, older, risk factors such as family history, smoking or drinking) while 62% did not have cancer, though it took an average of 162 days to confirm this. One can imagine the stress of the positive test followed by multiple further testing modalities over a half a year. Given these limitations, no national organization has recommended its use for cancer screening nor is it FDA approved. It is not covered by insurance and costs $795 out of pocket. We would be happy to discuss the pros and cons of this test at your next visit.

Foot Health

Jennifer DeLaney, MD

The feet are your base of support. Strong feet and ankles are necessary to prevent falls and injuries. Standard dress and athletic shoes can alter your natural gait and put you at risk for bunions, hammer toes and plantar fasciitis. Spending time barefoot or in a barefoot shoe that doesn’t confine the toes or alter the gait can help with balance, foot strength and common foot ailments. If you are developing hammer toes, cross over toes or bunions, or if your toes are simply crowded together, toe separators can help. Soft silicone toe spreaders are more comfortable; Foot Guru is a good brand. Orthotics can help relieve acute pain from plantar fasciitis or arthritis. However, wearing them all the time will weaken the intrinsic muscles of your feet, leaving you more prone to injury.

Some simple exercises for foot and ankle strength include:

Lifting the great toe off the floor while keeping the other 4 toes in contact with the floor.
Grasping a dish towel with your toes and pulling it towards your body by flexing the foot.
Standing with your toes 5 inches from the wall and flexing your ankles until your knees touch the wall.

If you are interested in learning more about strengthening your feet, listen to this podcast on foot health on Peter Attia’s the Drive.

Cannabis Withdrawal

Jacqueline Fairchild, MD

Did you know that a person with Cannabis Use Disorder can withdraw when stopping? Symptoms can include: anger, irritability, aggression, nervousness, or agitation. One may also experience a loss of appetite or weight loss, sleeping difficulty, restlessness, or a depressed mood. Physical Symptoms can include abdominal pain, sweating, fever, chills, and headache. Peak symptoms occur 1-21 days post cessation and symptoms are markedly reduced by four weeks. However, psychological symptoms may persist for up to 1 year.

Did you also know the term “marijuana” is thought to originate from the Mexican word “marihuana”? It came into widespread usage in the U.S. in the 1920s when anti-cannabis factions wanted to play off anti-immigrant sentiments by linking to the drug's "Mexican-ness." The Washington State Legislature recently passed a bill replacing the word "marijuana" with "cannabis" in all state laws, citing the alleged racist origins.

Quest Phlebotomist

If you have recently had blood drawn in our office, you may have noticed a new face. In April, we began an exciting endeavor with Quest Diagnostics to have one of their phlebotomists stationed at our office in the morning. We have found this to be a positive service for our patients - it frees up our staff for other patient-focused tasks while still offering you a comfortable experience with a skilled phlebotomist.

To make the process seamless, our staff enters your lab orders ahead of your appointment so they are ready to go when you arrive. In order to help with this, if you have outside lab work that you will be adding to your blood draw, we ask that you send us the orders a day or two ahead of your appointment. Thank you for your attention to this!

Payment Methods

Paying by check? Please remember to write your invoice number and/or indicate the patient the check is written for in the memo line. This helps make sure the payment is applied to the correct patient's account.

Online payment? Bill.com has updated their patient-facing website to make online payments even easier. You will hopefully find this update removes some of the pain points you may have experienced. Now the easiest way to pay is by clicking the "View and Pay Invoice" button within your email. This will give you the option to pay by ACH or credit card and directly links the payment to your invoice. Or you can also open the PDF attachment in your email and then go to the website listed within your invoice. This route will just have the additional step of logging in to your account first in order to link your payment to that invoice.

As always, if you have any questions, please reach out to ask.

Epic Update

We are continuing to make progress towards onboarding with Epic for our Electronic Health Records system and thereby having MyChart available! We are currently in the development phase which takes quite a bit of time, so we are looking at a possible Go-Live date around October. We will keep you posted!

Appointment Check-In

Please plan to arrive at least 5 minutes early for your physical or follow-up appointment to allow time for us to get you all checked in before your appointment. This allows us to keep your chart up to date and to complete any required forms. It will also allow you to get more face time with your physician.

Thank you!

Important Notice

Please be aware, our main office line, 314-993-1200, is unable to receive text messages. If you're intending to text your doctor but accidentally text this number instead, your message will not be received. Please double check the number you are texting before hitting send. As a reminder, the preferred methods of communication are either calling the office or emailing your doctor.