Dr. LeBaron’s Farewell Letter to Patients

Dear Colleagues and Patients,

It is with mixed emotions that I have decided to leave the Kaplan Center for Integrative Medicine. It has been a great honor for me to be a part of the treatment team here for the past 5 years and a privilege to work with each of you.

To my colleagues, thank you for generously sharing your knowledge with me. I have learned so much from each of you and I will miss working collaboratively together. Your insight and input have contributed to my professional growth and I will always value my time here.

To my patients, thank you for sharing your experiences and helping me to learn from each of you to provide individualized care to meet your medical needs. Thank you for allowing me to be a part of your life’s journey to better health. I am humbled and honored that you have entrusted me with your care.

Though I am moving on, your medical care will be seamlessly transitioned to Dr. Lisa Lilienfield or Dr. Nayo Wills, and for my prolotherapy patients, Dr. Dan Sheehan. They are wonderful doctors and in their hands, I know you will continue to receive nothing short of the highest level of care that you have come to expect at the Kaplan Center. The clinic’s staff are ready to help facilitate your transition.

As I bid farewell, I wish each of you continued improvement in your health, strength in your spirit, and hope within your heart. I will miss you all.

Be well,
Dr. Erika LeBaron

Happy Feet! The Kaplan Center Offers Custom Orthotics

The Kaplan Center for Integrative Medicine offers Full Biomechanical Analysis of your legs and Custom Orthotics.

Types of foot structures that benefit from orthotics are the rigid high arch foot, the over-pronated foot, and the sensitive diabetic foot.

When we have proper foot and ankle alignment, our healthy feet easily absorb shock and transfer our body weight from the heel at heel strike to push off. But not all feet are able to accomplish this smooth motion and mechanical stress.

Conditions that can benefit from custom orthotics include: Heel pain, plantar fasciitis, tendonitis, bunions, hammertoes, Morton’s toe, ankle pain, knee and hip pain, low-back dysfunction, repetitive injuries, and arthritis.

Benefits of having custom orthotics include:

* Reduced foot and ankle pain
* Less knee, hip and back pain
* Improved walking pattern and endurance
* Ability to stand longer
* Better balance
* Obtain proper alignment of your foot and ankle
* Unload pressure from a bunion
* Support for your arch
* Shock absorption for the entire bottom of your foot

For more information or a consultation with Michele McLellan, PT, OCS, CLT, on our custom orthotics please call at 703-532-4892, ext. 2.

A Letter to Patients from Nour Amri, Clinical Integrative Nutritionist

Hello, My name is Nour, and I want to heal your gut!

I feel so privileged to work as the Clinical Integrative Nutritionist here at the Center among a team of exceptional providers with a common goal: optimizing your health. My part is to look at your gut from the inside out to identify – and then restore – underlying imbalances that may be affecting other aspects of your health.

I took this role in 2018 after working closely with Dr. Kaplan for nearly 3 years while completing my degree in Integrative Nutrition. Since then I have been sharing my knowledge with my patients and working in partnership with them to address all their dietary concerns and goals.

I graduated with a Masters’ degree in Integrative Nutrition from Maryland University of Integrative Health and completed my clinical and research experience at the Kaplan Center. I am also trained in Mindful Eating, Stress Reduction Techniques, Culinary Arts, and am currently completing the training to become a Certified Ketogenic Nutrition Specialist (CKNS).

I approach my practice by combining the principles of Integrative Medicine and the fundamentals of Functional Nutrition. I strongly believe that the patient and practitioner are partners in the healing process and involving you in the decision-making is crucial for success. I also consider the mind, body, spirit, and community support in directing my recommendations. I use evidence-based medicine and back up my supplement and dietary recommendations with research. I also offer personalized dietary plans and strategies because we all have a different genetic makeup that is influenced by our environment and lifestyle. My consultations include weekly meal planning and shopping lists, healthful recipes and recommendations about cooking methods, food storage techniques, and teaching you how to eat mindfully.

While working as Dr. Kaplan’s research assistant, I had the unique opportunity to incorporate the science of our research with the application of the information while working with patients. One particular research study that I found to be most intriguing was looking at the gut microbiome of patients diagnosed with chronic pain and neuropsychiatric diseases and comparing it to a healthy population. I can honestly say that I am fascinated by how gut bacteria can be a major modulator of health and disease in the human body. My dedication and love for science and research help me remain up-to-date on the latest evidence-based trends and products to provide the best care to our patients.

If you have dietary concerns or want to improve your nutritional and overall health, I would love to partner with you and be part of your successful healing journey.

Cheers to health,
Nour Amri MS, LDN, CNS
Clinical Integrative Nutritionist

To schedule an appointment with Nour, please call 703-532-4892.

A Letter to Patients from Dr. Nayo Wills

Dear Patients,

I am thrilled to have this opportunity to introduce myself to you. My clients call me Dr. Nayo, and I am a Board-Certified Internal Medicine physician who has been practicing Functional and Integrative Medicine for over 10 years.

I love working with individuals who are interested in self-directed healing and optimization of their health. I am excited about the opportunity to share my understanding with you to prevent disease, regain whole health and wellness, and optimize your weight through mastery of your thoughts, implementation of proper nutrition, exercise, self-care, and other restorative practices, including meditation.

Over the last twelve years, I have gained extensive training and experience in Integrative and Functional Medicine, spirit-mind-body medicine, metaphysics, acupuncture, weight optimization, and nutritional healing. I’m passionate about sharing the knowledge that I have gained by offering seminars, webinars, and workshops to help everyone to implement real-time, practical changes. In short, I am on a mission to support people in taking back their power to create wellness in themselves!

I am very excited to join the Kaplan Center Team to help patients maintain or improve brain health, vitality and overall wellness. Utilizing a functional medicine and spirit-mind-body approach I will listen to you and your health goals, then together we’ll look for clues that identify what your body needs more support with and devise a treatment plan that will address those issues.

I look forward to getting to know you and supporting you on your path to better health.

Be Well,
Nayo Wills, MD

The Kaplan Center Welcomes Dr. Daniel Sheehan

It is with great pleasure we introduce the newest physician to join the Kaplan Center’s medical team, Daniel Sheehan, M.D.!
Dr. Sheehan is board-certified in Physical Medicine and Rehabilitation and holds particular interests in spine injuries, chronic pain management, and endurance sports medicine.
We are thrilled to offer our patients an additional physician and team member who understands the complexities of chronic pain and how deeply it affects the mind, body, and spirit. At the Kaplan Center, Dr. Sheehan will perform a number of specialized procedures with regenerative medicine therapies.

A Letter To Patients from Daniel Sheehan, M.D.

Dear Patients, Family, and Friends of the Kaplan Center,
I’m very happy to be joining the amazing team at the Kaplan Center for Integrative Medicine. The practice already has an outstanding reputation for treating chronic pain and illness and now we are able to expand the Rehabilitation Medicine services to offer state-of-the-art spine, sports, and regenerative procedures.
In addition to musculoskeletal ultrasound and prolotherapy treatments, I am excited to now offer advanced regenerative injections such as growth factors and PRP (Platelet Rich Plasma) therapy using fluoroscopic (X-ray) guidance. This will allow for increased safety, accuracy and efficacy of spinal procedures for a wide variety of neck and back problems.
After reading Dr. Gary’s book, Total Recovery, I was inspired to better understand the complex interconnections of chronic pain and bring more effective treatments to patients who haven’t found the help they need. At the Kaplan Center, I will be able to spend time listening to your story and building a therapeutic relationship. Then, I provide validation by offering diagnostics, biomarkers, and education. Ultimately, we get results.
The key is understanding that the body wants to heal itself. If we remove the barriers, we have a phenomenal capacity to repair, rebuild and remodel. As a team of specialized physicians and skilled practitioners, The Kaplan Center team will collaborate to guide your body and mind toward total recovery.
I am thrilled to be joining the Kaplan Center for Integrative Medicine team and look forward to being available to discuss your specific concerns. Please contact the office at 703-532-4892 to make an appointment with me.
Daniel Sheehan, MD

5 Questions to Ask Before Selecting Your Insurance Plan

Dear Patients,
October through December is typically open season for choosing an insurance plan for the upcoming year. When selecting a plan with an eye to going out of the plan network (e.g. The Kaplan Center) there are important pieces of information to know in order to make an informed decision.
Here are 5 questions to ask an insurance provider before selecting your plan.

  1. What is the out-of-network deductible?
  2. Is the out-of-network deductible separate from my in-network deductible?
  3. What is the coinsurance?
  4. What is the maximum amount of out-of-pocket expenses I will be required to pay annually?
  5. How does the plan determine the out-of-network allowed amount? Many use the Medicare fee schedule which is not always to the patient’s advantage. For Federal employees this information can be found in each of the offered Health Plan Overview documents.

Also, please think back to your experience this year with your current insurance company and ask yourself a few more questions:

  • Were my claims paid fully and without delay?
  • Did I have to work too hard to get the benefits of the plan that I paid for? For example, did my insurance company delay payment on claims while they requested medical records?
  • Did they ask on one claim or for many claims?
  • Did I have to appeal any denials?

Dealing with your insurance company should not be your part time job, though for some that’s what it has become.

The way insurance companies operate these days is not as cut and dry as it was a decade ago, and it is likely to get worse. Frankly, some carriers are more difficult to deal with than others and if you have a choice, please make a smart, informed choice. This decision should be based on:
1) the information you gather about what the plans offer (including prescription coverage for medications that you take) from available documents describing the plan – or better yet, the plan contract,
2) talking to co-worker experiences, and
3) any direct inquires you make to the insurance company.

If your employer offers FSA (flexible spending account) you should consider taking advantage of your FSA options. It is a terrific, easy way to save on taxes and spread out that portion of your healthcare cost over the year if you are able to estimate your out of pocket liability for the year.

If you have any questions, please feel free to talk to me. I can be reached by phone at 703-532-4892, ext. 603.

June Guzdowski
Billing Director, Kaplan Center for Integrative Medicine

Regular Aerobic Exercise Allows for Longer, Happier Lives

Two recent publications reinforce the benefits of aerobic exercise and provide even more motivation to get out and break a sweat on a daily basis.
The first study, published in JAMA Network Open last week, found that sedentary lifestyles are as harmful to one’s health as having a chronic illness. Over the span of 23 years 122,000 adult patients underwent periodic stress testing to determine the link between mortality and aerobic exercise. The study found that better cardiorespiratory fitness was directly associated with longer life spans and better overall health, with the inverse also being true.

A review and meta-analysis, published in the journal Depression & Anxiety, looked at the association between aerobic exercise and major depressive disorder (MDD). The results of 11 qualifying studies were examined and it was determined that aerobic exercise had a significant anti-depressant effect and can be considered an effective intervention for MDD and other mental health disorders. Click here to read the abstract.

Look, we all know about the benefits of exercising, but we don’t always stick with it. These studies really highlight the importance of daily movement in living longer and happier lives. Start off slow and find something you like and most importantly stick with it, as consistency is the key to reaping the long-term benefits and safeguarding your health.

September is Pain Awareness Month

In 2001, Pain Awareness Month was established with the goal of raising public awareness of all the issues related to pain and pain management. This hits close to home for all of us at the Kaplan Center for Integrative Medicine as we have been seeing and treating patients with chronic pain and illness for more than thirty years.
Health care organizations across the country take the lead with public campaigns and encouragement for individual chronic pain sufferers to be vocal with the challenges that affect their physical and emotional wellbeing. And with over 100 million people in this country living with chronic pain and depression we must remember that we are all touched by chronic pain.
How can you make a difference? Here are some simple ideas on how you can get involved:

  1. Share your story. Talk about your relationship with pain to a friend, loved one, physician, or support group. Sharing your experience can educate others, and knowing you are not alone is crucial for maintaining your emotional wellbeing. Here is a wonderful article about the power of support groups with information on how to find one in your local area.
  2. Get social. Follow one of the many chronic pain health organizations, including our Facebook page which offers daily posts featuring news on the latest research, provider insight and tips, and healthy recipes . By sharing information on treatments, new research and personal experiences within your network you are reaching a vast audience in mere seconds.
  3. Participate – or organize – a fundraiser. Many nonprofit pain organizations host annual fundraisers in a variety of formats. From Fun Runs/Walks to auctions there is something for everyone to be able to participate in. And for those who are more ambitious, many sites have information on how to become an organizer in your local community.
  4. Volunteer your time. Most non-profits can use an extra hand and will have a variety of ways to volunteer your time. Inquire about ways to help in fundraising, promotion/marketing, administrative help, or even peer mentoring. Evidence suggests that people living with chronic pain may even experience an improvement of symptoms when participating in volunteer opportunities.
  5. Make a donation. There are so many organizations dedicated to the study chronic pain. If you know someone suffering from a chronic pain condition, consider making a donation to a non-profit related to his or her condition.  In 2015, Dr. Gary Kaplan established the Foundation for Total Recovery in order to provide support and find a cure for all who suffer with chronic pain and depression by educating patients, partnering with leading researchers, academics and innovators, and studying data to find a baseline approach to diagnosing and curing neuro-inflammation. Other leading non-profits to consider include: U.S. Pain Foundation, American Chronic Pain Organization, National Fibromyalgia & Chronic Pain Association (NFMCPA), and the American Academy of Pain Medicine.


What Your Pharmacist Can’t Tell You, Unless You Ask

Naturally people are under the assumption that paying for their medications through their insurance plan allows them the best price available, however, this is not always the case. Consumers are losing out on potential savings because of “gag clauses” that prevent pharmacies from disclosing lower prices for prescription medications if paid “out-of-pocket” instead of using their prescription benefits. In fact, a 2018 study in JAMA found that about 1 in 5 prescriptions are being overpaid!

Unfortunately, the financial burden of prescription medications often causes patients to change the dose to make the medication last longer or choose not to take the medications at all. This is especially concerning for patients taking medication for chronic illnesses. At a time when premiums, deductibles, and copays are far from affordable for the average American, finding ways to make your prescriptions more affordable is essential.

How did we get here?

Pharmaceutical Benefit Managers (PBMs) are companies that act as intermediaries between pharmacies, drug manufacturers and insurance companies. The role of PBMs in the prescription drug marketplace is quite far-reaching, yet surprisingly most consumers know little or nothing about them. PBMs establish formularies (the list of drugs covered by the health plan), decide which pharmacies are included in the network, process claims, and even operate their own mail-order pharmacies. PBMs negotiate deep discounts with drug manufacturers, and in return, those manufacturers benefit from having their drugs widely available to consumers. PBMs reimburse pharmacies a certain percentage for each medication, and charge plan sponsors (insurance companies) much higher rates for those same medications, pocketing the difference. Very simply, PBMs make enormous profits as a result of cleverly crafted contracts and operate with virtually no oversight.

These “gag clauses” that ultimately hurt the consumer are found in many of the contractual agreements between PBMs and pharmacies. If pharmacists don’t play by the rules and volunteer lower-cost alternatives, they risk being penalized and/or dropped from the network.

What is being done about it?

Recently there has been a movement to create more transparency for consumers when buying their medications. Many states have already passed legislation, or have bills pending, that ban the practice of gag clauses (click here to find out about your state). The “Patient’s Right to Know Drug Prices Act” is one of two new bills recently introduced in the Senate. This bill advanced last month for a full Senate floor vote and there is hope that the other, “Know the Lower Price Act” will too.
The bottom line is that you or your trusted advocate must be proactive in every aspect of your healthcare. The only way to really know if you are receiving the lowest possible price for your medications is to do some research and ask a lot of questions. Here are some tips that may help you lower the cost of your prescription drugs*.

  1. Pay with cash: Ask your pharmacist if paying by cash will get you a lower price. Many pharmacists are not allowed to disclose that information to their customers unless they are specifically asked.
  2. Shop around: A recent Consumer Reports’ Special Report on drug costs found that there were enormous discrepancies in costs for several common generic drugs depending on where a prescription was filled. For example, after comparing cash prices from chain pharmacies, supermarket drugstores and independent pharmacies, a one month supply of atorvastatin (generic Lipitor, 20mg) ranged from $10.00 at the online pharmacy HealthWarehouse.com, to $135.00 at CVS & Target!
  3. Look for discount programs: Find out if your pharmacy has an in-store discount program or prescription card that allows you to receive additional savings on your prescriptions.
  4. Use an online service: There are some free, online services that can help consumers quickly get information on where to get the best cash price for a prescription.

    Good Rx – Collects prices and discounts from thousands of pharmacies. Consumers can get a discount card and/or coupons to present to the pharmacist for savings.
    Blink Health – Account holders purchase directly through Blink Health but pick up at their local, participating pharmacy.

  5. Ask about alternative options: Generic or other brand name medications may be less costly and a suitable substitute.

* These tips require paying for your prescription by cash rather than insurance. While it may get you a better price, keep in mind that these purchases will not be applied towards a deductible. If you have a high deductible and many medical expenses, it may make more financial sense to pay with your insurance.

The Kaplan Center does not endorse any program or site mentioned in this article. Consumers are encouraged to exercise due diligence to make the best, most informed decision on their own behalf.

Hormone Levels and Risk of Alzheimer’s

Last month at the Alzheimer’s Association International Conference in Chicago, studies were presented in relation to lower hormone levels contributing to possible risk of dementia.
One study, Women’s Reproductive History and Dementia Risk, which looked at 15,000 women in California, showed that women were less likely to develop dementia later in life if they started menstruating earlier and went through menopause later. Menopause at age 45 or younger increased risk by 28%. Also the risk of Alzheimer’s for women who had 3 or more children were 12% lower than those women who had one child.
Another study out of the U.K., Women’s Pregnancy History May Influence Alzheimer’s Risk through Alterations in Immune Function, of 133 elderly women, supported these findings. They looked at the number of months of pregnancy in their lives and found the higher the number, the lower the rate of Alzheimer’s.
One presenter remarked that the intense fluctuations of hormones related to menopause may be associated with increased risk of Alzheimer’s.
While it’s not clear if estrogen replacement protects against dementia after menopause, there is supportive evidence that if given to women in their early 50’s, estrogen and progesterone prevent the hormonal fluctuations, hot flashes and sleep disturbance that could be associated with dementia. The benefits of giving hormones after 65 is murky, in that there may be an increase risk in dementia, heart disease and breast cancer. In this age group, it is recommended to look at each case individually, depending on other medical conditions and to use the lowest possible dose with a safer delivery system, like transdermal estrogen and natural micronized progesterone. Some conditions that could benefit from hormone replacement later in life include multiple sclerosis, chronic pain syndromes, osteoporosis, or continuation of severe hot flashes.