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All posts by Alexandra Ames

Top Tips For Your Medical Video Consultation

Book Telehealth session in Trinidad

 

Top Tips for a Successful Telehealth Consultation:

1. Be on time..to maximize the most of your appointment

2. You must have a device with internet connection, a mike and camera.

3. Have a Private space – remember this is a medical consultation. You want it to be confidential. Ideally lock the door and turn off phone ringers to minimize interruptions

4. Consider letting family/work colleagues know that you are in a virtual appointment to avoid interruptions. If you are in an open plan office consider going to your car.

5. Have your photographic ID ready so that we can identify you.

6. If you have insurance please have your Insurance Card ready if applicable.

7. Have a list of questions you want to ask and important points you wish to make

8. Have your medications or at list a list with dosages to hand

9. Have any relevant Test results to hand

10. Think about your clothing: If the lesion you wish to discuss is on your leg, consider wearing shorts…if on the arm, wear a tank top etc.

11. If you have any medical equipment like a Blood pressure machine, thermometer, blood glucose testing kit have these to hand as they can provide the doctor with additional information.

Advancement in technology has made Telehealth and medical video consultation a reality. Learn more about what is Telehealth and its benefits . Telehealth and Telemedicine services are  especially useful for patients who are housebound or are unable to show up at the doctor’s clinic due to time constraints. Follow the tips above in your next virtual medical appointment to make the most of your time.

Book Your Telehealth Session With Ames Medical

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What is Telehealth/Telemedicine?

Telehealth and video consultation doctor in Trinidad and Tobago

 

What is Telehealth?

It a way for doctors and patients to have a consultation and exchange information and advice when they are not in the same place. This can be over telephone, video, email and whats app, using a telephone, smart phone, tablet, laptop or computer.

Is it Secure?

lt is vital that confidentiality is maintained, so here at Ames Medical we use something called a HIPPA compliant system. This is not Whats app/Facetime . It is a medical grade system that is very secure. We never record you.

Isn’t this very New?

Ames Medical was as far as we know, the first video consultation service in T and T and we therefore have 3 years of experience delivering this service. We always knew that it was going to be a big part of the future, so we invested in a fantastic platform, not weeks ago or months ago, but YEARS ago.

Now, during the pandemic, many of you are also just beginning to see the usefulness of Telehealth. – No waiting rooms exposing you to other patient’s illnesses, for example.

But we think, and always did think, that Telehealth has a role to play in the future too.

What Conditions Can you deal with on Medical Video Consultation

Telehealth will never completely replace a doctor’s visit but it is a useful option for minor ailments, like red eye, UTI, sore throat, medication and results etc. Clink here for a useful video on other things it can be used for :

Conditions appropriate for Telehealth and Telemedicine – by Dr. Alexandra Ames

It is also very convenient – less time in traffic and away from work. No need to leave your comfy PJs and bed if you are feeling under the weather and don’t want to come out.

What Can you really Examine on Video?

There is a saying at Medical School: “The history (or the patient’s story) is 80% of the diagnosis.” The Examination is to confirm what we think..  So much more can be examined on video these days….human ingenuity is an amazing thing. We can barely keep up with all the technology coming out. Just look at the wearable devices you have in your own home that can provide information! Your FIT Bit, Your Blood Pressure machines, your Blood Glucose machines, Apart from that, Video gives us an awful lot of information we can’t see on the telephone. Like, how you are breathing, if you look jaundiced or anaemic; we can see rashes. The camera is so good that we can have a really good look at the back of the throat. Plus, our medical video consultations have always been backed up by the fact that if we both underestimated the situation wrong and during the video call we think we really need to see you face to face to be safe, we will convert your appointment to an in-house one at no extra cost.

How Can I get a Prescription?

We can email prescriptions, sick notes and helpful leaflets and advice.

How do I Pay?

You can pay online via Paypal, Wipay or by direct transfer to Ames Medical Services account. The best bit? Your Insurance company may even cover it! – Many like Sagicor Health are now seeing the benefit of Video consultations to their clients…so ask them.

Wars like this one have always bred culture change, and we think this is one of them. Don’t be afraid of it, we can still bring you down to be seen in office if we need to….and look out for the next blog Tips for a Successful Telehealth Consultation.

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How to Save Money on Medical Costs

We are all Hurting right now.

But Health is Wealth so we need to be able to prioritize the important things. Here are some tips for how to save money on medical bills and medication:

 

 

  1. Switch to generic. Not all generics are created equal, but there are some really good ones out there Like the APO and Sandoz brand. You can literally save hundreds of dollars on an antibiotic prescription by switching. Also brand names like Panadol and Tylenol are just bog standard Paracetamol AKA Acetaminophen:  You can save 50% or more by not buying brand names. Ask your doctor or pharmacist if switching to generic is an option for you. Important note: certain medications classes DO need to be always the same brand – like for example anti- epileptics . Once you have found a brand (either generic or branded) then stick to it.

 

 

2.Can you switch to a CDAP version of your drug? The chronic disease assistance program is for ALL nationals. Ask your doctor if this is an option for you….and they are free! Aspirin, Metformin, just to name a few

 

 

3.Consider going direct to the supplier like Smith Robertson or Oscar Francois to save money. You will need an order from your doctor so talk to her.

 

 

4. Consider buying scored tablets and cutting them in half. If you are on a drug like Euthyrox for example, this comes in a variety of doses. If you are on 50mcg, it may be cheaper to buy 100mcg tablets cut along the scored line….YOU CANNOT do this with all drugs but if they are scored you probably can. Long release tablets are not suitable for this because they have a coating which controls how quickly the drug is released. But it’s worth asking your doctor or pharmacist if this is an option for your drugs. Don’t take the decision on your own as you need to make sure this is safe for your medication.

 

 

5. Attend your regular medication reviews: This may seem like an upfront cost, but it can save you hundreds in the long run as you can take the opportunity to talk to your doctor about the possibility of switching to cheaper generics. You can also look at combination tablets, For example, Galvus Met is a combination of Galvus and Metformin and is cheaper in combination than when bought separately. If you are on three or more Blood pressure tablets also review with your doctor to see if a combination tablet might be cheaper, and lets face it, easier to remember to take. Also, if you find that the drugs are not working for you as expected, then it’s better to know and do something about it sooner rather than end up with an expensive emergency hospital bill if you become ill.

 

6. Consider a dose box or medication reminder app and take medications as prescribed. There is no point forgetting to take medicines you have paid for as not taking your medications regularly can cause you to become ill and again, end up with a trip to the ER or a Hospital admission.

 

7.Go for your chronic disease appointments regularly – asthma, diabetes etc, Uncontrolled illness may again land you with an even bigger ER or hospital bill than your GP appointment!

 

8. Prevention is Better than Cure: Check your Insurance policy to see if you have an annual medical benefit. Using this to have your health check will detect problems earlier and make them cheaper in the long run

 

9. You do NOT always need a pap smear or mammogram every year. If you are healthy with no previous abnormal smears it is fine to have pap smears every 3 years instead of annually. A mammogram is fine every 2 years unless your history or family history means you should have them more frequently. Talk to your doctor about this

 

10. Colonoscopies are the gold standard for detecting asymptomatic bowel cancer or polyps before they become malignant. Check your insurance policy to see if you have preventative coverage for this. If you don’t, and you don’t have the $4K it costs to have a screening colonoscopy, then talk to your doctor about having a special stool test called the FIT test instead. This detects microscopic blood int he stool that you and I cannot see with the naked eye.

 

 

11. Ask your insurance provider about switching to copay options. Lots of local insurers now offer these options. This means that if you may only have to pay a percentage of the cost of your doctor’s visit or medication bill up front, and they pay the rest direct to the provider….so you don’t have to pay the whole bill up front then wait for re-imbersment. This can be a life saver when cash flow is a problem.

 

12. Are you taking your asthma inhalers correctly? – spacer devices mean more of the drug gets into your lungs rather than hitting the back of the throat. This means less wastage, better control and studies have shown that spacer devices can be as good as nebulisers!

 

13. Are you storing your medications correctly? – For example,Insulin needs to be stored in the fridge. If not it may not work as well.

 

14. Get vaccinated! Again preventing hospital admission..

I hope you found this helpful. Call us for a virtual medication review if you don’t want to come in!

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Sleep in the time of COVID: Part 1: Struggling to Sleep

My Prescription for Sleep during the lockdown:

 

It can be tempting to relax our regular sleep routine while in lockdown…especially since we are not going to work, or working from home. .But this lack of, or change in routine can sometimes exacerbate insomnia. Many of us barely know what day it is far less the time! We need to try to maintain our normal sleep rhythms.

Many of us are also not able to exercise as we usually would, and our body is missing those endorphins. This coupled with increased anxiety over this crazy situation we are in, can really affect our sleep…and lets face it, when we can’t sleep…we feel even more anxious and crazy! Think about it: The Japanese used to use sleep deprivation as a form of torture!

 

 

As much as possible try to stick to a regular bed time, and still set an alarm for waking up, as well as one for going to sleep

 

Resist the temptation to nap during the day

Exercise in the morning at home and not after 5pm. Exercising too late in the day can make some people feel “reved up”

Watch out for “workout ” drinks and supplements. Many of them contain Caffeine or taurine or “Green tea extract” or “Coffee bean extract” These all are basically stimulants and can keep you up at night!

Avoid Cigarettes especially before bed.  Nicotine is a stimulant.

Try to limit yourself to caffeinated beverages in the morning only, and certainly not after 3pm.

Avoid an alcohol night cap if you are struggling to sleep…alcohol can interrupt our normal sleep patterns

Dinner time is important. Try to eat at least 2-3 hours before bedtime. Going to be too full can increase heartburn which can wake you up at night with pain or a cough. Remember: Breakfast like a King, Lunch like a Prince, and Dinner like a Pauper.

What you eat is also important. Foods high in Tryptophans like Turkey and chicken can help promote good sleep.

 

Practice good sleep hygiene: Ideally the bedroom should be for sleep and sex only….but if you are forced to stay there because you are in isolation then keep a window open, and leave the curtains open during the day to let natural light in.

 

If you are in isolation Try to have a desk and comfortable lounge chair in the bedroom so you resist the temptation to spend all day in bed. 

 

At night, limit noise and increase darkness by using black out curtains or an eye mask and ear plugs if you need to.

 

DO NOT look at any screens like TV, Computer,  phone or tablet an hour before bed. The bright light breaks down our natural melatonin.

 

Have a wind down ritual: A warm shower, doing a crossword or planning what you are going to do/wear  the next day can help your brain understand it’s time for bed.

 

Sometimes medical conditions like depression, anxiety, pain, hot flushes and night sweats and restless leg syndrome can interfere with our ability to fall asleep. If you think you may be experiencing any of these, talk to your Doctor. Further updates will give more information on medical conditions which can affect your sleep.

Certain medications like Steroids and Diuretics are best taken in the morning to avoid interfering with sleep. Another common problem is Migraine tablets or “Multi symptom day tablets” – These sometimes contain caffeine. If they do, try to use these only during the day or use some without caffeine if this affects you. The common decongestant “Phenylephedrine” can also make children and some adults feel “hyper”

 

 

If you are still struggling try two Camomile tea bags in hot water and allow to draw for six minutes. You can add honey to this if you are not Diabetic. Camomile actually works on the same receptors int he brain as sleeping tablets!

 

 

You can also try 5mg of Melatonin, available over the counter, an hour before bed. This has been shown to be even more effective if you are over the age of 55.

Look out for my next update which will be on how to deal with waking up at night.

Night Night and Sleep Tight!

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