Can Pharmaceutical Drugs Increase Your Risk of Dementia or Alzheimers?

Researchers have discovered a significant link between high use of anticholinergic drugs and Dementia/Alzheimers. These drugs block the neurotransmitters in your body located in your central and peripheral nervous system.  Nerve impulses block the binding of a neurotransmitter called “acetycholine” to its receptor nerve cell.  Some of the nerve cells involved are connected to the Parasympathetic system.  This system is responsible for movements in your smooth muscles that you are not even aware of.  Smooth muscles are present in the Gastrointestinal tract, urinary tract, lungs, uterus, arteries, veins etc.   Many medications including over the counter drugs have strong anticholinergic effects.  Again, Anticholinergics are drugs that block the action of the neurotransmitter acetylcholine in the brain and body. Non-prescription sleep aids and the antihistamine Benadryl (diphenhydramine) -have shown an increased risk of developing dementia and Alzheimer’s disease in older people.

Anticholinergics can lead to many side effects, including drowsiness, constipation, retaining urine and dry mouth and eyes.

The researchers, led by Shelly Gray, a professor in the University of Washington School of Pharmacy in Seattle, reported their findings in JAMA Internal Medicine in January 2015.

Professor Gray suggests that health care providers regularly review their patients’ drug prescriptions and over the counter medications to decrease anticholinergic medications when necessary.

If providers need to prescribe anticholinergics to their patients because they offer the best treatment, then “they should use the lowest effective dose, monitor the therapy regularly to ensure it’s working, and stop the therapy if it’s ineffective,” she adds.

There is another study, that also shows that dementia risk linked to anticholinergics may persist long after people stop taking the drugs.  For instance, taking anticholinergics for more than 3 years linked to higher dementia risk.

For their study, Prof. Gray and colleagues tracked nearly 3,500 men and women aged 65 and over with no dementia symptoms at the start of the study. The participants were part of the Adult Changes in Thought (ACT) study in Group Health, an integrated health care delivery system in Seattle. Their researchers used computer records from the pharmacies that dispensed drugs to the participants.

From the pharmacy data they added up all the standard daily doses and worked out the cumulative anticholinergic exposure for each participant over the past 10 years. This was updated as participants were followed up for an average of 7 years.

Over the period of the study, nearly 800 participants developed dementia.

The results showed that the most commonly used medications were antidepressants like Doxepin or Sinequan, first-generation antihistamines (chlorpheniramine, Chlor-Trimeton), and antimuscarinics for bladder control (oxybutynin, Ditropan).

The researchers estimated that people taking at least 10 mg per day of doxepin, 4 mg per day of chlorpheniramine, or 5 mg per day of oxybutynin for more than 3 years would be at greater risk for developing dementia.

Gray also told Medical News about the dose risks associated with Benadryl: “The dose of diphenhydramine that would correspond to the highest risk group is taking the equivalent of 50 mg each day for longer than 3 years – or 25 mg per day for longer than 6 years in duration.” That is pretty scary considering the amount of patients that use Benadryl frequently.

Prof. Gray says there are alternative non-anticholinergic drugs for doxepin and chlorpheniramine. For example, to treat depression there are the selective serotonin re-uptake inhibitor (SSRI) like citalopram (Celexa) or fluoxetine (Prozac). And there are second generation antihistamines like loratadine (Claritin) for allergies.

References: Medical News Today: Catharine Paddock PhD

Berkeley Passed Measure Regarding Cell Phone Health Risks

According to the New York Times, Berkeley is the frontrunner of labeling phones with warnings for potential health risks.

The city passed a measure requiring cellphone stores to warn customers that the products could be hazardous to their health.  They are under the presumption that phones emit dangerous levels of cancer because of the radiation.  I agree and have been warning patient for years.  Just because there isn’t tons of evidence out there about brain cancer regarding phones, it seems odd to me why the rate of brain cancer is going up each year.  There must be a correlation.

The “Right to Know ordinance”, passed unanimously in May by the Berkeley City Council.  Retailers are supposed to notify customers, starting in August of 2015, that “you may exceed the federal guidelines for exposure” to radio frequency radiation by carrying a cellphone in a pants or shirt pocket, or tucked into a bra. The potential risk, the warning continues, “is greater for children.”

“We want to raise awareness,” said Ellie Marks, the founder of the California Brain Tumor Association. Ms. Marks does not live in Berkeley but brought her case here because, she said, “Berkeley has a reputation for taking progressive action.” She said she is convinced that her husband, Alan, a real estate agent, contracted brain cancer at age 56 from often having a cellphone pressed to his ear.

Not surprisingly, just like the tobacco companies who knew of the hazardous chemicals in their cigarettes, the cellphone industry is not allowing this measure to go unchallenged. A few weeks after the law passed a trade group, filed a First Amendment lawsuit against Berkeley, charging that retailers cannot be forced to say something that is “false.” Well, if it is not proven false then that statement is unwarranted in my opinion.  A hearing is set for Aug. 6 in federal court in San Francisco, and the ordinance will not go into effect until the matter is settled.  We will see how this progresses.

Berkeley has a habit of passing first-in-the-nation laws that seem radical but are promptly copied by other municipalities. The city has led the way on a variety of initiatives creating smoking bans, a sanctuary for immigrants in the country illegally, a Styrofoam ban and health benefits for domestic partners. So if Berkeley succeeds in its fight to warn people about cellphones, can Cambridge, Mass., and other cities be far behind?

“If you can get it passed in Berkeley, you have a beginning,” said Susan Wengraf, a City Council member. “If you can’t, forget it, or come back three years later.”

When interviewing people from Berkeley, reviews for the ordinance were mixed. “Labeling things that have a potential threat is always good,” said Benjamin Fahrer, a farmer who said he creates “urban agriculture on rooftops.” He likened the new law to notifying the public about secondhand smoke and GMOs.

While another interviewee, Bill Doran, who had his cellphone out while waiting in line for ice cream, said, “I’m a little skeptical about cellphones causing harm.”

Even though this is controversial, a Berkeley City Council member who helped write the legislation, Max Anderson, said he had spoke to his colleagues in May to pass the ordinance on ethical grounds. “Even if the science isn’t firm, if there’s a risk, we should proceed with caution,” he said.  Again, I agree.  At least say there may be a risk and let each person decide for themselves about the exposure.

Hip Pain, Do I Need a Hip Replacement?

Our hips are complex.  We have nerves, muscles, cartilage, tendons and ligaments all working in unison to help us move about, give us support, balance and stability. There are many people who have issues with their hips and have tried chiropractic before deciding to get a hip replacement and have found great improvement and have avoided surgery.

Chiropractic can be helpful in the treatment of acute and chronic joint conditions, as well as hip injuries.  After all, a hip is a joint!  We are experts regarding strains or sprains and overuse injuries, such as tendinitis and bursitis and postural issues. Some of the things we can significantly help with our care are:

* Discomfort       * inflammation         *Restoring and maintaining flexibility        *Increasing range of motion      *Strength, balance and stability in the joints and muscles

*alignment and function                    *reducing the risk of hip replacement and other joint surgeries

Our methods include but are not limited to: Adjustments to the spine and hip, soft tissue work, stretches, exercises, ergonomic and nutritional counseling.

Why Avoid Hip Replacement?

While hip replacement may seem like a quick and efficient solution to chronic hip problems or even getting a Cortizol shot seems quick and easy.   Both are more involved than many people may realize. After all, injecting yourself with a steroid is dangerous and is not recommended even by medical professionals to be done more than every 3 months.  Major surgery, and a full recovery from a joint replacement can take a year or longer, depending upon your health and fitness level.  Replacements have become very common and there are risks.

First, hip implants have a lifespan that ranges from 10 to 20 years. That means you will need another surgery to replace that artificial hip once it has reached the end of its lifespan.  If you are 40, that will mean probably 4 more procedures to keep you moving.  Also, failure of the joint can happen leading to another replacement much earlier than anticipated.

Revision procedures have become more common now because of the invention of metal hip replacements.  This was an attempt to make them last longer but some of these devices were poorly contrived leading to recalls and numerous complications.

Among the problems associated with these devices was “metallosis”.  This is a serious inflammatory condition that happens when there is shedding from the joint that is floating and causing friction leading to inflammation.  This can lead to severe pain, tissue damage and death, bone loss and failure of the implant to work properly.

It may be a good idea to think about natural solutions or non-invasive means before getting cut open and having a procedure done.  Remember, the surgeons are ready to do the replacement at any time, just make sure you have exhausted everything before doing so. There are usually several different things that you haven’t tried that will work.  Chiropractic has a great track record with joint work so give us a try first.  You may be surprised about the results!

Can Allergies Be Helped and Decreased With Chiropractic Care?

This year in the Bay Area, the weather has been unpredictable.  We have had extremely hot days followed by cold fronts coming in the day after.   We have had high winds and sporatic rain (yes, we are in a drought but it does rain once in a while, just not enough to make a difference).

Unfortunately for many people, drastic weather changes can start up allergy symptoms like runny noses, itchy eyes and sneezing. Hay Fever is pretty common during the spring and can keep creeping up if the weather is “spring-like.”

Hay fever erupts during spring when the flowers are pollenating and the weather is changing. Millions of us suffer from this condi­tion, which causes the body to become hypersensitive to pollen and other environmental substances. This condi­tion causes a number of irritating symptoms that can make life miserable.

What Causes Allergic Reactions?

Your immune system can remember and recognize toxins that are harmful for your body.  That is what it does.   Allergic symptoms like Inflammation, sneezing, cough­ing and vomiting are all a sign that your  immune system is working and is trying to get toxins out of your system.

So what is going on inside the body then?

When an allergic reaction starts, the body activates special immune cells called mast cells. On the outside surface of the mast cell, it has receptors that can recognize harmful toxins that have entered the body.  After they detect toxic substances, they release what are called histamines.  You may be familiar with over the counter items called “Anti-Histamines,” These are used to treat allergic reactions by connecting to the outside of the mast cells and inhibiting the allergic response.  Your body needs to be able to fight off substances and taking an Anti-Histamine will only prolong the response because the body has not been able to get the toxins out of the body.  If you want a natural remedy that doesn’t put an extra strain on the body, Chiropractic may be a wonderful solution for you.

Why Do People Get Allergies?

There are a couple of theories.  One is that people are very sensitive if you are a sensitive person.  This means if you are sensitive to stress, your body will respond to the stress and show a symptom, since the mind and body are connected.  Mediation and stress reduction strategies are helpful to reduce this mind-body reaction in many patients.  

The second theory is that an allergic reaction is a reaction to the environment. Your body takes this information and interprets it.  Your nervous system is the part of your body that does the interpretation.  

Can Chiropractic Help With Allergies?

There are numerous articles showing the beneficial effects of chiropractic adjustments and there effects on the immune and nervous systems.  So, with this information, t’s not surprising many chiropractic patients report a reduction of allergy symptoms when treated regularly for vertebral subluxations.  A vertebral subluxation is a misalignment or dysfunctional movement of vertebra.  This can cause a focal irritation in the spine, which then creates an abnormal signal received by the central nervous system.  When this happens, signals are not received properly and the body can not interpret information properly or fast enough so it will overwork and breakdown.  Reactions then result. 

Although scientific research shows chiropractic adjustments do not cause an improvement in everyone that has an allergy, our treatments can work for a large amount of people.  There is definite evidence that misalignments are one of the causes for the body to not be able to get rid of toxins in the body because of altered signals of the nervous system.

If you suffer allergies, consider chiropractic as one of your potential powerful options.  I have several patients who state that getting care decreases the symptoms and allow them to get a better nights sleep which is when the real healing begins.  


Why is Sugar Bad For You?

Not all types of sugars are bad.  Here are different types of sugars and the affects they have on your system:


Glucose is a simple sugar that your body likes.  All of your cells use Glucose as their primary source of energy.  Glucose is necessary for your body to function.  After Glucose is ingested,  it sends signals to the pancreas to produce insulin. Signals are then sent to the brain and metabolizes the food just eaten.  When the brain notices the food intake, it lets the rest of your body know that you are not hungry.  So, glucose basically lets your brain know that you are finished eating and that you don’t need to eat anymore.

Glucose, though natural, can have some issues for the body as well.  Your liver will produce what are called very low density lipoprotein (VLDL).  This is considered a bad cholesterol.  VLDL can cause cardiovascular disease.  Only 1 out of 24 calories ingested and processed by the liver turn into VLDL.

Sucrose and High Fructose Corn Syrup:

These two are linked together here because high fructose corn syrup (HFCS) and sucrose are really the same thing.  They are both contain a large amount of fructose and are highly sweet.   Sucrose is 50% fructose and HFCS is 55% fructose. The other remaining percentages consist of glucose.

In most cases, fructose is bad for you because of how the body processes it. Fructose can only be metabolized by the liver, which means a greater number of calories (about three times more than glucose) are metabolized by the liver and higher amounts of VLDL.  It also creates a larger amount of uric acid which leads to hypertension and high blood pressure.

Fructose also has negative affects on the brain regarding what you have consumed.  This happens because it alters a protein called “Leptin.”  This protein is important for energy intake and expenditure and is key for monitoring your appetite and keeping your metabolism working the way it should.  When you eat fructose, your body resists Leptin and you feel hungry even when you are not.  So, foods like soda contain high amounts of fructose which then trick your brain into thinking you are not full and your body thinks you are still hungry.  There have been studies showing that people who have consumed Fructose actually eat more than people who do not.

Processed v. Unprocessed Foods:

Fruit contains fructose, but as shown on the food pyramid, it shows that fruit is okay. How is that possible?  Well, it is because fruit is all natural and has large amounts of fiber.  Fiber monitors your satiety levels even though fructose does not.   This is why fruit is beneficial. The same goes for processed sugar. Sugar doesn’t exist naturally as the sugar that you buy at the store, but as a really tough stick called sugar cane.  It isn’t until you process the sugar can that all the fiber is taken out of it.  Without the fiber, you only have the bad portion of the sugar.  That’s why processed sugars can cause problems.

How Dangerous is Using Your Mobile Phone While Driving?

As you know, Californians need to be “hands free”.  Why?  Because it is dangerous to drive while texting and using a cell phone.  If you check the statistics they show that at any given time throughout the day, approximately 660,000 drivers are in some fashion, attempting to use their phones while behind the wheel of an automobile. Back when I was a kid, it was hard enough trying to maneuver the radio much less navigate through a phone.  Well, smartphones have made it easy for us to stay connected at all times through email, texting and internet but all of this technology has distracted people and make it hard to focus on just 1 task at hand. That task being driving. Cell phone distraction rates are alarmingly high and come with hefty fines if caught using your phone behind the wheel. Here are a few statistics that may alarm you:

  • The National Safety Council reports that cell phone use while driving leads to 1.6 million crashes each year.
  • Nearly 330,000 injuries occur each year from accidents caused by texting while driving.
  • 1 out of every 4 car accidents in the United States is caused by texting and driving.
  • Texting while driving is 6x more likely to cause an accident than driving drunk.
  • Answering a text takes away your attention for about five seconds. Traveling at 55 mph, that’s enough time to travel the length of a football field.
  • Texting while driving causes a 400% increase in time spent with eyes off the road.
  • Of all cell phone related tasks, texting is by far the most dangerous activity.
  • 94% of drivers support a ban on texting while driving.
  • 74% of drivers support a ban on hand-held cell phone use.

How do teen drivers fall into these statistics?

  • 11 teens die every day as a result of texting while driving.
  • According to a AAA poll, 94% of teen drivers acknowledge the dangers of texting and driving, but 35% admitted to doing it anyway.
  • 21% of teen drivers involved in fatal accidents were distracted by their cell phones.
  • Teen drivers are 4x more likely than adults to get into car crashes or near-crashes when talking or texting on a cell phone.
  • A teen driver with only one additional passenger doubles the risk of getting into a fatal car accident. With two or more passengers, they are 5x as likely.

2012 U.S. Cell Phone and Driving Statistics

  • In 2012, 3,328 people were killed in distraction-related crashes.
  • About 421,000 people were injured in crashes involving a distracted driver.
  • In 2012, 11% of drivers under age 20 involved in fatal accidents were reported to be distracted at the time of the crash.
  • 1/4 of teenagers respond to at least one text message every time they drive and 20% of teens and 10% of parents report having multi-text message conversations while driving.

2012 National Survey on Distracted Driving Attitudes and Behaviors

  • Nearly half (48%) of drivers admit to answering their cell phones while driving.
  • Of those who answered their phones while driving, 58% of drivers continued to drive while talking on the phone.
  • In the survey, 24% of drivers reported that they are willing to make a phone call while driving.
  • One in 10 drivers surveyed said that, at least sometimes, they send text messages or emails while driving.
  • Of the drivers surveyed, 14% said they read text messages or emails while driving.
  • A majority of respondents supported laws that banned talking on cell phones, texting, or emailing while driving.

What if I am a Pedestrian?  How dangerous is it to text while walking?According to Researchers conducting a study from the University of Washington in 2012, it can be.  They monitored 20 of Seattle’s busiest intersections and observed the following:

  • Pedestrians who text are 4x less likely to look before crossing the street, cross in crosswalks, or obey traffic signals.
  • They also found that texting pedestrians take an average of two seconds longer to cross the street.

Not only is it dangerous to text while driving but walking and texting is dangerous too.  I have had patients run into polls, get hit by a passing bicycle and even get hit by a car.  If you are going to use your phone, take the time to either pull to the side of the road or if not in a car, find an area that is safe.

Is Artificial Turf Safe To Have Kids Play On?

As you know, California is in a drought.  During this drought a lot of people are opting for artificial turfs to keep the watering low.

Every day, we let our kids play on these turfs and a lot of people don’t realize that it could be a health hazard.

What is being debated about artificial turf are particles in the turf called butadiene rubber or for slang… “crumb rubber.”  These particles are made synthetically from the rubber from old tires.

Dust will raise above the fields and smell like, old tires.   Now that these fields are becoming more prominent for athletics,  a number of people are questioning the safety of fields made of artificial turf.  Especially when it comes to soccer goalies.

There is not a lot of research on it yet but it is worth exploring.

In 2009, Amy Griffin, an associate head soccer coach at the University of Washington, was visiting to women goalies who were young but diagnosed with  non-Hodgkin’s lymphoma. After speaking with one of the nurses, she said “Don’t tell me you guys are goalkeepers. You’re the fourth goalkeeper I’ve hooked up this week.”

Later, one of the women at the hospital while undergoing chemotherapy said that she had a feeling the cancer was associated with what she said were “black dots.”

Artificial turf fields are now everywhere in the United States, from high schools to professional soccer fields and NFL stadiums.  Anyone who has played on these turfs will testify that the tiny black rubber crumbs (old tires), get everywhere.  Inside a uniform, in hair, cleats and sometimes swallowed.

Goalkeepers, are constantly in contact with the turf.  During practices and games, they make hundreds of dives, and each time, a black cloud of tire pellets into the air.  These particles can get into cuts, scrapes and into their mouths.  Coach Griffin wondered if those crumbs which are now known to contain carcinogens and chemicals – were making players sick.

She stated “I’ve coached for 26, 27 years.”  “My first 15 years, I never heard anything about this. All of a sudden it seems to be a stream of kids.” Since that hospital visit, Griffin has compiled a list of 38 American soccer players who have been diagnosed with cancer.   34 of them are goalies.  Nationwide, blood cancers like lymphoma and leukemia dominate the list.

While more testing is needed, New York City has stopped installing crumb rubber fields in its parks in 2008 and the Los Angeles Unified School District did the same in 2009. In Maryland, the Safe Healthy Playing Fields Coalition supports legislation to require warning signs at artificial turf fields and opposes a bill to use state funds to construct artificial turf fields.

Griffin still continues to do her own research on the topic and that she sends crumbs from each field her team plays on to a lab for testing.

“I’m looking for answers, because I’m not smart enough to come up with them on my own,” Griffin said. “I would love someone to say, ‘We’ve done some tests and we’ve covered all of our bases — and, yes, it’s safe.’ That would be awesome. I would love to be proved wrong.”

The jury is still out on this one but to be safe, play on a natural playing field just to be safe

What Are Muscle “Knots” and How Should They Be Treated?

This is in response to an article I just read in the NY Times.

According to an article in the NY Times regarding muscle knots,  “no one knows definitively what muscle knots are made of.”

This article states that experts believe knots, are “specific areas of contraction within the muscle fiber,” (Rob Grieve, a senior lecturer in physiotherapy at the University of the West of England in Bristol, England).

Mr. Grieve’s research results state that “the knots seem to develop when a muscle tenses repeatedly “and “are normally not caused by a specific, traumatic event,” “but by muscle overuse or faulty biomechanics.” (This is also known as slouching).

Mr. Grieve’s statement is something that I and many of my colleagues disagree with.  Knots have shown in several studies to be scar tissue and adhesions.  Knots can be caused by trauma, muscle overworking and strains. Over time these adhesions prevent muscles from contracting and stretching to their potential leading to discomfort and immobility. -Dr. Amie Gregory, DC, CCEP

The article continues to state that “scientists from Australia and the United States pointed out that muscle knots rarely show up on scans, leaving researchers with “no scientific basis” for believing that knotted muscle fibers make us sore. Instead, the researchers contend, the soreness is likely neural, involving the brain and irritated nerve endings”.

Yes, the nerves are irritated along with the muscle fibers.  Doctors can feel such fibers and of course any soreness that is felt in the body is ALWAYS a nerve.  That is our sensory mechanism in our body!  Muscles move, they don’t send pain signals.  Nerves do!  That is why Chiropractors study them and understand how the brain, spinal cord and nerves work so that we can eliminate the cause of discomfort. – Dr. Amie Gregory, DC, CCEP

The article goes on to say “Regardless of the possible cause, most therapists feel that the best treatment for purported muscle knots is to vigorously massage the sore spot or use a small, hard ball (such as those used for lacrosse) or a foam roller”.  – Well I do agree with that!  Finally!

Suggestions of injections were mentioned, but this is only a bandaid for the problem.  The pain will go away but continued usage of a body part that is injured will only lead to a long term problem that will not go away unless the CAUSE is treated.  Chiropractors find that cause and treat it allowing the body to heal without putting needles through your skin.  I think that is so much better than going and getting a shot every 3 months.

Chiropractors deal with sports injuries, car accidents and postural issues daily.  We can help people recover from muscle injuries and keep them functioning properly leading to a high quality of life.

How Can I Tell Whether I’m at High Risk for Gestational Diabetes?

According to the American Diabetes Association, you’re considered at high risk for this condition (and should be screened early) if:

  • You’re obese (your body mass index is over 30).
  • You’ve had gestational diabetes in a previous pregnancy.
  • You have sugar in your urine.
  • You have a strong family history of diabetes.

Some practitioners will also screen you early if you have other risk factors, such as:

  • You’ve previously given birth to a big baby. Some use 8 pounds, 13 ounces (4,000 grams, or 4 kilos) as the cutoff; others use 9 pounds, 14 ounces (4,500 grams, or 4.5 kilos).
  • You’ve had an unexplained stillbirth.
  • You’ve had a baby with a birth defect.
  • You have high blood pressure.
  • You’re over 35.

In addition, a study published in the March 2010 issue of Obstetrics & Gynecology found an association between excessive weight gain during pregnancy – particularly in the first trimester – and the risk of gestational diabetes. Researchers found the risk highest in women who were overweight to begin with and in nonwhite women.

Keep in mind that many women who develop gestational diabetes don’t have any risk factors. That’s why most practitioners will order the screening at 24 to 28 weeks for all their pregnant patients as a matter of course.

That said, a small number of women might be considered at such low risk that they might not have to get tested. You’re part of this group if you meet all of the following criteria:

  • You’re younger than 25.
  • Your weight is in a healthy range.
  • You’re not a member of any racial or ethnic group with a high prevalence of diabetes, including people of Hispanic, African, Native American, South or East Asian, Pacific Island, and indigenous Australian ancestry.
  • None of your close relatives have diabetes.
  • You’ve never had a high result on a blood sugar test.
  • You’ve never had an overly large baby or any other pregnancy complication usually associated with gestational diabetes.

What Is The Difference Between A Co-Pay And A Deductible?

I get a lot of patients coming in for care and they are confused about what a deductible and a co-pay are.  Here is a bit of a breakdown to help anyone understand the difference.

What is a CO-PAY?

A co-payment, or co-pay, is a flat amount paid for each visit to a doctor’s office or portion you pay for medication.   This is paid when you are seen and receive treatment, an exam or have a consultation.

Every health insurance company has different co-pays depending on the plan.  Most of the time they are printed on your insurance card.  There can be different co-pays for each profession you go to, for example, a Chiropractor is a “Specialist” and have a certain co-pay specifically for them.  A dentist may have another amount along with a Physical Therapist.  It all depends on your plan.  In addition to cutting a small portion of the costs by having you pay a portion for each visit, having a co-pay will also prevent people from seeking care for problems they consider trivial just to get the most out of the insured’s dollar or seek care for something a bandaid would be used for.

However, while the co-pay does lower costs for the insurance companies, by making people more mindful about when it is necessary to go to the doctor, It may also prevent people from getting medical attention when they may need it. For example, it can be costly for a person that has a long term problem and needs to see several doctors in a week for it or see one doctor several times a week or a month, if they have a $25.00 co-pay each time and can’t afford it, they may choose to see what happens and then the condition may worsen making it necessary for invasive treatments, x-rays, MRI or other necessary tests that can cost thousands of dollars.


A deductible is a fixed amount of money you have to pay before your co-pay kicks in and your full policy benefits can be utilized.

The amount of a deductible is normally calculated on a yearly basis and most policies restart in January and the deductible is then back up to its full amount.   Before you meet the allotted amount of your deductible, you have to pay the full price of the doctor bill.  Once you meet your deductible, then the co-pay is all you need to pay.  There are individual deductibles for single policy holders and family deductibles for families and both differ in price.

Normally, if your plan has a high deductible, it has a lower monthly cost.  So, just know that if something happens and you need care, it will be pricey.  If you are normally healthy and don’t see a doctor often this may be a plan you want to take your chances with.  However, if you are someone who is sick often, has a large family, or like to see a doctor more than the average person, you may want to get a lower deductible plan and pay a bit more each month for insurance.

A deductible is also considered an what is called an “out of pocket” expense and can work toward working this off.  In general, an out-of-pocket expense maximum is the amount you need to meet for paying for your doctor’s appointments before they will pay 100 percent of your health expenses. Normally, your deductible and coinsurance can be applied toward this maximum amount. Your co-payments or monthly insurance premiums are not included in “out of pocket” expenses.

What Does Co-Insurance Mean?

Coinsurance is used in several different types of insurance and is different depending on the type of insurance you choose. The way it works is basically instead of having a “set” amount to pay each time you see a doctor (after your deductible is paid), you instead pay a percentage for each visit.  This can be as little as 10% to 80%.  Then the insurance company pays a the remaining percentage to the healthcare provider.

Hope this helps!