Health & Fitness
Lyme Disease Remains Difficult to Diagnose | Print |  E-mail
Wednesday, 23 July 2014 14:10

Spread through the bite of an infected tick, Lyme disease is very prevalent on the West Coast

072414hWhile the Centers for Disease Control recently announced that Lyme disease is about 10 times more common than previously reported, there are ways you can protect yourself.

The new figures showed that as many as 300,000 Americans are diagnosed each year. Because Lyme disease is prevalent and serious, health officials are reminding people about prevention and detection.

Spread through the bite of an infected tick, Lyme disease can cause rashes and flu-like symptoms, and it’s more common than you may think.

Lyme disease is most prevalent here on the West Coast as well as in New England and the upper Midwest, but it’s a nationwide problem since infected ticks are in all 50 states.

Despite its prevalence, Lyme remains difficult to diagnose because its symptoms mimic other diseases, namely the flu and chronic fatigue syndrome.

To reduce your chances of exposure:

072414h1• During the warmer months, avoid wooded areas. After coming inside, bathe and check your entire body for ticks.

• If bitten, tweeze. If you find a tick on your skin, use tweezers to remove it as quickly as possible. Grab as close to the skin as possible, then gently pull upward without twisting. Removing ticks within 36 hours of attachment reduces the risk of infection.

• Know the symptoms. Early symptoms may include fever, chills, sweats, muscle aches, fatigue, nausea, headache and joint pain. Sometimes, a bull’s-eye rash appears.

• When in doubt, get tested. Receiving a tick bite is rarely noticed. If you have symptoms, it’s risky to take a “wait and see” approach. The earlier you test, the earlier you can be treated.

For more information, visit

CAPTION 1: Doctors now have faster and more accurate ways to test for Lyme disease, so people can get treated sooner and more effectively.

CAPTION 2: Lyme disease is spread by deer ticks like this one.

Typing No Longer Linked to Carpal Tunnel Syndrome | Print |  E-mail
Wednesday, 23 July 2014 14:09

072414h2By Eric Stuffmann, M.D. • Special to the Times

Despite heavy media coverage of the alleged link between repetitive motions like typing and carpal tunnel syndrome, several well-conducted studies investigating the causes of the condition have not shown any significant link between the two.

The actual cause of carpal tunnel syndrome can only be identified in the minority of cases. Diabetes, alcoholism, renal failure, rheumatoid arthritis, a tumor in the carpal tunnel and even pregnancy have been linked to the condition. In the majority of cases, though, no clear cause can be identified.

Although typing is an unlikely cause, there are other movements and behaviors that have been linked to the condition.

Frequent use of tools that cause strong vibrations in the hands such as a jackhammer and frequently performed activities with the hand, either flexed down or up as when turning a wrench at an awkward angle are both potential causes. There is also evidence that heredity may play a role.

No matter the cause, the condition can be treated and resolved by a simple 15- to 30-minute surgical procedure at a surgery center.

The carpal tunnel is a narrow passageway in the wrist bordered by three bones and a ligament. The passageway is shared by nine tendons and the median nerve, which gives strength to the thumb and is responsible for sensation in part of the hand.

Carpal tunnel syndrome occurs when excessive pressure builds up in the carpal tunnel, squeezing the median nerve. Numbness and tingling in the hand are the primary symptoms, but pain can also occur, and the symptoms can radiate up the arm.

By carefully cutting the transverse carpal ligament, a surgeon can relieve the pressure and resolve the condition. The ligament will heal, but the carpal tunnel will remain slightly larger.

For patients with mild to moderate cases, the symptoms will generally subside within two weeks of the surgery. Patients with more severe cases can take two months or more to find relief. If the condition is ignored long enough to cause muscle atrophy, though, some symptoms may persist.

Both traditional and minimally invasive procedures are available. Each has its own pros and cons, so discuss them with your surgeon and make sure you understand the differences between the two before making your decision.

Orthopedic Surgeon Eric Stuffmann, M.D., is a hand and upper extremity specialist affiliated with Eden Medical Center.

A Jump in Sexually Transmitted Diseases Reported in California | Print |  E-mail
Wednesday, 23 July 2014 14:07

The number of reportable sexually transmitted diseases (STDs) in California — particularly gonorrhea and syphilis — increased substantially in 2013 over the previous year, according to Dr. Ron Chapman, director of the California Department of Public Health.

“Sexually transmitted diseases can cause major health problems for people over time,” said Dr. Chapman. “This increase is concerning, particularly because STDs are preventable.”

In 2013, the gonorrhea rate increased 13 percent, while the syphilis rate increased 18 percent. Only the rate of chlamydia cases decreased slightly for the first time in almost two decades. Still, chlamydia is the most commonly reported disease in California.

STD rates continue to be highest in young people 15 to 24 years of age, especially for females, with over 66 percent of female chlamydia cases and over 54 percent of female gonorrhea cases being in this narrow age group. Young women are the most vulnerable to infertility and other long-term reproductive health problems caused by STDs.

“Any sexually active person can get an STD through unprotected sex,” said Chapman. “They should talk with their healthcare provider and ask if testing for STDs is appropriate.” An online directory of test sites is available at Many clinics offer free tests.

Chapman pointed out that in addition to getting tested regularly, individuals can reduce their risk by using condoms, reducing their number of partners, being in a monogamous relationship or practicing abstinence.


Now’s a Great Time to Shed Some Weight | Print |  E-mail
Wednesday, 23 July 2014 14:05

072414h3If you’re a man who is carrying a few extra pounds, there’s good news. Any time can be the right time to start and strengthen healthier habits and lose the weight.

Some find that the warmer weather of summer and early fall can be a great time to get in shape. That’s because the longer days can make it easier to find workout partners or teams to join. It can also be a great time to enjoy seasonal fruits and vegetables such as blueberries, peaches and sweet corn.

With extra pounds linked to health problems such as type 2 diabetes, heart disease and certain cancers, getting to a healthy weight can be a step in the right direction.

To help you “get in the game,” here are some tips from the National Institutes of Health:

Get Fitter, Stronger, Faster

• Start with a level of activity that feels doable. For example, 10 minutes each day. Increase frequency, time and intensity as you become able to do more.

• Mix it up. To get and stay on track, try different kinds of activities. Make sure your routine includes aerobic exercise (walking, jogging, biking), strength training (free weights, crunches, push-ups), and flexibility exercises like stretching or yoga.

Power Up With Nutrient-Dense Foods and Drinks

• Eat and drink smart. Choose foods and drinks that pack plenty of vitamins, minerals and fiber into fewer calories. Fruit, vegetables, lean meats and seafood, and water or fat-free milk are all good options.

• Outsmart your inner picky eater. Sneak in fruits and vegetables. Add berries to your cereal or crunchy vegetables to your sandwich.

Stick With It for the Long Run

• Form your own team. Find a workout partner or group to help you stay on track.

• Reward yourself when you reach your goals. Plan a basketball or soccer game, bike ride or healthy cookout with friends or family.

Learn more from WIN’s “Getting on Track: Physical Activity and Healthy Eating for Men.” The brochure features more tips and ideas for men, tools for figuring out if your weight is healthy, ways to assess portion sizes based on everyday items, and ideas for overcoming barriers to better health.

Contact WIN to get a single copy free, or go to

North American Precis Synd., Inc.

Whooping Cough Epidemic Looms in the Golden State | Print |  E-mail
Thursday, 10 July 2014 14:31

The number of pertussis (whooping cough) cases in the state has reached epidemic proportions, according to Dr. Ron Chapman, director of the California Department of Public Health.

By the end of last month, the number of cases had risen to 4,558 — almost double the number reported for all of 2013.

Pertussis is cyclical and peaks every 3 to 5 years. The last peak in California occurred in 2010; so it is likely another peak is underway, and July is traditionally the peak month for the illness.

“Preventing severe disease and death in infants is our highest priority,” says Dr. Chapman. “We urge all pregnant women to get vaccinated. We also urge parents to vaccinate infants as soon as possible.”

Infants too young to be fully immunized remain most vulnerable to severe and fatal cases of pertussis. Two-thirds of pertussis hospitalizations have been in children four months or younger. Three infant deaths have been reported.

The Tdap vaccination for pregnant women is the best way to protect infants who are too young to be vaccinated. All pregnant women should be vaccinated with Tdap in the third trimester of each pregnancy, regardless of previous Tdap vaccination. In addition, infants should be vaccinated as soon as possible. The first dose of pertussis vaccine can be given as early as 6 weeks of age.

Older children, pre-adolescents, and adults should also be vaccinated against pertussis according to current recommendations. It is particularly important that persons who will be around newborns also be vaccinated.

“Unlike some other vaccine-preventable diseases, like measles, neither vaccination nor illness from pertussis offers lifetime immunity,” says Dr. Ron Chapman. “However, vaccination is still the best defense against this potentially fatal disease.”

The symptoms of pertussis vary by age. For children, a typical case of pertussis starts with a cough and runny nose for one to two weeks. The cough then worsens and children may have rapid coughing spells that end with a “whooping” sound.

Young infants may not have typical pertussis symptoms and may have no apparent cough. Parents may describe episodes in which the infant’s face turns red or purple. For adults, pertussis may simply be a cough that persists for several weeks.


Defy Aging; Build Muscle | Print |  E-mail
Thursday, 10 July 2014 14:29

071014h1If you want good health, a long life and to feel your best well into old age, the No. 1 most important thing you can do is strength-training, says Dr. Brett Osborn, author of “Get Serious, A Neurosurgeon’s Guide to Optimal Health and Fitness.”

“Our ability to fight off disease resides in our muscles,” Dr. Osborn says. “The greatest thing you can do for your body is to build muscle.”

He cites a large, long-term study in the British Medical Journal of nearly 9,000 men ages 20 to 80. After nearly 19 years, the men still living were those with the most muscular strength.

Muscle is all protein. Fat, however, is an endocrine organ, meaning it releases hormones and other chemicals. When a person has excess fat, he or she also has a disrupted flow of excess biochemicals, which can increase insulin resistance and boost risk factors for stroke and high blood pressure, among other problems.

Strength-training has health benefits for everyone, he adds, no matter their size.

“Some fat is visceral fat — it’s stored around the organs and it’s even more dangerous than the fat you can see,” he says. “People who look thin may actually be carrying around a lot of visceral fat.”

So, what’s the workout Dr. Osborn recommends?

“Back to basics,” he says. “These five exercises are the pillars of a solid training regime.”

One caution: You should never begin a new, rigorous exercise routine without first checking with your doctor.

• The squat is a full-body exercise; it’s the basic movement around which all training should be centered. Heavy squats generate a robust hormonal response as numerous muscular structures are traumatized during the movement (even your biceps). Standing erect with a heavy load on your back and then repeatedly squatting down will stress your body inordinately — in a good way — forcing it to grow more muscle.

• The overhead press primarily activates the shoulders, arm extenders and chest. Lower-body musculature is also activated as it counters the downward force of the dumbbell supported by the trainee. From the planted feet into the hands, force is transmitted through the skeletal system, stabilized by numerous muscular structures, most importantly the lower back.

• The deadlift centers on the hamstrings, buttocks, lumbar extensors and quadriceps, essentially the large muscles of your backside and the front of your thighs. As power is transferred from the lower body into the bar through the upper body conduit, upper back muscles are also stressed, contrasting with the squat, which is supported by the hands. Deadlifts are considered by some to be the most complete training exercise.

• The bench press mostly targets the chest, shoulders and triceps; it’s the most popular among weightlifters, and it’s very simple — trainees push the barbell off the lower chest until the arms are straight. This motion stresses not only the entire upper body, but also the lower body, which serves a stabilizing function. This provides a big hormonal response and plenty of bang for your buck.

• The pull-up / chin-up stress upper body musculature into the body. A pull-up is done when hands gripping over the bar; a chin-up is where hands are gripping under the bar. Nine out of 10 people cannot do this exercise because, most simply, they haven’t put in the effort. It’s also been called a “man’s exercise,” which is nonsense,” he says. There are no gender-specific exercises.

“There are no secrets to a strong and healthier body; hard work is required for the body that will remain vital and strong at any age,” Osborn says. “Always practice proper form and safety. Otherwise, the result will be the opposite of your goal — an injury.”


Address Post-race Problems | Print |  E-mail
Thursday, 10 July 2014 14:27

071014h2By Carolyn E. McAloon, DPM • Special to the Times

It is time once again for that great Castro Valley tradition, benefiting Eden Medical Center’s Trauma Center, the Run to the Lake.

This event provides the opportunity for every one of us to lace up our running shoes and enjoy a morning walk, run or dash.

Whether you prefer an out and back paved 5K run/walk, a beautiful 10K course that winds along the rolling west trail of Lake Chabot, the free outdoor Health Expo, or the Kids Dash for ages 3 to 8, there is healthy fun for the entire family.

However, it is critical that you prepare yourself from the ground up for a good time. The best advice I can give you to prevent a Monday morning visit to the podiatrist is to select a pair of well-fitting running shoes, even if you are only walking the course.

The most common post-race problems come from choosing the wrong shoe. Shoes that are too short can cause black toenails. Shoes that are too narrow in the toebox can cause pinched nerve pain, ingrown toenails or calluses. Shoes that are too wide allow the foot to slide around which can cause blisters. Shoes that are too flexible can cause a stress fracture. In addition, make sure your shoes are not worn out. The average lifespan of most running shoes is 350 to 500 miles, so be sure to replace them in time for the race.

If you do have post-race foot trouble, try these tips:

• Use a moisturizer to care for dry, cracking, callused feet.

• While some of us suffer from dry feet, others suffer from sweaty, wet feet. Consider using antiperspirants on your feet after a brief soak to keep them dry.

• If your feet swell or get overheated when you run, consider applying ice briefly or soaking your feet in cool water. You can also decrease swelling by wearing compression socks when you run and elevating your feet afterwards. Most importantly, you need to rehydrate immediately after the race.

• To prevent blisters or chafing, dab friction-reducing petroleum jelly or a personal lubricant on your hotspots. If you do get a blister, seek professional care to avoid an infection or an open sore.

• Remember, foot pain is not normal. Be sure to take immediate care of injuries. Something minor can turn into a big problem if not taken care of quickly and we want to keep you on your feet so that you can enjoy a healthy, active lifestyle.

Carolyn McAloon, DPM, is a podiatrist affiliated with Eden Medical Center. Come meet Dr. McAloon, and many other care providers at the free Health Expo at this year’s Run to the Lake on Sunday, July 13, from 7:30 to 10:30 a.m. in front of Eden Medical Center, 20103 Lake Chabot Road, in Castro Valley.

Melanoma Kills Someone Every Hour | Print |  E-mail
Thursday, 10 July 2014 14:26

While this is a time of year when many Californians look ahead to lazy summer days at the beach or pool, it is essential to remember to protect yourself.

Skin cancers are rapidly on the rise, and an estimated 1 in 5 Americans can expect to be diagnosed with skin cancer in their lifetime. In the past three decades, more people have had skin cancer than all other cancers combined and the incidence of skin cancers jumped 77 percent between 1992 and 2006 alone.

Every hour, someone dies from melanoma, the deadliest form of skin cancer, according to Tim Turnham, executive director of the Melanoma Research Foundation.

The good news is that — with proper sun protection and routine self-examinations — the risk of skin cancers can be reduced.

Most importantly, your whole family needs to adopt healthy sun habits and use them consistently. Wear a “Broad Spectrum” waterproof sunscreen with an SPF of 30 every day, even when it is cloudy. Reapply sunscreen frequently, and don’t miss places like your ears, lips, feet and top of your head.

Seek out shade between 10 a.m. and 4 p.m., when the sun’s rays are strongest. Wear a wide-brimmed hat, sunglasses with 100 percent UV protection, and lightweight, loose-fitting clothing like long-sleeved shirts and pants to protect large areas of skin.

Skin cancer, when caught early, is highly treatable. New technologies exist that can treat cancers, often with minimal pain or scarring and without surgery. That’s why self-examinations are important.

Get in the habit of checking your skin regularly. Learn the pattern of your moles and freckles so you can identify changes. Look for new growths, spots or bumps that do not heal. Ask a friend or spouse to check the spots you can’t see.

When examining your skin, remember the ABCDs of Moles.

A — Is it Asymmetrical (oddly shaped)?

B — Does it have an irregular or vaguely defined Border?

C — Is it uneven in Color?

D — Look at its Diameter. Is it growing in size or larger than a pencil eraser?

If you find any changing moles, growths, spots or bumps that fit these criteria, see your doctor without delay. You should also see a physician annually for a professional skin exam.


Learn ‘Keys to Living Well with Diabetes’ | Print |  E-mail
Thursday, 10 July 2014 14:25

The Centers for Disease Control estimates that 23.6 million people in the U.S. developed diabetes in 2007 and an additional 1.6 million new cases were diagnosed during that same time frame. At least 57 million adults were at risk of developing this chronic disease.

Managing diabetes requires making lifestyle modifications, including monitoring blood sugar levels and modifying one’s diet. It is important for people who have diabetes or who have loved ones with diabetes to understand the disease and learn how to control the condition to prevent serious health complications.

“Keys to Living Well with Diabetes” is a free two-part diabetes management program being offered tonight, July 10, and next Thursday, July 17, at 7 p.m. at Eden Medical Center, 20103 Lake Chabot Road, in Castro Valley.

Presented by diabetic educator Lisa Quan and registered dietician Kathy Gamez, this program provides information about blood glucose monitoring, nutritional guidelines, exercises, and how to avoid complications.

In addition to this program, a special presentation, “Diabetes & Your Feet: Staying a Step Ahead,” will be presented on Thursday, July 24, at 7 p.m. by podiatrist Ronald Hull, DPM, who will discuss diabetic foot conditions and the importance of lowering your risk of developing these problems which can quickly become serious.

For more information and to register, call 1-888-445-8433.

Not All Goiters Cause Symptoms | Print |  E-mail
Thursday, 26 June 2014 13:34

062614h3By Farnoosh Farrokhi, M.D. • Special to the Times

Goiter is simply an abnormal enlargement of the thyroid gland, a butterfly-shaped gland at the base of the neck. The thyroid gland makes two main hormones which regulate body metabolism. The pituitary gland in the brain controls the function of thyroid by making a hormone known as thyroid-stimulating hormone (TSH).

Causes of Goiter

The most common cause of goiter worldwide is a lack of iodine in the diet. In the United States, where the use of iodized salt is common, a goiter is more often caused by an over- or underactive thyroid, or by lumps that develop in the gland itself.

“Hashimoto’s thyroiditis” is one of the causes of underactive thyroid which can result in goiter. This is an autoimmune condition in which there is destruction of the thyroid gland by one’s own immune system, rendering the gland unable to make enough hormones.

The brain senses the low thyroid hormone level and secretes more TSH to stimulate the thyroid. This stimulation causes the thyroid to grow and produce goiter.

Another common cause of goiter is “Graves’ disease” which causes an overactive thyroid. In this condition, one’s immune system produces a protein known as thyroid stimulating immunoglobulin (TSI). TSI stimulates the thyroid gland to enlarge and produce more hormones.

Occasionally, thyroid function is normal but goiter is caused by large lumps on the thyroid gland. These lumps are called “nodules.” Unlike the other goiters, the cause of this type of goiter is not well understood.

Symptoms of Goiter

Not all goiters cause symptoms. If they are large enough, they may cause a tight feeling in the throat, coughing, hoarseness, and difficulty swallowing and breathing. Diagnosis can be made by physical exam or thyroid ultrasound. Once diagnosed, thyroid function tests should be checked to determine if the thyroid is functioning normally or if it is under- or over-active.


Treatment options depend on the cause of the goiter. If the goiter is due to Hashimoto’s Thyroiditis, thyroid hormone supplements should be given as a daily pill. This treatment will restore thyroid hormone levels to normal, but does not usually make the goiter go completely away.

If the cause of goiter is an over-active thyroid, treatment with medications and radioactive iodine usually leads to a decrease or disappearance of the goiter.

In cases with normal thyroid function, small goiters usually do not need treatment; but for large goiters with compressive symptoms, surgical removal might be suggested.

Farnoosh Farrokhi, M.D., is a board-certified endocrinologist and is affiliated with Eden Medical Center. She is part of the Sutter East Bay Medical Foundation and can be reached at 510-204-1844. Dr. Farrokhi will be presenting a free talk on “Thyroid Health” tonight, June 26, at 7 p.m. at Eden Medical Center. Visit for more information.

Cervical Cancer: What Women Need To Know | Print |  E-mail
Thursday, 26 June 2014 13:33

While at any given time, nearly 80 million Americans are thought to have been exposed to the human papillomavirus (HPV), you can protect yourself.

It’s the most common sexually acquired infection in the United States. Most people who are sexually active have been exposed to it.

While HPV does not cause symptoms, the good news is that the virus usually clears on its own within two years of exposure. If the virus persists, however, certain types of HPV can lead to serious health conditions, including cervical cancer.

Screening Is Key

“No woman wants to hear the words ‘you have cervical cancer’ from her physician,” said Ann T. Moriarty, immediate past chair of the College of American Pathologists.

“Fortunately, excellent screening tests, such as the Pap test and the high-risk HPV test, have made cervical cancer one of the most preventable cancers. In fact, since the introduction of Pap screening programs in the U.S., the number of cervical cancer cases has decreased by 70 percent,” added Dr. Moriarty.

Pathologists are physicians who confirm cervical cancer by examining cells under a microscope. Sometimes called the “doctor’s doctor,” pathologists work closely with the other physicians on the patient care team to provide an accurate diagnosis and to determine if further testing is needed if cervical cancer is detected. They also help guide treatment.

Making Sense of it All

With the HPV vaccine and the use of HPV testing, cervical cancer screening guidelines have changed. Here’s what women need to know:

3 Women who are sexually active should begin cervical cancer screening at age 21.

3 Women between the ages of 21 and 29 should have a Pap test every three years.

3 Women between the ages of 30 and 65 may have a Pap test and an HPV test (called a co-test) every five years, if the test results are normal. Alternatively, these women may have a Pap test (without an HPV test) every three years.

3 Women over age 65 who have had regular screenings with normal results need not be screened for cervical cancer. Women who have been diagnosed with cervical precancer should continue to be monitored and screened.

3 The HPV vaccine is most effective when administered to children before they are sexually active (9-12 years). It protects both girls and boys. Parents should speak with their child’s pediatrician to find out what is right for their daughter or son.

3 To ensure accurate test results, ask your physician if your screening test will be performed by an accredited laboratory. The CAP accredits more than 7,500 laboratories worldwide, employing standards that exceed U.S. government regulations.

“Regular cervical cancer screening can save a woman’s life,” said Dr. Moriarty. “It’s important for women to speak with their physicians about the timing and tests that are right for them.”

To Reduce Your Risk of Cervical Cancer:

• Have regular cervical cancer screenings to detect precancer.

• Treat precancerous lesions to prevent cervical cancer.

• Vaccinate your child to prevent complications of HPV.

Visit to learn more about the pathologist’s role in your care.

— North American Precis Synd., Inc.

What Does Medicare Cover in the Hospital? | Print |  E-mail
Thursday, 26 June 2014 13:23

062614h2By David Sayen • Special to the Times

One of Medicare’s most important benefits is helping to cover your expenses if you need to be hospitalized. But what exactly is covered, and how much do you pay?

Medicare helps cover certain hospital services and supplies. To get the full range of benefits, you must have both Medicare Part A, which is hospital insurance, and Part B, which is medical insurance.

What you pay depends on whether you’re an inpatient or an outpatient. Staying overnight in a hospital doesn’t always mean you’re an inpatient. You’re an inpatient on the day the doctor formally admits you, with a doctor’s order.

You’re an outpatient if you haven’t been formally admitted as an inpatient, even if you’re getting emergency department services, observation services, outpatient surgery, lab tests, or x-rays.

If you aren’t sure whether you’re an inpatient or an outpatient, ask your doctor or the hospital staff, or call 1-800-633-4227.

If you’re an inpatient, Part A will help cover your stay. This generally includes a semi-private room, meals, general nursing care, drugs, and other hospital services and supplies.

Part A covers your care in acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, long-term care hospitals, and psychiatric facilities. How much you’ll pay depends partly on how long you stay.

Medicare pays for inpatient hospital care based on “benefit periods.” A benefit period begins the day you’re admitted to a hospital — and ends when you haven’t had any inpatient hospital care for 60 days in a row.

You can have more than one hospital stay within the same benefit period. There’s a limit on how many patient days Medicare will cover during a benefit period, but there’s no limit on the number of benefit periods you can have over your lifetime.

How much comes out of pocket when you’re in the hospital?

Part A has a deductible, which is $1,216 in 2014. You pay this deductible at the beginning of each new benefit period.

After you’ve paid that, there’s no co-payment for days 1 through 60 of each benefit period. For days 61 through 90 of each benefit period, there’s a co-pay of $304 per day.

You also have 60 “lifetime reserve days.” These can be used after day 90 of each benefit period, and your co-pay is $608 per day in 2014. After you use up these “lifetime reserve days,” you must pay all costs yourself.

Keep in mind that Part A doesn’t cover doctor fees or other medical services. That’s where Part B comes in. To get Part B, you must pay a monthly premium, which for most people is $104.90 per month this year.

You’ll also pay 20 percent of the Medicare-approved amount for most doctor services while you’re an inpatient. Part B also helps cover outpatient costs, such as doctors’ fees, emergency and observation services, lab tests and X-rays.

Finally, here are some things Medicare doesn’t cover in the hospital: a private room, unless it is medically necessary; private-duty nursing; TV or a phone; or personal items like toothpaste.

To learn more, visit

David Sayen is Medicare’s regional administrator for California.



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