Richard Bernstein M.D. F.C.C.P.
Trudy Trumpy P.A.
Internal Medicine,Asthma and Allergies, Well Women Care, Cosmetic Skincare Procedures
133 Defense Highway Suite 109
Annapolis, Maryland 21401
410-224-5558
Board Certifications:
Internal Medicine
Pulmonary Diseases
Named one of America's Top Physicians
Consumer Research Council of America
Fellow American College of Chest Physicians
Member American College of Physicians
Member American Academy of Otolaryngology Allergy
Member American Academy of Laser Medicine and Surgery
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Scroll down for future Educational Events
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About Our Practice
While no one likes going to the doctor, we are dedicated to providing the best clinical experience a medical practice can offer. Our core practice is Internal Medicine.
We are all going to age, thus our philosophy is to provide services that help prevent disease as well as treat them. We want our patients to live long healthy lives, feel good about themselves and enjoy life. By incorporating lifestyle management strategies such as nutritional counseling we can help our patients achieve these goals.
We provide cosmetic skincare for patients who desire these services. We believe all of our patients are beautiful just the way they are, but if you would like to enhance your appearance we provide a full range of cosmetic skincare products and procedures. Procedures include Botox, Juvederm, Radiesse, IPL, Laser, and light chemical peels. All of our injectable procedures are performed by Dr. Bernstein. We are committed to obtaining optimal results in a cost effective manner.
Dr. Bernstein has an extensive background in pulmonary diseases where his major area of interest was asthma and exercise physiology. Twenty-five percent of the population suffer from allergies. In addition to allergy testing and in office consultation we provide allergy seminars and workshops for our patients as we believe patient education is the key to optimal success. We are uniquely qualified to provide asthma and allergy services to our patients because of Dr. Bernstein's pulmonary background.
Most importantly we want to provide an environment that makes our patients feel comfortable. We view our patients as an extension of our family. That is why there will always be someone to answer the phone, fit in emergency visits for same day appointments and we still make house calls.
Our staff is here to serve you. We encourage feedback both positive and negative so we can provide you the best quality care.
Richard A. Bernstein M.D.
Trudy Trumpy P.A.
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Internal Medicine: The Shingles Vaccine
Patients often ask if they should get the shingles vaccine. The answer is unclear.The vaccine is marketed as Zostavax by Merck Pharmaceuticals. The vaccine costs physicians approximatly. $160 and is generally marked up to $ 200 to $250. In comparison a flu vaccine costs $11 and a pneumonia vaccine $25. Because thousands of people die from influenza each year and no one dies of shingles the cost defectiveness of this vaccine is questionable. A cost effectiveness analysis in the Annals of Internal Medicine put it in the intermediate cost effective category. Zostavax is approved for people 60 and older. While the pneumonia vaccine and flu vaccine are covered by Medicare part B, Zostavax is covered by part D. So you may or may not have coverage.
Shingles is due to a reexpression of the chicken pox virus. The risk increases as we age. About 90 % of Americans have had chicken pox and it is estimated 1/3 will get shingles. If you have already had shingles getting the vaccine is unlikely to be of benefit. If you have not getting the vaccine will cut your risk in 1/2 and reduce the likelihood of getting post herpetic neuralgia by 67%. This sounds impressive but you would have to vaccinate 370 people to prevent one case of post herpetic neuralgia over a 3 year period and it is unclear how long immunity will last from the vaccine. Nice how we can spin statistics to say what we want isn't it.
So should you get the shingles vaccine? It comes down to personal preference but I do not think there is a medical mandate. The shingles vaccine will reduce your risk of getting shingles and will decrease your risk of getting post herpetic neuralgia. It is safe. It will just cost you.
RAB
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| Asthma and Allergy: Is You Asthma under Control?
Is your Asthma under control? Most people don't know. It may also surprise you to learn that fifty percent of patients with asthma do not use their long term medications correctly. That is because they generally perceive their asthma to be under better control than it is and stop their medication. By using two simple tools determining Asthma control has become much simpler. These are an ACT Scoring sheet and a peak flow meter. An ACT scoring sheet allows you to rate your symptoms by asking a series of questions. These include:
Frequency of Daytime symptoms
Limitations of Daytime activities
Frequency of Exacerbation
Nocturnal Awakenings
Need for Rescue medication
By answering these questions a score is developed. Anything above 19 indicates your asthma is poorly controlled, and a score of 16-19 indicates inadequate control.
A peak flow meter is a simple tool to measure lung function. One blows into a hand held device and lung function is measured. Your lung function should not vary a lot during the day, and should be within 80% of your best.
By using these two tools together we can get a good idea of how well your asthma is controlled. This helps us develop a personalized program to allow the best control of asthma using the least amount of medications.
In January we will start our Educational Asthma and Allergy seminars to be held in our office. These are strongly encouraged for anyone who suffers from upper airway symptoms from allergic rhinitis, and chronic sinusitis as well as our Asthma patients. Pls call our office for dates and times (410-224-5558).
RAB
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| Longevity and Preventive Medicine: Count Your Blessings
There have been a number of studies looking at the impact of our beliefs on health. In 2003 Emmons and McCollough published a Study looking at this. Participants were assigned to 3 groups: (1)Count your blessings,(2) list daily hassles or (3) control. People who counted their blessings weekly by listing things they were grateful or thankful for had better health outcomes, fewer physical complaints, and reported better quality sleep.
In addition there have also been studies that patients who have a positive outlook on life have higher levels of Secretory IGA. This is an immunoglobulin that is our bodies first defense against upper respiratory infections. In particular laughter seems to generate increases in positive emotion.
So as we approach the new year here are my five recommendations to help make the new year a healthy one.
1. Count your blessings, believe in yourself and remember laughter is good medicine.
2. Strive to eat nine fruits and vegetables a day.
3. Take a break from watching and reading the news for 1 week every 3 months.
4. Include stretching and some form of exercise as a part of your daily routine.
5. Don't microwave with plastic. Use ceramic dishes and wax paper instead.
Happy Holidays!
Rab |
Aesthetics: Botox
Botox is now available in our office.I have to say that in the 20 years I have been in practice there are few services that we have provided that have made people as happy as Botox.
Botulism is a form of food poisoning that causes blurred vision, dry mouth , and can progress to paralysis and even death. Early outbreaks were thought to be due to sausage. The Greek word for sausage is botulus, and thus from some tainted sausage a phenomenon was spawned. The food poisoning is due to a toxin from the bacteria Clostridium botulism. Thus botulism is an intoxication and not an infection. Medical uses of botulism toxin began in the 1950's. In the mid 1970s it was shown that a strain of botulism toxin (strain-A) could weaken muscle around the eyes in monkeys. In 1977 the first studies were done in humans and in 1979 Dr Scott who did the original studies obtained the patent In 1987 while treating patients for blepharspasm, (the original indication for Botox), Dr. Caruthers made the observation that the wrinkles around the eyes disappeared..Allergan pharmaceuticals bought the patent in 1989, renamed the product Botox and the rest is history.
Botox-A is a highly purified form of botulism toxin. It is very safe and its effects generally last 3-5 months. Botox works by partially paralyzing muscles. Certain muscles in the face pull down and others pull up.By injecting certain muscles and not others Botox can change the way they work relative to each other, to obtain certain desired effects. Botox is generally most effective when dealing with the lines on the forehead, crows feet around the eyes and the glabellar region between the eyebrows. When injected appropriately wrinkles will diminish, and a minor lid lift will occur to create refreshed and relaxed look.
Botox requires no anesthesia other than ice and is well tolerated. It generally takes 2 days for the effects to start with the maximal effect being seen at 10 days. Before injecting I like to review with the patient all of the muscles we are going to inject and what a reasonable expectation of results will be. After the procedure patients should remain upright for 4 hours to prevent redistribution of the toxin. We also ask patients to use their facial muscles frequently post procedure by moving their brow muscles and frowning. This increases absorption of the toxin and effects will be seen more quickly.
And improved aesthetic effect can be seen if Botox is used concomitantly will fillers such as Juvederm, Restylane, or Radiesse. Fillers will also last longer if used with Botox. If you have any questions please fell free to call our staff or call for an appointment (410-224-5558) | |
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Asthma and Allergies: Workshop and Seminar
Jan 22 2008, May 20 2008, Sept. 23rd 2008
Location: Our Office
Time: 6-7 P.M.
Spring Seminar:
Healthy Aging: Seminar and workshop
Time and location: TBA
These event are complimentary but seating is limited. Please call 410-224-5558 to reserve a seat.
Thank you for taking the time to read our newsletter. We appreciate your referrals. If you think a friend or relative might benefit from our services or the information above, please forward this newsletter to them. Thank you.
Sincerely,
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Richard A. Bernstein M.D. |
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