By Natan Schleider, M.D. Written 12/31/2021 3 Minute Read
DISCLAIMER: WRITTEN BELOW IS BASED ON CDC AND NIH GUIDELINES AS OF 12/31/2021. OBVIOUSLY THESE GUIDLINES CAN CHANGE AT ANY TIME.
You should be prepared to answer my questions so I can give you advice!
Dr. Schleider: What kind of test did you have, a rapid test (essentially the same as a home test) or a PCR test (which is the one sent to the lab)? I ask because the rapid / home tests are likely to test positive if you have asymptomatic COVID19 ONLY 35% of the time. If you have COVID19 symptoms you are likely to test positive 64.2% of the time. THIS MEANS THERE IS A FALSE POSITIVE RATE OF 35.8% ON HOME OR RAPID TESTS. However, there true negative rate is 92% which is reassuring. [SOURCE: Evaluation of Abbott BinaxNOW Rapid Antigen Test for SARS-CoV-2 Infection at Two Community-Based Testing Sites — Pima County, Arizona, November 3–17, 2020 | MMWR (cdc.gov)]
Patient: I had a home test and it tested positive for COVID19, you still haven’t told me what I should do?
Dr. Schleider: If you want to be certain that your home or rapid test is indeed accurate, go get a PCR test.
Patient: Will do but what should I do or take in the meantime?
Dr. Schleider: My personal advice and what I advise my own family is to treat any symptoms aggressively. For example, if you have a runny nose with post nasal drip that is a breeding ground for not only COVID19 but other nasty infections like flus or bacteria that cause bronchitis or pneumonia. Get yourself the following: Zyrtec-D, a decongestant like Sudafed, Flonase, and a nasal rinse and decongestant which are available over the counter. USE ALL OF THEM ROUND THE CLOCK UNTIL FOR AT LEAST 1-2 WEEKS (I WILL COACH YOU THROUGH THIS OR ASK YOUR PHARMACIST FOR DOSING).
Patient: Is there anything else I can do, for example, I am developing a bad cough, maybe another bug has moved in?
Dr. Schleider: Great point. Having an antibacterial antibiotic on hand and an antifly antibiotic on hand can’t hurt.
THE NATIONAL INSTITUTE OF HEALTH (NIH) SAYS DOES NOT RECOMMEND STARTING A CORTICOSTEROID (IE DEXAMETHASONE OR PREDNISONE) FOR HOSPITALIZED PATIENTs NOT REQUIRING OXYGEN CITING NOT ENOUGH DATA.
HOWEVER, IF A HOSPITALIZED PATIENT DOES REQUIRE OXYGEN THE NIH SAYS THEY SHOULD GET A CORTICOSTEROID.
WHY WAIT UNTIL THE PATIENT IS TURNING BLUE AND NEEDS OXYGEN? START A CORTICOSTERIOD AND SEE HOW THE PATIENT DOES. WORST CASE IT DOES NOT HELP SYMPTOMS AND YOU END UP GOING TO THE HOSPITAL. BEST CASE HOSPITALIZATION IS AVOIDED AND YOUR LIFE MAY HAVE BEEN SAVED.
By Natan Schleider, M.D. 4 MINUTE READ
September 2nd 2021
FOR MORE INFORMATION ON TREATMENT OF OPIOD ADDICTION AND ALCOHOLISM VISIT NYC Psychiatry and Primary Care Physicians – Natan Schleider MD NYC Psychiatry and GP Physicians ADHD, Alcoholism, Anxiety, Drug Abuse, Mood Disorders AND ROUTINE MEDICAL CARE (doctorinthefamily.nyc)
Or contact us with questions!
By Natan Schleider M.D. June 20th 2021 3 Minute read
3. Ask your family doctor or psychologist or talk therapist for a referral to the best psychiatrist in NYC for bipolar.
4. Know your budget. The BEST psychiatrists in NYC often do not accept health insurance. If the best psychiatrists accept your insurance, realize you may be seeing them weekly or monthly. Copays and coinsurance fees may add up if using insurance.
5. Realize the BEST psychiatrist in NYC for bipolar disorder MAY NOT NEED TO BE A PSYCHIATRIST! For example, a NYC bipolar patient stable on their medicines can have them prescribed by their NYC Primary Care doctor. In addition, psychiatrists do not always do medical work ups to search for organic symptoms of bipolar disorder. In other words, a thorough physical exam and thorough lab testing should be done BEFORE bipolar diagnosis is made.
For more articles on mental health in NYC visit our blog: doctorinthefamily.nyc/blog
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THANKS FOR READING!
Dr. Natan Schleider M.D.
By Natan Schleider MD May 25th 2021 3 minute read
During a recent court case, an attorney states: ‘This addict has too much marijuana in their urine.’
A standard urine drug screen may be information, but does NOT speak to the quantity of drug a patient is testing.
NYC Home Urine drug testing is an essential component of monitoring patients who are receiving controlled medicines–medicines monitored by the DEA.
Why is HOME testing so important? Because it allows the physician to have the patient perform a RANDOM drug test in the comfort of their home in minutes.
How does it work? Patients are mailed urine drug test containers. At a random time, the physician will contact them and ask them to produce a urine sample within 5 minutes on camera live. This virtually eliminates the chance for a patient to mess with the urine sample.
Both doctors and patients should be familiar with the characteristics and capabilities of screening and confirmatory drug tests.
By Natan Schleider MD April 13th 2021
At $49 dollars for a teladoc psychiatry NYC consult, sounds like a bargain, and if its too good to be true,,,,
In my experience you get what you pay for: see How Much Does Teladoc Cost? | HowMuchIsIt.org
IF YOU ANSWERED YES TO 3 OR MORE OF THE ABOVE, TELADOC MIGHT BE FORE YOU!
IF YOU ANSWERED NO MOST OF THE ABOVE, CALL A REAL DOC, NOT A TELADOC.
NYC Psychiatry and Primary Care Doctors:
Please contact us with questions.
Updated by Natan Schleider M.D. May 25th, 2021
Some patients prefer seeing their doctors in person. I am all for that–unless you have COVID19 without symptoms or vice versa.
What about patients that need lab testing and or drug screening, how do you handle that? Good question, the answer is in part 2 of this blog.
Thanks for reading and to read similar article check this blog out: 7 Reason Why Virtual Psychiatry in New York City is here to stay
TO SCHEDULE AN APPOINTMENT WITH ME PLEASE CALL OR TEXT 646-957-5444 OR VISIT ZOCDOC
Virtual psychiatry are two abstract words we literally cannot put a finger on.
Virtual psychiatry generally means consulting via the internet live in real time with a mental health care medical doctor–a psychiatrist or physician who specializes in mental health–who is a human (not an AI robot) using any means of audio-visual communication like Skype or Zoom at an agreed upon time.
As a physician with six months experience with technical issues using computers to communicate: internet too slow, lost meeting ID code; empty ‘virtual waiting rooms’, no audio just visual or vice versa (resorting to hand signals or holding up a piece of paper that says ‘Turn on on your audio microphone’)—I prefer a device called a telephone or phone for short.
Virtual mental health care / virtual psychiatrists are used commonly, especially since the COVID19 pandemic began.
As I often like things explained to me like I’m a 6 year old, what exactly is virtual psychiatry?
Practicing live mental health care using virtual psychiatry requires a psychiatrist and a patient, each with a good internet connection, a computer to access the internet, and a webcam. Notice I emphasize the word GOOD.
A bad internet connection on either computer results in all sorts of technical issues like video will not work and screens appear black; audio and talking will not work so you see the psychiatrist on your screen but do not hear them
A virtual psychiatry consult is scheduled in the same was you scheduled doctor’s appointments in the last 20 to 40 years (except no walk ins which my office does not accept, nor do you want since you don’t know if a coronavirus 19 positive patient or staff member is sitting there symptom free and contagious).
So yo
Let’s start with definitions
virtual [ˈvərCH(o͞o)əl] ADJECTIVE