FREQUENTLY ASKED QUESTIONS

Although at LifeChoices Family Medical, we routinely follow the guidelines set forward by the CDC, we respect the parents’ decision to follow an alternative schedule or not to give certain vaccines. We are respectful of a family’s risk factors, health history, and concerns re: childhood immunizations.

To be accepted and to remain active in our practice, we do require that all families follow the well child check schedule and come for all of their preventive visits. Well Child Checks are expected at: birth, 1 month, 2 month, 4 month, 6 month, 9 month, 12 month, 15 month, 18 month, 24 month and 30 month. And then annually at 3 years and beyond.

We strive to offer options that work in cooperation with the body. The body is naturally good and thus we want to support it. This may mean wellness care, supplements or natural hormone replacement to optimize the normal functions of the body. We want to support the natural functions of your body vs. suppress it with chemicals that often create havoc on the body.

If you are experiencing a life-threatening emergency call 911 immediately for emergency medical services.

For urgent health care needs after our office is closed, please contact your nearest, contracted Urgent Care Facility or Emergency Room, then follow up in our office.  Contact your health plan for any additional information you may need to obtain emergency health services.

When the clinic is closed, the on-call medical provider will return phone calls.  Please call for medically related issues only.  Please do not call regarding billing or scheduling questions or regarding issues that could more easily be dealt with the next business day.  Your discretion is much appreciated.

Whether you are in a planned or an unplanned pregnancy it is important to verify your pregnancy. Use the online patient Request an Appointment link. One of our team members will contact you to confirm your appointment.

After your first visit to verify your pregnancy, your first prenatal care visit will be approximately 7-8 weeks after the first day of your last period. If you have experienced a pregnancy loss in the past, you can call and schedule a visit to discuss any questions or concerns you may have.

Depending on your preference, our patients deliver at all of the area hospitals by the hospitalist group or by a midwifery group. After delivery, many of our mommies come back to us for postpartum and gynecological medical services, and choose us for pediatric care. Both of our physicians are family medicine doctors.

Yes! After you deliver your sweet little one, Dr. Mariana Giron and Dr. Jonathan Keenan are here for you and can be your child’s pediatric care provider. Double check that we take your child’s insurance plan. We look forward to continuing your care and watching your family grow! All family members can come here for primary care.

The purpose of a preventive visit is to review your overall health, identify risks and find out how to stay healthy. Your insurance plan typically covers 100% of a preventive visit when you see a doctor in your plan network.

The purpose of an office visit is to discuss or get treated for a specific health concern or condition. You may have to pay for the visit as part of your deductible, copay and/or coinsurance.

If you schedule a preventive care visit and ask your doctor about a specific health concern or condition, we may code and bill the appointment as an office visit (or both a preventive AND an office visit).

To read more on the difference, click HERE.

What is an Annual Gyn Exam?

There’s a lot of confusion around what different terms mean for women’s healthcare. However, most people call their well women exam — an annual gynecological (gyn) exam. These appointments are designed to mainly address your sexual and reproductive health. During a gyn exam, you might receive a pelvic exam, a Pap test (which checks for cervical cancer), and a breast exam (you may be given an order for a mammogram which will screen you for breast cancer). You might also talk about family planning or your risk for sexually transmitted infections. 

Pelvic Exam

A pelvic exam assesses whether your uterus, cervix, ovaries, and bladder are healthy. This includes a visual and a manual checkup to look for anything that might indicate that something might be wrong. Many physicians recommend getting a pelvic exam once per year, but you may need more or less frequent exams depending on your specific circumstances and risk factors. 

Pap Test

Pap tests are a screening tool for cervical cancer and are often done at the same time as the pelvic exam. This test involves swabbing the cervix and then looking the cervical cells for abnormalities. In the past, women were recommended to get a Pap test every year between ages 21 and 65. However, these guidelines have changed, which may lead to some confusion over when you need a Pap test. Current recommendations are to receive a Pap test every three years so long as your past tests have been negative. Depending on your risk factors, our provider may recommend more frequent tests. 

Breast Exams

Breast exams are another part of a well woman exam and are an important part of preventative women’s healthcare. These exams can help with early detection of many things, including breast cancer. From ages 20 to 40, the recommendation for women at an average risk for breast cancer is to receive a breast exam from their physician every one to three years. After 40, the recommendation is to receive a mammogram every year. 

A mammogram is an x-ray for your breasts. Physicians use these x-ray pictures to look for changes to your breast tissue or other signs that could be cancer. Before 40, your breasts tend to be denser, which can make it difficult to detect the signs of cancer on a mammogram. That is why the recommendation switches from routine breast exams to mammograms as we get older.

What is a Preventive Care Exam?

A preventive care exam is an important part of taking care of your health, but it’s not the whole story. It helps address your health as a whole and screen for conditions that aren’t necessarily part of your reproductive system. 

A preventive care exam looks at your overall health. These are the appointments where you talk about your lifestyle and discuss your risks for conditions like high blood pressure.

Our healthcare providers provide a comprehensive preventive care exam to take a broader look at your health. Yearly checkups with our team include exams and screenings for your physical and mental health. We may conduct a physical exam and a blood test. We’ll also discuss options for staying healthy and any concerns you have about your health. 

At your annual preventive care exam, our team screens for many different health conditions that may affect you, some of which may not cause any symptoms. For example, depending on your age and risk factors, we might screen for:

• High blood pressure
• Diabetes
• Heart disease
• Sleep apnea
• Allergies
• High cholesterol
• Hormone imbalances
• Vitamin deficiencies

Our team personalizes these screenings based on health recommendations and your individual risk factors. Also, we’ll talk to you about your lifestyle and help you determine if there are any changes you can make to help reduce your risk for certain preventable health conditions. 

Women’s Healthcare Services and Screenings Should Change as You Age

Another important thing to know is that your annual exams and screenings will change as you age. As we get older, our health risks can change. Therefore, your yearly women’s healthcare exams should change, too.

We’ve already mentioned that you may need to switch to mammograms after a certain age, but that’s not the only change. Your exams may look different at each stage of your life. For example, your risk for osteoporosis goes up after menopause. Therefore, we may recommend including a bone density scan as part of your yearly checkup appointment once you reach menopause. Our women’s healthcare team personalizes your exam to you, which means it should change as your lifestyle and health risks do.

During your preventive care visit, your doctor will look at your health risks and talk with you about:

• Your current health
  • check your weight, height, temperature, blood pressure and pulse
  • listen to your heart and lungs
  • check your ears, eyes, throat, skin and abdomen
  • various immunizations
  • various cancer screenings, such as for breast, colorectal, cervical and prostate
  • certain blood tests to check such things as cholesterol or blood sugar
• Your family health history
• Past illnesses and surgeries
• Risks you may have for specific conditions
• How to maintain a healthy lifestyle

We maintain a directory of Preferred Providers. Click here for a complete list.

Disclaimer:  LifeChoices Family Medical does not examine, determine, warrant or endorse the information on any of the entries in this directory. Use of this directory is voluntary and will not result in any liability against our organization. In no event shall the organization be liable for damages to any user of the directory for the voluntary selection of any medical health professional, for the services provided by any companies and individuals listed herein, or for any other damages which may occur.

Furthermore, it is important to understand the difference between a directory and a referral service. A directory is simply a list of professionals or businesses, and no recommendations, guarantees or endorsements are made regarding the quality of service you might expect from any of the professionals or businesses listed.

A referral service, on the other hand, is a screening service, and a recommendation is being made, with at least some endorsement of the professionals or businesses listed in the service. Usually, a referral service will require a professional or a business to meet some quality criteria before they are accepted into the referral service and included in the database. This might include certain professional qualifications, a specific number of years of experience, passing a special test or training program not required by everyone in the profession or business, an absence of consumer complaints about the professional or business, etc. We do not verify the license or the qualifications of any professional or business listed. Understand also that inclusion or omission of particular professionals, businesses, organizations, or services does not imply a recommendation, or lack of, by LifeChoices Family Medical.       

Keep in mind that our providers will not provide a referral for sterilizations or a referral for abortions.

Prescription refills are a particularly complex issue in today’s world of insurance formularies and constant change. Each refill or substitution requires medical evaluation and a medical decision. Every effort will be made to refill prescriptions at your visit.  It is our goal that your prescription will last until your next visit.

If you require an emergency refill, contact your pharmacy and have them send us a fax. We will authorize enough medication to last until you can follow up in our office.  If possible, allow 72 hours, although we will answer most requests within one day.

All other refills, including new pharmacy refills, rewriting prescriptions for mail order pharmacies, medication change required by insurers, lost prescriptions and medication change requests for financial reasons will be handled by appointment.  These all require communication, good medical judgment and proper documentation and cannot be properly handled over the phone.  We strongly prefer not to refill antibiotics or narcotics by telephone. ADD medications require a monthly prescription picked up at
the office.

We will continue to do our best to comply with published formulary guidelines, but we will treat you as we feel is medically appropriate.  If you require a prior authorization for payment of your prescription please contact your health plan for information about covered medications and what information is required from your physician.  We will schedule an appointment as soon as possible so that you may bring this information to your physician, who will assist you in working to obtain the proper medications, with the most cost effective options.

Difficultly Breathing or Chest Pain

Aside from the stuffy nose and some general muscle aches, a cold or the flu should not make you short of breath or cause pain your chest. Chest pain and shortness of breath could be symptoms of a more serious problem such as heart disease, asthma, pneumonia, or others. Contact us right away or if your condition is serious go to the emergency room immediately.

Persistent Fever

A fever that won’t go away may be a sign of a secondary infection in your body and should be treated right away.

Vomiting or Inability to Keep Fluids Down

To stay hydrated your body needs fluids. If you can’t keep down fluids, you should schedule an appointment with us and in some cases you may need to go to the hospital to receive fluids intravenously.

Painful Swallowing

Painful swallowing is not normal. Minor discomfort when you swallow can come from a sore throat, but severe pain can be a sign of an infection or injury that needs to be treated by a doctor.

Persistent Coughing

A cough that won’t go away is usually just postnasal drip that may be treated with antihistamines. However, it could also be related to asthma or GERD, both of which can be treated by your physician. Over the past several years, doctors have noticed an increase in a former childhood infection called pertussis (whooping cough). If you or your children have an unexplained cough for more than two to three weeks, you should schedule an appointment to treat this type of infection.

Persistent Congestion and Headaches

Colds and allergies that cause congestion and blockage of the sinus passages can lead to a sinus infection. If you have symptoms that don’t go away with usual medication, you may need to be treated with antibiotics. Please see us if these symptoms persist.

Is It A Cold Or The Flu?

Knowing whether you have a cold or the flu is important because the flu can have serious complications such as pneumonia or even death. Treating flu within 48 hours of symptoms is best. Prescription antiviral drugs may reduce the time you’re sick.

It’s The Flu

Feel like a truck has hit you? It’s most likely the flu. Flu symptoms like sore throat, fever, headache, muscle aches, congestion and cough tend to come on suddenly and are more intense than cold symptoms. Colds on the other hand, usually include a runny or stuffy nose. Flu symptoms usually improve over two to five days, but you might feel run-down for a week or longer. Colds come on gradually and last about a week.

Flu Swab Tests Can Identify The Flu Fast

The quickest and most effective way to know if you have flu or a cold is to get a test at our clinic.  By taking a nasal or throat swab, your doctor can tell if you have the flu virus, usually within 30 minutes or less. If you test positive for flu and your symptoms started within the last 48 hours, your doctor may suggest antiviral treatment to help you recover more quickly.

Flu Prevention – Vaccines

At LifeChoices Family Medical, we do have the flu vaccine inhouse. Flu shots are especially important for children older than 6 months, pregnant women, adults older than 50 and people with chronic illness or suppressed immune systems.

WHAT DO I DO FOR AN EAR INFECTION FOR MY CHILD?

Ear infections are very common, especially in kids. The latest research indicates that when a child get colds, he or she will end up with an ear infection 61% of the time.

Diagnosing an Ear Infection

At LifeChoices Family Medical, our medical providers usually diagnose an ear infection by examining the ear and the eardrum with a device called an otoscope. A healthy eardrum appears translucent and pinkish-gray. An infected eardrum looks red and swollen.

Ear Infection Symptoms

The hallmark symptom of an ear infection is piercing pain in the ear. The pain may be worse when lying down, making it difficult to sleep. Other symptoms may include:

• Trouble hearing
• Fever
• Fluid drainage from ears
• Dizziness
• Congestion

Ear Infection Symptoms- Babies

It can be tricky to identify an ear infection in babies or children who are too young to tell you where it hurts. Signs to watch for are tugging or pulling on an ear, crankiness, trouble sleeping and loss of appetite. Many babies may push their bottles away because pressure in the middle ear makes it painful to swallow.

Home Care For Ear Infections

The immune system will put up its fight and you can take steps to ease the pain of an ear infection. Applying a warm washcloth can be soothing. Eardrops provide rapid pain relief, but check with your doctor before using them. Over-the-counter painkillers and fever reducers, such as ibuprofen and acetaminophen, are also an option. DO NOT give aspirin to children.

Antibiotics For Ear Infections

Antibiotics can help a bacterial ear infection, however in most cases the child’s immune system can fight off the infection. In a recent study, parents were asked not to give their child antibiotics (just treat the pain) unless the infection was “not better, or worse” after 48 hours. The delay resulted in far fewer kids taking antibiotics.

Complications Of Ear infections

Chronic or recurring middle ear infections can have long-term complications. These include scarring of the eardrum with hearing loss, speech and language developmental problems and meningitis. A hearing test may be needed if you child suffers from chronic or frequent ear infections. We can perform thorough hearing tests right in our clinic.

Preventing Ear Infections

The biggest cause of ear infections is the common cold, so one strategy for prevention is to keep cold viruses at bay. The most effective way to do this is frequent and meticulous hand washing. Other lines of defense include avoiding secondhand smoke, vaccinating your children and breastfeeding your baby for at least six months.

What Is Swimmer’s Ear?

Swimmer’s ear is an infection in the ear canal. It occurs when water or debris gets trapped in the ear canal. Bacteria breed in the water and cause pain, swelling and itching of the outer ear. Although it’s often associated with swimming, anyone can get swimmer’s ear. Breaks in the skin of the ear canal, such as from scratching or using cotton swabs, can also increase risk for infection. The condition is usually treated with medicated ear drops and keeping the ear dry.

MY HORMONES FEEL OUT OF WHACK. CAN I TREAT THAT IN A NATURAL WAY?

You know you, and you know when you don’t feel like you! Hormones are complex and sometimes they can just be a little off in both men and women. We specialize in getting to the root cause of these symptoms, identifying abnormalities in hormones and helping to restore and optimize hormones by using bio-identical hormone pellet therapy.

We promote a natural holistic way to manage your fertility.  At LifeChoices Family Medical, we focus on empowering women and men to understand their bodies and appreciate the importance of natural reproductive health to overall health and wellness.

We specialize in restorative reproductive medicine. We specialize in healthcare that works in cooperation with the body! Understanding the body and the normal fluctuations not only helps to manage fertility but can actually improve health outcomes. The body can tell us so much, we just have to listen. We recommend all women learn the biologic clues that the body reveals. This is done through fertility awareness charting.

We do not prescribe contraception/birth control, or refer for sterilizations or refer for abortions as these would alter normal body processes.  Our medical providers can share with you the fertility-awareness based methods that we recommend.

Additionally, we journey with couples experiencing infertility issues in a holistic approach using Creighton FertilityCare Management and NaProTECHNOLOGY. We also see many engaged couples and help them understand their bodies and cycles in order to prepare for the gift of marriage.

The pill seems to be the cure-all for acne, PMS, heavy bleeding, cramping and any other cycle issue you can think of for your teenage daughters.

Don’t believe the lie that the birth control pill will “regulate” her cycle or is her only choice for relief. Any type of hormonal birth control only shuts down her hormones and cycles, which will interrupt the normal development of her reproductive system and all the normal mental and physical changes that come with puberty. Your daughter may have bigger problems with her fertility in the future when she quits using birth control.  Make an appointment with one of our medical providers who will provide natural ways to deal with bad periods.

It is out of the scope of our physicians to provide the medical clearance for IVF or IUI. We can certainly see you for a physical and for an EKG.

Our fax number is (844) 971-6901. If you need to send us information including your new patient intake forms or to update any form including your new insurance card, you can email it to us at: info@lifechoicesmedical.com. You can also upload documents through your patient portal.

Keep in mind that it is your responsibility to make sure we accept your insurance plan every year and that you have coverage on the date of your appointment. You will be responsible for payment if you are not covered on date of service.

Marketplace: You can apply for the marketplace at https://healthcare.gov during open enrollment which is usually November 1 through December 15. If you would like to come here for care, select Ambetter (at this time we do not take myBlue and Oscar). If you missed open enrollment and you have a “life changing event” (marital status: marriage, divorce or widowed; children: birth, adoption, loss or ages out; serious illness: you, spouse, parent or child), you may still apply as long as it is within 30 days of the life changing event.

Medicaid: AT THIS TIME WE ARE ONLY ACCEPTING NEW MEDICAID PATIENTS FOR OB GYN CARE WITH SUNSHINE HEALTH. WE ARE NOT ACCEPTING NEW MEDICAID PRIMARY CARE PATIENTS. Wish we would be able to accommodate your family.  We had to make a decision to close the Medicaid panel.  As our practice grows, and more and more people hear about us, we are experiencing an overwhelming response for new patients.

Self Pay: We do have self pay rates for patients who do not have insurance. Prices are listed on our home page: scroll to the bottom of the page.