Archive for the ‘Lifestyle Changes’ Category

Breast Reduction Surgery: Is it Cosmetic Surgery, Reconstructive Surgery, or Doesn’t It Matter?

Wednesday, January 3rd, 2018 by doctor

Breast Reduction Surgery: Is it Reconstructive Surgery, Cosmetic Surgery or Doesn’t It Matter? Will my health insurance cover the surgery?

I recently saw a female college student, as a new patient consultation concerning “Breast Reduction Surgery”. This procedure also known as “Reduction Mammaplasty” is indicated for the treatment of symptomatic macromastia (large breasts). The commonly reported symptoms related to macromastia are that of: neck, shoulder and back pain secondary to the weight of the large breasts upon the musculoskeletal system. Other secondary symptoms include: breast pain and dermatitis or rashes beneath the breasts.
This above patient was referred by her gynecologist and arrived with a “prescription” recommending a consultation with a “plastic surgeon”. The patient believed, as many do, that since she was referred by her physician, that the surgery would be covered by her health insurance plan. She was requesting that the surgery be scheduled in four weeks, during her “winter recess” from college.
After completing a patient history and regional breast examination, my staff proceeded to explain to her the procedure necessary to try and obtain insurance authorization for her requested and indicated surgery. She had no other medical treatment or consultations concerning her macromastia. No history of being referred for physical therapy, chiropractic treatment, orthopedic consultation, or dermatology exam. The patients understanding of the “health insurance system” was that, if her referring physician recommended her for treatment, it must be a medically indicated and covered procedure.
Reconstructive Surgery vs. Cosmetic Surgery: It is universally believed by patients, that if a surgery is classified or considered “reconstructive”, it is medically indicated and an insurance covered procedure. This usually means to patients, that all fees related to that procedure will be paid by their health insurance. And if a procedure is considered “cosmetic”, it is not a medically indicated and covered procedure. It is my opinion that for years, breast reduction surgery has been thought of as a “Hybrid”. It is considered “reconstructive” in attempts to obtain insurance coverage for the surgery. It is considered “cosmetic” in that patients expect meticulous aesthetic expertise in the surgery and the post-surgical results. In our practice, it has recently become extremely difficult to obtain insurance coverage for breast reduction surgery. Insurance companies frequently require 2-3 documented reports from other referred specialists. Also the insurance companies commonly requests 6-12 months of documentation and treatment by either a: physical therapist, chiropractor, dermatologist or orthopedist.
Do Your Homework: The intent of this blog is simple and I hope that everyone who reads it understands one point. If you feel that you are a candidate for breast reduction surgery, and requesting coverage under your health insurance, it is important that you contact your health insurance carrier, and have them forward to you in writing, what their criteria are for coverage. Every insurance company has difference, independent criteria and indications, and one should not confuse the fact that “my friend” got it covered by her insurance, and she had “smaller breasts” than me. On the average, it takes between 3-6 months of preparation, seeking secondary consultations with other healthcare providers and possible therapy (physical therapy or chiropractics). Notify your primary care physician as soon as possible concerning any symptoms which may be related to your macromastia. It is never too early to start the process, and remember that what the insurance company’s criteria are this year might not be the same next year. Please contact our office concerning any questions you might have that relate to breast reduction surgery and coverage through your health insurance.

Why Do Good People…Make Bad Choices?

Tuesday, June 2nd, 2015 by doctor

Why Do Smart People Make Poor Decisions?


People often ask me, “Doctor, how can I make better decisions and choices in life”?

I feel like my life is in a descending spiral which I cannot stop”.  Often one thinks that because they seem to be highly educated, with lots of degrees or diplomas on the wall, or financially stable with lots of material wealth, that is synonymous with “good decision” making skills.   One often thinks that decisions in life go hand and hand with the above. People who are close to me hear me regularly repeat my mantra of life, “got to have a plan”.  Not just one plan, but plan A, plan B, and plan C.  Plan A, is always the plan that will give you the results which you think you really want and desire. Plan B, is a good and sometimes more realistic plan, that takes a different route or results than Plan A does.  Plan C is “Damage Control and Survival Mode”, to prevent you from going backwards or  losing ground. Plan C is there until you can reassess your choices and develop a revised Plan A or B.

Insanity: “repeating the same thing over and over, but expecting a different result”.

As a good friend told me you never learn anything by listening to yourself.  ”Give every man thy ear but few thy voice ” (Polinous, Hamlet, Act 1, Scene 3)  Also, I was told that if “Plan A doesn’t work, you NEVER repeat plan A” ( unless of course the situations change, or you revise Plan A, and then it is really Plan B). If nothing else, these are the two most important parts of this Blog: listen to everyone and everything and stop repeating the same wrong ways. You can stop reading or continue if you want more.


So why do good smart people make bad choices and decisions? This may not be the same for everyone and we need to take several factors out of the equation from the start, such as substance abuse and mental illness. In my opinion, it is due to a combination of several and often complex factors. My thoughts are that some of these factors include: 1-Family values and experiences.  Such factors include events during your childhood and life, religious and moral beliefs, and family and parental structure and happiness. 2- Money- Many people will base their decision making on a financial goal, thinking that the correct choice is the one that will make them financially secure, even though they may be poorer emotionally (Scrooge phenomenon).  3-Ego-  I feel that this can be the most powerful and or dangerous force. The fact that you always know what is right and that everyone else is wrong.

So let us now step back and look over our decisions and decision making process in life. Were any of your bad decisions made based on one of the factors outlined above? I’m not saying that this is good or bad.  What I’m implying is that, maybe one consistently  makes the same bad or incorrect life choices because of one of the above influencing forces. When we make a good or correct decision, we often forget about it and move on never giving it a second thought. When we make a bad or poor choice in life, it often haunts us forever, influencing future of additional incorrect choices. So let’s look at this more closely. But not at the bad, rather at the good choices in life. LG (life is good)

Think about a good decision you made in life: school, education, profession, marriage, children, etc. I am not implying that all of these were good choices in your case, rather try to find one that stands out. Now look and search for the people, place, situation or things that assisted you and made that choice correct in your life. Hopefully, you have found at least one. You need to go back to that place in your mind. You need to find that situation that allowed you to make that correct, good and emotionally rewarding decision. Now base future decisions in a similar fashion. Go back to people you trust to help you. We all need help! (no man is an island).  You have to break the chain of bad choices and events by going back to a good place in your life and mind and ask yourself, who helped me get here, what were the situations surrounding my success and how can I change things NOW in my life to make similar good choices. You already have everything you need to move ahead listed above in Part I and Part II. If you want more, read on:


Let’s move to the opposite side.  Let’s look at our bad decisions and life choices, and why we repeat then. We all make bad decisions. Its part of the learning process of life, right? But why do we repeat them?  Did you have a plan A and B?  Or did your ego say, I know it’s going to work, I know I’m right, everybody and everything is wrong.  So, why do we continue to make bad choices? You should know by now!  It is not simple but a combination of all of the above factors, and more!

First: You didn’t have a well thought out Plan A, you let your emotions or one of the above factors influence you, incorrectly!  Ego, Money, etc

Second: Did you have a Plan B to revert to. And sometimes you need to cut your losses and move fast like in the stock market. When a stock drops 10%, dump it, move on, you can always buy it back. In life, plan B should be set as a “default”. It should automatically kick in. Yes, you can cry, kick yourself, or whatever you want, but let Plan B takes it course. And never repeat Plan A.

Third: And this is bad when you keep on repeating Plan A.  It is because there is a feeling of comfort in Failure!  What is he saying?  I want to fail; it is comfortable for me to fail?  This makes no sense, unfortunately it makes a lot of “bad sense”. If you know that Plan A is the wrong decision and you are going to fail, and you do, then you have been successful in your endeavor! Cause you planned and completed your own failure! You may not agree with this theory, however, if you do, one of the only ways to get off of this carousel is to step off while it is moving! Fall flat on your face! And pick yourself up! And thank God you are still alive to move on.


Come on let’s end this already! You are telling me nothing! OK, here goes, bad decisions are contagious. But so are good choices. So you need to break the streak before you break your neck. Why does research state that you should never go food shopping on an empty stomach because you are hypoglycemic and hungry.  You therefore buy more, and the incorrect food products (make bad choices). The hormonal response of hunger affects your decision making! That’s It!  Why didn’t you just say that 1218 words ago! Because you wouldn’t understand the meaning of “HUNGER” as it relates to daily decisions and choices in life. We are all hungry for: Love, Friendship, Security, Good Health, Well Being and the Meaning and Purpose of life.  We hunger for the hope that we are here to make a difference, small or larger! Yes and that is it, simply stated, so don’t go shopping hungry, and don’t make decisions in life hungry.  Fill your life with the people and things that matter, and you will never be hungry. If you are not hungry, your decision process will be clear, focused and direct. “I am the bread of life, those that believe in me will never be hungry” (John 6:35).

Life Coach, We all Need One! Why Go it Alone?

Saturday, January 31st, 2015 by doctor

It seems like everyone has a “coach” these days. Yoga coach, Fitness coach, Cooking coach, Public Speaking coach, Weight or Nutritional coach.  Some times they are called “trainers”, “teachers”,” rabbi, yogi or “therapists”. I guess a life coach is the modern cross between a therapist, best friend and personal trainer.

A life coach is an outsider, non-family member who you can: talk to, bounce ideas off, discuss personal growth with, as well as seek advice, encouragement, along with constructive criticism. Their goal is provide positive direction in life, and promote personal growth... A life coach is usually a person who is sometimes as close or closer than your best friend, sibling or spouse. An important point being that a life coach is non-judgmental, and does not carry a grudge into the future sessions. They act on life issues, review the issue with you and assist you in dealing with the issue in a positive manner. They should not suggest revenge, hatred, retaliation, or promote any negative energy or emotions within you.

Let’s use a simple analogy of a personal trainer.  They demonstrate the correct way to perform an exercise or activity. Then observe you performing that activity.  Gives constructive criticism, comments on form, and encourages good activities.

There are several important points concerning a life coach. If things don’t work out, you can part your ways and move on. No personal baggage to worry about, however there is often a feeling of loneliness or emptiness until your void is filled.  A life coach needs to be an engaged listener. The first “life coaches” in history were probably bartenders! They would listen to hundreds of stories a day, sometimes the same or similar stories from different customers. However they rarely provided corrective criticism in fear of loosing a tip!

So what should one look for in securing a “Life Coach” these days? The best life coaches are recommended from others.  One must remember that each life coach, similar to personal trainers, work with many other and different people.  You will rarely find a life coach who is all yours! Second a life coach has to be one who you trust with your deepest, personal, most intimate and sometimes darkest secrets.   You must be able to open up to your coach without fear that they will discuss or reveal personal information to others.  The coach does not have to be emotionally disconnected from you. It is acceptable for you both to share emotions together; such as crying and laughter. Many feel and recommend that your coach be of the same sex, to decrease the temptation of a personal relationship. Most life coaches do not record any notes or keep any form of written or electronic records. It is a moment to moment interaction. You share a concern; interact through feedback or praise, encouragement or constructive criticism.

You should never feel that your coach is being “judgmental”.  They are not a part of your life to judge anything you do as “right or wrong”.  There position is simply to assist you in moving forward into a better positive place in your life.

Don’t “Try”…..Do!!!

Wednesday, December 10th, 2014 by doctor

Well the New Year is upon us and we are all writing down our resolutions. Those of you, who read our last Blog, remember there is no guarantee that our lives or situations will change, just because the calendar does. We all have to be proactive and make it happen!  One of my good friends brought a new light on this issue by removing the word “Try” from her vocabulary and her life.

I needed to think about this issue further, and the word “try” before sitting down and writing this Blog. Let us start by looking at the definition of the word “try”…”to make an attempt”. So now let us look at the definition of the word “ attempt”…”attempt implies making an essentially single effort, and usually suggests failure” So therefore we can surmise that “try implies an attempt leading to failure”.

Why would anyone want to start out with an attempt at failure.  Let us start out, with the idea of succeeding and obtaining a successful result. Nike, the inventor of the world famous “Swoosh” campaign, marketed the term “Just Do it”! Let’s look at the definition of “Do”…to perform, execute and successfully finish”. Whether it is sports, business or in life, this holds true.

Now knowing this minutia, you can understand why, as my friend said, don’t try,  just do.  Don’t attempt failure…perform, execute and be successful. This is how we need to approach and welcome the coming of the New Year.  It is not that easy, but it is a start.  We need to set and center our mind on success. Many have written on the power of positive thinking; however this is even simpler than that. Eliminate one word from your life (try). From the moment you wake up in the morning, to time you go to sleep. Believe and focus on success and not failure, and you will notice a gradual change in your life and how people perceive you as being successful.

Would you want your plastic surgeon to “try” to perform an operation or cosmetic procedure? I don’t think so!  Dr. Stephen Chidyllo and his staff at Central Jersey Plastic Surgery all strive for success. We Do!