Prevent falls and stay independent

As we age, fall prevention becomes an important part of staying healthy.  According to the National Osteoporosis Foundation, one -third of people over age 65 will experience a fall.  The Centers for Disease Control and Prevention (CDC) reports that each year, 2.8 million people 65 or older are treated in emergency departments for fall injuries 1  In older adults, a fall can limit your independence and mobility; sometimes leading to additional health concerns stemming from inactivity.  In addition, to bruises and pulled muscles, falls may also result in broken bones, making it hard to do things like take a bath or go for a walk.

Fall prevention can help prevent future chronic pain

Research also shows that if you avoid broken bones and injury, especially near a joint like your ankle or wrist, you’re likely to have less chronic arthritis pain as you get older 2, 3. You’ll also be able to get around more easily by yourself.  Individuals at risk for osteoporosis should take fall prevention very seriously and do what they can to strengthen bones through diet, supplements and exercise.  Discussing falls and fall prevention with your primary care doctor or provider is a good first step.  They can help you understand your risks and give you advice on safeguarding against falls.  Ask your doctor about preventing falls at your next visit.

ADC has pulled together some quick tips to help you prevent falls:

Download ADC’s Fall Prevention Flyer (PDF) here or share this post with friends and family.  ADC primary care doctors in internal medicine and family practice will be happy to discuss preventing falls with you.  Call us 24/7 at 512-901-1111 to make an appointment or get established with a primary care provider.



What can you expect at your first Travel Clinic appointment?

Your initial visit will take about an hour. If there are more than one client for a scheduled consult, and extended consult time will be required.  Paperwork for each traveler is required.

Our nursing staff will review:

  • Travel itinerary
  • Accommodations
  • Length of stay
  • Departure date
  • Previous immunizations

They will also review your general health history and recommend appropriate precautions and vaccinations.

On your first visit you will also be given an International Certificate of Vaccination. This document is approved by the World Health Organization as verification that proper procedures were followed in administering vaccines for foreign travel.

An International Certificate of Vaccination records:

  • Date and dose of all vaccinations received for foreign travel
  • Medical exemption from receipt of required vaccinations
  • Personal health history
  • Drug allergies
  • Current medications
  • Prescriptions for eyeglasses and contact lenses

The document will be updated by our Travel Clinic staff at all following visits.

We also provide a weekly updated computerized report, compiled by the World Health Organization, the Center for Disease Control and Prevention, and the US Department of State. This report provides you with the latest news on health related issues, environmental hazards, assessment of terrorism threat, and Embassy and consulate information.

If you are more than 15 minutes late, your consult may need to be rescheduled.  All patients much be present for consult.

Mid-Life Sexuality in Women

Female Sexual Dysfunction is most common between the ages of 45-65. This is due to many factors, some of which can be improved with education and communication. Problems can relate to diminished desire or arousal, pain with intercourse, or difficulties with orgasm. Of course any one with pain will also have a decrease in desire, so solutions may need to address several areas of concern.

Sexual desire

Decreased libido, or loss of desire, can be caused by body issue concerns (feeling unattractive due to weight gain or other signs of aging) or relationship issues. Chronic illness, medication effects, life stressors, depression, hormonal factors, and substance abuse may all inhibit desire. Chronic illnesses, especially the Rheumatologic diseases and obesity, may require position changes, bolsters, or oral sex. Medication changes can be discussed with your physician. Decreasing your outside responsibilities (work, caretaking, etc.) and practicing meditation or yoga can help with stress. The loss of estrogen at menopause can cause depression or sleep problems. Menopausal hormone therapy can help mood, sleep quality and increase energy.. Length of relationship is the number one predictor of decreased libido. Excitement needs to be reintroduced. Areas of conflict over money or family concerns often lead to decrease in intimacy. Affairs can also impact the relationship. Relationship issues may need to be addressed with individual or marital counseling.

Hormonal Factors

The levels of testosterone gradually decline with age. Surgically menopausal women who have had their ovaries removed lose about ½ of their testosterone. There are no FDA approved products for women, but testosterone therapy can help some women. It is very important to have regular blood levels however, because there are also risks with testosterone therapy. There is a new FDA approved pill for women, however, there are a lot of side effects & it must be taken every day & you cannot have any alcohol while using it. Although it was only approved for premenopausal women, it does work in some postmenopausal women.

Sexual Arousal

Decreased arousal is caused by decreased blood flow to the genitals, medications such as antidepressants and by lack of the right type of foreplay. Medication changes can be discussed with your physician. More foreplay, especially to the clitoris may be needed. It is important to communicate to your partner what type of stimulation feels best to you. There are sex toys that improve arousal (a new one is called Fiera). Oral over the counter products include Arginmax (use with caution if you have high blood pressure or herpes) & Stronvivo (a vitamin product that actually showed improvement in a scientific study). Topical products for “increased pleasure” (Zestra and others) are available, but they can be irritating to menopausal skin.
Orgasms are more difficult to achieve after menopause due to decreased blood flow to the genitals. Any of the options discussed under decreased arousal can help. Also, there are books with specific pointers. “For Yourself” by Lonnie Barbach, PhD has been around for years. Another book is “She Comes First” by Ian Koerner, PhD..

Painful Sex

Pain with intercourse can be caused by vaginal dryness due to medications, lack of hormones, and long breaks without intercourse due to divorce, death or prolonged illness of a partner. Particularly in women who have not had a vaginal delivery, decreasing frequency of intercourse can lead to pain. Systemic (whole body) or vaginal estrogen products are available by prescription. There is one prescription oral pill for pain due to vaginal dryness (Osphena). Lubricants need to be applied to both partners (before and during intercourse) and especially around the clitoris and labia. There are many brands but the least irritating ones are Pre-seed, FemGlide, Slippery Stuff, and Pink. For women who have had a long break without intercourse, vaginal dilators can be used to stretch the vagina. For women who have developed muscle tightness as a response to the pain, physical therapy for the pelvic floor muscles is available. Position changes, particularly female on top, can also help. There are also studies coming out about using cosmetic surgery tools inside the vagina to stimulate collagen formation. A laser procedure and a radio-frequency device are currently available but are not covered by insurance.

The first step to solving any problem is to recognize that it exists. Set realistic expectations. Try new things. Behaviors may need to be altered. Below is a list of general information that may be helpful.

  1. Moisturize daily.
    Menopausal skin is often more sensitive & requires more care. Avoid soaps & bubble baths. Rinse very well with warm water. Pat dry. External moisturizers include Lubrigyn, Neogyn, JuvaGyn, & AloeGlide. Internal moisturizers are usually used 2-3 times/wk., not before intercourse. These include Hyalo-Gyn (scientifically shown to be as good as estrogen), Replens, Luvena, & KY Liquibeads.
  2.  Nourish.
    Good nutrition & regular exercise are not only important for general well-being, but they increase blood flow to the genitals. This can also help with weight issues. The Mediterranean diet is a good choice.
  3. Talk.
    It is important to be honest with your partner. Explain what is changing with your body & the importance of adapting your sex life with aging. Concentrate on intimacy, not performance.
  4. Prioritize pleasure.
    Set aside 20 min. per week of “sacred time” for talking & touching, even if it doesn’t lead to intercourse. Hugging & kissing improve intimacy. Fatigue often causes decreased desire due to the physical & emotional demands of the day. Perhaps morning would be a good time for intimacy.
  5. Think.
    Although women can be aroused & willing for sex, libido usually comes from the brain. Reading erotica or romance novels can help. Also, during the encounter, concentrate on the sensations, not on your “To Do” list.
  6. Stimulate.
    In order to increase the blood flow to the area, it is important to stimulate the genitals regularly (at least weekly). This can be done with sex toys (vibrators, etc.) or masturbation. This is especially important for women without a current partner.
  7. Get started.
    Making an attempt to improve your sex life tells your partner that you care about the relationship.

Humana LogoADC adds three Humana Medicare Advantage Plans to insurances accepted

Beginning October 1, 2015 ADC patients may choose to enroll in three new Humana Medicare Advantage plans.  This will not affect the list of current plans accepted, rather patients will now have more enrollment options this Fall.

If you received a letter [Humana Medicare Advantage Notification (PDF)] about these new options you may have some additional questions.  We have compiled some frequently asked questions to help clarify the addition of the new plans.


  • Does this change mean I have to switch to Humana Medicare Advantage?
    No, this change does not mean you have to switch to Humana Medicare Advantage.  All other ADC plan participation remains the same, including traditional Medicare.  You are not required to switch from traditional Medicare coverage to Medicare Advantage coverage.
  • Will ADC no longer accept traditional Medicare?
    ADC will continue to accept traditional Medicare.  You are not required to switch from traditional Medicare coverage to Medicare Advantage coverage.  ADC was simply notifying our patients that in the event they wanted to explore Medicare Advantage as a coverage option, Humana is the only Medicare Advantage plans we are participating in currently.
  • Are the three Humana Medicare Advantage plans the only plans ADC will accept?
    At the current time for Medicare Advantage plans specifically, ADC is only participating with Humana.  Participating Medicare Advantage plans include:

  • If I do not switch what will happen to my care at ADC?
    If you do not switch, your care at ADC will remain the same.  All plan participation remains the same, including traditional Medicare coverage.

Humana Contact Information

For more information about the individual plans please contact a local Humana agent at 512-808-2822 or visit the Humana Guidance Center, 10710 Research Blvd., Ste. 120, Austin, 78759.

ADC Contact Information

For information about ADC insurances accepted, you may call our Managed Care department at 512-901-4477.

The Austin Diagnostic Clinic is now participating in a Medicare Shared Savings Program Accountable Care Organization

Doctor consultation

ADC Medicare patients will soon receive a letter from SW Provider Partners notifying them that their doctor is now participating in an Accountable Care Organization or ACO.

What is an Accountable Care Organization (ACO)?

  • ACOs are groups of doctors and other health care providers who voluntarily work together with Medicare to give you high quality service and care at the right time in the right setting.
  • Your doctor has agreed to participate in a Medicare Shared Savings Program ACO and to work closely with other doctors and health care providers in the ACO to coordinate care for Medicare beneficiaries, like yourself, who have traditional Medicare.
  • The ACO may share in any savings that result from providing you with high quality and more coordinated care.

ACOs do not change your Medicare benefits

  • An ACO is not a Medicare Advantage plan or an HMO plan
  • If you have traditional Medicare, you still have the right to see any doctor or admit to any hospital who accepts Medicare at any time.
  • Your ADC doctor may continue to recommend that you see particular doctors for your specific health needs, but it is always your choice about what doctors you see or hospitals you visit.

How will an ACO help my doctor coordinate my care?

  • YOu may benefit because your doctors will be part of a coordinated team.
  • You may not have to complete as many medical forms that ask for the same information.
  • Each of your doctors will know about the health issues they’ve treated and will have a more complete picture of your health through talking with other doctors.


If you have questions or concerns, you may speak with ADC’s Directory of Quality Improvement Programs at any time by calling 1-512-901-4471.  You may also visit www.medicare.gov/acos.html or call 1-800-MEDICARE (TTY users should call 1-877-486-2048).

Additional Resources:



To do: Go to class, call health educator, food log.

Image source: Thinkstock

Summer is quickly approaching and this is often the time of year when things get a little busy for most people. The school year is coming to an end, summer plans and vacations are approaching, and worries about how to keep the kids busy all summer. Now is the time when we really have to focus on our health and weight loss goals and really commit to sticking with the program commitments!


Patients who commit to consistent attendance are more successful in our program. You can’t get the support and guidance to help you be successful if you’re not making it a priority to be in class each week. We also want to make sure you consistently do your medical check in so that we can address any medical needs you have.

They say 90 percent of being successful is showing up! Make your weekly class attendance non-negotiable!

Midweek Phone Call

The midweek phone call may not seem important to some, but from experience, those patients who consistently do their phone call are more successful at achieving their weight loss goals.

This call is not just for your educator to know how you are doing, it also makes sure that you check in with yourself and recognize successes and challenges in your week. It’s just as much a tool for personal accountability as it is a time for you to receive one-on-one support from your Health Educator.

If you haven’t been making your phone call a priority, now is the perfect time to recommit to getting your call done every week!

Record Keeping

Tracking food intake not only has been shown to help people lose weight more efficiently, but it is also a crucial part of maintaining weight loss long term.

People are more conscious of what they eat when they are writing it down. It helps you keep track of what you are doing, makes you confront out of the box behavior, and helps your Health Educator know how to better coach you.

If you’ve gotten off track with keeping your records, set a short term goal to keep your records each day for the next week. Before you know it, it will become part of you daily routine!

Answers from the Texas Medical Association about the new health insurance marketplace, where to get help and where to sign up.

Healthcare.gov website

What exactly is this marketplace, and why should I care?

The Affordable Care Act (ACA) requires most individuals to have health insurance in 2014. So the law required that so-called health insurance exchanges — now referred to as marketplaces — be established in every state as another avenue for individuals to purchase private health insurance on their own. Most people get insurance through their jobs. But if you don’t have that option, you can shop in the marketplace instead of buying directly from insurance companies. Or maybe you have a certain condition that in the past prevented you from getting health insurance because it was too expensive or simply hard to get. Now you will have options in the marketplace.

Changes under the ACA also require that as of 2014, all individual and small group health plans must provide a minimum package of “essential health benefits,” which includes a basic set of services like physician visits, hospital and emergency care, preventive services like vaccines and screenings, and prescription drugs. So any health plan you purchase in or even outside the exchange must cover these services, and it cannot deny you coverage because of a preexisting condition.

Instead of having to search out health plans on your own, the marketplace is designed to be a one-stop shop where you can go online to check out your coverage options in one place, get easy-to-understand information, and compare plans before you make a decision. It’s kind of like Orbitz or Travelocity, but for health insurance instead of travel. You can also find out right then and there if you qualify for a tax break on your private insurance premiums — another feature of the health reform law — or for state programs like Medicaid or the Children’s Health Insurance Program (CHIP).

The time to sign up for plans offered in the marketplace is approaching fast: Open enrollment is slated to begin Oct. 1 for coverage beginning Jan. 1, 2014. Unless you qualify for an exemption under the federal law, you must get insurance starting Jan. 1 or you could have to pay a fine. Where can I get more questions answered? Because Texas chose not to launch its own marketplace, the federal government will run the
exchange here and serve as the main resource for information and enrollment.

Right now, you can go online to Healthcare.gov and CuidadoDeSalud.gov and find checklists, videos, and other resources to get ready for open enrollment, although actual plans and price comparisons won’t be available until Oct. 1. That’s when you’ll actually apply, too, but you can get ready now. A toll-free call center helps answer questions 24/7 at (800) 318-2596. Also, people known as “navigators” will be available in your community to help with the enrollment process beginning in October. (See “Where can I get help signing up?” below.)

Blue Cross and Blue Shield of Texas launched a campaign called Be Covered Texas to help Texans understand the federal health reform law and navigate the new insurance marketplace in Texas. Call (866) 427-7492 Monday through Friday, 8 am to 5 pm (CT), or go online anytime to BeCoveredTexas.org.

If you have questions about insurance you already bought in Texas or receive through your employer here, you can contact the Texas Department of Insurance at (800) 578-4677. If you think you’re eligible for Medicaid or CHIP, you can contact the Texas Medicaid Program at (800) 252-8263.

Where can I find out more about the marketplace?

There is a lot of information out there that can be difficult to sort through. Here are a few resources on the insurance marketplace we have found helpful, what to expect, and how to sign up:

  • Healthcare.gov is the federal government’s official website for consumer information on the marketplace and the health care law overall.
  • Another federal resource with explanations, checklists, and official forms, applications, and language materials, for instance, is marketplace.cms.gov.
  • BeCoveredTexas.org is an English-Spanish website that Blue Cross and Blue Shield of Texas set up to help Texans understand how the marketplace will work in this state and get signed up. The site offers materials like printable fact sheets on the marketplace and the health reform law and checklists to get ready.
  • The Kaiser Family Foundation developed an interactive map detailing each state’s insurance marketplace, and a subsidy calculator tool to help families estimate how much they could spend on health insurance and whether they qualify for financial assistance.

Where can I get help signing up?

Besides using the official marketplace website, Healthcare.gov, to apply for health insurance, the federal government has created ways for you to get live and in-person help.

You can call a toll-free number, (800) 318-2596, and talk to a trained customer service representative and get help in 150 languages. Online chats are also available.

Another way to get assistance is through community health centers. Texas has more than 60 centers where you can get help with information and enrollment. Here is a list.

You can also search for a “navigator” in your community by calling the federal government’s toll-free number or by searching for someone in your area at https://localhelp.healthcare.gov. Navigators are organizations like a local United Way branch that the government has funded and trained to help guide you through the process of selecting a health plan that’s right for you, figuring out if you qualify for tax credits or state programs, and assisting with preparing your electronic and paper applications. Here’s a list.

BeCoveredTexas.org also hosts local events to help families learn about the marketplace plans and programs and enroll right then and there. Both the federal government and Be Covered Texas have Facebook, email, and texting campaigns that you can sign up for to receive updates on the marketplace and reminders of important deadlines.

When can I create an account at the marketplace?

Even though you can’t sign up for insurance through the marketplace until Oct. 1, you can visit Healthcare.gov now to create the account you will need to enroll. You’ll start by going through some basic steps like providing your name, address, and email address to create a username and password, and entering information like whether you are eligible for insurance through your employer. You can always call (800) 318-2596 with questions, too.

How can I get ready to sign up?

You will have some decisions to make and important information to gather to sign up for health insurance coverage when the marketplace opens on Oct. 1. But there are a few things you can do now to get ready so it’s not so overwhelming.

  • Learn about different types of health coverage so you know what kind of plan fits you or your family.
  • Make a list of questions you may have before it’s time to choose a plan, such as whether you can keep your current doctor.
  • Make sure you understand how coverage works, including things like premiums, deductibles, and copayments. This will help you determine what you have to pay and when.  Healthcare.gov and BeCoveredTexas.org have helpful glossaries you can use to decipher these and other insurance terms.
  • Gather information about your household income, for example, pay stubs, W-2 forms, or tax returns. You will need this information to determine what kind of plan you may want, and whether you qualify for tax credits or public assistance. When you enroll, you will also have to provide information on any insurance you currently have, such as policy numbers and employer coverage.
  • Set your budget.
  • Ask your employer if it plans to offer health insurance coverage in 2014. If not, you may have to find insurance through the marketplace or other sources. You could pay a fine for going without coverage.

When can I sign up?

There are some important deadlines to be aware of to make sure you purchase health care insurance on time and avoid a penalty.

  • Starting Oct. 1, you’ll be able to enroll in the marketplace directly for coverage that begins as soon as Jan. 1, 2014.
  • Dec. 15 is the last day to sign up for insurance through the marketplace for it to be effective Jan. 1, 2014.
  • The enrollment period will be open until March 31, 2014 — the last day to sign up for health insurance coverage for 2014 to avoid a penalty next year. (There are some exceptions to that deadline. Go to Healthcare.gov to learn more.)

How do I sign up?

Starting Oct. 1, you will be able to shop for plans, file a marketplace application, and enroll in several ways: online at Healthcare.gov, by phone at (800) 318-2596, by mail, or with the help of in-person assistance programs mentioned above. (See “Where can I get help signing up?” above.)

There is a single application regardless of which health insurance plan you end up choosing. Once you file, you will automatically find out if you qualify for tax credits or state programs based on your income. Then you can choose the health plan that’s right for you through the online plan comparison tool.

Enrollment at Healthcare.gov takes four steps:

  1. Set up an account. You’ll provide some basic information to get started, like your name, address, and email address.
  2. Fill out the online application. You’ll provide information about you and your family, like household income, household size, current health coverage information, and more. You can view the application right now at marketplace.cms.gov. It will be available at Healthcare.gov by Oct. 1.
  3. Compare your options. You’ll be able to see all the options you qualify for (including private insurance plans, Medicaid, and CHIP) and any tax credits toward your monthly premiums, or out-of-pocket costs on deductibles, co-payments, or coinsurance. You’ll also see details on the costs and benefits of each plan option before you choose.
  4. Enroll. After you choose a plan, you can enroll and decide how you pay your premiums to your insurance company. If you or a member of your family qualifies for Medicaid or CHIP, a representative will contact you to enroll.

You can find this information and more at MeAndMyDoctor.com and HeyDoc.texmed.org.

Used with permission by Texas Medical Association.

About cord blood banking

Cord blood banking is the once-in-a-lifetime opportunity for parents to save the stem cells found in the blood of their newborn’s umbilical cord. The preservation of these stem cells, which are different from embryonic stem cells, allows families the benefit of having them available for existing or future medical treatments.

Cord blood banking is completely safe for both the mother and the newborn since cord blood is collected after the baby is born and after the umbilical cord has been clamped and cut.

Cord blood banking options

When deciding what is best for your and your family, it is important to know about all of your cord blood banking options.

  • Family banking allows you to store your newborn’s cord blood stem cells specifically for your family making them available immediately should your family ever need them. This service is provided by cord blood banks that charge a fee for collection, processing and storage in which you retain ownership of your newborn’s stem cells. Research has shown that transplants with related cord blood stem cells has doubled the survival rates as compared with unrelated (publicly donated) cord blood stem cells.
  • Public donation allows your family to offer your baby’s cord blood stem cells to the public network at no cost. Your donation may then be made available to any patient requiring a cord blood stem cell transplant. Your family does not retain ownership of the cord blood once it has been donated. As a result, there is no guarantee that it will be available should a family member need it. A fee is charged for stem cells released by a public bank to a patient undergoing a medical treatment. For more information about donating cord blood, please visit the Cord Blood Donor Foundation online at cordblooddonor.org.
  • Designated transplant program is a program sponsored by Cord Blood Registry that provided free collection, processing and storage for qualifying families with a medical need. The cord blood is to be used by a family member suffering from a disease treatable with cord blood stem sells. For more information please contact Cord Blood Registry at 1-888-CORD BLOOD.  Any expectant family with a child who has an established diagnosis of a disease that is currently treatable with cord blood may receive ViaCord’s premier cord blood banking and five years of storage services at no cost. Your child’s doctor will need to complete a medical referral form. If you would like more information please call toll-free 1-866-861-8435.
  • Medical waste means that the cord blood will be thrown out as waste. Once discarded, these cells cannot be retrieved for future use.

In addition to the current uses, new medical applications for cord blood stem cells are being discovered rapidly; however, banking cord blood does not guarantee that the cells will provide a cure or be applicable for every situation.

For more information visit the Texas Department of State Health Services and download this brochure: Umbilical Cord Blood Banking and Donation Brochure

Your obstetrician will order routine tests from the lab including:

Optional Screenings

Ask your obstetrician for more information about these options. As insurance coverage varies, please contact your benefits coordinator or insurance plan provider for details about screening coverage and out-of-pocket costs.



Because the strong magnetic field used for MRI will pull on any ferromagnetic metal object implanted in the body, MRI staff will ask whether you have

  • A prosthetic hip
  • An aneurysm clip in the brain
  • Heart pacemaker (or artificial heart valve)
  • Implanted port (brand names Port-o-cath, Infusaport, Lifeport)
  • Intrauterine device (IUD)
  • Any metal plates, pins, screws or surgical staples in your body

In most cases, surgical staples, plates, pins and screws pose no risk during MRI if they have been in place for more than four to six weeks.

Dyes used in tattoos and permanent eyeliner may contain metallic iron oxide and could heat up during MRI; however, this is rare. You may be asked if you have ever had a bullet or shrapnel in your body, or ever worked with metal. If there is any question about internal metal fragments, you may be asked to have an X-ray that will detect any such objects.

Tooth fillings usually are not affected by the magnetic field, but they may distort images of the facial area or brain, so the radiologist should be aware of them. The same is true of braces, which may make it hard to “tune” the MRI unit to your body. You will be asked to remove anything that might degrade MR images of the head, including hairpins, jewelry, eyeglasses, hearing aids and any removable dental work.

The radiologist or technologist may ask if you have any drug allergies and whether you have undergone any surgery in the past. If you are or might be pregnant, mention it to the MRI staff. MRI is generally avoided in the first 12 weeks of pregnancy.

How is the procedure performed?

You will be comfortably positioned on a special table that slides into the MRI system opening where the magnetic field is created. Then the radiologist and technologist perform the MRI sequencing at the control unit in an adjoining room. You will hear tapping noises during the exam. The tapping is created when magnetic field gradient coils are switched on and off to measure the MRI signal reflecting from your body. You will be able to communicate with the radiologist or technologist at any time by means of an intercom. Also, many MRI centers allow a parent or friend to stay in the room.

Depending on how many images are needed, the exam will generally take from 30 to 45 minutes, although a very detailed study may take longer. You will be asked to remain still during the actual imaging process, but some movement is allowed between sequences. Patients generally are required to remain still for only a few seconds to a few minutes at a time.

Depending on the part of your body being examined, a contrast material may be used to enhance the visibility of certain tissues or blood vessels. For this, a small needle connected to an intravenous line is placed in an arm or hand vein. The contrast material is injected about two-thirds of the way through the exam. MRI contrast material is less likely to produce an allergic reaction than the iodine-based materials used for conventional x-rays and CT scanning.

What will I experience during the procedure?

Some patients who undergo MRI in an enclosed unit may feel confined or claustrophobic, though the more open construction of newer MRI systems has done much to reduce that reaction. If you are not easily reassured, a sedative may be administered. Roughly one in 20 patients requires medication. MRI causes no pain, but you may find it uncomfortable to remain still during the examination. You may notice a warm feeling in the area under examination; this is normal, but if it bothers you, tell the radiologist or technologist.

If an injection of contrast material is needed, there may be discomfort at the injection site, and you may have a cool sensation at the site during the injection. Most bothersome to many patients are the loud tapping or knocking noises heard at certain phases of imaging. Earplugs may help.

Who interprets the results and how do I get them?

A radiologist, who is a doctor experienced in MRI and other radiology examinations, will analyze the images and send a signed report with his or her interpretation to your primary care physician.

Your doctor’s office will tell you how to obtain your results.

A body composition scan, also know as a DXA scan, is a low dose X-Ray and takes about 20 minutes. The scanner measures the grams of lean tissue, fat and bone in your body while producing an X-Ray type image of your body.

Skinfolds (calipers) and bioelectrical impedance — the tests commonly used in gyms — provide less accurate and less detailed information.

The cost for the exam is $85. This scan is not covered by insurance.

  • The DXA scan table has a weight limit of 350lbs and a height restriction of 6’5″;
  • Wear casual workout wear without zippers, studs or snaps.

You will receive the results the same day, after your scan is completed.

Use the results to set personal goals or take them to your next visit with your doctor to receive advice or recommendation about your weight/fitness goals.

For more information or to schedule a visit call us at 1-512-901-4030.   Our office is located in the ADC North Clinic, 3rd floor south entrance.

Younger woman walking next to older woman

Osteoporosis, which means “porous bones”, is not just a disease of the frail elderly.  Osteoporosis is a chronic condition when there is depletion of bone calcium resulting in weakened bones that break easily.

Osteoporosis is usually painless until a fracture occurs, which is usually the hip, spine or wrist.

Who is at risk for osteoporosis?

Twenty-five million Americans have osteoporosis. About 80 percent are women. However, men are also at risk of developing the disease. Determining risk factors are

  • Advancing age
  • Low calcium intake
  • Female
  • Caucasian or Asian
  • Excessive alcohol
  • Family history
  • Excessive caffeine
  • Small, thin bones
  • Menopause
  • Smoking
  • Sedentary lifestyle

How is osteoporosis detected?

It is now possible to detect osteoporosis before a fracture and to build up bone mass even after it has been lost. Detection can be simple, quick and painless. Bone densitometry, a noninvasive and accurate way of detecting osteoporosis, takes only 15-30 minutes.

Much like an X-ray, it uses a very low dose of radiation to measure bone density and bone mineral content.

What are the benefits of a bone density test?

The bone density test can be beneficial for any age or gender. It can provide early detection that other tests may miss. It can measure multiple sites of the body to determine the most appropriate treatment. It can estimate the risk for fracture.

Preparing for a bone density test

Do not take any solid pill containing calcium for 24 hours prior to the exam.

Do not have any procedures requiring IV contrast, barium or nuclear medicine studies for 3 weeks prior to the test.

What will I experience during a bone density test?

Prior to the exam you will be asked to remove any metal objects such as belts, jewelry, etc. If you are a woman, you will be asked to remove your bra. During the exam you will be asked to lie still while the body is being scanned.

Who will interpret the bone density results?

The bone density report will be sent to the Menopause and Osteoporosis Center. Doctors, trained to interpret this test, will forward the results to your doctor. Contact your doctor’s office for your results.

Can osteoporosis be treated?

Yes. Several medications are available that can either help to maintain or increase bone mass. Lifestyle changes and medical treatment are part of a total program to prevent future fractures. Your doctor will discuss the best treatment for you.

Your doctor may tell you you need to fast for some of the lab work we perform, but what does that mean?

Fasting means not eating or drinking for a period of time before your lab tests. Some blood tests are sensitive to food and drink in your system, and fasting helps ensure that the test results are more accurate.

Some common tests that require fasting are blood cholesterol, triglyceride and glucose level tests. Some tests that check for vitamin levels, such as Vitamin E or A may also require fasting. Your doctor will let you know whether your test requires it.

How long do I fast?

It depends. Some blood tests need you to fast for at least 12 hours. Some other tests only require an eight-hour fast. Your provider will tell you when to begin your fast, so you can plan your lab visit accordingly.

Many people fast overnight, then have their labs drawn early in the morning. That’s why our lab is so busy in the morning! Just make sure you follow the guidelines your provider gave you so the test results are not tainted.

What can’t I eat or drink?

  • Food
  • Gum, especially gum with sugar
  • Liquids other than water, unless with your doctor’s permission

What can I drink?

Water is allowed during a fast. Black coffee or tea may be allowed, but check with your doctor, because some tests are sensitive to caffeine.

Are you visiting one of our draw stations or our lab at the Main Clinic?

Our phlebotomists make every effort to make your visit comfortable.

Here are some things you need to know before you visit us.


We require orders from your ADC health care provider to draw your labs. If we don’t have any orders in our system, we won’t be able to perform them.

Please contact your provider to ensure your labs are in the system before you plan a visit to the lab.


Sorry, but we do not accept orders from out-of-network providers – verbal or written. All lab order must be from an ADC provider.

We also don’t accept out-of-network insurance. Take a look at the list of insurances ADC accepts to see if we take your plan.

Busy times

Our busiest times are between 7am and 1pm.

Early morning wait times range from 20  to 45 minutes.


Each test is different and insurance varies, so it’s not possible for us to tell you how much your lab work will cost.

We encourage you to look over our list of accepted insurances. If you have further questions about your bill, contact our Business Services department.

If you have Medicare, we may ask you to fill out an Advance Beneficiary Notice of Noncoverage form (ABN) to determine if you want the particular lab test done that Medicare may not pay for.


Would you like more information about our Weight & Health Risk Management program and the services we offer?

Fill our the contact form below and one of our staff members will contact you.

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Follow these links for helpful information about a disease state or the specialty of rheumatology.

A colonoscopy is a procedure that enables your physician to examine the lining of the colon (large bowel) for abnormalities by inserting a flexible tube that is about the thickness of your finger into the anus and advancing it slowly into the rectum and colon.

What preparation is needed?

The colon must be completely clean for the procedure to be accurate and complete. Your doctor will give you detailed instructions regarding the dietary restrictions to be followed and the cleansing routine to be used. In general, preparation consists of either consumption of a large volume of a special cleansing solution or several days of clear liquids, laxatives and enemas prior to the examination. Follow your doctor’s instructions carefully. If you do not, the procedure may have to be canceled and repeated later.

What about my medications?

Most medications may be continued as usual, but some medications can interfere with the preparation or the examination. It is therefore best to inform your physician of your current medications as well as any allergies to medications several days prior to the examination. These include:

  • Aspirin products
  • Arthritis medications
  • Anticoagulants (blood thinners)
  • Insulin
  • Iron products

It is also essential that you alert your doctor if you require antibiotics prior to undergoing dental procedures, since you may need antibiotics prior to colonoscopy as well.

What can be expected during a colonoscopy?

Colonoscopy is usually well tolerated and rarely causes much pain. There is often a feeling of pressure, bloating, or cramping at times during the procedure. Your doctor may give you medication through a vein to help you relax and better tolerate any discomfort from the procedure.

You will be lying on your side or on your back while the colonoscope is advanced slowly through the large intestine. As the colonoscope is slowly withdrawn, the lining is again carefully examined. The procedure usually takes 15-60 minutes. In some cases, passage of the colonoscope through the entire colon to its junction with the small intestine cannot be achieved. The physician will decide if the limited examination is sufficient or if other examinations are necessary.

What if the colonoscopy shows something abnormal?

If your doctor thinks an area of the bowel needs to be evaluated in greater detail, a forceps instrument is passed through the colonoscope to obtain a biopsy (a sample of the colon lining) or a small brush is introduced to collect these cells. These specimens are submitted to a pathology laboratory for analysis.

If colonoscopy is being performed to identify sites of bleeding, the areas of bleeding may be controlled through the colonoscope by injecting certain medications or by coagulating the bleeding vessels. If polyps are found, they are generally removed. None of these produce pain since the colon lining can sense stretching. Remember biopsies are taken for many reasons and do not necessarily mean that cancer is suspected.

What are polyps and why are they removed?

Polyps are abnormal growths from the lining of the colon which vary in size from a tiny dot to several inches. The majority of polyps are benign (non-cancerous) but the doctor cannot always tell a benign from a malignant (cancerous) polyp by its outer appearance alone. For this reason, removed polyps are sent to a pathologist for tissue analysis. Removal of colon polyps is an important means of preventing colorectal cancer.

How are polyps removed?

Tiny polyps may be totally destroyed by fulguration (burning) but larger polyps are removed by a technique called snare polypectomy. The doctor passes a wire loop (snare) through the colonoscope and severs the attachment of the polyp from the intestinal wall by means of an electrical current. You should feel no pain during the polypectomy. There is a small risk that removing a polyp will cause bleeding or result in a burn to the wall of the colon, which could require emergency surgery.

What happens after colonoscopy?

After colonoscopy, your physician will explain the results to you. If you have been given medications during the procedure, you will be observed until most of the effects of sedation have worn off (for 1/2 to 2 hours). You will need someone to drive you home after the procedure.

You may have some cramping or bloating because of the air introduced into the colon during the examination. This should disappear quickly with passage of flatus (gas). Generally, you should be able to eat after leaving the endoscopy area but your doctor may restrict your diet and activities, especially after polypectomy.

What are possible complications of colonoscopy?

One possible complication is a perforation or tear through the bowel wall, which could require surgery. Bleeding may occur from the site of biopsy or polypectomy. It is usually minor and stops on its own or can be controlled through the colonoscope. Rarely, blood transfusions or surgery may be required.

Other potential risks include a reaction to the sedatives used and complications from heart or lung disease. Localized irritation of the vein where medications were injected may cause a tender lump lasting for several weeks, but this will go away eventually. Applying hot packs or hot moist towels may help relieve discomfort.

Although complications after colonoscopy are uncommon, it is important for you to recognize early signs of any possible complication. Contact your physician who performed the colonoscopy if you notice any of the following symptoms: severe abdominal pain, fever and chills, or rectal bleeding of more than one-half cup. Bleeding can occur several days after polypectomy. Colonoscopy and polypectomy are generally safe when performed by physicians who have been specially trained and are experienced in these endoscopic procedures.

To the patient

Because education is an important part of comprehensive medical care, you have been provided with this information to prepare you for this procedure. If you have questions about your need for colonoscopy, alternative tests, the cost of the procedure, methods of billing, or insurance coverage, do not hesitate to speak to your doctor or your doctor’s office staff. Most endoscopists are highly trained specialists and welcome your questions regarding their credentials and training. If you have questions that have not been answered, please discuss them with the endoscopy nurse or your physician before the examination begins.

Thinking about joining our weight loss program but still have questions?

We’ve put together some of the most common questions we hear. Maybe this will help:

How does the clinic-based program work?

Research shows that structured diets using meal replacements are the most successful for weight loss and long-term weight maintenance.

Trained healthcare professionals provide practical support through weekly group sessions and individual phone contact.

Who provides medical supervision?

Our endocrinologists oversee our program. They follow a medical protocol, which includes routine doctor visits, checking of vital signs, lab work and heart monitoring.

Will my insurance pay for the program?

The short answer? It depends. Insurance coverage depends on a diagnosis. Your insurance and diagnosis will be reviewed to determine if insurance coverage is an option.

Insurance does not pay for meal replacement products.

How do I get started?

Joining is easy! First you’ll need to attend a free orientation. That’s where we describe the available diet options, what the program involves, medical supervision, cost and insurance.

The next step and set up a HRM® clinical/physical and enroll you in an upcoming class. New classes start every month.

Still have questions?

Send us a message with your contact information and one of our staff members will get in touch with you.
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If your mammogram demonstrates that you have dense breast tissue, which could hide abnormalities, and you have other risk factors for breast cancer that have been identified, you might benefit from supplemental screening tests that may be suggested by your ordering physician.

Dense breast tissue, in and of itself, is a relatively common condition. Therefore, this information is not provided to cause undue concern, but rather to raise your awareness and to promote discussion with your physician regarding the presence of other risk factors, in addition to dense breast tissue.

A report of your mammogram results will be sent to you and your physician. You should contact your physician if you have any questions or concerns regarding this report.

Learn more about this law from the Texas Radiological Society.

Would you like more information about the Travel Clinic and the services we offer?

Fill our the contact form below and one of our staff members will contact you.

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Please note: This form is not appropriate for medical communications.

Medicare can help pay for post-operative glasses.

Our Optical Shop can help you pick out your glasses after your cataract surgery.

Medicare guidelines cover 80 percent of the cost toward a basic pair of lenses and a frame. The rest may be covered by your secondary insurance.

Here’s how it works:

  1. About 4 weeks after you cataract surgery, your doctor will give you a prescription for your new lenses.
  2. Take your prescription to our Optical Shop, which carries a selection of frames covered by Medicare.

That’s it!

Our Optical Shop can help fit you into the lenses and frames your choose.

You can also upgrade beyond Medicare’s basic frames and pay the difference out-of-pocket for items such as:

  • A deluxe frame
  • Progressive lenses
  • Anti-reflective treatments
  • Transitions treatments
  • Specialty lenses

Hear more, strain less.

We offer a wide variety of hearing devices to our patients from various manufacturers. Take a look at some of our amplification options from one of these manufacturers, Oticon.

Ask us about our free trial period.


Alta Pro is Oticon’s newest and premium amplification device.  A range of breakthrough features combine to give you enhanced sound quality and reduce the effort required to listen and understand. One of these features allows you to personalize the sound based on your preferences by listening to sound samples in the office.  In short, Alta is Oticon’s best listening experience ever.

Available colors: Chroma Beige, Terracotta, Chestnut Brown, Silver, Silver Grey, Diamond Black

See the full Alta amplification line.


Forget about what you’ve heard about amplification up to now.  Intiga is so advanced, you’ll be amazed at how smart, how helpful and how transforming better hearing can be.

When you take control of your hearing with Intiga, you can engage more in life, and begin hearing more naturally. You will strain less to understand, so you have more energy to respond, communicate and give back. You can take part in life the way you want to.

Available colors: Chroma Beige, Terracotta, Chestnut Brown, Pure White, Silver, Silver Grey, Steel Grey, Diamond Black, Vivid Lilac, Natural Henna

See the full Intiga amplification line.


Agil is like no other amplification. It’s designed to improve your ability to hear and understand with reduced cognitive effort, even in difficult listening situations. There’s no need to avoid crowded restaurants, conference rooms or sporting events. No need to turn up the volume on the TV.

Since you won’t have to work so hard to hear anymore, you’ll have more energy to participate in conversations and your favorite activities.

Available Colors: Diamond Black, Steel Grey, Silver Grey, Silver, Chroma Beige, Terracotta, Chestnut Brown, Samoa Blue (available in miniRITE only)

See the full Agil amplification line.


Oticon Acto is designed to let you hear what you need to hear with greater comfort and convenience. The amplification instruments automatically adapt to the environment so that you can follow conversations, even in challenging situations.

Acto is discreet — it can fit securely inside your ear or behind it. The discreet organic shape virtually disappears behind your ears letting you and everybody else forget they are there.

Acto is also wireless, enabling you to connect to devices such as cell phones, TV and MP3 players.

Available Colors: Silver, Silver Grey, Steel Gray, Diamond Black, Chestnut Brown, Terracotta, Chroma Beige

See the full Acto amplification line.


Oticon developed the more affordable Ino amplification instrument to include essential features most people want in an amplification instrument.


  • Clear and comfortable sound processing
  • Automatic operation
  • A wide variety of instrument styles and options.

Available Colors: Diamond Black, Steel Grey, Silver Grey, Silver, Chroma Beige, Terracotta, Chestnut Brown

See the full Ino amplification line.

Amplification accessories

Accessories can enhance your hearing experience. Ask us about your options.

Watch how easily these accessories work together:

Multi-Test II device in hand

Multi-Test II device

An allergist uses skin testing to determine if a patient is allergic to airborne allergens, certain foods, insect venoms or sometimes medications. Allergy testing has been found to be more accurate than serologic (blood) testing.

Skin testing has changed significantly over the years.

Less painful and invasive methods are now available. ADC allergists use the latest in testing, offering a more efficient and less painful way to test for allergies. Results are quickly obtained on the day of testing. Intradermal testing is sometimes offered, but our primary method is using the Multi-Test II device.

The Multi-Test II enables your doctor to apply 72 skin tests in about 30 seconds. Results are available to the doctor in approximately 15 – 20 minutes.

This method of testing is well tolerated by adults and children.