Concierge Medicine

Respiratory syncytial virus (RSV) is a common respiratory virus that infects the nose, throat, lungs, and airway passages. RSV spreads via contact with respiratory droplets from an infected person or via touching surfaces contaminated with the virus and then touching your eyes, nose, or mouth.

RSV is the leading cause of lower respiratory tract infections in infants and young children.

However older adults can also contract RSV.

As per the CDC, RSV is responsible for estimated 60,000-120,000 hospitalizations and about 6,000-10,000 deaths in older adults in the United States.

Which adults are at highest risk for a severe RSV infection?

  • Older adults, especially over the age of 65
  • Adults with chronic heart or lung disease
  • Adults with weakened immune systems

Severe RSV Infection in Adults

Most adults who contract RSV infection develop mild cold-like symptoms such as runny nose, coughing, sneezing, fever. Healthy adults may have very mild symptoms but still can spread RSV to others. Some adults at high risk can progress to an RSV pneumonia.

Those infected with RSV are usually contagious for 3 to 8 days. People typically require 1 to 2 weeks to recover from RSV.

RSV can also lead to worsening of serious underlying lung (such as Asthma or COPD) and heart conditions ( such as Congestive heart failure).


  • Cover coughs and sneezes
  • Wash hands often with soap and water for at least 20 seconds
  • Avoid close contact with others who are sick
  • Avoid touching the face, particularly eyes, nose, and mouth
  • Clean frequently touched surfaces (such as doorknobs)
  • Consult a healthcare professional if you have cold-like symptoms that linger or worsen.


Sources: CDC, National Foundation for Infectious Diseases, Medscape


The flu season is coming and the best way to protect yourself against the flu is a yearly influenza vaccination.

Flu vaccination has many important benefits such as decreasing flu illnesses, less visits to the doctor, and most importantly it can decrease the severity of the symptoms as well as decrease of flu-related hospitalizations and deaths.

As per the Center for Disease Control (CDC), people 6 months and older should get an annual influenza vaccine with certain exceptions (please talk to your doctor!).

Influenza vaccination is especially important for people who are at a higher risk of serious complications from an influenza infection. As per the CDC, this includes…

  • Young children
  • Asthma
  • Neurologic and neurodevelopment conditions
  • Blood disorders (such as sickle cell disease)
  • Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
  • Endocrine disorders (such as diabetes mellitus)
  • Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
  • Kidney diseases
  • Liver disorders
  • Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
  • People who are obese with a body mass index [BMI] of 40 or higher
  • People younger than 19 years old on long-term aspirin- or salicylate-containing medications.
  • People with a weakened immune system due to disease (such as people with HIV or AIDS, or some cancers such as leukemia) or medications (such as those receiving chemotherapy or radiation treatment for cancer, or persons with chronic conditions requiring chronic corticosteroids or other drugs that suppress the immune system)
  • People with history of stroke
  • Pregnant people and people up to 2 weeks after the end of pregnancy
  • People who reside in nursing homes or other long-term care facilities
  • People from certain racial and ethnic minority groups are at increased risk for hospitalization with flu, including non-Hispanic Black persons, Hispanic or Latino persons, and American Indian or Alaska Native persons

Who should not get the flu vaccine?

People who SHOULD NOT get a flu shot include:

  • Children younger than 6 months of age.
  • People with severe, life-threatening allergies to any ingredient in a flu vaccine (other than egg proteins) should not get that vaccine. This might include gelatin, antibiotics, or other ingredients.
  • People who have had a severe allergic reaction to a dose of influenza vaccine should not get that flu vaccine again and might not be able to receive other influenza vaccines. If you have had a severe allergic reaction to an influenza vaccine in the past, it is important to talk with your health care provider to help determine whether vaccination is appropriate for you.

When is the best time to be vaccinated against flu?

For most people, September and October are generally good times to be vaccinated against flu. It takes about two weeks after vaccination to develop antibodies that protect against the flu.

Some individuals may benefit from two flu vaccines per season.

Different flu vaccines are approved for use in different age groups and patient populations. People should talk to their doctor before getting a flu shot, especially if:

  • you have an allergy to eggs or any of the ingredients in the vaccine. Talk to your doctor about your allergy.
  • If you ever had Guillain-Barré Syndrome (a severe paralyzing illness, also called GBS). Some people with a history of GBS should not get a flu vaccine. Talk to your doctor about your GBS history.
  • If you had a severe allergic reaction to a previous dose of any other flu vaccine, talk to your health care provider.
  • If you are not feeling well, talk to your doctor about your symptoms.


Please stay healthy during the upcoming flu season!

Dr. Drourr, Dr. Shtern and the staff of Concierge Medicine of Jupiter

Pulse Oximeter

A popular device that can be purchased over-the-counter is a pulse oximeter. It’s a device that can be placed on your finger (or toe) that measures the oxygen saturation level of your blood. Certain smart watches available on the market can also measure oxygen concentration of blood.

It is non-invasive, not painful, rapid, easy to use, and the measurements can be performed in the comfort of your own home.

These devices have become popular during the time of COVID-19 pandemic when knowing oxygen concentration of blood is crucial. A typical pulse oximeter also provides a reading of the heart rate.

Pulse oximeters measure changes in light absorption in blood. Amount of oxygen in the blood is measured with small beams of light passing through the blood in the digit being measured.


Healthcare professionals often use pulse oximeters to monitor blood oxygen levels of people who suffer with lung diseases (such as COPD, asthma, lung cancer, pneumonia), heart diseases (such as heart failure, coronary artery disease, or congenital heart disease), sleep apnea, and anemia. This is done at the hospital, the office, during sleep studies, during medical procedures that require anaesthesia, or at home.


How to take a reading at home

  1. Remove nail polish from the digit you are using for measurement.
  2. Make sure your hand is warm, relaxed, and below heart level.
  3. Place the device on your finger, earlobe, or toe.
  4. Keep the pulse oximeter on the digit as long as necessary to obtain a measurement. Fingertip readings may be delayed by 30 seconds and toe readings by 90 seconds.
  5. Remove the device once the test is over.


Pulse oximetry readings

An oxygen saturation level of 95 percent or greater is considered typical for most healthy people.

A level of 92 percent or lower can indicate potential hypoxemia, which is a seriously low level of oxygen in the blood and considered a medical emergency.

Various factors can affect readings, including a person’s skin tone, poor arterial blood flow in the measured extremity, low blood pressure, low temperature of the measured extremity, hypothermia, nail polish, artificial fingernails, motion, and exposure to excessive light.


pain relievers

Whether a headache, toe pain, or a muscle ache after a prolonged tennis game, many of us has found our way into our local pharmacy with intentions to purchase over-the-counter pain medications.

Most people expect over-the-counter pain medications to be safe. However, there are several important side effects everyone should be aware of.

Two common examples are pain and fever reducing medications. These two medications can be found alone or purchased bundled with other medications in one pill for multi-symptom relief.


Acetaminophen (Tylenol)

–        Used for pain and fever

–        Although this medication is found over the counter, it has a black box warning issued by the FDA of “hepatotoxicity”, which means this medication can be toxic to the liver. This means there is a risk of acute liver failure which can lead to liver transplantation or death especially in doses of greater than 4000mg per day

–        This medication should be avoided by patients with history of prior allergic reactions to this group of medications and patients suffering from severe active liver disease

–        Caution must be taken if patient chronically uses alcohol, is dehydrated, malnourished, or has kidney disease

–        Adverse reactions to acetaminophen include anaphylaxis (severe allergic reaction), hypersensitivity reactions, rash, liver toxicity, acute kidney injury, chronic kidney disease if taken for a long time, anemia, and low platelets


Ibuprofen (Motrin, Advil), Naproxen (Aleve)

–        These medications belong to a class of medications called NSAIDS (Non-Steroidal Anti-Inflammatories)

–        They are used for treatment of pain, fever, and some inflammatory conditions such as arthritis

–        These medications also have a black box warning issued by the FDA.

o   Use of NSAIDs increases risk of serious and potentially fatal cardiovascular thrombotic events (such as heart attack and stroke)

o   NSAIDs also increase risk of serious and potentially fatal gastrointestinal adverse events that include bleeding, ulcers, and perforation of the stomach or the intestines.

  • Elderly patients and patients that have history of peptic ulcer disease or gastrointestinal bleeding are at a greater risk for serious gastrointestinal events.

–        Serious reactions reported with use of NSAIDs include

o   Gastrointestinal bleeding, ulceration, and perforation

o   Heart attack, stroke, blood clots

o   Hypertension

o   Heart failure

o   Kidney failure (many different types)

o   Liver toxicity

o   Anaphylaxis, allergic reactions including Stevens Johnson Syndrome

o   Bronchospasm

o   Rashes including sensitivity to light

o   Low platelets, Anemia, and low white blood cell count

o   High potassium

o   Abdominal pain, nausea, constipation

o   Ringing in the ears

Please consult with your doctor prior to taking any medications over the counter.


Buyer Beware!

The team of Concierge Medicine of Jupiter


Concierge medicine is an enhanced doctor-patient relationship where the patient pays a retainer fee to a doctor who takes care of their primary medical needs. Concierge medicine is a term used to describe the primary care received by a practitioner that is not impacted by other patients and the time taken to see these patients.

There are many benefits of concierge medicine that includes the following:

Increase in availability

There is additional accessibility with concierge medical care as doctors are able to offer their services after hours and are readily available to communicate with patients via telephone calls, text, email, and even virtually. They can guarantee you an appointment for the very same day or for the day after which means you don’t have to wait long at all to see a medical practitioner.

Concierge doctors have a proactive approach

With concierge medicine, patients are monitored on a more regular basis without being inhibited by time constraints. Doctors are therefore able to provide more thorough care, and through regular visits can detect conditions before they develop as opposed to treating conditions as they occur. 

Concierge doctors provide all-round care

Concierge doctors have more time at their disposal to go through each patient’s medical history and formulate accurate diagnoses based on this information. They are better equipped to recommend referrals if need be, and they can better manage illnesses (especially chronic) as they are very familiar with the patient’s medical history and have regular contact with the patient.

Concierge medicine saves on costs

The time pressures placed on ordinary care practitioners can sometimes lead to additional medical testings that need to be done over and above the doctor’s visit. These tests can add up cost-wise and place a bigger financial burden on the patient than if there were seeing a concierge doctor. Concierge doctors have that extra time at their disposal to be able to investigate and do more research into a medical diagnosis without incurring additional costs.

You have a more familiar relationship with your doctor

Because concierge doctors can see patients more regularly, they become more familiar with their medical history;  this allows them to provide patients with better service and it also allows patients to feel more comfortable and at ease around their doctor.

Concierge medicine offers the best and most up to date medical care

Concierge doctors are concerned with providing the best possible medical care and service to patients. This goes hand in hand with staying on top of the latest medical news, trends, and latest medical technological developments to ensure that patients receive the most up to date treatment.

Concierge medicine is a recent trend that is growing and proving more and more popular when it comes to medical care.

If you are looking for more information about concierge medicine and what it entails contact us today.


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