COMPANY MD April/May Issue

A SHARED VISION

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Dave and LeDona Claflin, founders of FasTest, are taking their business acumen and are rapidly expanding to new markets.

HOW TO CHOOSE HEALTH INSURANCE p 44

THE START CENTER CANCER CARE p 46

HOW MASSAGE CAN HELP TREAT INJURY p 54

HAVING TROUBLE LOOSING WEIGHT? HORMONES MIGHT BE KEY p 56

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INSURANCE |

HEALTH INSURANCE: WHAT TO CHOOSE AND WHY

By Ron Cisneros You just walked into Luby’s. Spread out ahead of you is a dizzying array of food choices. For those of us with little or no self-control, a man-made disaster is in the making. For those blessed with a greater constitution, there still exists confusion and agony over choosing which sides will accompany your turkey or grilled fish. And whether you pile on the calories or make your mom proud with healthy, green choices, there still exists the matter of payment. After all, Luby’s is not free. Thus a trip to Luby’s requires the skill of balancing the needs of your body, the desires of your mind, and the ability of your pocketbook to pay for it all.

Purchasing your employee benefits is like the cafeteria line; in more ways than you might think. Like your plethora of choices in the Luby’s line, you could have a dizzying array of benefit choices ahead of you. Some of those choices, like the gooey mac-n-cheese at Luby’s, are going to have a lot of appeal but offer very little benefit in the long run. Other choices may cost a little more and seem a little less appetizing but will be critical to your well being in the long run.

In addition to health insurance, your employee benefit specialist could offer you cancer insurance, accident insurance, dental insurance, short term disability insurance, long term disability insurance, critical illness insurance, hospital gap insurance, life insurance, and vision insurance. There could be other non-insurance options as well – Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), and Flexible Spending Accounts (FSAs).

Now you have to decide between that which you really need, that which you want, and what you can afford.

Health insurance tends to be the most agreed upon benefit and usually the most expensive. If it were a food item at Luby’s, it would probably be something green. You know you need it and it is good for you but it is not the tasty mac-n-cheese. Still, most people recognize that they need it, although in over twenty years of selling it, I have yet to meet someone who really wants to pay for it. After all, when it comes to buying employee benefits, health insur-

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ance can quickly eat up your budget. There are a variety of reasons for its high cost including but not limited to government mandates and regulations. Another factor is poor consumer selection.

A common complaint about health insurance, aside from cost, is that it is seldom used; at least by those who have the good fortune of being healthy. That is, however, the rub with all manner of insurance policies. For those of us with good driving records, the monthly bank draft for our auto insurance is an annoying monthly reminder that we are paying for a benefit we are not using. And yet we still carry our auto insurance policy because we know that one day our good luck will run out.

So it is with health insurance. We may not be using it today or tomorrow but most of us will have the good fortune to grow older and as we age, we will most certainly use our health insurance. With that in mind, it is important to consider how we use our health insurance and what we really need.

Too often consumers - the very same consumers who complain about not using their health insurance – are preoccupied with low deductibles and copayments when they should be considering higher deductibles and plans without copayments. High deductibles and simplified plans translate to lower premiums. Premium savings can be set aside in HSAs to be used against the higher cost of healthcare in the future.

Like health insurance, life insurance can seem like a waste of money; particularly for the young. But before you make a decision to pass on the life insurance, consider this: You could go your whole life without a disability or the need for a long term care facility but you are guaranteed a death and you have no certainty of when it may occur.

You could make a stronger case for life insurance if you are in your forties, married and have two kids at home than you could if you were in your twenties and single. Still, the circumstances of your life could change and you may not be able to purchase guaranteed life insurance in the future.

In some cases, the ability to purchase group life insurance on a guaranteed issue basis is only available at the time you are first eligible for benefits.

Choosing not to take life insurance at that time could unnecessarily put you at risk.

In group plans, life insurance is a safe, inexpensive option. In some cases, it is usually paired with accidental death and dismemberment coverage, which offers you additional risk aversion for pennies on the dollar. Think of it as a side dish of broccoli or green beans. Your mom will be happy and it will not bust the bank.

Another must have is disability insurance. If you were unable to work for several months due to disability or illness, how would you make ends meet? Disability insurance is not sexy. It will not help you get a pair of new frames for your glasses. It will not help you get your teeth cleaned and pearly white.

You may never use it at all though there does exist a great statistical likelihood that you will. According to the Council for Disability Awareness, over 1 in 4 of today’s 20 year-olds will become disabled before they retire! Even more surprising is the cause of long term absences, which are more commonly related to illnesses like heart attacks and cancer rather than accidents.

What disability insurance will do is help you make your car payment, your mortgage payment, your utility payments, and keep food on the table. Disability insurance protects your income, without which, your ability to enjoy

life would be greatly diminished.

When you are twenty and invincible, mac-n-cheese may seem like a necessity. It is cheap and goes a long way to filling your belly. By the time you reach you middle age, you may not need any more help filling your belly and you might even be willing to spend a bit more for something that better suits your needs. Insurance can be the same way.

There are, however, some types of insurance which should most always be on your plate. The next time you are faced with an array of benefit choices, remember your veggies‌ life, health, and disability. thecompanymag.com | 45

PRACTICE FEATURE |

Th e START Center for Cancer Care i n Boerne

By Karen Adams

It was early winter of 2013 and Bobbie Winn thought she had a bad chest cold. Her chest felt heavy and her cough was rough, so she decided to see her family practice physician. After a few tests, it was determined that Ms. Winn had a cancerous tumor in the right part of her chest and needed immediate treatment to kill the cancer cells, which were inoperable. Ms. Winn, 75, had just moved to Bandera from

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Midland and did not have a local family practice doctor, let alone an oncologist. But her daughter, a hill country resident, recommended a visit to the team at The START Center for Cancer Care (The START Center) in Boerne.

“The doctors and nurses at The START Center were exceptional on all levels, especially Dr. Kalter, my doctor and advocate,” said Ms. Winn.

Many residents in Boerne and the surrounding areas do not realize that The START Center facility located at the Methodist Boerne Medical Center on Menger Springs Road offers cutting-edge, customized cancer treatment with groundbreaking, accelerated drug development efforts.

“It is a part of our mission to provide cancer patients living in and around Boerne the same quality of care that they would find in our San Antonio facilities,” said Steven Kalter, M.D., an oncologist and specialist with The START Center.

“Our patients, just as Ms. Winn, are being treated with some of the most advanced treatments and technologies available today.”

Ms. Winn started her treatments, which consisted of both chemo and radiation, on November 8, 2013 and finished February 25, 2014. “All the signs are pointing to remission,” said Winn.

“What a blessing it has been to have these wonderful doctors and advanced treatments available in Boerne,” said Winn. “My commute from Bandera was quick, and the convenience of having a location that was close and accessible made it much easier for me and my family, especially as we tackled a draining disease,” she said.

The physicians of the START Center aim to usher in a new era in cancer treatment, one that combines customized, streamlined cancer treatment with groundbreaking, accelerated drug development efforts. The center houses a full spectrum of clinical care for cancer patients, including chemotherapy, state-of- the-art radiation therapy, hormonal therapy and wellness programs. The START Center in Boerne is located at 134 Menger Springs Road; phone 210593-5900. More at www.thestartcenter.com.

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A SHARED VISION Dave and LeDona Claflin, founders of FasTest, are taking their business acumen and are rapidly expanding to new markets.

By Ben Schooley Dave and LeDona Claflin have truly done it all. From the earliest days of the marriage, they both knew that their career paths would probably involve breaking out of the corporate race and instead, striking out on their own. From a house cleaning company to an overnight shipping company, and ultimately to the medical testing company Fas-Tes, the Claflins have sought to not only better their own lives, but are also seeking to better the lives of those around them.

Dave begins, “I grew up in the Beaumont area, and was certain I would go into computer robotics because that’s what was supposed to be the next big thing. I made it through one semester in that major, and by the end of my 2nd semester, my professor showed me that he was a genius and I was not.” Perhaps a bit discouraged, Dave dropped out of school and worked selling cars, selling insurance, and even selling MLM deals. With none of it engaging him, he eventually went back to college at Lamar University and received a 4.0 in Real Estate Investment.

While Dave moved on to work for Prudential in the commercial real estate division, his wife LeDona was expecting their first baby while her own graduation from college loomed. She continues, “I always knew that Dave would be successful, and one day I was just watching him work like crazy for Prudential and I told him that if he was going to work so hard at something, it should be his own. Why only get a fraction of the profit when you’re doing so much work?”

And with that, the young family opened a Merry Maids franchise. Dave explains, “It was phenomenal. We ran that for 13 years, and just loved it. However, we did see that there was a ceiling for it. It was never going to be any bigger than what we had established, and so with that, we were able to sell it.” Upon the sale, the family went to

Hawaii for a celebratory trip, and while away on the trip, Hurricane Rita hit the Gulf Coast in 2005. Shortly before the sale of Merry Maids, they had bought into a franchise for Worldwide Express, which was a web-based shipping service. So, from his hotel room in Hawaii, Dave and the family began to think about what other options were out there for them to live.

“We were sick of hurricanes,” Dave explains. “We had a friend that had come to Boerne to help establish a new church, 1910 (previously Watermark). So we came over to visit and help her get the youth ministry set up, and ready for the first service.. On launch day, we looked at the hills, and the skyline, and the water, and the cool little snow cone lady that is over by the river. We know now that it only happens where you get one day per year that has absolutely perfect weather, but we were here for that day, and we fell in love.”

Shortly before the hurricanes, LeDona had lost her mom to cancer, and shortly after the hurricane, Dave’s mother passed, also from cancer. “We started talking about how the kids didn’t have grandmas, and we thought ‘Why do people wait to retire to move to a place they love and then only know strangers when they get there?’ All of our vacations were in the Hill Country, and so we figured we’d always retire here. After helping our friend with her ministry, we kicked around the idea and decided to move here.” And with that, they became Boerne’s newest residents in 2007.

As they worked to lay down roots in their new town, Dave was still required to cold call in his territory for his shipping franchise, which required him to head back to Beaumont frequently. “I was cold calling one day and I walked into a company that did drug testing, and they had packages all over the place, which made them a good prosthecompanymag.com | 49

pect for me. He told me about his business, and we sat there for 2 hours, and he explained the entire concept. Every time I went back I would go see him and learn more about it. I asked him if he would pray about teaching me his business, and I promised to help him organize his business better so that he could franchise it. So he trained us both, and he said he prayed about it, and said that someone else taught him the business, and he owed someone else the same gift, and that was us.”

And with that, Fas-Tes was founded and opened in 2008 on I-10. As everyone remembers, 2008 was a pretty tough year, and opening a new business during this time was pretty risky. However, at the same time, the Claflins saw how lucky they actually were. Dave explains, “Our Worldwide Express business was cut in half literally overnight. DHL (the main supplier) stopped domestic deliveries and that wiped us out. Literally overnight we were at 50% capacity.

It made Fas-Tes all the more important for us and even more of our focus.”

From that first day, Fas-Tes has been growing. “In an economy when most people were laying off staff, we kept growing. It was because the Lord had His hand on our business, and we were offering a service that was different than our competitors. We serve people within 5 minutes. It’s all we do, and we’re able to specialize. We give results immediately, there’s no 3-5 day wait and people see real value in that.”

Eventually investing in the Ten Oak Storage Center on Old San Antonio Road (by Kendall Elementary School), the Claflins continued to look for ways to involve themselves locally, and invariably, they have been led back to 1910 Church. “We are very heavily involved in youth Ministry at 1910. I’m a youth counselor and I’ve gotten to watch the kids grow from kid’s church up through the youth programs, and it’s been wonderful. Our life tends to be our work and our church. Our church and our work. Day in and day out.”

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Fas-Tes has quickly grown to having 10 franchisees now, and there is no end in sight. Fas-Tes is providing a superior opportunity for those looking to break into the market. “You have to have certifications to do this business, and finding someone to get you the certifications is a challenge, and we do a lot to assist our franchisees. Relationships with the national labs is necessary, too, and we provide that as well. As we grew, more labs want to use you because they see your volume.

So we have national agreements where these franchisees get our pricing which saves them considerably. They also have the pricing structure set, the agreements are in place, and the legal avenues are all prepared. The policies are prepared, and the entire structure as well as the understanding of ongoing law changes. Vendor relationships are key, and our insurance relationships help them, also.”

While the business of Fas-Tes is focused on growth, the Claflins are also focused beyond the business world toward areas of growth. “Our main goal is to fund missionaries right now. Instead of being a missionary in the field, we’d like to ensure that we can provide them the resources they need to fund their mission. We want to do this so we can fund missions for kingdom-building activities. What drives us is that we want to grow this to where we can privately fund missions where people will never know about our support, but it will be a legacy that will continue on for generations and will always be a secret. That’s what’s in our heart. More so than anything else, that’s what’s in our heart.” thecompanymag.com | 51

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37131 IH-10 W., Ste. 400 • Boerne, TX 78006 • 830.331.1291 Visit us on the web at www.allcountyhomecareandhospice.com 52 | COMPANY MAGAZINE

OVER 30 YEARS OF EXPERIENCE • Creating a healthy mind • Improving the functionality of the nervous system • Achieving optimal nutrition • Building personalized exercise regimens • Minimizing the intake of toxins • Message therapy: - Deep tissue - Sciatica relaxation - Pre natal - Therapeutic - Reflexology - Lomi lomi • Community Support

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MASSAGE |

WHAT IS MEDICAL MASSAGE...

AND DO YOU NEED IT?

By Nancy Frazier, LMT, CCT, MMT

Do you have pain that doesn’t seem to go away? Are you contemplating pain shots, taking anti-inflammatory meds continuously or even considering surgery? Does your pain return when the medicine/shots wear off? Did your Physician or Physical Therapist recommend massage but when you tried that, it still didn’t work? In any of these scenarios, Medical Massage may be just the help you were looking for.

Medical Massage is a results based massage. This type of massage is primarily the application of specific treatments that are targeted to specific problems. The individual presents a diagnosis from the Physician, Chiropractor or Physical Therapist to the MMT (Medical Massage Therapist) and treatment begins after a thorough assessment/evaluation by the MMT. People may also independently seek the services of a MMT without a prescription. The MMT will customize the session for each client based on a person’s current medical or orthopedic condition. The goal is to normalize the soft tissues of the body and to achieve balance. Some of those outcomes are reduction in pain, increased range of motion, stability and increased functionality. One thing that is also a benefit of this type of massage is that the therapist will usually explain in laymen’s terms, what it is that they are doing and why they are doing it. This explanation also assists in the client’s confidence and healing if they know what is going on and why!

Medical Massage therapy focuses on treating painful medical conditions which affect the soft tissues of the body. It is not as harsh as deep tissue massage. Advanced techniques such as structural integration, neuromuscular re-education, cupping, myofascial techniques and PNF (proprioceptive neuromuscular facilitation) techniques are some of the common techniques used during a treatment session to treat painful or traumatized tissues. Treatments focus on problems involving an individual’s musculoskeletal system which also may include releasing tight muscles, stretching shortened muscles and tendons, and decompressing joints.

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Acute Pain: Acute pain for the most part, results from disease, inflammation, or injury to tissues. It is immediate and usually of a short duration. Acute pain is a normal response to injury and may be accompanied by anxiety or emotional distress.

Chronic Pain: Chronic pain is a continuous pain that persists for more than 3 months, beyond the time of normal healing. It ranges from mild to severe and can lasts weeks, months, or years even up to a lifetime. Chronic pain can often interfere with a person’s quality of life, sleep, and productivity.

Back Pain Injuries: Spine injuries such as sprains and fractures can cause chronic pain. Sprains are tears in the ligaments that support the spine, and they can occur from twisting or lifting improperly. Less commonly, back pain may be caused by more severe injuries that result from accidents and falls. MMT’s commonly rely on the direction and diagnosis of Physicians and Chiropractors for treatment plans and evaluations.

Sports Injuries: The term sports injury, in the broadest sense, refers to the kinds of injuries that most commonly occur during sports or exercise. Fortunately, most sports injuries can be treated effectively, and most people who suffer injuries can return to a satisfying level of physical activity after an injury.

Medical massage is useful in addressing conditions such as: Carpal tunnel syndrome Sciatica Piriformis syndrome Rotator cuff injuries Pain associated with bulged or injured spinal disks (medical massage cannot ‘fix’ the disk, but can help alleviate much of the pain associated with the injury).

Migraines/headaches Pain associated with pregnancy Constipation Range of motion issues Fibromyalgia Back and Neck pain Plantar fasciitis (involving pain in the foot) Repetitive use injuries such as those listed and tennis elbow, Golfer’s elbow Pain associated with restricted fascia Pain associated with postural imbalances Muscle cramps Restless Legs Syndrome Sports/Exercise injuries Work Injuries Auto Injuries Carpal Tunnel Syndrome Edema (swelling) Injuries sustained in traumas such as falls or automobile accidents Thoracic Outlet Syndrome (numbness/tingling in hands/arms There is also a growing demand for pre and post-operative care, CAM (Complementary Alternative Medicine), treatments after Physical Therapy and those who are seeking additional therapies alongside their Physician directed treatments.

Any massage therapist can claim to be a medical massage therapist. Massage customers should evaluate the training that their therapist has received to make sure the therapist is qualified to treat specific conditions.

Nancy Frazier, LMT, CCT, MMT Owner of Massage Matters in Boerne, Texas Nancy moved to Boerne in 2008 and started Massage Matters in 2009. One of her goals is to be the foremost therapeutic Massage Therapy clinic in the county. Focusing on helping others is her greatest thrill and she is grateful for that opportunity. Always improving, she is currently increasing her skills by becoming a Clinical Aromatherapist by the end of 2014. On her days off she loves to walk her Beagle, fine art painting and laughing with her husband.

thecompanymag.com | 55

HEALTHY LIVING |

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TRYING TO LOSE WEIGHT? CHECK YOUR HORMONES.

By Leigh Ann Grasso, Pharm.D., R.Ph.

Many people have started a diet and exercise regimen to attain their “beach body” for the summer. We are taught that eating right and exercise alone, will allow us to achieve our desired weight. Not true! Yes, a well-balanced diet and a regular exercise routine are an essential component to losing and maintaining body weight. Balanced hormones also play a vital role in weight management among other functions.

These hormones include thyroid, estrogens, progesterone, testosterone, and cortisol.

The thyroid produces hormones that are primarily responsible for regulating the rate of metabolism. When your thyroid does not produce enough of these hormones, you can get symptoms such as weight gain, fluid retention (bloating), dry skin and hair, constipation, cold and heat intolerance, low blood pressure, aching muscles and joints, depression, swollen neck, infertility, high cholesterol, and memory impairment. Yet, more than half of all people with thyroid disease are unaware of their condition. Doctors typically perform a screening test of thyroid hormone production called TSH (thyroid stimulating hormone) which is actually produced by the anterior pituitary gland. TSH is an indirect measurement of how much thyroid hormone the body requires and should only be used as a screening tool for thyroid disorders. The reference range for this test is often too broad to trigger the doctor to address it as an underactive thyroid disorder. When the TSH lab is greater than 2, I recommend testing the actual hormones made by the thyroid. This test would include free T4 (levothyroxine) and free T3 (liothyronine) measurements as these are the actual hormones that interact with receptors to produce a response and are used in thyroid replacement. Estrogen dominance can hamper the conversion or activation of thyroid hormone T4 toT3. Levothyroxine is reserve or inactive thyroid which is converted to T3 making it biologically active thyroid that interacts with our receptors to produce a response. About 80% of circulating T3 is derived from secreted T4; therefore, excess estrogen can cause low thyroid symptoms which include impaired weight management.

Estrogen dominance can occur when you have more estrogen than progesterone creating an imbalance. Symptoms of estrogen dominance may include weight gain, fluid retention, low sex drive, pre-menstrual syndrome (PMS), headaches, blood sugar problems, nervousness, irritability, fibroids, heavy menstruation, endometriosis, sleep disturbances, sugar/carb cravings, and mood swings. These symptoms can occur when a woman has a hysterectomy or when she begins the process of menopause, often as early as her mid-thirties. Many women in this age category who experience “menopausal” symptoms are told they are “too young” for menopause, but in fact there is no age minimum for hormone imbalance. Menopause is defined as not having a menstrual cycle for 12 consecutive months.

Pre-menopause defines a period of time leading up to menopause when hormones begin declining and becoming out of balance when compared to our most fertile years. Premenopause can last 10-15 years depending upon when the progesterone begins to decline. Many women have symptoms such as anxiety, depression, mood swings, and sleep disturbances that can be attributed to hormonal imbalance, but instead they are given drugs to treat the symptom and not the cause.

With the abundance of estrogen-like compounds in our environment, estrogen dominance is very common among women. These compounds are often referred to as “xenoestrogens”. Xenoestrogens are found in plastics, fertilizers, pesticides, and food. By balancing your hormones, many of these symptoms will often disappear. This balancing act can be achieved through hormone replacement with compounds that are identical to the hormones your body naturally makes and by minimizing xenoextrogen exposure.

Cortisol is a hormone made by your adrenal glands in response to a stressor. Small increases in cortisol help the body by giving short bursts of energy, immunity, heightened memory, and increased pain tolerance. Chronic stressors, including inflammation and exercise, keep cortisol levels elevated for extended periods of time. Too much cortisol

is actually bad for the body resulting in abdominal weight gain, decreased bone density and muscle mass, blood sugar imbalance, high blood pressure, decreased thyroid function, and lowered immune function. With our busy lifestyles, it is important to get adequate rest. Relaxation and meditation gives the body downtime to expunge mental stress to achieve a decline in cortisol to a normal baseline. Herbal supplements, called adaptogenic herbs, can also assist in cortisol augmentation. The source of chronic inflammation should be addressed as well to prevent cortisol elevation.

If any of the symptoms above sound like the way you have been feeling, Annie’s Apothecary has the ability to measure your hormones non-invasively and offers personal consultations to get you back to feeling ‘normal’.

Dr Leigh Ann Grasso, University of Texas alumnus, is the compounding pharmacist and owner of Annie’s Apothecary in Boerne.

Her passion is educating people to improve their health by replacing hormonal and nutrient deficiencies. She lives in Fair Oaks Ranch with her husband and three children. thecompanymag.com | 57

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What is hospice?

Hospice is not a place, but rather a philosophy of care focused on providing comfort to individuals with life limiting illness. Alamo Hospice focuses on physical, mental, social, and spiritual well-being for patients, their families, and their support network. We provide care to patients in their own homes, assisted living facilities, and other community-based care settings.

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 Hometown delivery of service • Mission-driven, Active community resource, Local decisions, Local leadership and staff.

• Local Medical Director Ben Stahl MD  National reach • Recognized “model program” for quality care, Boerne “Best of the Best” • National recognized accredited prepared program.  Team approach to care • Access to 24 hr. care by the hospice team to include; Physician, Registered Nurses, Social Workers, Spiritual care coordinators, Bereavement counselors, Dieticians, Pharmacists, Hospice aides, Various therapists (massage, pet, PT, OT, ST), and Volunteers.

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