Telemedicine (video appointments) during Covid-19

Steps to make a video appointment with Dr. Prokupek

Step 1: Make an appointment with Dr. Prokupek here.

Step 2: Look for a text or email from our office that has a link to your video appointment.

Step 3: On the day and time of your appointment:

On your smartphone or computer:

• Click on the text or email link you receive from our office. No login required. Or you can start the visit by logging into the Healow app or Patient Portal.

• Set aside a secure and private location for your appointment.

• “Arrive early” by logging into the Healow app, Patient Portal, or clicking the link within the email reminder or text message your doctor’s office sent you.

• Fill out any patient questionnaires and vitals if applicable (answers are not mandatory on either form, but fill in what you can).

• Click “Proceed” to check your computer’s speed and ability to support a TeleVisit.

• Click “Start TeleVisit” to enter the virtual waiting room.

• Dr. Prokupek will begin the face-to-face TeleVisit

• Disconnect when the visit ends.

Steps to make a video appointment with Jeanne Hershey-Weber

Step 1: Make an appointment with Jeanne Hershey-Weber here.

Step 2: Download the Healow app here.

Step 3: Once installed, open the app and tap the ‘gear’ icon in the top right.

Step 4: Under General Settings tap h2h > and then Enroll > then Agree to Terms and Conditions

Step 5: Enter your mobile number, and select Verify (A validation code will be sent to your phone)

Step 6: Enter validation code in app

Step 7: Tap Complete Enrollment

Coffee, Caffeine, and Hemorrhoids

Various lifestyle and dietary factors can worsen the swollen veins in the lower part of your anal area known as hemorrhoids or piles. One of these factors is the caffeine present in the most popular beverage, coffee that has been a staple of the American diet for decades.

How does Caffeine Impact Hemorrhoids?

While caffeine helps you jumpstart your day, it may affect your bowel movements in a negative way. The relationship of caffeine with bowel movements becomes more important in the setting of hemorrhoids because this brew tends to soak up water from your food waste that causes dehydration and hardens your stools. Caffeine can thus lead to constipation, especially when slurped in high amounts.

Having constipation has ripple effects during a hemorrhoid flare-up since it will not only irritate and aggravate the pain of hemorrhoids due to prolonged sitting and/or straining but the constant pain and discomfort will further worsen constipation, triggering a vicious cycle.

Coffee is not the only food that contains caffeine. This ingredient hides in so many foods than you can imagine — teas, sodas, chocolates, energy drinks to name a few. So be sure to watch out what you're feeding your tummy if you want your hemorrhoids to heal faster.

In addition to constipation, older scientific experts did find some link between coffee consumption and diarrhea due to the belief that coffee stimulates bowel movements and leads to diarrhea. However, more recent studies have failed to reveal such a correlation. Although there's no sufficient evidence, many people still report diarrhea after brewing coffee in high quantities.. If you're one of them, you need to limit your caffeine intake since diarrhea will also exacerbate your hemorrhoids.

Moreover, while caffeine would not cause a hemorrhoid flare-up in everyone, I generally advise my patients to avoid or limit foods and medications (like over-the-counter cough and cold medicines) that contain this ingredient during a hemorrhoid flare-up.

Cut down your Caffeine Habit

Here are a handful of tips to help you kick your caffeine habit and speed up a pain-free recovery from hemorrhoid flare-up:

Switch to decaffeinated coffee and other alternatives. Cutting down on caffeine can be challenging for some people who consume it regularly. They just can’t start their day without a hot caffeine rush early in the morning. Though an 8-ounce cup of decaf coffee still contains about 2-to-15 mg of caffeine, this ingredient is present in a much less quantity as compared to a cup of regular coffee (which has between 95 and 200 mg). Additionally, green tea is a much healthier alternative to coffee as it carries only 25 to 50 mg per cup.

Get rid of it gradually. For regular caffeine drinkers, going cold turkey can trigger symptoms of caffeine withdrawal, including but not limited to irritability, headaches, and trouble concentrating. To prevent such niggling symptoms, try to cut back your caffeine intake at a slow but steady pace while introducing coffee alternatives at the same time. This will allow your body to get used to the change.

Drink lots of water. Never underestimate the power of water! Water satisfies your need for drinking a liquid while also stimulates bowel movements and makes you poop. Regular and easy bowel movements without any straining will help your hemorrhoids heal faster. Start substituting your favorite pick-me-up beverages with water.

Exercise. Caffeine drinkers need the endorphin rush, which is what keeps them more alert and focused. By exercising, you’ll not only stimulate your brain cells to release feel-good chemicals like endorphins but also help speed up your digestion and bowel movements, all in all keeping a hemorrhoid flare-up at bay. The idea is to simply trick your brain into thinking that it’s getting the caffeine rush without even consuming any caffeine.

If you’re experiencing a hemorrhoid flare-up and need more tips or treatment, get one-on-one consultation by clicking the button below and booking an appointment today.

How Stress Affects Hemorrhoids?

Stress response, also known as the fight-or-flight response, is a key to survival during stressful situations. This response alerts and prepares us to face various threats. But stress response is good when active only for a limited period. 

That said, many of us are a lot more stressed than ever before, meaning that the fight-or-flight response stays active during most parts of our lives. And why shouldn't it be? After all, we are trying to thrive in the fastest-paced world of the present era.

Too much stress can be a killer. That is the reason the rates of various diseases (like high blood pressure, heart disease, bowel problems, depression, anxiety, etc.) are going sky-high today. 

What’s the Link between Stress and Hemorrhoids?

Our focus here is the link between stress and hemorrhoids. Stress does not directly cause or exacerbate pre-existing hemorrhoids. Instead, it can upset your tummy inducing stomach cramps, constipation, or diarrhea. Then severe constipation or diarrhea, in turn, leads to hemorrhoids. 

Why does stress upset your tummy?

Well, when you’re stressed out, your brain sends out signals to your tummy, which then reacts. What’s more surprising is that when your tummy is upset, it will also cross-deliver messages to your brain, which then responds. In other words, the two systems (gut and brain) crosstalk with and respond to each other's signals. This two-way link between the gut and brain is also what triggers an IBS (irritable bowel syndrome) flare-up in people who are prone to stress and anxiety. 

Simply put, tummies of some people are naturally “wired'' to respond to stress, and distressed bowels, in turn, can invite many un-welcomed guests, including the annoying hemorrhoids.

How stress affects your digestion?

There's no way to say for sure how stress affects digestion in different people. It may either overstimulate (think stomach cramps and diarrhea) or slow down your digestive system (think abdominal gases, and constipation). Why stress has such variable effects on digestion is not clear. That said, we believe that it’s probably due to the release of different forms of certain stress hormones that either accelerate or slow down your bowel movements. If severe, both the extremes of the digestive spectrum will result in or worsen hemorrhoids.

Tame Stress to Prevent Hemorrhoids 

Using stress-coping strategies can help you return to your regular bowel movements and keep hemorrhoids at bay or help treat the swollen rectal veins if you already have them.

Here are my top 6 bits of advice to diffuse stress:

1. Meditate:

Mindfulness meditation instills a sense of serenity and helps you focus your mind and banish the flight of stressful thoughts that may be crowding your mind and causing stress.

2. Bust a gut:

Sometimes, good laughter is all that you need to dissipate stress. Laughter lowers stress hormones while amping up the release of feel-good chemicals. So, try watching a comedy or talking to or hanging out with friends who make you feel good and relaxed. 

3. Spend time with family and friends:

When you're stressed, try to connect with your loved ones. This will help divert your attention from the stressful situation, provide the support that you need, and may even help you find a way out of your problem. 

4. Play upbeat music:

Music is a fantastic stress reliever as it can help you distract, ease muscle tension, and take the edge off stress.

5. Seek help from a counselor:

If stress-coping tools do not work, I suggest talking to a professional therapist or counselor.

6. Get moving:

Finally, exercise. Almost any form of exercise and physical activity will help pump-up the release of feel-good endorphins and promote a sense of well-being and calm. It will also help regulate your bowel function. 

Keep your mind and bowels healthy so you don't have to bear the consequences like hemorrhoids. If you think you have hemorrhoids, get in touch with me by booking an appointment today.