Frequently Asked Questions

General

  • A second opinion can often be helpful. Sometimes it’s to re-evaluate your treatment modalities if you feel like you’ve hit a wall. Sometimes it’s to make sure you’re not missing anything diagnostically.

    Because the nervous system is so interconnected with the body (heart, gut, immune system, etc) I will always take a whole systems approach. Unfortunately, this practice is often not possible in our traditional model of care and patients end up seeing multiple doctors without anyone putting the puzzle pieces together.

    Often times complementary therapies like acupuncture, DNS or chiropractics can be really helpful but you just don’t know where to start or who to see. Lifestyle modifications (sleep, movement, mental health, nutrition) can almost always be helpful and will be targeted and specific.

  • For the Dementia Prevention Pathway I specialize in working with patients age 25 to 75. This is when we can have the most impact on optimizing brain health since dementia pathology starts decades before the disease (or cognitive deficit) begin.

    Adult patients (over 18) are seen for the Neurologic Consultation Pathway.

  • I will make specific recommendations regarding medications, dosing and timing but will generally not take over prescribing them. I will do my best to work with your other medical providers to help implement any changes.

    I may prescribe specific supplements and will give you instructions and options for how to obtain these from third-party tested sources.

  • During our introductory call we will review how to send me any prior records or give me permission to request them so that I am able to review this prior to your visit.

  • I have spent the last 25 years as a general adult neurologist so I have expertise in diagnosing and managing a broad array of conditions such as epilepsy, migraine, multiple sclerosis, neuropathy and neuromuscular disorders, gait and movement disorders (such as Parkinsons Disease) as well as dementia (such as Alzheimers Disease).

  • Over 21 years I built many special relationships with my patients and their families and I miss them dearly. The Neurologic Consultation Pathway is an option for prior patients if they feel that a single visit would be helpful to review their status, medications and other treatment modalities.

  • I do not participate in any insurances but Healthspan Neurology is NOT a concierge practice. There are no premiums, membership or monthly fees. My payment model is simple - you pay for when you are seen and when my services are utilized. Please see the bottom of the Dementia Prevention Pathway or Neurologic Consultation Pathway page for fee details.

Dementia Prevention Pathway

  • Anyone with a family history of dementia needs to take dementia prevention seriously. We know changes start in the brain decades prior to symptom onset so it’s appropriate for anyone who is concerned about their memory or thinking.

    The good news is that nearly half of dementia cases can be delayed or prevented with modifiable behaviors. Given how much we value are cognition it is something anyone with a brain needs to be concerned about.

  • Dementia Prevention should be highly individualized to be most effective and we use data to direct our strategy. All patients will have baseline in-house cognitive testing using an FDA class 2 medical device (included in my charges). Bloodwork will almost always include advanced lipids, hormone, nutritional, metabolic and inflammatory testing (non-routine).

    We will also discuss whether genetic testing might be appropriate for you, what it could mean in terms of your risk and most importantly, what would you gain by knowing this information.

    Further testing may also include:

    • NeuroQuant MRI

    • Continuous Glucose Monitoring (CGM)

    • body composition DEXA

    • coronary CT calcium scan

    • vascular studies

    • sleep study

    • exercise physiology testing

    • serum amlyoid/tau biomarkers

  • Most testing will be done at a local lab or imaging facility in Rochester, NY that participates with insurance so it may be directly covered by your insurance.

    There is some testing that I know insurance will almost definitely not cover. In these cases, although I can not guarantee charges from an outside facility, I can provide information about the fees that they have set.

    I will always consider cost/benefit when prioritizing testing and will try to help get prior authorization for testing when possible.

  • Yes. I welcome you to schedule an introductory phone call to discuss your needs and determine whether the Dementia Prevention Pathway or the Neurologic Consultation Pathway are appropriate for you.

  • No, I do not.

  • Congratulations! You have already built the foundations of optimizing your brain health. This takes a lot of time and energy but I want you to work smarter, not harder and knowing the data can help you know how to focus your efforts.

    The Dementia Prevention Pathway will 1) identify your healthspan goals 2) determine your individual risk factors so you know how to prioritize your efforts 3) objectively measure your progress over time to keep you motivated 4) break it down for you into a simple stepwise strategy and personalized tactics 5) hold you accountable.

    We are in it for the long game!

  • I really value the in-person experience but understand that telemedicine is often more convenient or all that’s possible. Home visits are also an option for patients with mobility issues. I invite you to discuss your preferences during out introductory phone call.