Listen to your heart.

INITIAL VISIT:

During your initial consultation, Dr. Steinbaum will review your medical history and your medical records. She will review all your concerns and issues and focus on your risks for heart disease, unique to you, and determining how best to assess your concerns. We will review the diagnostic tests and go through the rationale for each one. Many of the tests can be performed in our office, and often on the same day, for your convenience. If you choose to, we could also schedule them in advance.

At my practice, we take a preventive, personalized approach to women’s heart health.

Together, we’ll create a strategy tailored to you—based on your specific risks, symp-toms, and goals, to increase your overall wellness. If there are issues and concerns, we take time to listen, to ask the right questions, and use the right tools to find the right answers. Getting you feeling back to yourself (and even better than that!) is our main goal.

You will never hear us say, “You’re fine,” or “Nothing’s wrong with you. It must be stress,” in this office! 

What to Bring:

• Please fill out the New Patient Intake Form prior to your visit.

• Be sure to provide the contact information for your primary care physician and pharmacy.

• Please bring any relevant bloodwork and studies you’ve had done previously along with a list of your medications and supplements.

We truly save your time slot to ensure that there is no pressure for you and for us. When an emergency happens, we understand. Life happens. But, if you need to reschedule, please give us the courtesy of 24 hours, or we will have to charge you $X.

Our currently available in-office testing includes the following. We will only suggest tests that we think are relevant to you and your health needs.

EKG:

A routine EKG ( electrocardiogram ) can give us a roadmap of cardiac functioning.

MONITORING:

For palpitations or “arrhythmias,” we have monitoring devices that are wireless that connect to a special phone allowing us to get the results in real-time. If you have a problem, we will know right away what’s going on with you and call you immediately if there is an issue!

ANS TESTING:

We can assess your autonomic nervous system and determine if you have POTS (postural orthostatic tachycardia syndrome) or other issues of imbalance. The sympathetic nervous system (fight or flight) is usually in overdrive with stress, and we can see if the stress is having on impact on your heart.

LAB WORK:

The lab work we do enables us to determine your risk. We use these tests to determine cardiovascular risk, better understand your metabolism and have insight into your genetics. We don’t need you to be totally fasting, but make sure that you haven’t had a heavy meal or a sugary one before your visit.

ECHOCARDIOGRAM and CAROTID ULTRASOUND:

Our experienced team of ultrasound technicians are trained specifically in cardiovascular disease. We can evaluate the heart structure and function, diagnosing issues with the heart muscle, the valves and cardiac function. We also can get clues into other issues that might need to be addressed.

The carotid ultrasound looks at the carotid arteries, which are similar to the coronary arteries of the heart. With carotid disease, there is a 25-60% association with coronary artery disease. We can also measure the thickness of the carotid artery, implying the beginning stages of atherosclerosis.

CARDIEX:

Using a simple blood pressure cuff we place on the arm, we essentially us this machine the same way as a blood pressure cuff. Not just measuring blood pressure, but also measuring central pressure, augmentation pressure and SEVR, can give a more accurate assessment of arterial health. Treatment in terms of exercise, diet, supplements and hormone replacement will be maximized.

CPET:

Women’s cardiovascular disease often presents differently, and our stress testing allows us to detect early signs of disease before it develops. Through our testing, we can also pick up endothelial dysfunction, stiffness of the arteries, and microvascular disease, the most common form of heart disease in women. Using our test, we can not only provide a diagnosis, but we can also give a personalized preventive treatment strategy for medication and supplements, and an exercise prescription designed specifically for you.

Our cardiopulmonary stress test is done on a bicycle. A mask is put on your face to measure your respiration. A blood pressure cuff it also placed on your arm to measure your blood pressure throughout the tests, along with ekg leads on your chest to monitor your heart rate. The bicycle gets faster and harder throughout to ensure you do enough “work” on the bicycle for us to get an accurate result. It’s best not to eat before the test, but if your test is in the afternoon, have a bit to eat in the morning.

Whether your plan includes exercise, nutrition, hormone optimization, weight management, supplements, stress reduction, or medication, we design a roadmap that is personalized, evidence-based and focused on prevention.

When appropriate, we might suggest more advance testing that we do not do in the office.

Examples include:

• Cleerly CTA

• Cardiac MRI

TEST RESULTS:

Test results can take up to 2 weeks to get back. Once your results become available, Dr. Steinbaum uses a 3-dimensional approach to make clinical decisions. Objective information is integrated with your symptoms and history to make a comprehensive plan of care. If there is something Dr. Steinbaum feels is urgent, you will be contacted by our staff (phone or email), in advance of a scheduled telemedicine or in-office appointment. An in-depth discussion of non-urgent results (the majority) are comprehensively reviewed during a follow-up appointment with Dr. Steinbaum.

Please be aware that there is a fee for Telemedicine appointments.  The fee “reflects not simply the time on the call but Dr. Steinbaum’s expertise and additional time devoted to reviewing the results and studies, communicating with other providers and the in-depth analysis prior to your meeting.

Please be aware, we are always advocating for you, including negotiating on your behalf with insurance companies for pharmaceutical coverage, imaging tests and scheduling. Consider us your own personal health care advocates. We will work hard for you, but please understand that it is time consuming. We might make the hard work look easy, but in today’s healthcare climate, it is definitely not!

PRESCRIPTIONS:

You can request a refill on a current medication prescribed by Dr. Steinbaum by calling the office phone number and leaving a detailed message.  Please provide the name and dose of the medication you require as well as how often you take it (ie: daily, twice a day, etc.).  Also, let us know to which pharmacy you would like the medication sent.

To ensure the best possible care, we require that you be seen at least once every 12 months in order to continue receiving medication refills.

If it has been more than a year since you have been seen by Dr. Steinbaum and your prescription no longer has refills available, you will need to make an appointment before any additional refills will be authorized.

We recommend scheduling your annual visit 2–3 months in advance to help secure a day and time that works best for you.

If you have any questions, please contact the office.

PAYMENT INFORMATION or BILLING:

Dr. Steinbaum does not accept insurance and has opted out of Medicare. This decision was made based on the restrictive guidelines imposed by insurance companies,  which are in conflict with Dr. Steinbaum’s philosophy of personalized and quality care.

Payment is required at time of visit. We accept Visa, MasterCard, American Express, checks or cash. We will provide you a superbill that you can submit as an out-of-network provider.

EMAIL / COMMUNICATION:

I encourage you to contact me or my staff with any questions or concerns.  Please note, for more involved matters, it may be best to schedule an appointment.

For appointments, you can email: sthefanie@srsheart.com (((????)))

Clinical questions, you can email: rachel@srsheart.com (((????)))

We do believe that some supplements are very helpful. When we analyze the data and trials on supplements, the underlying is message is one size does NOT fit all and more is not better. Supplements should be tailored to the needs of the patients and checked routinely, the same way you would assess the effects of a medication by checking your blood tests.

THORNE

https://www.thorne.com/u/drsuzannesteinbaum

Supplements that we recommend, depending on our evaluation:

• Omega 3

• Magnesium

• Vitamin D3

• Coenzyme Q10

• B-complex

• L-arginine

VINIA

- Link- DISCOUNT CODE- DR.Suzanne ( I need to look this up)

Vinia counteracts all of the biochemical issues that happens to the arteries during menopause. In the lining of the artery we see and increase in Endothelin-1 and a decrease in Nitric Oxide. This leads to stiffness of the artery, or endothelial dysfunction. This then leads to high blood pressure, worsens hot flashes and sets the stage for atherosclerosis, or plaque in the arteries

MyAdesso

https://myadesso.health

An app that empowers you with education, by giving you a personalized analysis of your heart risk through the Adesso Heart Score. It helps you track aspects of your lifestyle that you are hoping to improve and provides you lifestyle information, including diet, exercise, and stress management. It also empowers you to become your own best health advocate by teaching you everything you need to know about cardiovascular disease and health.

OURA Ring

If you are having sleeping issues or trying to manage stress, the oura ring gives you insights into how you can improve these aspects of your life.

Apple Watch, FitBit, Garmin, Whoop

Tracking devices to monitor your heart rate during exercise. Some of them do lots of things, but others are simple enough to become a tracker to make sure you are exercising in the right target heart rate zone.