My experience with Occupational Therapy

“I developed Carpal Tunnel Syndrome, which caused numbness and discomfort in my hands. Dr. Lori Thompson, my primary care provider, referred me to Chad Royer, the occupational therapist and certified hand therapist at Premier Healthcare. We were hoping initially that therapy could help avoid surgery. The occupational therapy, along with non-steroidals, was part of a comprehensive treatment plan.

First, Chad evaluated me and did testing to determine how significant my carpal tunnel was, how much sensation I had lost and how much it was limiting my strength and mobility. His findings were much worse than I expected. He recommended exercises that are used to help create more space for the nerve and increase circulation to it. After the testing, we had a frank conversation about the amount of damage my nerves showed. He recommended that I make an appointment with Dr. Hoyer, an orthopedic surgeon specializing in hand surgery. I wound up having an EMG (Electromyogram), performed by Dr. Beck, that demonstrated I had severe changes in nerve impulse conduction due to carpal tunnel syndrome in both of my hands.

After Dr. Hoyer performed carpal tunnel surgery on my right hand, I had a follow-up visit with Chad Royer where he removed my dressing, did sensory testing again, and prescribed an exercise regimen to keep me from losing strength and mobility during the healing process. The exercises helped insure that the tendons did not scar together as I healed, decreasing my mobility. The sensory testing showed that in less than a week of my surgery, I had already clearly improved. Chad also gave me instructions on taking care of the wound and techniques to decrease scarring.

Now, 4 months later, I am back to doing my household chores, playing volleyball and baking bread pain free!”

Shared by Bloomington, IN, resident and Premier Healthcare patient, Ann.


I have heart disease. What do I do? Tips for living a heart healthy lifestyle.

As cardiologists, we look at risk factors for the development of coronary artery disease or heart artery blockages. These risk factors include smoking, high blood pressure, high cholesterol, diabetes mellitus, and family history of heart disease.

On the other hand, if you have had a heart attack, stent or bypass surgery, we look at what got you into this trouble in the first place and try to modify those risk factors as well as we possibly can.

First, and foremost, if you are a smoker you need to quit.  Smoking injures the lining cells of your arteries, called the endothelium, and makes you much more likely to build up cholesterol blockages called plaque. This plaque buildup slowly blocks blood flow of the arteries. To treat the cholesterol that is circulating in your bloodstream, we use medications that can drop levels by 50%.

Second, if your blood pressure is high, it is important to get it under control. There are several lifestyle changes that can help lower your blood pressure:

  1. Weight Loss
  2. Exercising regularly
  3. Eating healthy
  4. Reducing sodium intake
  5. Limiting alcohol intake
  6. Cutting back on caffeine
  7. Reducing stress.

Third, if you are diabetic, get your blood sugar under as much control as you can achieve. Premier Healthcare has two Endocrinologists who can help patients with Diabetes control their blood sugar levels. Visit: or call 812.333.5976 today.

Finally, though you can’t choose new parents and therefore change your health history, you can take steps now to effectively reduce your future risk of heart disease. Visit: or call 812.331.3401 or 812.331.3402 today.

Written by Premier Healthcare Cardiologist, David Blemker, MD, FACC

What is Angina? Common Chest Pain Misconceptions

What is Angina? Common Chest Pain Misconceptions

Many of my patients are surprised that cardiac chest pain is not a sharp stabbing pain. It is more often described as a pressure, ache, or squeezing discomfort. Patients commonly label it as a pressure like someone or something, i.e. an elephant, is sitting on their chest. The take home message is that if your chest hurts in any way, no matter how seemingly insignificant, you should go and have it evaluated because it could be your heart.

Especially in February, for American Heart Month with events like Go Red for Women, we address heart disease in women. The need for this month of awareness is because females often have atypical symptoms that may not include chest discomfort. They can often present with indications like shortness of breath during exertion, or easy fatigability. Also, women may have discomfort in their back or in their abdomen. The bottom line is, if you feel some or any of these symptoms, I would rather you seek attention repeatedly for a false alarm than have you ignore the symptoms and wind up regretting it.

Written by David Blemker, MD, FACC, Cardiologist at Premier Healthcare, LLC

The Weight Loss Clinic at Premier Healthcare: Ideal Protein

Premier’s Weight Loss Program in conjunction with Ideal Protein

The Ideal Protein line used in the weight loss clinic was medically designed over 25 years ago by a doctor in France. Here at Premier Healthcare, each person is medically supervised and assessed weekly during the course of the program.

The program itself helps each person stabilize their pancreas and blood sugar levels through proper nutrition and will cause the body to live off stored fat. It is a program that does not mess with muscle mass, but will burn away the stored fat.

With the weight loss clinic, it incorporates protein into the diet daily and lowers the amount of calories and carbohydrates ingested. With that becomes an increase in fat burning and a weekly weight loss. It is expected that women will lose 2-3 pounds weekly and men 3-5 pounds weekly if the protocol is followed properly.

Premier Healthcare Weight loss clinic is headed by staff that is very knowledgeable of the Ideal protein line and are trained to monitor patients through their weight loss journey.

The Weight Loss clinic is a safe and effective program and will give a person results if followed properly. The ideal protein line has 75 different foods that range from breakfast choices to sweet treats. It is not a drink system; it is based off a variety of products that each person can choose what they want to eat weekly.

If interested in the program, it is a requirement that every person attend a free workshop. Workshops are held every second and fourth Tuesday of each month from 5:45pm to 6:30pm. The workshops will go over the program, costs, and give out samples of the products for people to taste. Each person must sign-up to attend the workshops. The number to call and signup for a workshop is 812-331-3401.

National Family Health History Day

Today is National Family Health History Day, which just so happens to fall on Thanksgiving! Just as you are spending time getting to know your loved ones and sharing a meal together, you should also take some time to learn about your family’s health history and what sort of genetic predispositions you may share.

Knowing your family’s health history can help you learn about any genetic health risks you or your loved ones may have and what are the best ways to prevent these. To learn more visit:

Premier Healthcare has a certified Indiana Navigator to help make sure you are covered for Open Enrollment!

What is a Navigator?

Indiana Navigators are individuals certified to help consumers complete insurance affordability program applications for health coverage under Medicaid and the Marketplace.


Who can use the services of an Indiana Navigator?

Any individual or a family applying for enrollment in a health insurance affordability program may use the services of a certified Indiana Navigator.


What should I expect from an Indiana Navigator?

Navigators are to serve as impartial, knowledgeable resources for consumers enrolling in health insurance affordability programs. While helping consumers complete applications for health coverage, Navigators are expected to provide fair, impartial, and accurate information to consumers.

  • We will be providing assistance with helping individuals or patients fill out Indiana Application for Health Coverage.
    • Application process will take AT LEAST 1 hour to complete, therefore meeting with a Navigator generally requires and appointment to be made in advance.
    • Once completed, applicants will then see all the plans which they are eligible for.
    • We cannot provide specific plan details for the consumer without going through the application process. ( This will show all co-pays, deductibles, etc. that go along with that plan)
  • Specific plan questions must be directed to the plan (i.e. Anthem, Medicaid, etc.)- we are not knowledgeable on the specificity of each plan
  • Navigators will be doing outreach services within the community to make individuals/patients aware of this service that will be available to them.


Open Enrollment Dates:    November 15, 2014-Open Enrollment Begins

December 15, 2014-Last day to enroll for coverage that begins January 1, 2015

  •               December 31, 2014-Coverage for 2014 Marketplace Plans ends
  •               January 1, 2015-Coverage begins for 2015 Marketplace Plans
  •               February 15, 2015-Open Enrollment Ends

Special Enrollment Period and Criteria:

To qualify for a Special Enrollment Period, you must have a qualifying life event.

Examples of qualifying life events include:

  • Marriage or divorce
  • Having a baby, adopting a child, or placing a child for adoption or foster care
  • Moving your residence, gaining citizenship, leaving incarceration
  • Losing other health coverage due to losing job-based coverage, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances.
  • Important: Voluntarily ending coverage doesn’t qualify you for a Special Enrollment Period. Neither does losing coverage that doesn’t qualify as minimum essential coverage.
  • For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions


Information needed for an appointment:

**You must have an email account set-up in order to apply online**

Demographic Information: (Name, DOB, SS#, Marital Status, Address, Etc.)

Health coverage Information

Additional Information

Household Income Information: (Tax filing information, Current employment, Other Income, Deductions, Etc.)



Contact Information:

Danacia Wiechers-Certified Indiana Navigator


Location: 550 S. Landmark Ave l Bloomington, IN 47403

*Appointments also available at our East Side Location and Linton Location*



Link to Indiana Department of Insurance to verify Certification:



*Once plan options are available, we can include what Insurance Plans are available*

We know its time for our annual flu shot, but when is it time for another Pneumonia shot?

“I know I need my annual flu shot, but is it time for another pneumonia shot?” This question is very common from patients this time of year and we all need to be aware that pneumococcal vaccine recommendations for patients 65 and older have recently changed.

In August, the Advisory Council on Immunization Practices recommended and last month the Centers for Disease Control and Prevention (CDC) published these new guidelines, thus making them official. The widely used Pneumovax 23 (PPSV23) vaccine is now being used in conjunction with a newer pneumococcal conjugate vaccine (PCV13). The new PCV13 covers 13 subtypes of Streptococcus pneumonia as compared to the PPSV23 which covers 23. However the PCV13 has been shown to have as good or better immune response (i.e. protection) than the PPSV23. Obviously using just the new PCV13 would leave one without protection to some strains of Streptococcus pneumonia (i.e. pneumococcus). Therefore, the recommendation is that patients 65 or older should receive both of these vaccines in series, separated by a period of 6-12 months. Studies have shown that the best response comes from giving the PCV13 first and then following with the PPSV23.

Confused yet? The ACIP offers the following scenarios as a guideline:

  1. If you are of age 65 or greater and have had no pneumococcal vaccinations in past
    1. It is recommended that you receive PCV13 then PPSV23 6-12 months later
  1. If you are of age 65 or greater and have received PPSV23 at age 65 or more
    1. It is recommended that PCV13 is given to you at least 1 year after the PPSV23
  1. If you are of age 65 or greater and received PPSV23 before age 65
    1. It is recommended that you receive PCV13 (at least 1 year after original PPSV23 given)
    2. And one further PPSV23 given 5 years after initial PPSV23 and 6-12 months after PCV13

If a patient has received a PCV13 prior to age 65 it should not be repeated, it is a once in a lifetime vaccine. The PCV13 and PPSV23 should not be given together and recommended minimal interval is 6 months. It is acceptable to give the PCV13 with the annual flu shot. Side effects from the PCV13 are similar to the PPSV23 and include pain, redness, and swelling at the injection site, temporary limitation of movement of the affected arm, headache, chills, and generalized muscle pain.

If you have questions please ask your provider at your next visit.

This article was written by Dr. Wesley Ratliff, MD, of Premier Healthcare, LLC on 10/28/2014

For details see MMWR September 19,2014/63(37); 822-825