Sherrie Koenigseder, MSN, APRN, NP-C

09/21/2025

💙 September is Alopecia Awareness Month 💙

Alopecia is an autoimmune disorder in which the body’s immune system mistakenly attacks hair follicles, leading to hair loss. This can be temporary, recurrent, or permanent.

🔹 Possible causes & contributing factors:

Viral infections – Mono / Epstein-Barr Virus (EBV), COVID-19, influenza, and others

Genetics – Family history of autoimmune disease or alopecia

Hormonal shifts – Pregnancy, menopause, thyroid disorders, polycystic o***y syndrome (PCOS)

Immune dysregulation – Associated with other autoimmune conditions (thyroid disease, vitiligo, lupus, rheumatoid arthritis)

Environmental factors – Toxins, pollutants, poor nutrition, or gut dysbiosis

Medications – Some chemotherapy agents, biologics, or immune-modulating drugs

Nutrient deficiencies – Low iron/ferritin, vitamin D, zinc, or biotin levels

🔹 What can make alopecia worse?

Reactivation of EBV or other viral infections

COVID infection or vaccine response (can trigger autoimmune flares in susceptible individuals)

Stress & trauma – Both physical and emotional

Chronic inflammation – Poor gut health, food intolerances, uncontrolled autoimmune disease

🔹 Types of Alopecia:

1. Alopecia Areata – Sudden patchy hair loss on the scalp or body.

2. Alopecia Totalis – Complete loss of scalp hair.

3. Alopecia Universalis – Loss of all body hair, including eyebrows, eyelashes, and scalp.

✨ Alopecia is more than “just hair loss.” It’s an autoimmune condition with many possible causes and triggers. Awareness builds understanding, compassion, and support for those walking this journey.

09/20/2025

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09/20/2025

💪✨ Did you know? Women lose 3–8% of their muscle mass each decade after 30.

That’s why so many women feel like they’re “gaining weight out of nowhere” even though they’re eating the same foods they always have. The truth is: your basal metabolic rate (BMR)—the number of calories your body burns at rest—drops right along with muscle mass. Less muscle = slower metabolism = easier weight gain.

The good news? The key to longevity, strength, and vitality is muscle! 🏋️‍♀️ Building and maintaining muscle doesn’t just keep your metabolism humming—it supports bone health, balance, and even reduces risk of chronic disease.

👉 Ladies, don’t fear the weights. Resistance training, protein-rich nutrition, and lifestyle choices that preserve lean muscle are your best allies for healthy aging.

Muscle isn’t just about looks—it’s your metabolic currency for life. ✨

09/20/2025

As we approach open-enrollment season for many health insurance carriers, pay close attention to their network. Do some cold calling before picking a plan for an entire year.

An insurance "ghost network" refers to a health insurance provider directory that looks robust on paper but, in reality, contains many providers who are not actually available to see patients.

Here’s what that means in practice:

Key Features of a Ghost Network

Outdated listings: Many providers listed in the insurer’s directory may have retired, moved, or no longer accept that insurance.

Limited availability: Some providers listed may technically be in-network but are not taking new patients or have extremely long wait times.

Misleading coverage: The directory creates the appearance that patients will have good access to care, when in fact the options are very limited.

Why It Matters

Patients may sign up for insurance plans thinking they’ll have plenty of choices for doctors or specialists, only to find they can’t realistically get appointments.

This can delay care, especially for specialties where access is already limited (mental health, for example).

It’s considered a form of deceptive marketing, and regulators have criticized insurers for maintaining ghost networks.

Example

An insurance plan lists 100 psychiatrists in your area. But when you call:

20 don’t take new patients,

30 don’t actually take your insurance,

25 no longer practice at that location,

leaving maybe 25 who might realistically be available.

👉 In short: a ghost network is a provider directory that looks full but is “haunted” by names that aren’t truly accessible.

09/19/2025

09/16/2025

Call for Nominations NP Week 2025: Shine a Spotlight on a Trusted Voice in Your Region!

Scan the QR code to submit your nominee!

09/15/2025

💊 Are We Over-Prescribing Medications in the Elderly? 💊

One of my goals as a provider is to simplify medications whenever possible. Many times, I find patients are taking medicines they don’t even know the reason for—and sometimes, one prescription is just treating the side effect of another.

👉 For example, I once had an elderly patient ask for a medication for overactive bladder. After reviewing her medications, I noticed she was on a diuretic (a “water pill”)—which naturally makes you urinate more. When I asked why, she said it was prescribed for ankle swelling. But the swelling actually started after her blood pressure medication was increased—a common side effect of that drug.

✅ Instead of adding yet another pill, we adjusted her blood pressure medication, stopped the diuretic, and as a result:

Her blood pressure stayed controlled

The ankle swelling went away

She no longer felt like she had overactive bladder

She avoided dehydration and unnecessary medications

Too often, another prescription gets added instead of addressing the root cause. In this case, she could have been given an overactive bladder medication—which can increase the risk of cognitive issues in older adults.

💡 The lesson: More medications aren’t always better. Sometimes the best medicine is taking less.

09/15/2025

Understanding Nurse Practitioner Education

👩‍⚕️ Patient: “I heard nurse practitioners only have 750 clinical hours compared to physicians… is that enough?”

👩‍⚕️ NP: “That’s a great question — and here’s the truth. Those 750 hours you hear about are just the graduate-level clinical training I completed while earning my Master’s degree. But that’s only part of the story.”

👉 “Before becoming a nurse practitioner, I was a registered nurse. That means I completed a full Bachelor of Science in Nursing program with hundreds of clinical hours and years of direct patient care experience at the bedside — in hospitals, clinics, and sometimes critical care settings.”

👉 “So by the time I started my NP program, I had already cared for thousands of patients. The graduate program then built on that foundation, teaching me advanced pathophysiology, pharmacology, diagnostics, and management of complex health conditions.”

👩‍⚕️ Patient: “So your training is layered on top of your nursing career?”

👩‍⚕️ NP: “Exactly! Nurse practitioner education isn’t just about those 750 hours — it’s about the combination of RN experience, years of practice, and advanced graduate training. That’s why research consistently shows that NPs deliver safe, effective, and compassionate care with outcomes equal to physicians.”

💙 Bottom line: NPs are not a shortcut in healthcare or a fill-in for physician shortages — we are highly educated, deeply experienced, and committed to providing patients with excellent, holistic care.

09/15/2025

A Systematic review analyzing NP care of chronic conditions in primary care.

"Multiple chronic conditions (MCCs) are more common and costly than any individual health condition in the United States. The growing workforce of nurse practitioners (NPs) plays an active role in providing primary care to this patient population. This study identifies the effect of NP primary care models, compared with models without NP involvement, on cost, quality, and service utilization by patients with MCCs. We conducted a literature search of six databases and performed critical appraisal. Fifteen studies met inclusion criteria (years: 2003–2021). Overall, most studies showed reduced or similar costs, equivalent or better quality, and similar or lower rates of emergency department use and hospitalization associated with NP primary care models for patients with MCCs, compared with models without NP involvement. No studies found them associated with worse outcomes. Thus, NP primary care models, compared with models without NP involvement, have similar or positive impacts on MCC patient outcomes."

McMenamin, A., Turi, E., Schlak, A., & Poghosyan, L. (2023). A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions. Medical care research and review : MCRR, 80(6), 563–581.

Multiple chronic conditions (MCCs) are more common and costly than any individual health condition in the United States. The growing workforce of nurse practiti...