Wednesday, July 27, 2016

Stroke Awareness: Know Your Risk Factors

As more people are diagnosed with hypertension the incidence for stroke increases.  Currently about 1 in 3 persons worldwide has been diagnosed with hypertension.  This indicates that the incidence for stroke is more likely than ever before. Diabetes, high lipids, obesity, and cigarette smoking are also risk factors.

Strokes are cerebrovascular accidents, CVA for short.  Strokes may occur from uncontrolled high blood pressure, but may also occur when blood clots block the major arteries to and in the brain cutting off oxygen.  Hemorrhagic strokes may cause bleeding in the brain secondary to a ruptured artery.  The most common cause is from severe hypertension.  Other causes include aneurysm and malformations of arteries and veins in the brain.  Ischemic or thrombotic strokes happen when blood clots block the carotid arteries or arteries in the brain because of fat deposits in the vessel lining (atherosclerosis).  This cuts off or decreases blood flow to the brain.  Embolic strokes usually result from blood clots elsewhere in the body like pulmonary embolism (PE) or deep vein thrombosis (DVT).  Clots from the area involved migrate to the brain and block blood flow. 

Mini strokes called transient ischemic attacks, TIAs for short, usually last a few hours.  If longer than 24 hours, it is considered a CVA.  The impairments that occur are not permanent.  TIAs signal that one is at risk for a potential stroke with lifelong impairment. 

Signs and symptoms of strokes include:

  • Dizziness, lightheadedness
  • Weakness or loss of function  in arm, leg, face on one side
  • Slurred speech or loss of speech
  • Blindness 
  • Mental  confusion or loss of consciousness
  • Unsteady gait


The pseudonym FAST is a simple way to recognize general stroke symptoms. Face droops; Arm weakens; Speech difficulty; Time to call 911. 

Risk factor reduction is a good way to protect yourself and prevent strokes.  Keep your blood pressure in normal range.  Eat low fat dpet to keep lipids low.  Refrain from smoking.  Stay active with regular exercise.  Make less stress a priority as well. Best health!

Keep Your Medical Records Current

The best way to find the medical care you need and deserve is to be informed and prepared starting with your complete medical history.  Your medical record is the foundation of your health maintenance.  Collecting your records from your PCP (primary care physician) and each healthcare provider helps you stay current and up to date with your medical care and treatment.  Keeping track of the vast amount of medical information that concerns you is very important.  

A medical release authorization form is required to have your medical records released to you.  Medical record release forms are available through your doctors' offices, hospitals, clinics, and insurance providers.  Many providers have them available on their websites.  Internet searches will bring up medical release forms that can be used anywhere.  Once your form is completed, mail or fax to the healthcare provider. Charges may be incurred for copying and mailing records. 

Electronic health records (EHRs), also called electronic medical records (EMRs), are computerized versions of your medical records.  This format is replacing hard copy medical records. Patients are able to access their records anytime through secure patient portals to look at health provider reports and test results. You can also directly email your doctors, make appointments, get medication refills, and much more.  This can eliminate unnecessary visits and phone calls. 

Once you have obtained your medical records, it is important that you check for accuracy.  If any information is inaccurate, report it immediately to your healthcare providers so it can be corrected.  Make a request to the provider to correct the medical record.  If this fails, submit a statement verifying the mistakes so it can be added to your medical record.  This can prevent future medical errors.

As EHRs become more prevalent, it will be easier to see and access yours on a routine basis.  You will be able to print your records at home.  As you gather your medical record information, keep it in a folder off the computer.  Make a cover sheet listing your medical conditions, medication, allergies/ adverse reactions, operations, family history, social history, and any other pertinent information. This medical summary can then be used on your doctor visits, especially an initial one with a new doctors.  

Help your health care providers provide you with optimal health care.  Keep up with your medical records to enhance and improve your health decisions.  Best health! 

Sunday, May 15, 2016

Losing Weight Sensibly

Here are some things you can do to lose weight and keep it off sensibly:
  • Make good eating habits part of your life long health maintenance plan.  Avoid yo-yo dieting.  This often results in recurrent weight gain - each time!
  • Learn good eating habits.
  • Eat small portions.  Five small meals a day will be less caloric and give you more energy with less hunger.
  • Enjoy foods you like that may more unhealthy less frequently. 
  • Exexrcise routinely.  Frequent intervals of 10 minutes 2 to 3 times a day a few times a week is adequate.  Start slow like with five minutes for first week.  This will help encourage a positive attitude and more activity.
Ask your primary care health provider to refer you to dieticians and nutrition specialists for more details.  Weight loss surgery is an option that can be considered if obesity is causing and making other health problems more serious; however, serious side effects can occur and you can gain the weight back.  Talk to a doctor that specializes in bariatric surgery for details.

Healthy weight is always great. It is one time when less is more.

Best health!

Ways to Protect Your Skin From Sun Damage

As summer approaches more of your body is exposed to sun.  Remember to practice good skin care by keeping your skin safe from those damaging UVA and UVB rays that cause serious, irreparable sun damage and skin cancer. Simple things you can do include:
  • Limit sun exposure – avoid 10AM to 3PM, spend less than one hour in direct sun - less or none if fair complexion, burn easily, prone to skin cancer.
  • Wear protective clothing – wide brim hats, long sleeves, long pants, skirts and/ or clothes made with sun protection fabric.
  • Umbrella and shade.
  • Use sunscreen SPF 15 or greater. Put on every hour if sweating or swimming. Put on every area exposed to sun, and be sure to remember behind those ears and on the neck.
  • See your family doctor and/or dermatologist for moderate to severe sunburn, or any suspicious skin spots that fail to heal.
Home remedies to ease the suburn: gel from aloe plant; oatmeal bath; ice pack in soft cloth; powder on bed sheets; vinegar & baking powder paste. Keep yourself well hydrated by drinking lots of water. Also, do a self skin exam monthly to keep track of any abnormal skin lesions.  Best health!

by J. L. Richardson, MD, family practice physician, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide.

Tuesday, April 12, 2016

Patient Doctor Commuincation: Listening Is Primary

In this ever changing world of new technology conversations with your doctor face to face are becoming less frequent.  Prior to modern technological advances, most talking to your doctor was done in person during the office or home visit.  Any talk after the visit was by phone, fax, and/or postal mail.  Today this has expanded to e-mail, electronic health records (EHRs), and telemedicine.  Many patients feel that face doctor time is too short and often overshadowed by intense study of the chart and other distractions.  Many doctors overlook the fact that what you have to say will help them diagnose you. 

Studies have shown that missed diagnoses are more likely if the doctor has failed to listen to the patient.  Distractions like patient chart review, interruptions during the office visit, leaving the room to take care of something else, and more decreases the patient’s time.  This unprofessional, unmannerable behavior leaves the patient at a disadvantage.  After getting ready for the appointment and being transported and possibly waiting over one hour to see the doctor, the patient gets an average of less than five minutes of fifteen minute visit to talk.  This is a major faux pas. Patients are able to help lead the doctor to correct diagnoses and treatment over 90% of the time if they listen to the patient.  Less listening invites more unnecessary tests, procedures, and incorrect diagnoses than one can imagine as the doctor tries to rule out what is wrong.

Listening to patients’ history and doing a comprehensive physical exam contributes more to getting the correct diagnosis.  Blood and diagnostic tests add to this; however, if the patient doctor communication is unclear, these could be the wrong tests.  For the patients’ best interest (and less misdiagnosis for patients, malpractice for doctors) communication must be a priority.  The following suggestions for doctors will help:

  • Avoid distractions when you are with a patient.
  • Give more time for those that need it like hearing impaired, elderly, illiterate.  If hearing impaired, write down conversation to each other.
  • Listen intently to patients without interruption when they are talking.  More important information and more information will be obtained that way.
  • Take more time to answer questions.  Use patient information handouts as applicable (include books, CDs, websites, etc.on pages)) for more reliable factual information
  • Review patients’ medical record before you see them.  The more you see them the better you will get to know them requiring less chart review before each visit.
Doctor and patient communication is important in every patient’s health care.  Miscommunication can lead to adverse outcomes, inaccurate diagnosis, improper treatment, and poor overall health care.  Listening is a primary diagnostic tool that should be used all the times.  Best health!