How to Save on Your Health Costs

Spending your health dollars wisely is easy to do. These tips are a must for saving your health as well as your money.

1. Keep your weight stable. It is the healthy thing to do. This will save on grocery and clothing expenses.
2. Get prescription meds in bulk quantity of 100 versus thirty day supply especially if you are paying for your meds.Buy nonprescription medical items in bulk when on sale. You will be amazed at your savings when you buy a six to twelve month supply on sale. This tip is also effective for emergency preparedness.
3. Check with your state provisions for health care. Many states have low cost insurance plans available. Check what your state has to offer by contacting the state health agency.
4. Talk with your doctor by phone, fax, and email to save on the cost of an office visit payment. This avoids wasting valuable time waiting in the doctor's office especially when time constraints often result in patients being seen 30 to 60 minutes after the given appointment time. Save your time and money.
5. For blood pressure checks, get yourself a home blood pressure monitor. Call in your readings. Many doctors will discover that your blood pressure is actually stable when the stress of the doctor's white coat is absent. For diabetics, a home glucometer is very useful for monitoring blood sugar.

Invest in your most important asset - YOU. Great health is true wealth!

Tips for Effective Communication

1. Listen a lot.
2. Be specific.
3. Ask for a reasonable change that will relieve the gripe.
4. Make sure your patient/healthcare provider understands what you want and you understand what she or he wants.
5. Deal with only ONE issue at a time.
6. ALWAYS consider compromise.
7. Never assume you know what the other is thinking. Check it out. Don't assume or predict reactions, rejections, or acceptance.
8. Accept what the other feels. Don't tell your patient/healthcare provider what he or she should or should not be feeling.
9. Don't name call or label.
10. Sarcasm is dirty fighting - call each other on it.
11. Stay in the present. Grievances should be dealt with at the earliest possible moment. Don't save them up to use as weapons.

Great health relies on effective communication by everyone - YOU the patient, your family, and your health care team. Best health!

Your Weight: When Less is More

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!

Healthcare Deja Vu Come True?

As health care access decreases and costs increase, we must look ahead to improving it for everyone.  In 2011 employers paid an average of $11,000 for employees and their families, while yearly insurance premiums rose from $13,000 to $15,000.  The following is an excerpt from "Building an American Healthcare System" released in 2002 when the average premium paid by employers was $6500. While proposing ways to decrease cost and access, one is able to see that good healthcare can be deja vu come true.

One stop shopping for medical care is in order. By having more clinics, easy access to care will help people to get what they need in a timely manner. Waiting to see the doctor is one of the reasons our health care is out of control. The Public Health facilities will be a setting in which health care providers will employed and compensated as in the private sector. It will be just as prestigious to work for the Public Health as the private sector. In addition, permanent protection of physician incomes can be guaranteed by the government much like the recent ruling in Britain (British Medical Journal, April 5, 2003). The concept of second rate, low paying health care for the low income associated with Public Health Service must be changed and amplified. We must be proud to work for our country’s health system, and to obtain top notch health services! In this set up, the uninsured are insured and objectives of the Fair Care to the Uninsured Act of 2003 will be met. This is very important. Those without insurance are sicker, die younger and receive less care for many conditions. The risk of illness increases the longer one is without insurance.


More emphasis from the USPHS for education, prevention and screening, eldercare, disabled care, chronic condition care/ chronic multisystem illness (CMI), health awareness, and education is needed. The Public Health clinic will evolve from the barely visible building or little trailer in the field to highly visible, easily accessible structures. Vacant malls and warehouse buildings can be bought and transformed to mini-medical facilities that provide it all. Pre-existing clinics in the area can be merged, or remain as satellite facilities. The goal is to have health care at every corner much like the neighborhood convenience store. The era for traveling 100 miles to your doctor, waiting half a day or more only to spend the average 5 minutes with your health care provider must cease.

Minnesota has set up a system that covered about 95% of its residents under 65 in 2001 (86% in 2000). It uses government and private insurance together to achieve insurability.  "Approaching Universal Coverage: Minnesota’s Health Insurance Plans" by Debra Chollet & Lori Achman of Mathematica Research Policy, Inc.states that it has been successful at serving "all populations in need at all levels of income". Coverage is included for the "medically uninsurable" like the person with chronic multisytem disease, or pre-existing conditions. Its GAMC and MA plans includes coverage for expenses that occurred in the 3 months prior to application, and do not have premiums or co-pays. Minnesota's programs have been, or are currently used in other states, and can be used to help lay the foundation for health care uniformity. The Commonwealth Fund has several publications that look at other states' health systems, and universal health coverage.

The effort to consolidate the American health system is a priority. Karen Davis' summary, "Time to Change: The Hidden Cost of a Fragmented Health Insurance System", states that the present system "is not up to the challenge of ensuring a healthy and productive nation because it is 'fragmented' ". The focus of her summary exemplifies how lack of uniform health services costs more with less results.


Attention must also be placed on employer health provisions.  In 2002 companies spent an average of $6500 per person for health care. This does not include the patients' out of pocket payment for services. The pages of uncovered services listed in many insurance handbooks grows longer. About 41 million employed by small business pay directly for services at prices compatible with the Medicare and Medicaid models. Through the leadership of the Public Health Service all businesses are uninsured primarily because it is unaffordable. Congress is presently looking at a concept called an Association Health Plan (AHP) as part of the Small Business Health Fairness Act. This would allow small business owners to offer large corporation health discounts. It would also be uniform nationwide. The AHP is in use in some states, and has come and gone in some. Last year 16 states closed down 48 AHP plans. This would be a great opportunity to "phase in" national coverage. As employer health programs are phased out, patients should be offered the option to obtain national insurance. Each person preventive and screening will be done without charge. Eventually this will lead to a healthier people, and health system at a much lower cost.

  

Health Education Affects Your Health & Care

Care systems can be set up based on the prevalence of disease and proven preventive measures. For instance, heart disease kills about 1 million/ year, and about 1.5 million hospitalizations occur as a result. We can build on existing programs that focus on guidelines and evidence-based data for the most prevalent conditions, and implement them in our clinics. The USPSTF is dedicated to this type of service. The USPSTF recently found evidence that early detection (with bone density tests), and treatment of osteoporosis in women without symptoms reduced the risk of fractures. Globally speaking, the recent World Cancer Report by WHO has found that cancer may rise by 50% by 2020. One third of these can be prevented. That is very significant! The following table lists (British Medical Journal, March 29, 2003) the costliest conditions to treat.

The 15 costliest treatments (and number of people with diagnosis) in 1997 Heart disease $58bn (17 million) Cancer $46bn (9 million) Trauma $44bn (37 million) Mental disorders $30bn (20 million) Diabetes $20bn (10 million) Hypertension $18bn (27 million) Cerebrovascular disease $16bn (2 million) Osteoarthritis $16bn, (16 million) Pneumonia $16bn (4 million) Back problems $13bn (13 million) Kidney disease $10bn (2 million) Endocrine disorders $10bn (18 million) Skin disorders $9bn (20 million) Infectious diseases $6bn (16 million)

Alongside the USPHS is the HHS which has in place the ACHI, Association for Community Health Improvement. This group focuses on communities
networking together for better health. It is in 42 states (D.C. and Canada), and is composed of people from different areas of medicine. This is a valuable resource to use in developing health system uniformity because it is almost nationwide, at the local community level, and very diversified. HHS has 300 programs that help in "protecting the health of all Americans and providing essential human services". The Medicare program is the largest health insurer in the nation. In April 2003 HHS had a national
summit, "Steps to a Healthier USA: Putting Prevention First" that addressed prevention and promotion of healthy lifestyles. Funds ($15 million) for “Healthy
Communities” will help communities do their part. The ODPHP works to promote disease prevention and healthy living. Their program, Healthy People 2010* is "the prevention agenda for the Nation". It outlines health objectives for the Nation.

Providing more health information is vital. TV is the most powerful, and most accessed way to get information. Almost everybody watches TV, has a TV, and talks about what is on TV (even if they say they don't watch TV you can be sure you will be asked, "Did you see on TV..."). In addition to public service announcements, more television programming on health issues can be added to the daily schedule on existing channels. Eventually Public Health TV will be available with daily medical news, and basic health information. After all, we have 24-7 dedicated channels for theology, sports, news, finance, cartoons, and music, to name a few, yet basic health programming is still in its infancy.

More basic health information should be available. Health TV channels now tend to focus on lifestyle changes (cooking, exercise, etc.), and reality shows focusing on emergencies, patient procedures, etc.. In the news media there is an occasional mention of the latest outbreak of the disease of the month, and maybe a mention of a profound medical study. This is good, but there is a need for more basic information programming that lets me know about this hypertension that I have, or the headache that won’t go away, or what doctor should I see for what I have. We need to know all the risks and complications as well as the different treatments for what we have so a more informed decision can be made. Like going on the Internet, or to a textbook, there will be a program that addresses a particular health concern. A daily health news show highlighting the latest medical developments is greatly needed. The Internet provides such information.
There are webcasts on the Internet that are becoming more accessible for professionals and the public. Some managed care providers have treatment guidelines for enrollees and doctors to view on their websites. The mantra for the 21rst century will be, "If
doctors don't educate themselves, patients will educate them".  Most people have a TV so what better place to start. In the future, computers will be in almost every home, too. With the Internet patients are able to access the same information as their doctor.

Providing educational materials that are easy to read and understand, i.e. at the lowest grade level possible, are essential, and key. This includes audio and visual learning - books, television, tapes, CDs, computer - as well as direct teaching. This is available
on the Internet with health sites just for kids like www.kidshealth.org and www.bam.gov . Health literacy systems can be of more use for distance learning technology via webcast teleconferences, and television programming. Learning in the home is effective and convenient.

Let your health home schooling begin!

*now Healthy People 2020

How Health Education Affects Your Health

Over the long term prevention saves lives and money. Preventive care should have a primary focus from cradle to grave. Studies to prove its efficacy in combination with evidence-based guidelines deserve attention. A study to determine if the history and physical exam, lab tests, body scan, and other diagnostic tests helps in the prevention, diagnosis, and treatment of disease would probably show us better overall outcomes as well as less cost than if the conditions were not detected early.

EDUCATION BEGINS AT HOME. Public education begins at home, in schools, and in the community (e.g. medical facilities, church, stores). Education focused on self management of asthma has been shown to improve clinical outcomes (British Medical Journal, June 2003). Basic medicine should start formally at the preschool level. Thereafter, basic classes in medicine and interactive education such as a student presenting a medical project, or volunteering in a medical capacity, should also be available. This can be used as education credits in high school and college. Our children are our future and our inspiration. Let's see their medical visions for America’s health system today!

EDUCATION SHOULD BE FREE. In Qatar this is the case.  Incidentally, health care is free there, too. They have developed a relationship with several of our medical schools, and have actual campuses. Let’s build on this, and in turn study with them to see how we can make our system better...and free. We live in a nation where many choose military service to get a free education. This is an enormous commitment to make for something everyone is entitled to.

Modifying the education process hopefully will provide more doctors, and make more want to be doctors. Funding a study on the correlation of the length of medical training with quality of job performance after training would tell if three years of medical
school be as good as four. If so, this will lead to earlier entry into the actual job as doctor with less cost for university and student = more appealing for people to seek this as their occupation = more doctors, and other health care workers. It should be easier for a health care worker to "upgrade" to a doctor. For example, a physician assistant that wants to be a doctor should not be expected to study another four years. The high cost for education becomes a large debt to be paid back on a lower salary while training. The cost for medical school is approaching $100,000*. An option is to expand the scope of practice for health providers that are experienced with clinical skills near the physician level to provide the same services. These will be the "diagnosticians".

The IOM report "Health Professions Education: A Bridge to Quality" (April 2003), has found that health care professionals "are not being adequately prepared to provide the best and safest medical care possible, and there is insufficient assessment of their ongoing proficiency". They propose that the education process will be focused on five areas: delivery of patient-centered care, working as a team member that is interdisciplinary, use of evidence- based protocols, the application of quality measures, and the use of IT. Oversight by groups that license, accredit, and certify will be used to improve education for health providers. New standards that accurately assess proficiency of skills are being developed and used. As this is developed, the licensing system should be addressed to ensure uniformity. It would make sense for health care professionals to have one license for practice in all states. Standards for licensing should be the same in all states. This allows for a seamless integration of health provider service and care, as well as a more effective use of these services. Like providers, patients should be able to obtain medical care in any state. That way a patient has the choice of going anywhere in the USA if they are unable to get the care they need in a timely manner in their state of primary residence. The European Union will allow patients to seek free medical care in any of the countries in its union effective 2004 (Canadian Medical Association).

As the population ages there will be a greater need for those with more experience in geriatrics, and chronic multisystem illness.  Medical schools and the federal government will need to increase focus in this direction. The CDC notes that the people over 65 years old will increase from 35 to 70 million by the year 2030.

Baby boomers start retiring in 2011. This is about 12% of
population increasing to 20%. The Alliance for Aging estimates a need for 36,000 geriatricians (now there are about 9,000 with an estimated drop to 6,000 by 2004). Changes in the medical education process must be made to increase the overall number of qualified health care workers necessary to provide for all.

by J. L. Richardson, M.D.
excerpt from "Building An American Health System", 2003

*average debt for medical school in 2010 was $158,000 http://bit.ly/RA0QQZ


 
 

Health Care Fiscal Physical

Back in 2002 healthcare experts made it apparent that our healthcare system was unable to serve everyone. Analysis of the situation is outlined below.

Fiscal discipline is a must. Every penny should be accounted for. In 2003 health care spending is projected to be about $1.6 trillion. In 2000 it was about $1.3 trillion (13% of GDP) compared to $73 billion (7% of GDP) in 1970. Health spending costs for 2001 were 37% for hospital outpatient, 28% for physician services,21% for prescriptions, and 14% for hospital inpatient. According to the American Hospital Association (AHA), hospitals provided $21.5 billion in uncompensated care in 2001; however, the government pays for most of health care. About 20 -30% is administrative, much being attributed to redundancy and overhead costs ("Government Share of Health Care Expenditures" by Asaf Bitton, James Kahn, M.D., M.P.H. from University of California, San Francisco - March 5, 2003, msJAMA). The CMS
estimate for 1999 government health spending is 45.2% ($548 billion). The elderly, disabled, low-income children, and some low-income adults are covered by government. Medicare and Social Security gets 7% of this amount. This is expected to double in 10 years. The average monthly health insurance premium for an individual is $255 ($3060/yr.), while that of a family is $663 ($7956/yr.) which represents a 12% increase from 2001 to 2002.

The forecast for 2004 federal budget is a record $2.7 trillion. Payroll taxes comprise 38% of the federal revenue. Taxes collected for 2003 are expected to be about $1.9 trillion (Congressional Budget Office, CBO, current budget projection report, March 7, 2003 - (www.cbo.gov). Projected health spending for 2003 is $1.6 trillion. This is over half of the budget! Furthermore, the Office of Management & Budget forecasts that the federal government will run a deficit of about $316 billion for fiscal year 2003 reaching $385 billion for 2004. This is projected to decrease in 2005 with forward projections of a $10 billion surplus by 2012. The
government debt is actually an estimated $6.4 trillion (about
$70,000/ family).

So where does this leave health costs? The HHS expense alone for 2002 is greater than the deficit ($460 billion). The majority of this ($375 billion) is for the CMS. For 2004 the projected expense for HHS is expected to be $500 billion. Other basic government allotment proposals for 2004 are: $400B for Medicare prescription program (over 10 years); $35B for uninsured (federal and state funds); $5 B for SCHIP; $2B for FDA; $60B to Dept of Defense (about $15B for aid to other nations, $21B for military health care); part of estimated $20B to rebuild Iraq (starting with a $2.5B down payment this year). There is $9 billion of “other”. There is an extra $80B approved for war costs ($62.4B to Pentagon, $4B for domestic security, $2.2B for state and local law enforcement and emergency workers; $7.9 foreign aid; $1.1B for Jordan; $1B for Israel; $1B for Turkey; “and money for Afghanistan, the Philippines and Colombia”). This includes $2.9B for airlines (many have filed for bankruptcy or are on the verge in spite of funds given after 9/11), and "for other projects pushed by lawmakers". This is money for use up to the end of the fiscal year ending 9/30/03. What are these "other" projects ($16M for SARS research and $142 M for smallpox vaccine program are $158M of this $2.9B) ? Not included in this is extra 26 weeks of unemployment for employees which was requested by some lawmakers.

So what attention will health care get if a person is unable to get a stipend to live off of while seeking employment? All of this should be itemized and accounted for with more priority given to health and well being. How much can we expect to get for our ailing health system with these other "priorities"? Perhaps much of it can be put on the backburner, while more monies are allotted for remodeling the American health care system to provide health care for all.

Excerpted from "Building An American Health System" (2003) by J. L. Richardson, M.D.

High Blood Pressure Home Remedies

Treating hypertension with lifestyle changes that promte good habits is key to staying 120/80, the normal blood pressure reading. Of course, maintainimg healthy weight for your height, eating the right foods, regular exercise, limited alcohol intake, avoidance of cigarettes and severe stress help. If these things fail to keep you 120/80 then you will need blood pressure medication prescribed by your primary care physician or cardiologist.

Many regimens start with a diuretic ("water pill") either alone or combined with any other medication groups like beta blockers, angiotensin converting enzyme inhibitors, calcium channel blockers, and more. Many of these have lots of side effects as well as create new medical problems (e.g. diuretics can cause loss of potasssium resulting in cramping, heart rhythm abnormalities; beta blockers can cause bradycardia, exacerbate asthma, COPD). When used in combination this can worsen. Home remedies may offer healthier and safer treatment.

Some high blood pressure home treatments include:
- honey and onion juice in equal amounts equal to 2 teaspoons daily
- garlic clove daily
- foods: fruits esp banannas, oranges, apples, watermelon. papaya; fish (less
red meat; vegetables especially carrots, spinach; whole grains; low fat
- apple cider vinegar 2 tablespoons daily
- aloe vera
- tea (black, green, hibiscus)
- coconut water ("noelani")

Many of these remedies also help other maladies, but more importantly they are natural, wholesome and inexpensive requiring no prescription. Remember to also halt the salt!

Best health!

Health Books: Healing Reading

Reading good health books is a great way to improve your health and well being. The best books help you care for your health and encourage as well as teach. The following books are recommended primarily because they teach you things you can do for yourself that you can incorporate in your lifestyle to make it healthier.


Merck Manual for Health & Aging
by Merck

Savvy Patient Toolkit
by Margo Corbett

Why, Charlie Brown, Why? A Story About What Happens When a Friend Is Very Ill
by Charles M. Schulz

The Empowered Patient
by Elizabeth Cohen

What's Wrong with Me? The Frustrated Patient's Guide to Getting an Accurate Diagnosis
by Lynn M. Dannheisser & Jerry M. Rosenbaum M.D.

YOU: The Owner's Manual
by Mehmet Oz, M.D. & Michael F. Roizen. M.D.

Inner Pulse
by Marc Siegel. M.D.

Healing Back Pain
by John E. Sarno, M.D.

Living Well with Chronic Fatigue Syndrome
by Mary J. Shomon

New Choices in Natural Healing
by Doug Dollemore & Bill Gottlieb

Patient Handbook to Medical Care: Your Personal Health Guide
by J. L. Richardson, M.D.

Why Screening Tests Are Important

Screening tests save lives. Talk to your doctor and do your own research on tests you need and how often. What the guidelines suggest and what you need nay be different.

Common screening tests for women include:

1. mammogram/ MRI for breast cancer
2. PAP smear & HPV test for cervical cancer
3. stool check for blood (fecal occult blood test, FOBT; colonoscopy, baseline at 50
for colorectal cancer
4. cardiology doctor for cardiovascular prevention(get EKG, ECHO, and thallium
stress test if indicated)
5. bone density scan to check for osteoporosis
6. counseling for smoking cessation, alcohol/drug dependence, and domestic violence
7. evaluation for depression and other mental disorders if necessary
8. complete physical exam, and routine blood tests


Common screening tests for men include same as above except mammogram and PAP smear.


Be sure your doctor goes over the test results with you and explains EVERYTHING! Leave with your questions answered! Be sure to follow up with your doctor to prevent any delays.

Get a copy of your test results. That way you will know if you were told everything and that the information is accurate. Research your results and diagnosis. Things you don't understand, ask again. Getting a second (and sometimes tiebreaker third because you were told different things by each doctor!) opinion is a reasonable research tool, also.

Patients must be their own advocate and take charge of their health. Health maintenance and prevention are so important to one's quality of life. Make it an important part of yours!

Ways to Protect Your Skin From Sun Damage

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.
Best health!


by J. L. Richardson, MD, family practice physician, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide. http://amzn.to/13m51UU

Patient Handbook to Medical Care: Your Personal Health Guide is written for patients by a medical doctor "to inform and educate patients about medical care". Health maintenance, prevention, early detection, and early treatment are the foundation for great health.


This Writer's Digest International Self-Published Book Award winner informs patients about
basic medical care. By reading this how-to reference book you will learn:

• how to keep a medical diary
• how to get your medical records
• how to document your complete medical history
• what the physical exam should include
• about preventive tests and when to get them
• about tests your doctor orders
• about specialists and other medical providers
• about health care plans and coverage
• how to seek quality health services.

Sample the beginning free at Amazon Kindle store http://amzn.to/bL3GHm and free excerpts at Google Books http://bit.ly/NoUuCB . Best health!

Taking Charge of Your Health

True wealth is great health. It is time for you to take responsibility for your health. It is time for you to know what your health numbers are. It is time for you to know your medical conditions, risk factors, and family medical history.


Give yourself a medical checkup. Start by writing or typing or recording your medical history - medical conditions, surgery, treatments, family history. Add your medication. Save it. Update it. Add to it. Correct it. Keep it current. Keep a copy in a secure place.

Examine as much of yourself as you can. Look at your skin, hair, nails, eyes, teeth, and every part of your body that is visible to you. Make note of any abnormalities. Make note of any symptoms you have - new, old and ongoing. Go through each body system. Add this information to your medical history.

Add to this your doctors' and health care providers' names, phone number, land address, and email address.

Call your doctor for an appointment for a comprehensive CPE (complete physical exam).  Get it done routinely (yearly, every other year, etc,). Take your information and notes with you on your appointment. Review everything with your doctor. Take notes.

Sign a medical record release to obtain a copy of your medical record from each doctor you see at the time of the visit.

Be sure to schedule a follow-up appointment within a month or less to go over everything with your doctor. Get copies of your information including blood tests, and any other tests as well as medical notes.

Take charge. Care for your health, Be the healthiest you can be. Great health is true wealth!

Organ Donor Business

Organ donation is big business. How can you be sure your organs will be used after you're dead instead of being killed for them while you're alive? The movie "Inhale" provides a detailed look at the underground world of organ donation. Words written on this blog can do little justice to this topic.  For more information and facts on organ donation check these resources:

• http://organdonor.gov/index.html
• http://donatelife.net/
• http://www.mayoclinic.com/health/organ-donation/FL00077
• http://jama.ama-assn.org/content/299/2/244.full.pdf

Best health!

Basic Health Tests

These basic health tests can help your doctor with your diagnosis and treatment. Know what they are so you know that you are getting it when it is needed. These can be baseline, routine screening tests as well.

EKG

This test, also known as an electrocardiogram, gives information about your heart. It is usually done by the primary care doctor as part of a routine physical, especially if heart disease runs in your family. Typically, this test is done on anyone complaining of chest pain or discomfort. Small patches with adhesive on the back are placed on the chest, arms, and legs while the patient lies on her or his back. The electrode patches are attached to the wire cables running from the EKG machine. The heart’s electrical activity is recorded on paper. By looking at this “heart tracing” graph, the doctor can tell if there are any abnormalities like irregular heartbeats (called arrythmias), damage to heart muscle
from a heart attack, poor blood flow to the heart that causes chest pain (called angina), and heart enlargement. The doctor has been trained to know what changes or abnormalities need further testing, treatment, or hospitalization.

X-Ray

This test uses small amounts of radiation through an X-ray machine to make pictures. Itcan be done on almost any part of the body to check out a patient’s symptom, and/or the
doctor’s findings during the physical exam. Many primary care doctors have X-ray equipment in the office. If not, the patient may be referred to a special office (diagnostic center) that performs Xrays or to a local hospital radiology department.

X-rays are most commonly done on the chest, abdomen, back, joints, and extremities (arms and legs) and are done either with the patient lying down or standing up, depending on the part of the body being checked. After you have been positioned, the X-ray film cassette is placed in the machine next to the body part being X-rayed. The radiation from the machine will pass through the body part being X-rayed onto the film. The radiology technician (the person who operates the X-ray machine) will then move to a closedspace in the same room and press the buttons to take the X-ray.

During this test it is important that a protective lead shield apron be placed over the reproductive parts of the body.  Usually the technician will need to take more than one view, and so you will be asked to move a certain body part or turn a certain way. Different X-ray views give the radiologist (the doctor who reviews and interprets X-rays) a more complete view of the body part. Using the information from this test and the information from your history and physical, your doctor will be able to determine the proper diagnosis (what the problem is), treatment, and/or more tests, if needed.

There is some concern that the radiation from X-rays may be harmful. Studies have shown that small amounts of radiation are not linked with an increased risk of health problems. Over the years the amount of radiation used for X-rays has been decreased.



Ultrasound

This test is also referred to as a sonogram or sound wave test. The ultrasound uses sound
waves to make images of body parts. This changes electrical energy to sound waves that go throughthe skin into your body. When the waves contact the body’s organs, they reflect to the transducer, producing echoes. The echoes are then converted into still or moving images by a computer that makes a picture of your organs. The technician is able to see this on the monitoring screen and to make an X-ray or Polaroid-type picture. The ultrasound uses no radiation.  In this test the technician applies gel to the area to be tested. A transducer held by the technician is moved back and forth against that part of the body. This sends out the sound waves that go back into the computer.

The sonogram is commonly used to look at your internal organs in the abdomen (such as the gallbladder, kidneys, liver, spleen, and pancreas), prostate, uterus, and ovaries. It is also used to look at blood vessels (arteries and veins), the thyroid gland, breasts, and the skull. In a pregnant patient, actual moving images of the fetus can be seen. As there is no radiation exposure, the sonogram is very valuable in following fetal development in pregnancy. It is also able to detect and diagnose other conditions related to pregnancy. Sonograms are also useful in checking the heart. These are called echocardiograms or Doppler echos.



Computerized Axial Tomography
(CAT Scan, CT Scan)

The CT scan is another way to make images of body parts. The CT scanner uses X-ray beams that rotate around the body. These beams then go through a detector, and a computer analyzes and processes the data into an X-ray film. The CT machine has a table that is pulled in and out of the machine, which is a large hollow tube (like a doughnut) that can surround the body. During the test the patient lies down on the table. The scanner (inside the hollow tube) then rotates around the patient.  The CT scan is able to image many parts of the body. It detects more than a regular X-ray and produces two-dimensional views. This test is commonly used to pick up tumors, infections, enlarged organs, and many other abnormalities.


 

Magnetic Resonance Imaging (MRI)

The MRI scan is another diagnostic test that does not use X-rays. Instead, it uses magnetized energy. The images produced are extremely detailed pictures of the body part scanned. It is very much like looking at the pictures in an anatomy book or almost like looking at a person internally. The MRI machine is designed muchlike a CT scan machine, except a magnet is in the hollow tube instead of X-ray beams. The test is also done while the patient lies down on a table that moves in and out of the machine. The MRI scan takes about thirty minutes to an hour. The MRI is not recommended for persons with metal or electronic implants (such as pacemakers, joint pins, prosthetics, artificial heart valves, metal fragments, shrapnel, IUDs, etc.), as those might interfere with the machine. Be sure

your doctor and technician are made aware if you have any such implants. For the claustrophobic person, the closed space of the MRI machine may create some anxiety.  Again, alert your doctor and technician. A mild sedative may be necessary prior to the test to help relax you, or you may be sent to a facility that has an open MRI. MRI scans are useful for scanning almost any body part for almost anything. Tumors, cysts, aneurysms,
herniated back discs, and orthopedic conditions are among the many abnormalities that can be detected with this test.


Mammogram

The mammogram is a plain X-ray picture of the breast. It requires a special machine that
compresses each breast against X-ray film to take the picture. The X-ray passes through the breast tissue and shows how the breast looks inside.  This test is excellent for detecting tumors and cysts. It may also show if the area is benign (no cancer) or malignant (cancer). The mammogram is able to pick up cancers that are too small to be felt or seen. It is a valuable cancer screening test.

What Your Blood Tests Really Mean

When the doctor orders blood tests (also called lab tests, blood profile/ panel), she or he is checking for certain things. The most common tests are CBC (complete blood count), basic complete blood panel, and UA (urinalysis). The CBC checks the body’s WBCs (white blood cells) and RBCs (red blood cells). In the lab the cells are examined for size, shape, and number. The WBCs may tell if you may have some type of infection or leukemia(cancer of the white cells). The RBCs carry oxygen to the rest of the body. This is done by hemoglobin, which is carried inside the RBCs.  Some inherited diseases, such as sickle cell
anemia and thallassemia, can be identified by abnormal RBC shape and size. Also included in the CBC is a platelet count. Platelets are cells that help your blood to clot, for instance to stop the bleeding after a flesh wound.

The basic complete blood panel measures many different things. Included in these tests are:

• Na = sodium

• Cl = chloride

• K = potassium

• Mg = magnesium

• Glc = glucose (sugar)

• Ca = calcium (bone mineral)

• PO4 = phosphate (bone mineral)

• BUN = blood urea nitrogen (kidney)

• Cr = creatinine (kidney)

• SGOT = serum glutamic oxaloacetic transaminase (liver)

• SGPT = serum glutamic pyruvic transaminase (liver)

• GGT = gamma glutamyl transferase (liver)

• Alk phos = alkaline phosphatase (liver, bone primarily—also gallbadder)

• Fe = iron

• TIBC = total iron binding capacity

• transferrin = iron

• uric acid = checks gout

• chol = cholesterol (fat)

• LDL = low density lipoprotein (“bad” cholesterol)

• HDL = high density lipoprotein (“good” cholesterol)

• TG = triglycerides (fat)

Blood panels may differ from lab to lab. The above tests make up the basic chemistry panel. This should be part of a routine checkup. Some panels may include more tests than those listed above. The urinalysis (UA) may or may not be included, but it is important. Urine tests are able to check for infection, sugar, blood, protein, and many other things. Additional tests that may be ordered by the doctor for preventive screening will depend on your symptoms, diagnosis, family history, and age. Some of these tests are:

• PSA = prostate specific antigen (prostate cancer test)

• TSH = thyroid stimulating hormone (thyroid function)

• T4 = thyroid hormone (thyroid hormone level)

• B12 = vitamin B12

• folate = B vitamin

The Pap smear test and stool for occult blood (blood in stool that cannot be seen with the

naked eye) should also be performed. The Pap smear is a test for females that checks for cancer of the cervix. The stool test, also called Hemoccult test, checks for blood in the stool, which may indicate bleeding from the bowels secondary to cancer, ulcers, or other serious conditions.


Other tests than those listed may be checked depending on your history and physical exam. Be sure you are scheduled for a return visit to follow up on all tests. Some doctors’ offices will also let you know by phone or mail, especially if there is an abnormal test that must be checked before your next appointment.

Your symptoms, the doctor’s physical findings, and blood test results are what the doctor looks at when deciding the next tests that need to be done. This and any additional tests may be used for screening, diagnosis of conditions, and for ongoing management of disease once it is present.

Your Family Doctor

Patient Handbook to Medical Care is the best doctor visit you can have anytime!  When you read this book you will feel healthier, wealthier and wiser!

Are you getting the medical care you deserve?  Are you getting the right tests? Patient Handbook to Medical Care: Your Personal Health Guide by J. L. Richardson, M.D. lets you know! This book is written for patients by a medical doctor "to inform and educate patients about medical care".


ABOUT THE BOOK

This Writer's Digest International Self-Published Book Award winner informs patients about
basic medical care. By reading this reference book you will learn:

• how to keep a medical diary
• getting your medical records
• your complete medical history
• what the physical exam should include
• about preventive tests and when to get them
• about tests your doctor orders
• about specialists and other medical providers
• about health care plans and coverage
• how to seek quality health services.

This 112-page easy-to-read. large print paperback handbook will help patients stay in charge of their health maintenance and overall care.  "Patient Handbook to Medical Care: Your Personal Health Guide" is a concise, informative overview of health care basics. It provides patients with a doctor's perspective on professional healthcare, and allows them to become their own best advocates.

It also includes "My Health Notes", blank pages for you to write your own health notes!  This is a great way to keep track of your health concerns, and start your medical diary.This book will tell you how to take care of your most important asset- YOU!


ABOUT THE AUTHOR

Dr. Richardson is a family medicine doctor with over 25 years of experience in the medical field.  Dr. Richardson's undergraduate and medical degrees were received from the University of North Carolina at Chapel Hill, and residency training was done at Georgetown University and Providence Hospital in
Washington, D.C.  Dr. Richardson is a member of the American Academy of Family Practice (AAFP), the Florida Academy of Family Practice (FAFP) as well as University of North Carolina Alumni
Association.

Past affiliations include: Managed Care Ombudsman Committee for the Florida Agency for Healthcare
Administration (AHCA); National Association of Managed Care Physicians; Dade County Medical
Association; American Medical Women's Association; Board Member fof McLamore Children's Center of  Children's Home Society of South Florida; Grove Outreach Physician Volunteer; 1999 Special Olympics Physician Volunteer; Cedars Hospital (Miami, Florida) Medical Staff and Utilization Review Committee; and American Board of Quality Assurance and Utilization Review Physicians. Dr. Richardson has experience with independent medical record review and patient advocacy issues.

Bend of the River Books is proud to announce that Patient Handbook to Medical Care is now in 59 libraries throughout the United States. Our goal is to ensure that everyone has free public access to read and learn the importance of health maintenance, prevention, and wellness. This expert's guide to personal health care is the ideal book "to inform and educate patients about medical care".

Best health!