Surge in Surgery

How many surgeries does the average person have in a lifetime?  According to the most recent study of its kind from 2002, it was found that you could need surgery at least 9.2 times if you live to 85 years of age. It is no surprise that surgeries increase with age.  Surgery is also prevalent in women during their reproductive years.  For both men and women between ages of 45 to 75 there is also an increase.  Three of the top ten most common surgeries were for women’s gynecological conditions.  C-sections ranked as number one.  For men the top surgery was for cardiac conditions (angioplasty, heart bypass).  Fortunately many surgeries done today are minimally invasive done as an outpatient instead of in a traditional hospital stay.

These facts indicate that you will have surgeries in your lifetime.  Think about the cost of this.  Would you be able to pay for it?  Rising health care costs and increase in illness have made this nearly impossible for most on an average income of today. The sensible and responsible thing to do is have health insurance.  Is your health more important than that $50,000 car or $200,000 home you insure? Plus these insurances are usually required.  Your health deserves to be insured as well.

If your health insurance policy has been cancelled, your health insurance provider has other plans that will fit your need with comprehensive, affordable coverage that covers more and includes your same providers.  Look at the cancelled product as new and improved health benefits at a much lower price. Basically your policy has not been “cancelled”, but upgraded with many more options.

There is also the option of looking at the National Healthcare Insurance Exchange by phone, paper application, online, or in person at designated places.  This offers more choices from other health insurance providers with different “levels” of coverage.  Each level offers basic and free preventive care from less than 60%  to 90% coverage.  The cost is now actually less than what you may have paid previously under the “cancelled” policy!  Now that health insurance is more affordable and chances are you will need surgery, it makes sense to have it.  Plus you get the chance to maintain your health with prevention and proper treatment in hopes of preventing surgery.

The yearly cost of your health insurance premium is much less than the cost of one major surgery and recuperation (equals 5-10 years worth). Even if you have enough cash to pay, you will save more than your money by being insured. Get covered for good health!

Best health!

White Coat Hypertension: Is it Really High Blood Pressure?

Is it really high blood pressure or is it the white coat? White coat hypertension is a term that refers to high blood pressure (HBP) when you visit your doctor or other health care provider.  It is normal during other times.  Are you really hypertensive if this is the case?  Do you really need the DASH diet and medication?

High blood pressure is defined as three consecutive blood pressure readings at or above 140/90, or one reading above 160/100.  These readings are most commonly obtained when you visit your doctor which can be from one time to several times a year.  Needless to say the preparation and anxiety that go with doctor's appointments is enough to make any one's blood pressure go up normally! Getting ready and getting there can surely create this effect, but is this enough to make a diagnosis of high blood pressure when your blood pressure checks weekly or daily are normal?

HBP monitoring by patients outside the doctor's office may prove that white coat hypertension is what it is.  Normal readings outside the health setting in your everyday environment are more accurate and real. By tracking your own blood pressure at home you may find that your blood pressure is normal most of the time.  You can also see what makes it abnormal, too, and avoid or decrease these things. If it stays consistently high without white coats, treatment with diet and medicine may be indicated.

Best health!

Internet Information and Your Health

Health information once obtained from bought or borrowed hard copy books, magazines, and papers is now available on your computer in seconds. Many studies have shown that the Internet is rapidly becoming the main source of health information for patients and health care providers around the world.  This has made it a tool of preventive medicine individually and globally.  Many are able to "pre-diagnose" themselves and maintain wellness by the time they seek medical care.  This makes for a shorter differential diagnosis dilemma for your doctor; thereby, shortening the time for correct diagnosis and treatment.

Health literacy on line also includes abundant applications for your smart phone and computer, interactive social media, and websites from health providers and institutions.  One of the most interactive and informative is Twitter.  Lists such as these for doctors,  http://bit.ly/2XWKw29 and medical/health http://bit.ly/2GWkbvH  contain lots of information that links directly to sources. Most of these include websites as well as individual snippets of information called "tweets".  Searches for specific health information can also be done using the internal search box.

While the Internet may help diagnose, it far from replaces your doctor's advice. Use it as a health literacy tool to educate yourself.   Check out "What the Internet Does for You and Your Health" http://bit.ly/a3RAjw for more health literacy lessons. Best health!

Are You Too Old for Colon Cancer Screening?

Eighty" is the "new" fifty. Why? Many are in good health as natural and unnatural aging occurs.  This may be attributed to ongoing healthy lifestyle habits, good genes, as well as preventive screening.  In addition, early intervention and treatment of conditions found from preventive screening add additional healthy years.  Should preventive screening tests like colonoscopy be abandoned after 80 years of age?

Scientific studies report that one is more likely to die of something other than colon cancer after 80 years of life.  This may be interpreted to mean that at age 80, your last screening colonoscopy if positive for colon cancer, will really be a diagnosis you can live with until you die. In fact, the colonoscopy itself gets riskier with more complications as one gets older especially after 65.  Chronic conditions can potentially increase complications as well. Life expectancy is expected to decrease anyway in spite of the risk that cancer increases with age.

Though current guidelines are without an age limits, there is much controversy over whether colonoscopy after 80 is beneficial.  The risk of complications from colonoscopy as well as the prep and sedation get much higher after 65.  There is up to 75% higher risk of gastrointestinal bleeding and perforation of the gut after 80.  Add more risk if chronic conditions like stroke or heart attack are part of the past medical history.

Much medical success and good health depend on you.  Individual assessment based on your medical history, physical exam and tests is key to obtaining the best outcome for you, regardless of "one size fits all" guidelines.  These guidelines are just that, a guide to help you and your doctor decide if you are too old for colon cancer screening via colonoscopy. 

Here's to making 100 the "new" fifty!

Best health!

Men's Health Month Memorandum: Check-up Time!

"If I had known I was going to live this long, I would have taken better care of myself." — Mickey Mantle

Statistics show that men are less likely than women to get routine health checkups and physical exams. Men are more likely to seek medical attention when there is an acute problem, and once that has resolved not until another acute problem. Part of the reason for this is lack of health education. Men are also more prone to the "this can't be happening to me" syndrome. Is ignorance truly bliss? Short term, maybe. Long term, no.

So what is a fella to do? Make a yearly checkup routine. Do it around your birthday or holiday like Father's Day or Christmas as a gift to yourself (your most important asset!). In addition to a complete medical history (be sure to take your notes and questions http://bit.ly/122ZEeF) and physical exam, there are other things your doctor should do. This includes:

• complete blood panel including a PSA (prostate specific antigen) if over 40 or have a history of prostate cancer in your family - please note that PSA screening is very controversial as to if it should be done and should be discussed at length with your doctor as this test does save lives
• EKG, baseline at first physical then every 2-3 years - yearly if over 50, have risk factors such as smoking, obesity, hypertension, diabetes, increased cholesterol, family history of heart disease
• cardiac screening by a cardiologist if any signs or symptoms of heart disease especially if there is a family history of heart attack, angina
• colon cancer screening with stool guaiac cards - stool samples are placed on these and returned to your doctor who checks for blood (this should be done when a rectal exam is performed, but if for some reason it is not, be sure to get these cards)
• colonoscopy, baseline at 50, sooner if stool positive for occult blood or gross rectal bleeding, weight loss, stomach symptoms

Be sure to include regular visits to the dentist, and optometrist or ophthalmologist (eye doctor).

Best health, guys!

by J.L. Richardson, M.D., family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide.

Heart Health Check List

Heart disease and high blood pressure are leading causes of many health issues today.  High blood pressure (hypertension) affects about 1 in 3 people worldwide.  Studies have shown that screening and prevention can change this to healthier hearts.  As one gets routine physical check-ups for the entire body, the same should be done for the heart.

Basic check your heart list:
___Heart and vascular exam by health care provider
___Blood pressure*, pulse, weight, height
___EKG

For further evaluation, especially if symptoms are present, and/ or a strong family history of heart and vascular disease see a cardiologist for more testing.

Tests may include:
___Doppler echocardiogram (checks heart valves, size, etc.)
___Stress test - nuclear, doppler or exercise (heart function)
___Heart MRI scan (artery disease)
___Interventional studies like cardiac catherization, angiogram (checks artery blockage, valves)

Help your heart and overall health with these tips:

1. Maintain a healthy weight.
2. Eat healthy small portions.
3. Exercise regularly - every little bit counts! Just do it regularly.
4. Keep blood pressure* under control.
5. Keep stress level low.
6. Get adequate sleep.
7. Take an aspirin a day if in a high risk group. Check with your health care provider.

*Add home blood pressure checks to your list.  It will help you and your heart!  http://mypatienthandbook.blogspot.com/2009/03/high-blood-pressure-home-checks_21.html

Best health!

Health Maintenance: How You Gain When You Maintain

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 may 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, colonoscopy)
4. EKG, ECHO (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 third (because you were told different things by each doctor!) evaluation and assessment is sometimes necessary to get what is right for you.

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 - maintain and gain your best health!

*What Your Blood Tests Mean http://mypatienthandbook.blogspot.com/2012/03/what-your-blood-tests-really-mean.html

Basic Diagnostic Tests http://mypatienthandbook.blogspot.com/2012/04/basic-health-tests.html

How to Make Your Doctor Visit Easier

Visits to your doctor or any healthcare provider can be frustrating and time consuming for all involved.  These are some things you can do to make it an easier and more productive.

One of the first things you want to do is make a written or typed medical history to take with you, especially if this is your first visit to a new doctor. Make a copy for you and your doctor. You both will be able to refer to it as needed. This will save valuable time, and give you and your doctor more time to talk instead of flipping through your medical record. It can be difficult trying to "remember" what test or procedure you had 10 years ago or even last year.

It is a good to make appointments when you are well and stable.  Keep a list of things you want to talk to your doctor about. Update the list before each visit. This way you will be able to keep track of what has been discussed, and what needs to be discussed. Try to talk about the most important things first especially those that need immediate attention. Each time you go for your visit, you can refer to your list and take up where you left off. Be sure to express your immediate concerns first. We all know how short a doctor visit can be.

Request copies of your medical records from all your doctors. "The medical record is the cornerstone of keeping track of everything pertaining to your health." This gives you a complete assessment of all your medical problems. You will be able to check the accuracy of your records, and bring any errors or absent information to your doctor's attention. Let your doctor know about anything you do not understand, or if there is something you are unable to read due to poor handwriting. It is surprising to see how many doctors are often unable to read their own writing.

Schedule your appointment for first available times in the morning or afternoon.*  This will likely ensure that you will be seen on time with a shorter wait time and longer visit.  It will help you and your doctor focus on your total health care versus acute, intermittent health concerns that can easily take up your whole time. Unless an emergency arises, the wait should be less than 15 minutes.  If there is an emergency you should be notified and given the option of waiting or rescheduling, or going elsewhere for treatment. 

The easiest thing you can do is be on time.  Best health!

*How to Make Your Doctor Appointment http://bit.ly/akMrpX

by J.L, Richardson, M.D., family medicine expert and author of Patient Handbook to Medical Care: Your Personal Health Guide, honorable mention of Writer's Digest International Self-Published Book Award** and Indie Excellence Award finalist.

(**Written by a reliable source, this book is the perfect quick reference for all of those squeamish people who hate going to the doctor. I am one of those people. I hate wondering why a certain test was performed, exactly what a common diagnosis may mean, what the proper specialist for my malady might be called, and negotiating the maze of health insurance forms and other paperwork that seems to accompany my ailment; thereby adding insult to injury. To avoid the mystery, misery, and tedium of the wellness process, I often remain sick in order to forego or delay much needed medical appointments. The author writes for people like me; she writes in a calming, professional tone and explains, in as simple and non-threatening a manner as possible, what I can expect along every step of the healing process. By learning to keep a medical diary, knowing what to expect of my medical staff as well as how to decode their complicated language, and then by understanding the basics of the complex American healthcare system, I can take charge of my own healthcare. This little book provides me with all the tools necessary to do just that. ~Writer's Digest)

Your Medical Information

One of the first things your doctors and healthcare providers want to know is why you made your appointment. Once you answer this question (hopefully before interruption) there will be questions about your general health and wellness, as well as more information about your reason for the visit. For specific concerns you may be asked:

• How long has this been going on?
• What have you done for it?
• Have you had it before?
• Where does it bother you?
• How often does it occur?
• What makes it better or worse?
• Are there any other symptoms?

You will be asked about how the other parts of the body are working, such as your eyes, ears, heart, breathing, and so on. This is called the “review of systems” (ROS). If there are any problems not related to your main problem, now is the time to let the doctor know.
This will be followed by your past medical history (PMH), which includes:

1. Diseases you have (high blood pressure, sugar diabetes, arthritis, cancer, depression,
   etc.), or have had that are better or gone (including childhood diseases such as
   measles, mumps, and inherited disease)
2. Operations and times you were in the hospital (including accidents)
3. Medication, including prescription, over-the counter (don’t forget about vitamins),
   natural (garlic, aloe), and herbal
4. Allergies and reactions to anything and what it did to you (for example: breaking out in a
   rash, swelling, itching, upset stomach, etc.)
5. Smoking, alcohol, drug use (how much, how often)
6. Shots (childhood, flu, last tetanus, etc.)
7. Sexual (active, using protection, number of partners, diseases)—in females this will also
   include menstrual period, pregnancy, last mammogram, and Pap test
8. Family history (conditions that run in family
   such as cancer, high blood pressure, etc.)
9. Social history—your job or jobs; family; marital status; living arrangement (house,
   apartment, alone, etc.); transportation (drive self, public transport, walk); ambulation
   (use walker, wheelchair); disability (deaf, blind, amputee, etc.); religion, ethnic customs, and traditions

If there is anything left out or that you feel the doctor should know, now is the time to speak up. It is sometimes hard to get someone’s full attention, so take advantage of it while you have it. Some doctors’ offices will have you fill out forms asking the above questions or will ask you the questions and fill out the form for you. This is not a substitute for the doctor’s personal interview and questions.

Writing or typing this information is a sure way to keep all of your PMH http://bit.ly/f8FZ55 . Make a copy for your doctor. While talking you both can refer to this vital source of health information.

Best health!