Know Your Medical History

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!

Free Prescription: Prayer - Use as Needed

Pray for me. This often forgotten yet basic request is often deferred until times of severe health duress. How effective is prayer in helping heal your illnesses or that of someone else? Combining this with other forms of treatment has proven effective in managing illness, especially chronic disease.

Prayer is considered an alternative health treatment; however, faith healing is the only way to many. Man made medical treatments like drugs and surgery combined with modern technology have overshadowed prayer. Prayer, like many other alternative "natural" treatments, is usually left off the intern and resident training in medical school. Research has shown that many patients pray for their health regardless of religious background, and that is does indeed have healing health benefits.

Praying for oneself as well as being prayed for are effective in staying healthy as well as in healing. The beautiful thing is that you can do it anywhere, anytime without paying any money. No health insurance is required.

Best health!

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

This book provides 112 pages (large print) of health information that will tell you what your doctor should be asking you, telling you, and doing for you - as taught in medical school and used since Hippocrates. http://amzn.to/13m51UU

Personalized Precision Medicine

As we look forward to medical breakthroughs of the future, precision medicine becomes more of a reality in your medical care. Precision medicine uses treatment and intervention based on a person’s genetic and non-genetic (e.g. lifestyle, environment).  Unlike the present but ever changing protocols for wellness and disease management that are used on everyone, precision medicine is individualized just for you.  It will be your own prescription for staying well and treating your ailments. 

The basis of precision medicine is genomics.  Sequencing of your genome is done.  This molecular process identifies normal and abnormal genes.  Genomic mutations are studied and tested for different characteristics.  The results of this testing allows for prevention, diagnosis, and treatment based on your molecule makeup within your genes that have been influenced by family history, lifestyle, and environment.  DNA analysis of your genes in addition to a thorough history and physical will help your doctor determine what you have and what health risks may be present.  This information will then be used for further diagnosis and treatment.  Prevention of conditions that you are prone to develop may be less likely to develop if at all.

Precision medicine has become prevalent in drug treatment as well as disease diagnosis.  Clinical pharmacogenetics makes use of patient’s genetic data as a guide for drug therapy.  This information can then help your doctor pick the right medication for you. Pharmacogenetic information for blood thinners like coumadin and clopidogrel can be helpful in choosing which will work best for you with least complications.  Neonatal (newborn) diabetes and mature onset diabetes of the young (MODY) are rare causes of diabetes.  The cause of these types of diabetes is from an inherited mutation of one gene (monogenic).  Genetic testing can make the correct diagnosis that would otherwise be missed or misdiagnosed.  Some cancers have specific gene mutations that can be detected and treated successfully based on this information.  Drugs are made to target these and eradicate the cancer.

Thousands of disease genes and genetic tests have been discovered since the Human Genome Project of 2003.  As costs go down and precision medicine improves, personalized medicine will get more precise.  Prevention instead of treatment will be more likely.  Genetic tests and treatments for the individual will be precisely what the doctor orders for you.  Best health!

Chronic Disease: Controlling the Incurable

Chronic disease affects more people as they age. It will affect everyone at some time in their life. Over 80% of the health costs worldwide are incurred by 20% of persons with one chronic disease or more. Chronic disease is defined as any illness that lasts more than three months, and/ or is recurrent. This includes such diseases as morbid obesity, arthritis, heart disease, diabetes, depression and many more. Most primary care doctors and family physicians see more patients with chronic diseases than any other health conditions.  The initial visit of the majority of patients seen on first visit have at least two or more chronic conditions.


Chronic disease management begins first and foremost with knowing as much as you can about the diseases that affect you.  Research yields information that strengthens your knowledge base of cause, effects, and what can be done to make it better or even preventable.  There are many evidence-based treatments that work, but some may help you more than others if at all.  For example, low back pain may be helped with hot or cold therapy, massage. acupuncture, spinal alignment. epidurals. medication and more.  Your spouse benefits from cold therapy and massage which hardly helps you. Hot therapy and acupuncture improves your pain and function, but not that of your spouse.  You must find what works best for you.  Ask your doctors for different treatments other than those they order as well.


Chronic disease responds favorably to a nutritious diet.  With medication noncompliance over 50% for whatever reason, you eat daily which allows for good, healthy food. Many foods have medicinal qualities that help control disease processes while keeping the healthy parts healthier.  Cooked dry beans are the perfect example.  They can provide as much as 9 to16 grams of fiber and 15 to 25 grams of protein in one-fourth cup  (60 to 150 calories).  A 14 ounce bag can yield about eight to ten cups at a cost of less than $2. Eaten alone or in other dishes, beans have powerful potent antioxidants that overpower cellular oxidative stress of chronic disease states.  High fiber is good for so many chronic problems such as heart disease, high lipids, diabetes, hypertension and more.  As you decrease processed foods in your diet, and add more fresh food your body responds with lower blood pressure, less pain, less overall stress, and good feelings of good health!


As chronic diseases progress especially with aging, many people move less.  Less movement opens the door for more chronic disease, and worsening of any you may already have.  Daily motion is the magic potion lotion.  Movement in activities of daily living count, and exercise helps.  At least ten minutes per day helps.  At home exercise programs work and are less stressful than going out.  Fancy home gyms with exercise equipment are nice but unaffordable for many.  Sitting, standing or laying you can do arm circles, leg raises, torso twists, and more.  Walking in place also works.  This type of activity improves physical and mental status to better.


You can control chronic diseases by choosing that which helps what you have.  Controlling the incurable involves routines designed for you.  This in itself improves overall quality of life and gives positive personal satisfaction that helps mental issues that may become chronic in themselves.  Best health!

Read and Learn for Your Health

Read what you need. Learn about what you need to maintain good health and well-being.  Health literacy is an important part of your self-care health care.  It helps promote better health and quality of life. 

Medical science progresses so rapidly!  It is impossible for health care providers to keep up with all these new developments. Be aware of treatments your doctors and healthcare team have yet to hear about or are unlikely to ever find out about.  The overwhelming amount of new health information that comes out is far too much for many to stay current on every disease and treatment.  This should not stop you the patient from finding out all you can.  The same goes for wellness.  Participating in your health care is mandatory to maintain good health, achieve wellness, and overcome illness.

There are so many different treatments and modalities that compliment traditional medicine.  As many lack training in these areas they are unable to tell the patient.  Asking your doctor is a good starting place as is telling your doctor about the things you have read about or tried that helped.  In turn this may evoke a response by your physician to find out more, and even share with other patients and colleagues who may in turn share their “new” information which your doctor can share with you.

Reading and learning are vital to good health.  Informed choices based on fact have proven to yield better health outcomes.  Best health!

Screening for Cancer

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 cancer include:

• mammogram and/or MRI for breast cancer
• PAP smear & HPV test for cervical cancer
• stool check for blood (fecal occult blood test, FOBT); colonoscopy, baseline at 50 for colorectal cancer
•  chest X-ray and or CT scan for lung cancer
• complete physical exam, and routine blood tests

Be sure your doctor goes over the test results with you and explains everything. Get all of your questions answered! Timely follow up with your doctor is important to prevent any delays in diagnosis and treatment.

Get a copy of your test results. This will help you understand your diagnosis and make sure all is accurate.  Research your results and diagnosis. Getting a second and sometimes tiebreaker third opinion (because you were told different things by each doctor!) is a reasonable and smart thing to do.  This offers more alternatives and insight enabling you to get the right treatment for you based on facts.

Cancer screening is a healthy thing to do.  If cancer runs in your family, get checked for it early.  Many may dissuade you based on clinical guidelines and cost. Guidelines are recommendations.  The cost for your health is priceless.  Since you are paying for it, get what you deserve and need based on your individual medical history.  The cost of prevention is usually far less than the cost of treating and living with cancer.

Best health!

Family Health: Continuity of Your Care

Your family's health is of utmost importance.  Continuity of care is disrupted all to often due to lack of communication and follow-up.  Make sure your family members have accurate information for each person,  These suggestions will help you continue your health care communication continuous with less stress:

• call your doctor's office, testing center prior to appointment to be sure all is on time as scheduled
• reschedule appointments that are over an hour late especially if it jeopardizes your health conditions (e.g. persons with diabetes, hypertension, arthritis)
• read often on your health condition
• use email, fax, postal mail if unable to reach your doctor by phone
• get copies of your medical records and reports from all doctors you see
• contact your doctors for your test results, specialists reports if you fail to get contacted within 1 week
• tell your doctor what other doctors have told you as these reports often arrive after your visit, if at all

Best health!

Asymptomatic Symptomanic Static on Routine Pelvic Exams

Guidelines for pelvic exams in women has been "updated" again.  Avoiding pelvic exams in asymptomatic, non pregnant adult women is the newest "recommended" guideline.  Could this mean that a woman who meets these criteria should refrain from routine exams until she becomes symptomatic and/ or pregnant?  If this were the case, how many women would be left out of possibly being diagnosed with a disease that was indeed asymptomatic until diagnosed on a routine pelvic exam?

In asymptomatic non pregnant females, my diagnoses have included cervical cancer in an 80 year old, ovarian cancer in a 20 year old, massive uterine fibroid tumor in a 40 year old.  The routine pelvic exam was able to detect these malignant and pre-malignant conditions before they became life threatening.  Early detection allowed these ladies to escape the perilous pitfalls of cancer.  In these cases simple surgery was the cure.  They remained asymptomatic and cancer free by continuing with their routine pelvic exam and checkup.

Without symptoms may appear to indicate a disease free state, but often times it reveals disease.  It is up to patients and their health care providers to include routine exams in their health care plan.  Routine can be yearly, every other year or two, or less frequently depending on the patients medical history.  Routine evaluation and assessment is based on each individual.

Routine pelvic exam guidelines are just that, suggested recommendations that should be considered.  For this doctor and many others, especially women, routine pelvic exams will still be part of a well woman visit as deemed necessary.  The schedule is as follows:

• 18 - 20 first pelvic exam, sooner if sexually active and/or symptomatic
• 20 - 60 pelvic exam every year to every other year unless symptomatic
• 60 - life pelvic exam every 2-3 years unless symptomatic

Routine pelvic exams and pelvic/ transvaginal sonograms together offer earlier detection and diagnosis of more gynecological diseases that can be treated effectively before they affect a woman's quality of life.  In addition, they help avoid "all in your head" misdiagnosis, and can be lifesaving.  As for the concern of "false positives" and unnecessary tests...forget about the asymptomatic symptomatic static.  Most abnormal exams and tests can be repeated and followed on a closer routine schedule that may prevent riskier intervention.  Talk with your doctor about what is best for you.  Best health!

Prevention Requires Less Intervention

Prevention and early detection are important for your health and wellness.  Routine check ups are shown to improve overall health while requiring less medical intervention and treatments.  Done on a "routine" basis means just that - in a consistent manner based on your health profile.  As one gets older, or if one has chronic disease they may become  more frequent than every few years.  As you prepare to see your doctor you will find that Patient Handbook to Medical Care: Your Personal Health Guide is the ideal reference book to inform you about what checkups and tests you may need for prevention intervention.

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

Patient Handbook to Medical Care: Your Personal Health Guide is on Kindle, and can be borrowed via the Kindle Owner's Lending Library.

Colonscopy for Colon Cancer Screening

Have you had your colonoscopy?

• baseline if 50 years of age
• history of colon cancer in family
• personal history of colon polyps, cancer
• rectal bleeding
• have a disease that is a risk like Crohn's disease
• chronic abdominal pain
• rapid unexplained weight loss

Check with your primary care physician. You will then be directed to your gastroenterologist (GI doctor, for short) for a complete evaluation. Ask your PCP for occult blood stool cards to take home to check for blood in the stools.

The Hemoccult test checks for blood that is not detected by the human eye. After you complete your stool sample cards, return to your PCP by mail or in person. They will be checked by your doctor. Any GI exam without this test and/or a rectal is incomplete.

Best health!

J.L. Richardson, MD is a family medicine doctor, patient advocate, author and publisher of Patient Handbook to Medical Care: Your Personal Health Guide.