Preventive Guidelines: Do Lower Medical Numbers Make Chronic Disease More Likely?

Hypertension has new numbers that are lower for normal.  To be considered normotensive your blood pressure numbers should be lower than 120/80 versus the former normal blood pressure below 140/90.  This is the new recommendation from the cardiology experts.  This may be shown to cause less morbidity and mortality, but it may cause more people to be considered hypertensive.  If your reading on three doctor visits is over 120/80, you will be considered a patient with hypertension.

This is just one of the many medical measurements or blood tests where the WNL (within normal limits) has been lowered.  Cholesterol was at one time considered normal at 300.  The normal now is under 180.  New tests can have the same effect.  The BUN and creatinine were once the basic kidney function tests.  Now the GFR is added to these.  Your BUN and creatinine can be normal while your GFR suggests kidney disease based on your sex and your ethnicity. 

Do lower medical measurements and numbers really mean that more patients will have some chronic disease sooner? Or does it mean lower numbers mean better health with less morbidity and mortality?    Good health care will help keep you and your numbers healthier.  Keeping a lifestyle of healthy food, exercise, good sleep, and minimal stress are important health care routines for better health.  These can be integrated with complementary medicine and medication treatments if necessary. 
You should know the measurements and numbers of all your health tests.  This helps you attain better understanding and control of the unhealthy abnormal.  Lower numbers can mean less chronic disease if you know what you have and how to keep it from becoming chronic disease.  Best health!
  

Part 1: Basic Diagnostic 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, and routine screening tests as well. 
The EKG, 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 arrhythmias), 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.
The X-ray test uses small amounts of radiation through an X-ray machine to make pictures. It can 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 X-rays 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 closed space 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.



If you are uninsured, these tests are still available at affordable rates.  Check and compare prices by phone or Internet to find lowest prices.  Your healthcare provider may also be able to direct you to a clinic, hospital or testing center that fits your budget.  Some providers also have payment plans that allow payment over time.  Make your own healthcare plan affordable rather than go without.  Best health!

Timely Tip: Your Medical To-Do List

As  you think over things to discuss with your doctor, you may be amazed to see how many are unresolved, and fortunately not life-threatening. It can be a task to try to get them all taken care of in a timely manner.
Make your medical to-do list before doctor visits. Update it after your doctor visits.  Keep your notes together in a folder (off computer and/or on computer), or notebook.  This creates an overview of your medical issues.  It will also help you keep up with the unresolved as well as resolved issues. Best health!

10th ANNIVERSARY PATIENT HANDBOOK TO MEDICAL CARE THANK YOU

This year marks the tenth anniversary since publication of Patient Handbook to Medical Care: Your Personal Health Guide.  Thank you all for reading my book and nine year old blog.  This book was written to help each and every one of you for we all are patients at some time in our lives.  The primary intent and purpose for writing Patient Handbook to Medical Care: Your Personal Health Guide was to help patients learn the basics involved in seeing your doctor and healthcare providers.  It was far too much to tell in a short office visit so I decided to write it down and self-publish!
Since 2006 publication, Patient Handbook to Medical Care: Your Personal Health Guide has become available in many libraries and bookstores (on and off line). There is a Kindle e-book with plans for the audible version.  The blog has been viewed by so many!  Book giveaways, sales, and blog reads are an indication of the patient interest in health facts and information. Health literacy improves your health care in all ways. It helps you make the right choices for you and your family.

Again much thanks to you all! Best health!

Keep a Happy Heart, Be Heart Smart

A healthy heart is a cheerful heart.  Keep your heart smart and happy with this quick, easy to understand information.

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 if there is a strong family history of heart and vascular disease see a cardiologist.

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, valve function)

Heart health habits:

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.
8. Love, laugh, and let go!

Have a happy, healthy heart! Best health and love!

J.L. Richardson, MD, family medicine, is the author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

Father's Day Health Checkup

"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's 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
• mental health assessment

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.

Home Health Testing

Getting access to your doctor or health service may be a greater challenge than your health problems these days.  More patients are turning to home health care, treatment and diagnosis.  Preliminary self diagnosis aids are as close as the Internet and the corner drugstore.  DIY medical test kits are accurate and may aid your doctor in the final diagnosis.  Studies show that home testing may save your health, time, and money by making a correct diagnosis and starting treatment sooner.  Home health tests help many find answers to your healthcare concerns quickly and conveniently in the privacy of your home.

Home health testing is a mega billion dollar business which is an indication of their popularity and use. Many reliable test products crowd retail and drug store shelves across the world.  These tests enable you to screen, monitor, and/or diagnose yourself. 

As good as it may sound, DIY home testing is not a replacement for professional health care especially if the symptoms worsen or persist.  Once you have positive tests consult with your doctor or other health provider.  Get the tests repeated along with the others your doctor gets.  If a health care provider ignores your request, get another, or check at independent facilities that do testing for you.

 

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!

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!

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.