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.

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!

Heart Screening Checklist

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!

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

www.mypatienthandbook.com

www.twitter.com/MD4U

www.twitter.com/drjfpmd

Patient Handbook in Your Library

Dear Librarians,

A FREE copy of Patient Handbook to Medical Care: Your Personal Health Guide will be donated to your library upon request until Labor Day.

Bend of the River Books is proud to announce that Patient Handbook to Medical Care is now in 60 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".

Thank you for all your support. It is so appreciated.

Best,
Dr. Richardson

read excerpts from Google Books http://short.to/kbv1

TEST YOURSELF?

Many doctors are concerned that some tests like the body scan will lead to unnecessary procedures that could harm patients. Often these tests may show abnormal things that are “normal” meaning that the abnormal finding is something that is just there. It is benign, and not life threatening.

What does the doctor do when a patient comes in with a test that they have done on their own? The patient has decided that I may need this test because heart disease, and /or cancer runs in my family, plus heart disease is the number one killer. Should I have a heart scan, body scan or a virtual colonoscopy? My doctor has told me that tests like these may find things that are benign, but something serious may show up. It could be something that would turn up in a few years and possibly be life threatening, but if I check now maybe I can do something about it.

What does the doctor do when a patient comes in with abnormal test results from a test they orders and paid for themselves?
1. Repeat the test
2. Refer the patient to a specialist
3. Do more tests to check it out
4. Scold the patient and say “It’s okay. There’s nothing to worry about.

What does the patient do?

J.L. Richardson, MD is a family practice doctor, and author of the award winning "Patient Handbook to Medical Care: Your Personal Health Guide".

http://mypatienthandbook.com

High Blood Pressure - Home Checks

High blood pressure, also called hypertension affects 1 in 3 adults. Stay 120/80! Know your numbers.

For more accurate measures of your blood pressure and what affects it consider home blood pressure monitoring. Buy a blood pressure monitor for home use. Wrist and arm monitors are available at Amazon, Target, Walgreen's, CVS, Wal-Mart, and local medical supply stores. Shop on line by doing a search for "blood pressure monitor". One of the top finds is for those made by Omron, and of course, the store brands.

Record your blood pressure readings daily starting with morning, midday, and night. Make a note of your activity and how you are feeling. You may notice that extreme anxiety makes it go up, or that your head hurts. The correlation to your pressure will help you manage your symptoms.

If your blood pressure is borderline at 140/90, you want to start a low salt diet. The best is the DASH diet (http://bit.ly/hnbsL). Exercise, weight control, and stress reduction are other things to include in your treatment plan. For higher blood pressure readings over 140/90, medication may be necessary. Take your home blood pressure results in to your doctor. This will help in deciding on the best treatment for you.

Share your results with your doctor so medication and lifestyle changes can be made if necessary. You may find that while your blood pressure is high in the doctor's office, it may be normal in everyday activity. Remember, the doctor's result is a one time reading every few months. With normal home results, and high results at your doctor visits you may have "white coat" hypertension. There is much controversy over whether this should be treated. Check with your cardiologist.

American Heart Association http://hearthub.org/ for your cardiovascular concerns.


by J.L. Richardson, MD, author of the award winning Patient Handbook to Medical Care.

mypatienthandbook.com/
www.twitter.com/MD4U

Heart Valve Screening

Should screening for heart valve disease be routine? Should you wait until you have symptoms and need surgery?

Today it was reported that Robin Williams (the famous Mork) will be having surgery on his aortic heart valve. Yesterday former First Lady, Barbara Bush, had surgery for aortic valve disease. Both were reported as having shortness of breath. Mrs. Bush also had dizziness. Other signs and symptoms may include chest pain, fast heart beat, weakness, and leg swelling.

As with many conditions, there may not be any symptoms. This would be reason enough to consider routine preventive screening with an echocardiogram of the heart. This test shows the heart valves very well. It also assesses heart function. The echo, as it is called for short, is a great test for looking at the heart. It uses the same technique as a sonogram for pregnancy

The best news of all is that the ehco is noninvasive - no needles! It is done quickly in less than thirty minutes. It is also affordable.
These are supporting reasons for making this test a part of routine preventive screening. It is so easy!

Talk to your primary care physician and cardiologist. See what is best for you.

Heart Health Checklist

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.

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!

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

http://mypatienthandbook.com

Heart Health Month Tips

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. Tests may include:
___Doppler echocardiogram
___Stress test - nuclear, doppler or exercise
___Heart MRI scan
___Interventional studies like cardiac catherization


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

Love, laugh, and let go! Have a happy, healthy heart!

Heart Disease Screening

EKG? Stress test? Echocardiogram? Nuclear stress test? Angiogram? CT scan? Which test is the best for checking for heart disease, also known as coronary artery disease (CAD)? The best way to look at the heart is directly. Short of an autopsy, there is no other way. So what do you do?

Thanks to modern medical technology a electron-beam computed tomography (EBCT) scan (also called fast CT) of the heart is able to show heart vessels coronary artery calcium (CAC), hard plaque that causes blockage. An angiogram/ cardiac catherization shows actual blockages. This is invasive requiring injection of dye into a main artery to view the coronary arteries, and is the gold standard for detecting CAD. The heart scans are noninvasive, and give a rather good look at CAC (hard plaque) in heart vessels which can also be a predict cardiac events like heart attacks.

The most current consensus document (2007) from the American
College of Cardiology Foundation and American Heart Association does not recommend the scan for asymptomatic people with a high risk of coronary artery disease, or for those at low risk, nor as a screening tool. It is considered reasonable in the asymptomatic with intermediate risk, and for the symptomatic person prior to an angiogram for definitive diagnosis.

The document also cites studies that compare fast CT with EKG stress test, nuclear perfusion scan, stress echocardiogram and angiogram. "The accuracy of fast CT was significantly higher than either treadmill testing or technetium stress in the diagnosis of obstructive CAD." Other studies included angiography (the gold standard), fast CT, EKG, and nuclear (with thallium and technetium) exercise stress testing. The fast CT correlated closer with the angiogram than the other tests especially if the CAC score from the fast CT was over 100. If arteries are occluded more than 50%, this will likely show on the fast CT. "Three studies have documented that CAC is a rapid and efficient screening tool for patients admitted to the emergency department with chest pain and nonspecific electrocardiograms."


So why are cardiologists continuing to pass on recommending the fast CT? Is it because it is more convenient for the doctor to do the other tests because they are more "readily available" like in the doctor's office or nearby hospital? It seems like a fast CT could be just as "readily available". Do they get paid more for these other tests that may yield less information like the specific areas where CAD may be localized?

The fast CT sounds too good to be true. Is it? Does it give more accurate information about heart vessel blockage in 10 minutes than the other tests mentioned, excluding the angiogram? I have been watching my vessels with fast CT for about 5 years now. I felt that my family history of heart disease and my risk factors warranted more than an EKG or stress test which have also been done. Both failed to correlate with the findings of the fast CT.