Free Book Read: Audible and Visual Health Literacy

Health literacy is very important.  It is essential in keeping yourself healthy.  Reading is the best way to be health literate.  Reading in itself is an intangible vitamin that should be ingested daily.  

Patient Handbook to Medical Care: Your Personal Health Guide is available to help you with basic health literacy in seeking medical care.  This book is a medical reference book.  It is meant to be read and referred to as needed.  This book may be accessed for free on Kindle Unlimited as a visual read. An audible read is available through BlogTalkRadio as Patient Handbook to Medical Care.

Learn good health.  Be health literate.  Best health!

Your Medical History & Preventiuon Guidelines

Preventive health guidelines were developed to improve one’s health using things that prevent disease and detect it early.  They are based on credible research in which the criteria have been studied extensively.  The United States Preventive Services Task Force (USPSTF) is a leading resource for preventive health guidelines along with doctor specialty organizations like the American Academy Of Family Physicians and American Academy of Pediatrics.  There are so many that it can become confusing as to what you should do.  Like one size fails to fit all so do the guidelines. How will you know what you need and when you need it?

Use your medical history as your guide in deciphering through different health organization guidelines.   Though they may address the same thing, there will be similarities and differences.  If you have a history of cancer, you may want to get a mammogram or colonoscopy more often. If there is a family history, you may want to get tests sooner than the guidelines suggest.  Abnormal physical exam findings warrant testing regardless of guidelines.

Be sure to review guidelines from different organizations. This gives you a broader view of what you need.  Look at the pros and cons as they fit you.  Focus on those that concern you and your condition.  Discuss them all with your doctors and healthcare providers to plan your guidelines. Your medical history is your guide to the guidelines right for you.  Best health!

Abnormal Health Test Followup

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, or cancer runs in my family, and they pose serious health risks. Should I have a heart 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 order and pay 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.”



Some doctors are concerned that some preventive medical tests will lead to unnecessary procedures that could harm patients. Often these tests may show abnormal things that are “normal”.  Normal variants are common and usually cause no disease.  Some abnormal normal findings do require further workup and treatment.  Follow up with repeat interval testing and comparison of previous tests is a good way to check on abnormal tests.  If all remains stable, a procedure may be unnecessary.


Health decisions require a team approach between patient and doctor.  This is based on each individual patient's medical history.  There are guidelines that help guide treatment, but they must be tailored for each individual patient.  Any abnormal test results warrant follow up whether your doctor orders the test or you do. Best health!

Get Preventive Health Tests You Need

If you are at risk for some disease whether or not it is inherited, why not check for it early? Get checked for everything you possibly can that is available.  Make this a lifestyle change like weight control, exercise, and proper diet.  Help yourself and your health care with preventive tests.
Many doctors are concerned that tests obtained by patients on their own will lead to unnecessary procedures. 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, or a virtual colonoscopy? Patients are often told that tests may find things that are benign, but something serious may show up. It could be something that would turn up in a few years that could have been prevented if detected early.
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? What is best for your good health.  Best health!

Part 2: 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 ultrasound is also referred to as a sonogram or sound wave test. It uses sound waves to make images of body parts. This changes electrical energy to sound waves that go through the 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, CT or CAT 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.


The MRI (magnetic resonance imaging) 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 much like 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.

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.


Medical diagnostic tests are screening as well as diagnostic tools.  Along with a thorough history and physical, these tests can help make a correct diagnosis. Best health!

Use Your Medical History As Guide Guideline

Preventive health guidelines were developed to improve one’s health using things that prevent disease and detect it early.  They are based on credible research in which the criteria have been studied extensively.  The United States Preventive Services Task Force (USPSTF) is a leading resource for preventive health guidelines along with doctor specialty organizations like the American Academy Of Family Physicians and American Academy of Pediatrics.  There are so many that it can become confusing as to what you should do.  Like one size fails to fit all so do the guidelines. How will you know what you need and when you need it?
 
Use your medical history as your guide in deciphering through different health organization guidelines.   Though they may address the same thing, there will be similarities and differences.  If you have a history of cancer, you may want to get a mammogram or colonoscopy more often. If there is a family history, you may want to get tests sooner than the guidelines suggest.  Abnormal physical exam findings warrant testing regardless of guidelines.
 
Be sure to review guidelines from different organizations. This gives you a broader view of what you need.  Look at the pros and cons as they fit you.  Focus on those that concern you and your condition.  Discuss them all with your doctors and healthcare providers to plan your guidelines. Your medical history is your guide to the guidelines right for you.  Best health!

HEALTH INSURANCE PRICES RISING

Your health insurance price is going higher.  Since July 2015 there have been reports of health insurance premiums rising in 2016.   Prices have risen by 25 per cent or more with many health insurance plans.  It may actually be cheaper to be uninsured especially if you are healthy and stay that way.  Since the Affordable Care Act took effect in 2014, insurance premiums are on the rise again.  If deductibles are included, it resembles prices of yesteryear.  The premium may be less, but adding the deductible balances out to about the same yearly amount as before the health law was passed. 

With premiums likely to rise as much as 25% again next year this could set the stage for more uninsured as patients find they may be able to do better without insurance. The 2016 yearly penalty imposed if one declines to be insured by a health plan is $695 per adult and $347.50 per child but can be no more than $2085 per family or 2.5% of family yearly taxable income.  This increased over 50% from $325 and $162.50 respectively in 2015 with total to be no more than $925 or 2% of yearly taxable income. In 2014 when the Affordable Care Act went into effect the penalty started at $95 per adult and $47.50 per child with total to be no more than $285 or 1% of yearly taxable income. 

Many are paying between $200 to over $1000/ month for “affordable” health insurance.  If health care could be attained at less than $2085 a year, could it be to your advantage to opt of health insurance coverage and pay the health premium penalty? The choice is yours to make for health coverage.  With or without it, price increases continue. Though it may appear cheaper and healthier to be uninsured it may be more risky.  One unexpected consultant visit or diagnostic test can easily exceed $2085 for the year! 

If you are without any major illnesses or chronic disease, and have a healthy genetic predisposition, do you really need health insurance?  Should you save your money in a medical fund until you need it instead of having health insurance?  There are folks doing this, and they are spending less on their medical care than the price of what health insurance would cost.  Many are able to afford their medicines (if they are taking any) and other treatments as well as routine screening tests that may be needed.  Their own health savings account is their “insurance”.  Saving enough money for your health care is difficult because health changes as unexpected health challenges arise especially with aging. 


Should you have health insurance?  Do you have enough money in your budget for health insurance and/or a health savings account? It is prudent to have some type of coverage solely because your health is so important.  Health insurance is prevention intervention as well as diagnosis and treatment coverage.   As more insurance companies focus on wellness and prevention, more services are covered at much less than what you will pay for them yourself. Health insurance benefits do seem to give you more bang for your buck and your body.
The choices for your personal health maintenance are there.  Health insurance is important like home and car insurance.  You are your most important asset.  To keep the car and house  while maintaining financial stability, you must stay in good health.  Find a plan to fit your needs medically and financially.  Even if you have health insurance, unless it's the "gold" plan you will most likely have to pay some out of pocket as well (deductibles, copays, full pays for services not covered).  Saving your health can help save your money. Best health!

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!

10 Money Saving Medical Tips

You are your most important asset. Saving your health saves you money. These money saving medical tips can help you do both.

• Keep your health insurance coverage. This is as important as your home and food. Cut expenses elsewhere to keep it in your budget. Let your doctor know if you do not have insurance coverage. Many offer discounts to the uninsured as do other health providers like hospitals and diagnostic centers.
• If you lose your job, get COBRA through your employer. You will have at least 18 months of coverage. You will have to pay for it. It is worth it.
• Be sure you are up to date on your health maintenance. Get in now for your physical and preventive tests (mammogram, blood tests, eye exam, shots, etc.).
• Check your medication, prescription and non-prescription. Review these with your doctor to discontinue any you really do not need, and/or can't afford. Let your doctor know if you are unable to afford any of your medication, so other options can be discussed such as drug assistance programs. Research them yourself on the Internet, and by calling or writing the drug company that makes your medication. Remember to include your non prescription medicines in your budget (like cough medicine, stool enhancers, pain relievers, etc.). Talk with your pharmacist.
• Discontinue unhealthy habits like smoking and excessive drinking. These items cost money and your health.
• If you become disabled, you can withdraw money from your IRA without paying the penalty and taxes. You may need this money to pay for present or future health costs. It may benefit you more while you are well enough to enjoy it. By the time retirement rolls around, you may not be around.
• Eat healthy small servings. Smaller portions of healthy food save your money and your health. Remember this when you eat out.
• Exercise at home. Save your money and time on that gym membership. You can reap the same and better benefits with a home exercise program with or without expensive exercise equipment. Turn on the TV and participate in the fitness shows that are best for you. Exercise DVDs and tapes are a one time expense that can be used again and again. Ride your bicycle, take a walk or jog in your neighborhood. It all counts.
• Continue your home exams like self breast exams, and self scrotal exams. You may detect something early. There is much controversy about the self breast exam, and it is no longer recommended by some. Common sense tells you that self detection is a smart thing to do.
• Save money for your health bank. As insurance companies and plans cover less, you will be paying for more for services and premiums. Keep a nest egg for health expenses.

Remember that YOU are your most important asset. Great health is true wealth!

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!

Family Health: Guide Yourself to Quality Healthcare

Consumer demand, new drugs and medical technologies, litigation, higher insurance premiums, and other factors have all been fueling rising healthcare costs. At the same time, many patients justifiably feel that medical services have become increasingly impersonal. Too often, quality attention from the proverbial family doctor has been replaced by the “assembly line” approach of faceless bureaucracies. How is a patient to successfully navigate this modern maze of providers, specialists, insurers, and so forth and at the same time get the attention they need to maintain personal (not to mention financial) health? 

Patient Handbook to Medical Care: Your Personal Health Guide
offers an overview of the healthcare system from a different point of view and advises patients on how they can take their health into their own hands by becoming both informed and proactive.

As Dr. Richardson eloquently puts it:

In our society we are accustomed to taking a doctor’s word on the state of our medical condition and treatment whether or not we understand it and either without asking any questions or without getting adequate answers to the questions we might pose. Today that might not be a healthy situation. It is necessary to be informed to get the most from your health plan and to get the best medical care from the medical resources available in the healthcare system. By reading this book, you will find out how to take charge of your most important asset—you.

This philosophical perspective is that the patient, insofar as it is possible, needs to take charge of his or her health care self care. 

The book is structured in a logical, reader-friendly manner, providing overviews of all the major topics related to healthcare, from effective record keeping to obtaining quality health coverage.

The first step toward taking charge of your health is keeping accurate medical records and a medical diary. Patients are offered a detailed overview of how their doctor visit should go educating readers about all the various aspects of a routine physical or checkup.  Patients will recognize whether they are receiving quality, comprehensive care, and will know what they should be getting.  The core philosophy is that knowledge offers patients more health options and better health.  Subsequent chapters educate patients about the importance of preventive checkups, common medical tests, the various kinds of doctors and specialists, and healthcare quality.

Patient Handbook to Medical Care: Your Personal Health Guide is essential knowledge in an easy-to-assimilate large print format bound paperback book (adjustable print on e-books). Readers will walk away from the book with a much clearer idea of what to expect from the healthcare system, and what to do to ensure the preservation of their own health.  Best health!

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.

 

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.

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

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.

Your Physical Exam: Below the Waist

After the physical exam above the waist is completed, the rest of the exam follows. For females, the pelvic exam and rectal exam are done next. The pelvic exam can also be done by a gynecologist, a doctor who specializes in female medicine. This depends on your preference and/or if your primary care doctor chooses to refer you. It is an examination of the female external(outer) genitalia (parts) and internal (inside)reproductive sexual parts. The first female exam should be done at any age if there are any symptoms. Routinely, the first pelvic exam is done once the female is sexually active (having sex) or 18 years of age. It is recommended that a third person or chaperone who is an authorized health professional should be in the room for this exam. Every health care setting should have chaperone policies in place for gynecology exams. This should always be presented as an option, if there is no policy or law. Furthermore, it should be offered to a patient for the full physical examination, especially if the physician is the opposite sex of the patient.

The assistant will help you get in position. Your legs will be placed in stirrups (foot holders) that are at the end of the table. You will then slide your hips down until the buttocks touch the edge of the table. Your legs will then be able to relax
apart. (Some doctors have more comfortable exam chairs.) For those who might not be able to do this, there is the frog-leg position. The heels are brought together while the legs are bent: the heels are, thus, brought as close as possible to the
buttocks, like frog legs. For persons not able to assume either of these positions, referral to a gynecologist is necessary. Please note also that you should not be put in this position until the doctor is ready to examine you. That’s just good manners on the doctor’s part. Once the exam begins, the doctor will instruct you when to lie down. You should also be informed when and where you will be touched during each part of the exam. The doctor will be wearing latex gloves to do this part of the exam. You may also request that a mirror be placed so that you can watch the exam.

There are five basic parts of the pelvic exam. The first part is the exam of the external genital area where the doctor inspects and palpates for any abnormalities. The second part of the exam is done using a tool called a speculum. This is for looking into the vagina and at the cervix. It resembles a fancy pair of tongs (or a pelican beak) and is either plastic or metal. Most doctors
will and should warm the speculum with water before use. This allows for easier passage of the speculum. In the closed position the speculum is then placed gently in the vagina and opened to keep the vagina walls apart. When this is done,the doctor is able to see the cervix. The third part of the exam involves doing a Pap smear, which is a screening test for cancer of the cervix. A thin wooden stick about the size of a popsicle stick(called a spatula) and a stick with a tiny (about quarter-inch) brush on the end are used to do the test. When gently rubbed against the cervix, they are able to pick up cells. The cell samples are then placed on a glass side or in a test tube, which is then sent to the lab. The speculum is then removed.
Part four is the bimanual exam, which includes palpation of the internal female organs. One or two fingers that have been lubricated are placed in the vagina, while the other hand presses
over the pelvic (lower abdomen) area. The uterus(womb) and ovaries (eggs)can be felt for any tenderness or masses. The last part of the exam is the rectovaginal exam. Using a clean lubricated glove, one finger is inserted into the vagina and a
second finger into the rectum. This is an important part of the exam for two reasons: to check the rectum for bleeding and masses, and to further palpate the female organs. A complete
pelvic exam includes a rectal exam. The stool is checked for blood by placing a sample of stool from the gloved finger in the rectum onto a special card (commonly called guaiac or Hemoccult cards). If there is no stool for the specimen, your doctor will give you cards with instructions on how to collect samples at home. Once completed, the cards are returned to the doctor to be checked for blood. This is a very important test. Small amounts of blood in the stool cannot be seen with the naked eye but can
be detected with this test.

The male genital exam is the equivalent of the female pelvic. The doctor inspects first. With gloved hands, the penis glans (tip) and shaft are checked. If the male is not circumcised, the
foreskin (extra skin) should be pulled back. Then each scrotal sac is palpated to check the testicles for any abnormal lumps or bumps. This is a good time for the doctor to show you how to do your own monthly scrotal exam. Next the famous “cough” test is done in standing position. This is to check for hernias and is done with the insertion of the examining finger into the scrotal
and inguinal (groin) area while the patient coughs. It is done on the right and left side. The rectal exam follows and is usually done with the doctor’s lubricated gloved index finger inserted into the rectum. In addition to checking the stool
for blood, the prostate gland (which makes male fluids) is also checked for size, tenderness, and masses. This is an important cancer screening test for men and should be done routinely after age 40.

Examination of the musculoskeletal system(arms, legs, back), nervous system (including mental health), and skin mark the end of the complete physical. The extremities (arms and legs)are checked for symmetry (the same on both sides, and were being checked as you got on and off the exam table, to see if you required assistance or were using an assistive device such as a wheelchair,walker, or cane. Following instructions and answering the doctor’s questions during the exam allows for an indirect check of the nervous system. The skin can be inspected as each of the previous parts of the physical is done. Be sure to
have the doctor show you how to do your own self skin exam.

The inspection of the extremities continues as the doctor looks for scars, skin color change,edema (swelling), and effusions (joint swelling). The joints of the arms and legs are then tested for range of motion (actual movement) actively (movements done by patient) and passively (extremities are moved by the doctor). They are also checked for any tenderness, swelling, and
warmth or coolness. The strength, reflexes, and sensation(feeling)in the extremities are usually tested at this time or can be included in the neurologic(nervous system) exam. Strength is tested by resisting the doctor’s strength. Pushing the hand against the doctor’s hand, kicking the leg out, and gripping a finger with your hand are all relative tests of strength. The reflexes are checked with a reflex hammer at several places on
the arm (front and back of the elbow, above the wrist) and leg (below front of knee, back of ankle on Achilles’ tendon). Sensation can be checked using different items but is usually checked by light touch on the same parts of the arm or leg at
the same time. A sterile pin touched lightly on the area to be checked can also be used. Different areas of the body are touched while the patient’s eyes are closed and the doctor asks whether the touch feels the same on both sides or if a sharp or
dull feeling is experienced with the pin. Position sense is checked by being able to tell if your finger or toe is being held up or down with eyes closed. Vibration sense is tested on a finger or toe joint with a tool called a tuning fork (a six-inch
or so steel piece that vibrates when tapped lightly). Your job is to tell the doctor if it’s vibrating and when it stops. Finally, the extremities are checked for the pulses(circulation) in the arm and leg and for any vein abnormalities.

The rest of the neurological exam involves checking the way you walk, talk, and answer a few questions designed to check the mental state(such as where you are, the date, ability to identify a simple object). The cranial nerves(nerves involving the face and neck area) can also be checked now, if they were not included in the head and neck exam. During the back exam the doctor first looks at your posture. The shoulders and hips are checked for symmetry and deformities. The muscles of the neck, posterior thorax (chest), and lower back are palpated to check for any tenderness or spasm. Likewise, the bones of the spinal column are also checked. Movement of the neck and lower back is
done actively and passively in all directions of movement.

Please be reminded that the way the physical exam is done may vary from doctor to doctor. This is unimportant as long as a complete physical exam is done. Please note that the above
description of the CPE is quite generalized and does not include every specific detail. Book references for more detail include: "Bates Pocket Guide to Physical Examination and History Taking" by Barbara Bates, M.D., et al. (also available on CDROM
and VHS tape), and "Bedside Diagnostic Examination" by Drs. Elmer and Richard DeGowan. Many medical school curricula use
these references.

Once the physical exam is complete, the doctor and assistant will leave the room so you can get dressed. If an EKG (electrocardiogram — heart tracing) and X-ray are going to be done, you may be asked to get partially dressed (bottoms only) and keep the gown on. If blood has not been taken, that can be done at this time, too. Following these tests you will be able to get fully dressed. The doctor will then sit down with you in the office or exam room and discuss your symptoms,the physical findings (normal vs. abnormal), diagnosis, and whether any further tests or treatments are needed.

This is also the time for obtaining any prescriptions and to be told about any further tests or specialists whose expertise will be required. The doctor may also counsel you with information about your diagnosis and treatment, as well as any number of preventive healthcare topics. You may also be given handouts and booklets. Doctors may refer you to pertinent medical and patient education websites such as www.webmd.com. Email is becoming another way to talk with your doctor, in addition to phone calls, regular mail, and faxes. Prescriptions for medication are usually given to the patient at the end of the visit. Prescriptions are written orders for medicine that the doctor
has chosen for you. The patient should take these to the drugstore as soon as possible to stay well or to hasten recovery. Prescription medication must be dispensed by a licensed pharmacist. Some doctors fax or call the prescription in to your drugstore. Asking the doctor to do this for you will ensure you receive your medication promptly and will save you a trip to the drugstore. Some doctors are now using e-prescriptions
over the computer to send in patient prescriptions. By giving your doctor the number for the druggist you use, you will be able
to get a prescription filled in less time. You may also get prescriptions for medicine that can be bought over the counter—that is, without a pharmacist. Your pharmacist is the best person to help you with obtaining your medicine, discussing side effects and interactions, what the medicine is for, and so on. Be sure to discuss this with your doctor, too.

Best health!



Patient Handbook to Medical Care: Your Personal Health Guide http://amzn.to/13m51UU FREE with Kindle unlimited!

Incidentaloma Incidents

When I had my initial body scan 10 years ago unexpected findings were discovered. These incidental incidentalomas had failed to cause any symptoms. An incidentaloma is the medical term for incidental findings that you may have been born with or acquired which are usually benign. Harmless and benign as they may be, further investigation is warranted, This may involve direct testing with a biopsy and possibly surgical excision.

Though most inidentalomas are benign, they may continue to grow inside the body. This may endanger other organs and become life threatening. Routine scans done at one, two, three, six months then annually is an accepted standard of care for following incidentalomas. In addition, periodic blood tests that correlate with it will help show any changes from the incidentaloma.

Of the five abnormal findings on my body scan, one proved life threatening. The ginormous kidney stone stuck in my kidney had caused no symptoms. Had it remained undetected, kidney failure and/or loss of a kidney surely could have occurred. Another incidentolama required biopsy and proved to be benign (was initially found on a cardiac stress test!). The others continue to be unchanged and asymptomatic. Followup with routine scans is the way they have been followed and they remain stable.

If you are concerned about cost and/or whether your health insurance will cover it, you may want to consider self pay. This test was worth each penny of my $750. Plus no prescription or referral is needed unless it is covered by Medicare. My insurance company now covers scans of each area with incidentolomas. Though not a body scan, the results are the same.

Incidental incidentolomas affect all of us. Once found they should be checked. Be sure to see any specialists that may be necessary to decide if biopsy, surgery, or simply following routine scans is enough.

Best health!

How to Get Your Medical Records: Your Life on File

Communicating with your health care team is vital. To be sure nothing is missed, take the time to collect your medical records from all the doctors you see. This includes notes from your primary care doctor and specialists, tests, and surgery reports. You may want to start with your primary care doctor, the doctor who sees you the most.

To obtain your records, you should submit a medical record release form. This form gives your doctors and other health providers permission to release your records to you. This can be done at the doctor’s office, by mail, or by fax. You can get a record release form at doctors’ offices or at other medical facilities such as hospitals and clinics.

The medical record is your life and health on paper. Once you get your records, it is important to review them for accuracy. If any information is inaccurate or any reports are missing, bring it to your doctor’s attention. You might find some
things your doctor did not tell you about or things you simply do not understand. If your doctor is unable to get the missing information, contact the source directly for copies of your reports.

Gather this information into a folder or notebook. Add a cover sheet with your name, address, phone number, email, and date of birth. On this page make a list of your medical conditions, all the medicines you take, your allergies (and any other reactions to medication), operations you’ve had, and a history of diseases that run in your family. You will be able to make copies to take to any doctor you go to. This also prevents the delay that occurs when records are sent from doctor to doctor, which can take from weeks to months to years.

Best health!

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

Patient Handbook to Medical Care 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.

www.mypatienthandbook.com/

www.twitter.com/MD4U

www.blogtalkradio.com/drjfpmd

Women's Health Checkup

Ladies, schedule your routine screenings and appointments to 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) 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 osteoporsis
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.

Get in 5 to 10 minutes of exercise a day at least and eat healthy! Laugh a lot and love a lot!

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

Doctor Visit Tips

Going to the doctor can be quite a challenge. These tips will help you make the most of your doctor visit.

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.

Start keeping 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." 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 legibility. It is surprising to see how many doctors are often unable to read their own handwriting.

Stay on top of your health care with these tips. After all, great health is true wealth!

Click on "Comments" below to add your tips and questions.

by J. L. Richardson, MD, family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide, the perfect tool for helping you make your medical visits the best.

http://www.mypatienthandbook.com/
www.twitter.com/MD4U
www.blogtalkradio.com/drjfpmd



More tools to help you with your doctor visits:

http://www.mypatienthandbook.com/ - *medical history form on website.

Medical record release form - http://office.microsoft.com/en-us/templates/TC010234611033.aspx?CategoryID=CT101433201033

Medical tests A to Z - http://www.medicinenet.com/procedures_and_tests/article.htm

Specialists A to Z - http://www.healthadvantage.org/body.cfm?id=85