Healthy life lines include:
- Be literate in health.
- Focus on prevention to avoid intervention.
- Constantly do things to improve your health.
- Embrace healthy routines.
- Limit and avoid multitasking.
- Find funny and laugh daily.
- Keep a health diary.
Mostrando entradas con la etiqueta prevention. Mostrar todas las entradas
Mostrando entradas con la etiqueta prevention. Mostrar todas las entradas
jueves, 23 de marzo de 2017
Healthy Life Lines: Simple Tips to Improve Your Health
Live healthy. Live simply. Check out new book "Healthy Life Lines: Simple Tips to Improve Your Health" http://amzn.to/2nLf1u0. This short book consists of one line health tips for better health and wellness. These tips will encourage you to live a lifestyle of good health. "Healthy Life Lines: Simple Tips to Improve Your Health" is available FREE on Kindle Unlimited.
Healthy life lines include:
Healthy life lines include:
lunes, 8 de febrero de 2016
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!
miércoles, 3 de septiembre de 2014
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:
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
jueves, 2 de mayo de 2013
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
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
domingo, 21 de octubre de 2012
Healthcare Deja Vu Come True?
As health care access decreases and costs increase, we must look ahead to improving it for everyone. In 2011 employers paid an average of $11,000 for employees and their families, while yearly insurance premiums rose from $13,000 to $15,000. The following is an excerpt from "Building an American Healthcare System" released in 2002 when the average premium paid by employers was $6500. While proposing ways to decrease cost and access, one is able to see that good healthcare can be deja vu come true.
One stop shopping for medical care is in order. By having more clinics, easy access to care will help people to get what they need in a timely manner. Waiting to see the doctor is one of the reasons our health care is out of control. The Public Health facilities will be a setting in which health care providers will employed and compensated as in the private sector. It will be just as prestigious to work for the Public Health as the private sector. In addition, permanent protection of physician incomes can be guaranteed by the government much like the recent ruling in Britain (British Medical Journal, April 5, 2003). The concept of second rate, low paying health care for the low income associated with Public Health Service must be changed and amplified. We must be proud to work for our country’s health system, and to obtain top notch health services! In this set up, the uninsured are insured and objectives of the Fair Care to the Uninsured Act of 2003 will be met. This is very important. Those without insurance are sicker, die younger and receive less care for many conditions. The risk of illness increases the longer one is without insurance.
More emphasis from the USPHS for education, prevention and screening, eldercare, disabled care, chronic condition care/ chronic multisystem illness (CMI), health awareness, and education is needed. The Public Health clinic will evolve from the barely visible building or little trailer in the field to highly visible, easily accessible structures. Vacant malls and warehouse buildings can be bought and transformed to mini-medical facilities that provide it all. Pre-existing clinics in the area can be merged, or remain as satellite facilities. The goal is to have health care at every corner much like the neighborhood convenience store. The era for traveling 100 miles to your doctor, waiting half a day or more only to spend the average 5 minutes with your health care provider must cease.
Minnesota has set up a system that covered about 95% of its residents under 65 in 2001 (86% in 2000). It uses government and private insurance together to achieve insurability. "Approaching Universal Coverage: Minnesota’s Health Insurance Plans" by Debra Chollet & Lori Achman of Mathematica Research Policy, Inc.states that it has been successful at serving "all populations in need at all levels of income". Coverage is included for the "medically uninsurable" like the person with chronic multisytem disease, or pre-existing conditions. Its GAMC and MA plans includes coverage for expenses that occurred in the 3 months prior to application, and do not have premiums or co-pays. Minnesota's programs have been, or are currently used in other states, and can be used to help lay the foundation for health care uniformity. The Commonwealth Fund has several publications that look at other states' health systems, and universal health coverage.
The effort to consolidate the American health system is a priority. Karen Davis' summary, "Time to Change: The Hidden Cost of a Fragmented Health Insurance System", states that the present system "is not up to the challenge of ensuring a healthy and productive nation because it is 'fragmented' ". The focus of her summary exemplifies how lack of uniform health services costs more with less results.
Attention must also be placed on employer health provisions. In 2002 companies spent an average of $6500 per person for health care. This does not include the patients' out of pocket payment for services. The pages of uncovered services listed in many insurance handbooks grows longer. About 41 million employed by small business pay directly for services at prices compatible with the Medicare and Medicaid models. Through the leadership of the Public Health Service all businesses are uninsured primarily because it is unaffordable. Congress is presently looking at a concept called an Association Health Plan (AHP) as part of the Small Business Health Fairness Act. This would allow small business owners to offer large corporation health discounts. It would also be uniform nationwide. The AHP is in use in some states, and has come and gone in some. Last year 16 states closed down 48 AHP plans. This would be a great opportunity to "phase in" national coverage. As employer health programs are phased out, patients should be offered the option to obtain national insurance. Each person preventive and screening will be done without charge. Eventually this will lead to a healthier people, and health system at a much lower cost.
One stop shopping for medical care is in order. By having more clinics, easy access to care will help people to get what they need in a timely manner. Waiting to see the doctor is one of the reasons our health care is out of control. The Public Health facilities will be a setting in which health care providers will employed and compensated as in the private sector. It will be just as prestigious to work for the Public Health as the private sector. In addition, permanent protection of physician incomes can be guaranteed by the government much like the recent ruling in Britain (British Medical Journal, April 5, 2003). The concept of second rate, low paying health care for the low income associated with Public Health Service must be changed and amplified. We must be proud to work for our country’s health system, and to obtain top notch health services! In this set up, the uninsured are insured and objectives of the Fair Care to the Uninsured Act of 2003 will be met. This is very important. Those without insurance are sicker, die younger and receive less care for many conditions. The risk of illness increases the longer one is without insurance.
More emphasis from the USPHS for education, prevention and screening, eldercare, disabled care, chronic condition care/ chronic multisystem illness (CMI), health awareness, and education is needed. The Public Health clinic will evolve from the barely visible building or little trailer in the field to highly visible, easily accessible structures. Vacant malls and warehouse buildings can be bought and transformed to mini-medical facilities that provide it all. Pre-existing clinics in the area can be merged, or remain as satellite facilities. The goal is to have health care at every corner much like the neighborhood convenience store. The era for traveling 100 miles to your doctor, waiting half a day or more only to spend the average 5 minutes with your health care provider must cease.
Minnesota has set up a system that covered about 95% of its residents under 65 in 2001 (86% in 2000). It uses government and private insurance together to achieve insurability. "Approaching Universal Coverage: Minnesota’s Health Insurance Plans" by Debra Chollet & Lori Achman of Mathematica Research Policy, Inc.states that it has been successful at serving "all populations in need at all levels of income". Coverage is included for the "medically uninsurable" like the person with chronic multisytem disease, or pre-existing conditions. Its GAMC and MA plans includes coverage for expenses that occurred in the 3 months prior to application, and do not have premiums or co-pays. Minnesota's programs have been, or are currently used in other states, and can be used to help lay the foundation for health care uniformity. The Commonwealth Fund has several publications that look at other states' health systems, and universal health coverage.
The effort to consolidate the American health system is a priority. Karen Davis' summary, "Time to Change: The Hidden Cost of a Fragmented Health Insurance System", states that the present system "is not up to the challenge of ensuring a healthy and productive nation because it is 'fragmented' ". The focus of her summary exemplifies how lack of uniform health services costs more with less results.
Attention must also be placed on employer health provisions. In 2002 companies spent an average of $6500 per person for health care. This does not include the patients' out of pocket payment for services. The pages of uncovered services listed in many insurance handbooks grows longer. About 41 million employed by small business pay directly for services at prices compatible with the Medicare and Medicaid models. Through the leadership of the Public Health Service all businesses are uninsured primarily because it is unaffordable. Congress is presently looking at a concept called an Association Health Plan (AHP) as part of the Small Business Health Fairness Act. This would allow small business owners to offer large corporation health discounts. It would also be uniform nationwide. The AHP is in use in some states, and has come and gone in some. Last year 16 states closed down 48 AHP plans. This would be a great opportunity to "phase in" national coverage. As employer health programs are phased out, patients should be offered the option to obtain national insurance. Each person preventive and screening will be done without charge. Eventually this will lead to a healthier people, and health system at a much lower cost.
martes, 16 de octubre de 2012
Health Education Affects Your Health & Care
Care systems can be set up based on the prevalence of disease and proven preventive measures. For instance, heart disease kills about 1 million/ year, and about 1.5 million hospitalizations occur as a result. We can build on existing programs that focus on guidelines and evidence-based data for the most prevalent conditions, and implement them in our clinics. The USPSTF is dedicated to this type of service. The USPSTF recently found evidence that early detection (with bone density tests), and treatment of osteoporosis in women without symptoms reduced the risk of fractures. Globally speaking, the recent World Cancer Report by WHO has found that cancer may rise by 50% by 2020. One third of these can be prevented. That is very significant! The following table lists (British Medical Journal, March 29, 2003) the costliest conditions to treat.
Alongside the USPHS is the HHS which has in place the ACHI, Association for Community Health Improvement. This group focuses on communities
networking together for better health. It is in 42 states (D.C. and Canada), and is composed of people from different areas of medicine. This is a valuable resource to use in developing health system uniformity because it is almost nationwide, at the local community level, and very diversified. HHS has 300 programs that help in "protecting the health of all Americans and providing essential human services". The Medicare program is the largest health insurer in the nation. In April 2003 HHS had a national
summit, "Steps to a Healthier USA: Putting Prevention First" that addressed prevention and promotion of healthy lifestyles. Funds ($15 million) for “Healthy
Communities” will help communities do their part. The ODPHP works to promote disease prevention and healthy living. Their program, Healthy People 2010* is "the prevention agenda for the Nation". It outlines health objectives for the Nation.
Providing more health information is vital. TV is the most powerful, and most accessed way to get information. Almost everybody watches TV, has a TV, and talks about what is on TV (even if they say they don't watch TV you can be sure you will be asked, "Did you see on TV..."). In addition to public service announcements, more television programming on health issues can be added to the daily schedule on existing channels. Eventually Public Health TV will be available with daily medical news, and basic health information. After all, we have 24-7 dedicated channels for theology, sports, news, finance, cartoons, and music, to name a few, yet basic health programming is still in its infancy.
More basic health information should be available. Health TV channels now tend to focus on lifestyle changes (cooking, exercise, etc.), and reality shows focusing on emergencies, patient procedures, etc.. In the news media there is an occasional mention of the latest outbreak of the disease of the month, and maybe a mention of a profound medical study. This is good, but there is a need for more basic information programming that lets me know about this hypertension that I have, or the headache that won’t go away, or what doctor should I see for what I have. We need to know all the risks and complications as well as the different treatments for what we have so a more informed decision can be made. Like going on the Internet, or to a textbook, there will be a program that addresses a particular health concern. A daily health news show highlighting the latest medical developments is greatly needed. The Internet provides such information.
There are webcasts on the Internet that are becoming more accessible for professionals and the public. Some managed care providers have treatment guidelines for enrollees and doctors to view on their websites. The mantra for the 21rst century will be, "If
doctors don't educate themselves, patients will educate them". Most people have a TV so what better place to start. In the future, computers will be in almost every home, too. With the Internet patients are able to access the same information as their doctor.
Providing educational materials that are easy to read and understand, i.e. at the lowest grade level possible, are essential, and key. This includes audio and visual learning - books, television, tapes, CDs, computer - as well as direct teaching. This is available
on the Internet with health sites just for kids like www.kidshealth.org and www.bam.gov . Health literacy systems can be of more use for distance learning technology via webcast teleconferences, and television programming. Learning in the home is effective and convenient.
Let your health home schooling begin!
*now Healthy People 2020
|
The 15 costliest treatments (and number of people with diagnosis) in 1997 Cancer $46bn (9 million) Trauma $44bn (37 million) Mental disorders $30bn (20 million) Diabetes $20bn (10 million) Hypertension $18bn (27 million) Cerebrovascular disease $16bn (2 million) Osteoarthritis $16bn, (16 million) Pneumonia $16bn (4 million) Back problems $13bn (13 million) Kidney disease $10bn (2 million) Endocrine disorders $10bn (18 million) Skin disorders $9bn (20 million) |
Alongside the USPHS is the HHS which has in place the ACHI, Association for Community Health Improvement. This group focuses on communities
networking together for better health. It is in 42 states (D.C. and Canada), and is composed of people from different areas of medicine. This is a valuable resource to use in developing health system uniformity because it is almost nationwide, at the local community level, and very diversified. HHS has 300 programs that help in "protecting the health of all Americans and providing essential human services". The Medicare program is the largest health insurer in the nation. In April 2003 HHS had a national
summit, "Steps to a Healthier USA: Putting Prevention First" that addressed prevention and promotion of healthy lifestyles. Funds ($15 million) for “Healthy
Communities” will help communities do their part. The ODPHP works to promote disease prevention and healthy living. Their program, Healthy People 2010* is "the prevention agenda for the Nation". It outlines health objectives for the Nation.
Providing more health information is vital. TV is the most powerful, and most accessed way to get information. Almost everybody watches TV, has a TV, and talks about what is on TV (even if they say they don't watch TV you can be sure you will be asked, "Did you see on TV..."). In addition to public service announcements, more television programming on health issues can be added to the daily schedule on existing channels. Eventually Public Health TV will be available with daily medical news, and basic health information. After all, we have 24-7 dedicated channels for theology, sports, news, finance, cartoons, and music, to name a few, yet basic health programming is still in its infancy.
More basic health information should be available. Health TV channels now tend to focus on lifestyle changes (cooking, exercise, etc.), and reality shows focusing on emergencies, patient procedures, etc.. In the news media there is an occasional mention of the latest outbreak of the disease of the month, and maybe a mention of a profound medical study. This is good, but there is a need for more basic information programming that lets me know about this hypertension that I have, or the headache that won’t go away, or what doctor should I see for what I have. We need to know all the risks and complications as well as the different treatments for what we have so a more informed decision can be made. Like going on the Internet, or to a textbook, there will be a program that addresses a particular health concern. A daily health news show highlighting the latest medical developments is greatly needed. The Internet provides such information.
There are webcasts on the Internet that are becoming more accessible for professionals and the public. Some managed care providers have treatment guidelines for enrollees and doctors to view on their websites. The mantra for the 21rst century will be, "If
doctors don't educate themselves, patients will educate them". Most people have a TV so what better place to start. In the future, computers will be in almost every home, too. With the Internet patients are able to access the same information as their doctor.
Providing educational materials that are easy to read and understand, i.e. at the lowest grade level possible, are essential, and key. This includes audio and visual learning - books, television, tapes, CDs, computer - as well as direct teaching. This is available
on the Internet with health sites just for kids like www.kidshealth.org and www.bam.gov . Health literacy systems can be of more use for distance learning technology via webcast teleconferences, and television programming. Learning in the home is effective and convenient.
Let your health home schooling begin!
*now Healthy People 2020
How Health Education Affects Your Health
Over the long term prevention saves lives and money. Preventive care should have a primary focus from cradle to grave. Studies to prove its efficacy in combination with evidence-based guidelines deserve attention. A study to determine if the history and physical exam, lab tests, body scan, and other diagnostic tests helps in the prevention, diagnosis, and treatment of disease would probably show us better overall outcomes as well as less cost than if the conditions were not detected early.
EDUCATION BEGINS AT HOME. Public education begins at home, in schools, and in the community (e.g. medical facilities, church, stores). Education focused on self management of asthma has been shown to improve clinical outcomes (British Medical Journal, June 2003). Basic medicine should start formally at the preschool level. Thereafter, basic classes in medicine and interactive education such as a student presenting a medical project, or volunteering in a medical capacity, should also be available. This can be used as education credits in high school and college. Our children are our future and our inspiration. Let's see their medical visions for America’s health system today!
EDUCATION SHOULD BE FREE. In Qatar this is the case. Incidentally, health care is free there, too. They have developed a relationship with several of our medical schools, and have actual campuses. Let’s build on this, and in turn study with them to see how we can make our system better...and free. We live in a nation where many choose military service to get a free education. This is an enormous commitment to make for something everyone is entitled to.
Modifying the education process hopefully will provide more doctors, and make more want to be doctors. Funding a study on the correlation of the length of medical training with quality of job performance after training would tell if three years of medical
school be as good as four. If so, this will lead to earlier entry into the actual job as doctor with less cost for university and student = more appealing for people to seek this as their occupation = more doctors, and other health care workers. It should be easier for a health care worker to "upgrade" to a doctor. For example, a physician assistant that wants to be a doctor should not be expected to study another four years. The high cost for education becomes a large debt to be paid back on a lower salary while training. The cost for medical school is approaching $100,000*. An option is to expand the scope of practice for health providers that are experienced with clinical skills near the physician level to provide the same services. These will be the "diagnosticians".
The IOM report "Health Professions Education: A Bridge to Quality" (April 2003), has found that health care professionals "are not being adequately prepared to provide the best and safest medical care possible, and there is insufficient assessment of their ongoing proficiency". They propose that the education process will be focused on five areas: delivery of patient-centered care, working as a team member that is interdisciplinary, use of evidence- based protocols, the application of quality measures, and the use of IT. Oversight by groups that license, accredit, and certify will be used to improve education for health providers. New standards that accurately assess proficiency of skills are being developed and used. As this is developed, the licensing system should be addressed to ensure uniformity. It would make sense for health care professionals to have one license for practice in all states. Standards for licensing should be the same in all states. This allows for a seamless integration of health provider service and care, as well as a more effective use of these services. Like providers, patients should be able to obtain medical care in any state. That way a patient has the choice of going anywhere in the USA if they are unable to get the care they need in a timely manner in their state of primary residence. The European Union will allow patients to seek free medical care in any of the countries in its union effective 2004 (Canadian Medical Association).
As the population ages there will be a greater need for those with more experience in geriatrics, and chronic multisystem illness. Medical schools and the federal government will need to increase focus in this direction. The CDC notes that the people over 65 years old will increase from 35 to 70 million by the year 2030.
Baby boomers start retiring in 2011. This is about 12% of
population increasing to 20%. The Alliance for Aging estimates a need for 36,000 geriatricians (now there are about 9,000 with an estimated drop to 6,000 by 2004). Changes in the medical education process must be made to increase the overall number of qualified health care workers necessary to provide for all.
by J. L. Richardson, M.D.
excerpt from "Building An American Health System", 2003
*average debt for medical school in 2010 was $158,000 http://bit.ly/RA0QQZ
EDUCATION BEGINS AT HOME. Public education begins at home, in schools, and in the community (e.g. medical facilities, church, stores). Education focused on self management of asthma has been shown to improve clinical outcomes (British Medical Journal, June 2003). Basic medicine should start formally at the preschool level. Thereafter, basic classes in medicine and interactive education such as a student presenting a medical project, or volunteering in a medical capacity, should also be available. This can be used as education credits in high school and college. Our children are our future and our inspiration. Let's see their medical visions for America’s health system today!
EDUCATION SHOULD BE FREE. In Qatar this is the case. Incidentally, health care is free there, too. They have developed a relationship with several of our medical schools, and have actual campuses. Let’s build on this, and in turn study with them to see how we can make our system better...and free. We live in a nation where many choose military service to get a free education. This is an enormous commitment to make for something everyone is entitled to.
Modifying the education process hopefully will provide more doctors, and make more want to be doctors. Funding a study on the correlation of the length of medical training with quality of job performance after training would tell if three years of medical
school be as good as four. If so, this will lead to earlier entry into the actual job as doctor with less cost for university and student = more appealing for people to seek this as their occupation = more doctors, and other health care workers. It should be easier for a health care worker to "upgrade" to a doctor. For example, a physician assistant that wants to be a doctor should not be expected to study another four years. The high cost for education becomes a large debt to be paid back on a lower salary while training. The cost for medical school is approaching $100,000*. An option is to expand the scope of practice for health providers that are experienced with clinical skills near the physician level to provide the same services. These will be the "diagnosticians".
The IOM report "Health Professions Education: A Bridge to Quality" (April 2003), has found that health care professionals "are not being adequately prepared to provide the best and safest medical care possible, and there is insufficient assessment of their ongoing proficiency". They propose that the education process will be focused on five areas: delivery of patient-centered care, working as a team member that is interdisciplinary, use of evidence- based protocols, the application of quality measures, and the use of IT. Oversight by groups that license, accredit, and certify will be used to improve education for health providers. New standards that accurately assess proficiency of skills are being developed and used. As this is developed, the licensing system should be addressed to ensure uniformity. It would make sense for health care professionals to have one license for practice in all states. Standards for licensing should be the same in all states. This allows for a seamless integration of health provider service and care, as well as a more effective use of these services. Like providers, patients should be able to obtain medical care in any state. That way a patient has the choice of going anywhere in the USA if they are unable to get the care they need in a timely manner in their state of primary residence. The European Union will allow patients to seek free medical care in any of the countries in its union effective 2004 (Canadian Medical Association).
As the population ages there will be a greater need for those with more experience in geriatrics, and chronic multisystem illness. Medical schools and the federal government will need to increase focus in this direction. The CDC notes that the people over 65 years old will increase from 35 to 70 million by the year 2030.
Baby boomers start retiring in 2011. This is about 12% of
population increasing to 20%. The Alliance for Aging estimates a need for 36,000 geriatricians (now there are about 9,000 with an estimated drop to 6,000 by 2004). Changes in the medical education process must be made to increase the overall number of qualified health care workers necessary to provide for all.
by J. L. Richardson, M.D.
excerpt from "Building An American Health System", 2003
*average debt for medical school in 2010 was $158,000 http://bit.ly/RA0QQZ
miércoles, 8 de agosto de 2012
Health Books: Healing Reading
Reading good health books is a great way to improve your health and well being. The best books help you care for your health and encourage as well as teach. The following books are recommended primarily because they teach you things you can do for yourself that you can incorporate in your lifestyle to make it healthier.
Merck Manual for Health & Aging
by Merck
Savvy Patient Toolkit
by Margo Corbett
Why, Charlie Brown, Why? A Story About What Happens When a Friend Is Very Ill
by Charles M. Schulz
The Empowered Patient
by Elizabeth Cohen
What's Wrong with Me? The Frustrated Patient's Guide to Getting an Accurate Diagnosis
by Lynn M. Dannheisser & Jerry M. Rosenbaum M.D.
YOU: The Owner's Manual
by Mehmet Oz, M.D. & Michael F. Roizen. M.D.
Inner Pulse
by Marc Siegel. M.D.
Healing Back Pain
by John E. Sarno, M.D.
Living Well with Chronic Fatigue Syndrome
by Mary J. Shomon
New Choices in Natural Healing
by Doug Dollemore & Bill Gottlieb
Patient Handbook to Medical Care: Your Personal Health Guide
by J. L. Richardson, M.D.
Merck Manual for Health & Aging
by Merck
Savvy Patient Toolkit
by Margo Corbett
Why, Charlie Brown, Why? A Story About What Happens When a Friend Is Very Ill
by Charles M. Schulz
The Empowered Patient
by Elizabeth Cohen
What's Wrong with Me? The Frustrated Patient's Guide to Getting an Accurate Diagnosis
by Lynn M. Dannheisser & Jerry M. Rosenbaum M.D.
YOU: The Owner's Manual
by Mehmet Oz, M.D. & Michael F. Roizen. M.D.
Inner Pulse
by Marc Siegel. M.D.
Healing Back Pain
by John E. Sarno, M.D.
Living Well with Chronic Fatigue Syndrome
by Mary J. Shomon
New Choices in Natural Healing
by Doug Dollemore & Bill Gottlieb
Patient Handbook to Medical Care: Your Personal Health Guide
by J. L. Richardson, M.D.
miércoles, 18 de julio de 2012
Why Screening Tests Are Important
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 nay 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, FOBT; colonoscopy, baseline at 50
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 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 tiebreaker third because you were told different things by each doctor!) opinion is a reasonable research tool, also.
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!
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, FOBT; colonoscopy, baseline at 50
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 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 tiebreaker third because you were told different things by each doctor!) opinion is a reasonable research tool, also.
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!
lunes, 16 de julio de 2012
Ways to Protect Your Skin From Sun Damage
Remember to practice good skin care by keeping your skin safe from those damaging UVA and UVB rays that cause serious, irreparable sun damage and skin cancer. Simple things you can do include:
Best health!
by J. L. Richardson, MD, family practice physician, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide. http://amzn.to/13m51UU
- Limit sun exposure – avoid 10AM to 3PM, spend less than one hour in direct sun - less or none if fair complexion, burn easily, prone to skin cancer.
- Wear protective clothing – wide brim hats, long sleeves, long pants, skirts and/ or clothes made with sun protection fabric.
- Umbrella and shade.
- Use sunscreen SPF 15 or greater. Put on every hour if sweating or swimming. Put on every area exposed to sun, and be sure to remember behind those ears and on the neck.
- See your family doctor and/or dermatologist for moderate to severe sunburn, or any suspicious skin spots that fail to heal.
Best health!
by J. L. Richardson, MD, family practice physician, patient advocate, and author of Patient Handbook to Medical Care: Your Personal Health Guide. http://amzn.to/13m51UU
domingo, 15 de abril de 2012
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.
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.
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
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.
lunes, 19 de marzo de 2012
What Your Blood Tests Really Mean
When the doctor orders blood tests (also called lab tests, blood profile/ panel), she or he is checking for certain things. The most common tests are CBC (complete blood count), basic complete blood panel, and UA (urinalysis). The CBC checks the body’s WBCs (white blood cells) and RBCs (red blood cells). In the lab the cells are examined for size, shape, and number. The WBCs may tell if you may have some type of infection or leukemia(cancer of the white cells). The RBCs carry oxygen to the rest of the body. This is done by hemoglobin, which is carried inside the RBCs. Some inherited diseases, such as sickle cell
anemia and thallassemia, can be identified by abnormal RBC shape and size. Also included in the CBC is a platelet count. Platelets are cells that help your blood to clot, for instance to stop the bleeding after a flesh wound.
The basic complete blood panel measures many different things. Included in these tests are:
Other tests than those listed may be checked depending on your history and physical exam. Be sure you are scheduled for a return visit to follow up on all tests. Some doctors’ offices will also let you know by phone or mail, especially if there is an abnormal test that must be checked before your next appointment.
Your symptoms, the doctor’s physical findings, and blood test results are what the doctor looks at when deciding the next tests that need to be done. This and any additional tests may be used for screening, diagnosis of conditions, and for ongoing management of disease once it is present.
anemia and thallassemia, can be identified by abnormal RBC shape and size. Also included in the CBC is a platelet count. Platelets are cells that help your blood to clot, for instance to stop the bleeding after a flesh wound.
The basic complete blood panel measures many different things. Included in these tests are:
• Na = sodium
• Cl = chloride
• K = potassium
• Mg = magnesium
• Glc = glucose (sugar)
• Ca = calcium (bone mineral)
• PO4 = phosphate (bone mineral)
• BUN = blood urea nitrogen (kidney)
• Cr = creatinine (kidney)
• SGOT = serum glutamic oxaloacetic transaminase (liver)
• SGPT = serum glutamic pyruvic transaminase (liver)
• GGT = gamma glutamyl transferase (liver)
• Alk phos = alkaline phosphatase (liver, bone primarily—also gallbadder)
• Fe = iron
• TIBC = total iron binding capacity
• transferrin = iron
• uric acid = checks gout
• chol = cholesterol (fat)
• LDL = low density lipoprotein (“bad” cholesterol)
• HDL = high density lipoprotein (“good” cholesterol)
• TG = triglycerides (fat)
Blood panels may differ from lab to lab. The above tests make up the basic chemistry panel. This should be part of a routine checkup. Some panels may include more tests than those listed above. The urinalysis (UA) may or may not be included, but it is important. Urine tests are able to check for infection, sugar, blood, protein, and many other things. Additional tests that may be ordered by the doctor for preventive screening will depend on your symptoms, diagnosis, family history, and age. Some of these tests are:
• PSA = prostate specific antigen (prostate cancer test)
• TSH = thyroid stimulating hormone (thyroid function)
• T4 = thyroid hormone (thyroid hormone level)
• B12 = vitamin B12
• folate = B vitamin
The Pap smear test and stool for occult blood (blood in stool that cannot be seen with the
naked eye) should also be performed. The Pap smear is a test for females that checks for cancer of the cervix. The stool test, also called Hemoccult test, checks for blood in the stool, which may indicate bleeding from the bowels secondary to cancer, ulcers, or other serious conditions. Other tests than those listed may be checked depending on your history and physical exam. Be sure you are scheduled for a return visit to follow up on all tests. Some doctors’ offices will also let you know by phone or mail, especially if there is an abnormal test that must be checked before your next appointment.
Your symptoms, the doctor’s physical findings, and blood test results are what the doctor looks at when deciding the next tests that need to be done. This and any additional tests may be used for screening, diagnosis of conditions, and for ongoing management of disease once it is present.
martes, 26 de julio de 2011
Spill the Pills, Take a Knife Slice: Surgery vs. Conservative RX
Conservative treatment is the mainstay for many chronic diseases. This means that your healthcare team will most likely encourage you to avoid surgery unless it is life threatening issue. Why is the stigma of surgery avoidance associated with poor outcomes? This day in time savvy surgery techniques and fewer post operative complications complications are more likely to restore your quality of life to a livable level. In other words three years or more of taking pills with or without complimentary treatment can be more costly in the long run with a poor quality of life.
How will you know if surgery sooner rather than later is best for you? Talk with your doctors and healthcare providers. If you find there is disagreement, seek out more opinions until you find what is best for you. Surgery is preventive and can improve one's quality of life in months especially if conservative treatment fails. Conservative treatment may help, but after many years it is less likely and becomes more costly in every way primarily in worsening of symptoms.
Spare yourself countless years of needless suffering. Do your homework. See what treatments work best for you. Talk with your healthcare providers about new treatments, and look for doctors (specialists) who have experience in the area. If you've been getting around with the same nagging symptoms and watching your years pass you by without improvement or feeling good on the same treatment year after year, get on with it! Consider surgery if it is an option.
Great health is true wealth!
How will you know if surgery sooner rather than later is best for you? Talk with your doctors and healthcare providers. If you find there is disagreement, seek out more opinions until you find what is best for you. Surgery is preventive and can improve one's quality of life in months especially if conservative treatment fails. Conservative treatment may help, but after many years it is less likely and becomes more costly in every way primarily in worsening of symptoms.
Spare yourself countless years of needless suffering. Do your homework. See what treatments work best for you. Talk with your healthcare providers about new treatments, and look for doctors (specialists) who have experience in the area. If you've been getting around with the same nagging symptoms and watching your years pass you by without improvement or feeling good on the same treatment year after year, get on with it! Consider surgery if it is an option.
Great health is true wealth!
domingo, 20 de marzo de 2011
Your Physical Exam: Above the Waist
After your doctor has taken a thorough medical history, a complete physical exam (CPE) is performed. The doctor started your physical exam from the time you were greeted just by looking at you. Are you able to get up and shake hands? Are you able to sit back down? Is there a cane or walker lying beside you? Are you speaking clearly? Are you tearful? This and many other observations can tell the doctor a lot. So the physical has begun before the doctor puts a healing hand on you.
The head, eyes, ears, nose, and throat (HEENT) are usually inspected first. The doctor looks at the scalp for any hair loss or other abnormalities. Your head is palpated (touched and felt) to check for any lumps, swelling, or sore spots. The eyes are next. You will be asked to follow the doctor’s finger with your eyes up, down, left, right. This tests your eye muscles. Pulling down the lower eyelid and pulling up on the upper eyelid allows for inspection of the white of the eye and the eyelids. The eye reflex is checked by shining a light on the colored part of the eye and is done with the lights dimmed (or light off and door cracked). The doctor uses the ophthalmoscope (an instrument) to look inside the eye. The blood vessels and nerve to the eye can be seen. Certain abnormal findings in the eye indicate diabetes, high blood pressure, and other maladies. For any findings that are abnormal with the eye, you will be sent (“referred” is the
up-to-date term) to an ophthalmologist (eye specialist). Routine eye exams by the ophthalmologist may also detect some diseases that are known to progress toward blindness or other complications. Looking at and reading from an eye chart tests the vision.
Can you hear a whisper? How about a watch ticking? Faint noises close to the ears allow a doctor to check to see how well you can hear. Formal hearing tests (like audiometry) are done by an otolaryngology doctor, also known as the ENT (short for ear, nose, and throat) doctor. Hearing tests may also be done by hearing aid centers. The doctor uses the otoscope (the same instrument used for the eyes with an attachment made for looking in the ears) to look in the ear canal and at the eardrum. Using the same tool, each nostril and the mouth are inspected. A stick called a tongue blade is used to hold the tongue down when the doctor asks you to say “aaaaahhhhh.” This is done so that the throat and the rest of the mouth can be checked. This procedure also tests the nerve for the gagging reflex (part of the nervous system exam). A gloved finger may be used to palpate (touch) the inside of the mouth. Any problems here will earn you a referral to the ENT doctor or dentist. Now may be a good time to ask any questions about the exam thus far. Please wait for the doctor to remove the gloved hand first.
The neck exam is next. At this time the thyroid gland is palpated. This is best done while the doctor stands behind the patient and places the right hand around the right side of the neck and the left hand on the left side of the neck. If any swelling or lumps are noted, further blood tests and a thyroid and/or neck scan may be ordered by the doctor. The lymph node glands can also be checked at this time. They are located in the front, back, and sides of the neck. They are also in the armpit and groin and are checked with those parts of the body. The lymph nodes should not normally be enlarged. More blood tests and Xrays may be ordered if they are enlarged.
Inspection, palpation, and percussion (lightly tapping) as well as listening to the chest give the doctor a chance to check the lungs. The doctor listens with a tool called a stethoscope, which makes the sounds louder. It is placed on the bare skin (beware of the doctor who tries to listen on top of your clothes) starting at the top of your upper back moving from the left to right, or right to left, from the top to the bottom of the chest
while you take deep breaths. The same will be done on the chest.
Then the stethoscope will be placed over the heart on the left and right sides of the breastbone. These areas are where the heart valve sounds are heard best. You may also be
asked to do certain things like holding your breath or bearing down (as when having a bowel movement). This makes some murmurs easier to hear. Certain positions may also be better for hearing some heart sounds. Your doctor has been trained to listen for certain things. If any abnormal sounds are heard, more tests may be ordered. These may include an X-ray of the chest(CXR, for short) and heart tracing(electrocardiogram—EKG, for short). Usually these can be done in the office after completion of the exam. Depending on your complaints, symptoms, and the results of the CXR and EKG, you could require more tests that are not done in the primary care physician office.
The breast exam is also done at this time. The doctor will let you know exactly what is to be done. For female patients, it is recommended that a third person or chaperone be present when this exam is done. After the gown is lowered to the waist, the doctor looks at the breasts with the patient sitting up on the exam table. The breasts should look the same size (sometimes one can normally be a tad larger or smaller than the other) and shape with the nipple positioned centrally. The breast is also checked to make sure there is no abnormal swelling, lumps, skin discoloration, or skin changes. Next you will be asked to put your hands on your hips and then raise your arms above your head much like doing your own breast inspection in front of the mirror. The doctor will again look and examine for any abnormal places. While you lie down on the exam table, the doctor will palpate each breast up and down vertically from right to left or vice versa. Palpation in a circle from out to in is another technique used. Breast tissue under the arm is also checked. The nipples are then squeezed gently to check for any discharge. Deeper palpation of the axilla (armpit) is then performed to check the lymph node glands. These steps are then repeated on the opposite breast. Any abnormalities may warrant a
mammogram and/or sonogram and possibly a surgeon’s evaluation. Men should also receive a breast exam. This is a good time for the doctor to teach to do your own self breast exam (SBE).
Now it’s time to look, listen, tap, and feel the abdomen, the area many people refer to as the stomach. This is where the liver, spleen, kidneys, bowels, and female reproductive organs are located. With this lineup of important organs the doctor has a lot to check. This part of the exam is done in the supine (lying on your back) position. Looking at the abdomen for scars tells about anysurgery you may have had. Listening with the stethoscope for overactive or underactive bowel sounds and/or bruits (sounds made by abnormal blood flow through arteries when there is blockage) is next. By tapping and feeling, a doctor is able to check for enlargement of the vital organs listed and to make sure that there are no abnormal internal masses or swelling. At this time the groin is also checked for any enlarged lymph nodes. If there are any abnormalities, further tests will be ordered by the doctor.
Patient Handbook to Medical Care: Your Personal Health Guide
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The head, eyes, ears, nose, and throat (HEENT) are usually inspected first. The doctor looks at the scalp for any hair loss or other abnormalities. Your head is palpated (touched and felt) to check for any lumps, swelling, or sore spots. The eyes are next. You will be asked to follow the doctor’s finger with your eyes up, down, left, right. This tests your eye muscles. Pulling down the lower eyelid and pulling up on the upper eyelid allows for inspection of the white of the eye and the eyelids. The eye reflex is checked by shining a light on the colored part of the eye and is done with the lights dimmed (or light off and door cracked). The doctor uses the ophthalmoscope (an instrument) to look inside the eye. The blood vessels and nerve to the eye can be seen. Certain abnormal findings in the eye indicate diabetes, high blood pressure, and other maladies. For any findings that are abnormal with the eye, you will be sent (“referred” is the
up-to-date term) to an ophthalmologist (eye specialist). Routine eye exams by the ophthalmologist may also detect some diseases that are known to progress toward blindness or other complications. Looking at and reading from an eye chart tests the vision.
Can you hear a whisper? How about a watch ticking? Faint noises close to the ears allow a doctor to check to see how well you can hear. Formal hearing tests (like audiometry) are done by an otolaryngology doctor, also known as the ENT (short for ear, nose, and throat) doctor. Hearing tests may also be done by hearing aid centers. The doctor uses the otoscope (the same instrument used for the eyes with an attachment made for looking in the ears) to look in the ear canal and at the eardrum. Using the same tool, each nostril and the mouth are inspected. A stick called a tongue blade is used to hold the tongue down when the doctor asks you to say “aaaaahhhhh.” This is done so that the throat and the rest of the mouth can be checked. This procedure also tests the nerve for the gagging reflex (part of the nervous system exam). A gloved finger may be used to palpate (touch) the inside of the mouth. Any problems here will earn you a referral to the ENT doctor or dentist. Now may be a good time to ask any questions about the exam thus far. Please wait for the doctor to remove the gloved hand first.
The neck exam is next. At this time the thyroid gland is palpated. This is best done while the doctor stands behind the patient and places the right hand around the right side of the neck and the left hand on the left side of the neck. If any swelling or lumps are noted, further blood tests and a thyroid and/or neck scan may be ordered by the doctor. The lymph node glands can also be checked at this time. They are located in the front, back, and sides of the neck. They are also in the armpit and groin and are checked with those parts of the body. The lymph nodes should not normally be enlarged. More blood tests and Xrays may be ordered if they are enlarged.
Inspection, palpation, and percussion (lightly tapping) as well as listening to the chest give the doctor a chance to check the lungs. The doctor listens with a tool called a stethoscope, which makes the sounds louder. It is placed on the bare skin (beware of the doctor who tries to listen on top of your clothes) starting at the top of your upper back moving from the left to right, or right to left, from the top to the bottom of the chest
while you take deep breaths. The same will be done on the chest.
Then the stethoscope will be placed over the heart on the left and right sides of the breastbone. These areas are where the heart valve sounds are heard best. You may also be
asked to do certain things like holding your breath or bearing down (as when having a bowel movement). This makes some murmurs easier to hear. Certain positions may also be better for hearing some heart sounds. Your doctor has been trained to listen for certain things. If any abnormal sounds are heard, more tests may be ordered. These may include an X-ray of the chest(CXR, for short) and heart tracing(electrocardiogram—EKG, for short). Usually these can be done in the office after completion of the exam. Depending on your complaints, symptoms, and the results of the CXR and EKG, you could require more tests that are not done in the primary care physician office.
The breast exam is also done at this time. The doctor will let you know exactly what is to be done. For female patients, it is recommended that a third person or chaperone be present when this exam is done. After the gown is lowered to the waist, the doctor looks at the breasts with the patient sitting up on the exam table. The breasts should look the same size (sometimes one can normally be a tad larger or smaller than the other) and shape with the nipple positioned centrally. The breast is also checked to make sure there is no abnormal swelling, lumps, skin discoloration, or skin changes. Next you will be asked to put your hands on your hips and then raise your arms above your head much like doing your own breast inspection in front of the mirror. The doctor will again look and examine for any abnormal places. While you lie down on the exam table, the doctor will palpate each breast up and down vertically from right to left or vice versa. Palpation in a circle from out to in is another technique used. Breast tissue under the arm is also checked. The nipples are then squeezed gently to check for any discharge. Deeper palpation of the axilla (armpit) is then performed to check the lymph node glands. These steps are then repeated on the opposite breast. Any abnormalities may warrant a
mammogram and/or sonogram and possibly a surgeon’s evaluation. Men should also receive a breast exam. This is a good time for the doctor to teach to do your own self breast exam (SBE).
Now it’s time to look, listen, tap, and feel the abdomen, the area many people refer to as the stomach. This is where the liver, spleen, kidneys, bowels, and female reproductive organs are located. With this lineup of important organs the doctor has a lot to check. This part of the exam is done in the supine (lying on your back) position. Looking at the abdomen for scars tells about anysurgery you may have had. Listening with the stethoscope for overactive or underactive bowel sounds and/or bruits (sounds made by abnormal blood flow through arteries when there is blockage) is next. By tapping and feeling, a doctor is able to check for enlargement of the vital organs listed and to make sure that there are no abnormal internal masses or swelling. At this time the groin is also checked for any enlarged lymph nodes. If there are any abnormalities, further tests will be ordered by the doctor.
Patient Handbook to Medical Care: Your Personal Health Guide
http://amzn.to/13m51UU FREE with kindle unlimited!
miércoles, 22 de diciembre de 2010
Healthy, Wealthy and Wise
Prevention and wellness.
Transform America to a wellness society.
Wellness and prevention are missing...make them a centerpiece of healthcare reform.
Promote wellness and prevent disease.
Transition from sick care to a true health care system.
Preventing illness and staying well are as important as curing illness.
Wellness and disease prevention are as important to your health as early detection and treatment. If we incoporate this into our healthy lifestyle agenda, we will stay on the right path to Healthy People 2020, the nation's health promotion and disease prevention program. Wellness, health maintenance, prevention and early detection will make you healthier, wealthier, and wiser!
by J. L. Richardson, M.D., family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide, a premiere health guide that helps you and your health care team take the best care of you.
Tweet with Dr. Richardson
Patient Handbook Website
Transform America to a wellness society.
Wellness and prevention are missing...make them a centerpiece of healthcare reform.
Promote wellness and prevent disease.
Transition from sick care to a true health care system.
Preventing illness and staying well are as important as curing illness.
Wellness and disease prevention are as important to your health as early detection and treatment. If we incoporate this into our healthy lifestyle agenda, we will stay on the right path to Healthy People 2020, the nation's health promotion and disease prevention program. Wellness, health maintenance, prevention and early detection will make you healthier, wealthier, and wiser!
by J. L. Richardson, M.D., family medicine doctor and author of Patient Handbook to Medical Care: Your Personal Health Guide, a premiere health guide that helps you and your health care team take the best care of you.
Tweet with Dr. Richardson
Patient Handbook Website
domingo, 14 de noviembre de 2010
Health Books: Must Read Healing, Part 2
Health literacy is the sure way to help you and your health care team make the best medical decisions for you. Making healthy lifestyles permanent is one of the keys to good health. The following books are recommended primarily because they teach you things you can do for yourself that you can incorporate in your lifestyle to make it healthier.
Barney & Baby Bop Go to the Doctor
by Margie Larson
Women's Bodies, Women's Wisdom
by Christiane Northrup M.D.
The Medical Advisor: Complete Guide to Alternative & Complimentary Treament
by TIME Life Books
Dr. Koop's Self Care Advisor
by Everett C. Koop, M.D.
Merck Manual
by Merck
Savvy Patient Toolkit
by Margo Corbett
The Empowered Patient
by Elizabeth Cohen
Patient Handbook to Medical Care: Your Personal Health Guide
by J. L. Richardson, M.D.
Best health!
Barney & Baby Bop Go to the Doctor
by Margie Larson
Women's Bodies, Women's Wisdom
by Christiane Northrup M.D.
The Medical Advisor: Complete Guide to Alternative & Complimentary Treament
by TIME Life Books
Dr. Koop's Self Care Advisor
by Everett C. Koop, M.D.
Merck Manual
by Merck
Savvy Patient Toolkit
by Margo Corbett
The Empowered Patient
by Elizabeth Cohen
Patient Handbook to Medical Care: Your Personal Health Guide
by J. L. Richardson, M.D.
Best health!
viernes, 5 de noviembre de 2010
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!
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!
sábado, 30 de octubre de 2010
What Internet Does For You & Your Health
Prior to any medical diagnosis you or doctor visit, you are able to check things out for yourself. Textbooks in your personal home library and the public library along with information your health care providers may have given you is initial information most patients are exposed to initially. The Internet is now the primary source for health information for patients and health care providers all over the world. This is the only place you can find valid, up-to-date medical information from all over the world. In a few hours you know as much if not more than any new medical school graduate about your health conditions.
A survey done by the CDC (Center for Disease Control) reports that over 50% of Americans look up health information on line in 2009. Women were more likely than men to research health information on the Internet. Direct patient-doctor interactions like email, prescription refills, and appointments were used infrequently (5%). Disease specific information is the most searched health information followed by medication. nutrition and fitness.* Most of the patients discussed their findings with their doctors. Key word search using the search engine, Google, was the primary way information was located. Specific websites were second. Over 98% reported the material was reliable and easy to understand.
Information like this helps you and your medical care team help you get the best care possible. Wellness, prevention, early detection and treatment are a few hours and a few clicks away - free. The Internet is a valuable resource that does the following:
by J.L. Richardson, M.D., family medicine physician and author of Patient Handbook to Medical Care: Your Personal Health Guide.
*study from Dept. of Family Medicine, Wayne State University School of Medicine, Journal of American Board of Family Medicine, 2006
A survey done by the CDC (Center for Disease Control) reports that over 50% of Americans look up health information on line in 2009. Women were more likely than men to research health information on the Internet. Direct patient-doctor interactions like email, prescription refills, and appointments were used infrequently (5%). Disease specific information is the most searched health information followed by medication. nutrition and fitness.* Most of the patients discussed their findings with their doctors. Key word search using the search engine, Google, was the primary way information was located. Specific websites were second. Over 98% reported the material was reliable and easy to understand.
Information like this helps you and your medical care team help you get the best care possible. Wellness, prevention, early detection and treatment are a few hours and a few clicks away - free. The Internet is a valuable resource that does the following:
- provide you with information that will keep you healthy and well
- help you find the latest research, clinical trials, treatments, doctors for any illness
- allow you to communicate with your health care providers directly (email, telemedicine)
- find and share research thereby promoting your health literacy i.e learning and teaching for every one involved
- help you find virtual and real communities that provide support for your conditions and diseases as well as social interaction
- search and shop for insurance and other medical aid, supplies, etc.
by J.L. Richardson, M.D., family medicine physician and author of Patient Handbook to Medical Care: Your Personal Health Guide.
*study from Dept. of Family Medicine, Wayne State University School of Medicine, Journal of American Board of Family Medicine, 2006
martes, 28 de septiembre de 2010
Body Scan for Early Detection
No prescription is needed for a body scan.. This is one of the most efficient health assessment tools that appears to be under utilized by the medical profession (fear of finding stuff they are unable to answer?). It is rather affordable, however, results yielded may pave the way for more expensive tests.
Reasons you should have a body scan:
_early detection of disease
_baseline exam for future reference & comparison
_follow chronic disease & abnormal findings like incidentalomas
more on these incidental findings here: http://bit.ly/9ANS09
Physical exams fail to pick up disease at the earliest possible stage. Total body scanning in conjunction with a physical exam and blood tests increase the likelihood that health issues will be detected earlier.
Best health!
by J.L. Richardson, M.D., family medicine physician and author of Patient Handbook to Medical Care: Your Personal Health Guide"
http://www.mypatienthandbook.com/
www.twitter.com/MD4U
Reasons you should have a body scan:
_early detection of disease
_baseline exam for future reference & comparison
_follow chronic disease & abnormal findings like incidentalomas
more on these incidental findings here: http://bit.ly/9ANS09
Physical exams fail to pick up disease at the earliest possible stage. Total body scanning in conjunction with a physical exam and blood tests increase the likelihood that health issues will be detected earlier.
Best health!
by J.L. Richardson, M.D., family medicine physician and author of Patient Handbook to Medical Care: Your Personal Health Guide"
http://www.mypatienthandbook.com/
www.twitter.com/MD4U
jueves, 2 de septiembre de 2010
Prevention Checkups: Is It Time for You?
Staying healthy and disease-free is what prevention is about. The complete physical is the beginning of prevention. The breast exam checks for cancer, as do the Pap smear and rectal examination. Depending on your age and sex, there are guidelines for when to have certain tests. These guidelines are recommended by health organizations such as the U.S. Preventive Services Task Force, American College of Physicians, American Cancer Society, and American Heart Association. These guidelines are by no means laws, but they serve as useful suggestions for you and your doctor to use in your prevention and treatment program.
So how often should you have a complete physical? When is it time for your next tetanus shot? I have reviewed guidelines from the various health organizations mentioned above and compiled a summary of adult preventive care standards. These are also based on my own clinical experiences and on the number of lives saved by doing tests, regardless of whether the time frame of the guidelines was observed.
ADULT PREVENTIVE STANDARDS
AGE:------------18–25----26–40 ----41–60----60+
Physical Exam 1–3 years 1–3 years 1–2 years yearly
Height/Weight 1–3 years 1–3 years 1–2 years biannual
Blood Pressure 1–3 years 1–3 years every year biannual
Eyes and Ears 1–3 years 1–3 years 1–2 years every year
Mouth 1–3 years 1–3 years 1–2 years every year
Breast Exam every year every year every year every year
Pap Smear* 1–2 years every year every year 1–3 years
Prostate Exam if needed if needed every year every year
Scrotal Exam every year every year every year every year
Rectal Exam if needed if needed every year every year
Stool Blood if needed if needed every year every year
COMPLETE BLOOD PANEL
AGE:---------18–25----26–40 ----41–60----60+
Lipid Panel 5 years 5 years every year every year
Liver Panel 5 years 5 years every year every year
Hepatitis 5 years 5 years every year every year
Kidney 5 years 5 years every year every year
Blood Count 5 years 5 years every year every year
Thyroid 5 years 5 years every year every year
Urine 5 years 5 years every year every year
Electrolytes 5 years 5 years every year every year
Glucose 5 years 5 years every year every year
Prostate (PSA) if needed if needed every year every year
HIV — test if any risk factors or exposure —
IMMUNIZATIONS**
AGE:----------------18–25----26–40 ----41–60----60+
Tetanusdiphtheria 10 years 10 years 10 years 10 years
Pneumococcal — as needed for persons at risk — once after 65
Influenza (flu) — as needed for persons at risk — every year
Hepatitis — — — — as needed for persons at risk — — — —
Measles-Mumps-Rubella — — if no antibodies, get 2nd dose — —
TESTS / PROCEDURES
AGE:---------18–25----26–40 ----41–60--------60+
Mammogram if needed 2–3 years every year every year
Chest X-ray baseline if needed if needed if needed
Electrocardiogram — — baseline — — every year every year
Colonoscopy if needed if needed 3–5 years 1–3 years
Body Scan baseline 1–3 years 1–3 years 1–3 years
DENTAL — — — — — — every year — — — — — —
MENTAL — — — — — — as needed — — — — — —
For any abnormalities, repeat screening and follow-up should be done sooner or more frequently depending on the individual person. For example, if your cholesterol is found to be increased when you are 18 years old or younger, you would want to have that checked at least every year instead of every five years. For people with a family history of breast cancer, yearly mammograms may start as early as the twenties.
Persons with a history of chronic illness (diabetes, hypertension, cancer, etc.) should have a yearly physical regardless of age. Frequent routine visits during the year are also in order for those with any chronic illness. In addition to preventive health screening tests, preventive health counseling is also very important. In addition to the doctor’s verbal counseling, ask for patient education references. Reading and knowing as much as you can about staying healthy also helps improve your quality of life and can make you feel better!
*Some sources recommend that after two normal PAP smears, repeat every 1–3 years.
**For further details, refer to the “Recommended Adult Immunization Schedule” published by The Advisory Committee on Immunization Practices (ACIP) from the Centers for Disease Control and Prevention (CDC).
So how often should you have a complete physical? When is it time for your next tetanus shot? I have reviewed guidelines from the various health organizations mentioned above and compiled a summary of adult preventive care standards. These are also based on my own clinical experiences and on the number of lives saved by doing tests, regardless of whether the time frame of the guidelines was observed.
ADULT PREVENTIVE STANDARDS
AGE:------------18–25----26–40 ----41–60----60+
Physical Exam 1–3 years 1–3 years 1–2 years yearly
Height/Weight 1–3 years 1–3 years 1–2 years biannual
Blood Pressure 1–3 years 1–3 years every year biannual
Eyes and Ears 1–3 years 1–3 years 1–2 years every year
Mouth 1–3 years 1–3 years 1–2 years every year
Breast Exam every year every year every year every year
Pap Smear* 1–2 years every year every year 1–3 years
Prostate Exam if needed if needed every year every year
Scrotal Exam every year every year every year every year
Rectal Exam if needed if needed every year every year
Stool Blood if needed if needed every year every year
COMPLETE BLOOD PANEL
AGE:---------18–25----26–40 ----41–60----60+
Lipid Panel 5 years 5 years every year every year
Liver Panel 5 years 5 years every year every year
Hepatitis 5 years 5 years every year every year
Kidney 5 years 5 years every year every year
Blood Count 5 years 5 years every year every year
Thyroid 5 years 5 years every year every year
Urine 5 years 5 years every year every year
Electrolytes 5 years 5 years every year every year
Glucose 5 years 5 years every year every year
Prostate (PSA) if needed if needed every year every year
HIV — test if any risk factors or exposure —
IMMUNIZATIONS**
AGE:----------------18–25----26–40 ----41–60----60+
Tetanusdiphtheria 10 years 10 years 10 years 10 years
Pneumococcal — as needed for persons at risk — once after 65
Influenza (flu) — as needed for persons at risk — every year
Hepatitis — — — — as needed for persons at risk — — — —
Measles-Mumps-Rubella — — if no antibodies, get 2nd dose — —
TESTS / PROCEDURES
AGE:---------18–25----26–40 ----41–60--------60+
Mammogram if needed 2–3 years every year every year
Chest X-ray baseline if needed if needed if needed
Electrocardiogram — — baseline — — every year every year
Colonoscopy if needed if needed 3–5 years 1–3 years
Body Scan baseline 1–3 years 1–3 years 1–3 years
DENTAL — — — — — — every year — — — — — —
MENTAL — — — — — — as needed — — — — — —
For any abnormalities, repeat screening and follow-up should be done sooner or more frequently depending on the individual person. For example, if your cholesterol is found to be increased when you are 18 years old or younger, you would want to have that checked at least every year instead of every five years. For people with a family history of breast cancer, yearly mammograms may start as early as the twenties.
Persons with a history of chronic illness (diabetes, hypertension, cancer, etc.) should have a yearly physical regardless of age. Frequent routine visits during the year are also in order for those with any chronic illness. In addition to preventive health screening tests, preventive health counseling is also very important. In addition to the doctor’s verbal counseling, ask for patient education references. Reading and knowing as much as you can about staying healthy also helps improve your quality of life and can make you feel better!
*Some sources recommend that after two normal PAP smears, repeat every 1–3 years.
**For further details, refer to the “Recommended Adult Immunization Schedule” published by The Advisory Committee on Immunization Practices (ACIP) from the Centers for Disease Control and Prevention (CDC).
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