Fast and Easy Health Tips

How to Prepare for an Acute Doctor’s Visit

“Just because you doctor has a name for your condition doesn’t mean he knows what it is.”

     Acute visits are appointments with the health care provider that revolve around a specific complaint.  Common examples of acute visits are cold symptoms, fever, stomach pain, diarrhea, constipation and weight loss.  Use this visit to focus on the current problem and not to discuss multiple other problems.  Acute visits are usually set up for short periods of time, often only 10 minutes.  There is limited time, so use that time wisely. 

     Come to the appointment prepared.  Filling out the acute visit form before the appointment assures proper information is transmitted to your health care provider.  When acutely ill, a prepared history can significantly enhance the doctor’s ability to accurately diagnosis and treat the problem.   Diagnosis can be made the majority of the time with only a history if the right questions are answered.  The problem is that the right questions are not always asked.  Solution: answer the questions before they are asked. 

     The next part of the acute visit is the physical exam that is preformed to confirm the findings on history.  If the history and physical are inconclusive, diagnostic tests are ordered.  

     Many of these tests can be eliminated with the use of a good history and physical exam.  While many diagnostic tests are necessary to make the diagnosis, many are not necessary and may cause more harm than good.  No test is without risk including immediate risk from the test such as risk of infection with a blood draw or long-term risk such as exposure to radiation from x-rays, CAT scans and MRIs. 

Fast and easy tips in Preparing for an Acute Visit

• Before the visit get a copy of the acute visit form at  https://sites.google.com/site/fastandeasyhealthtips  
• Record the name of the doctor you are seeing and the date you are seeing him 
• Describe why you are seeing the doctor. 
• Describe the symptoms you are presenting with.  Utilize the acute visit describing form at https://sites.google.com/site/fastandeasyhealthtips
• While at the appointment have the doctor give you a diagnosis and record it on the form at https://sites.google.com/site/fastandeasyhealthtips  
• Record the treatment including medications ordered, how to take the medications and side effects
• Record any follow up recommended by the doctor including: when to follow up, any situations that would require you to follow up sooner, any information that the doctor wants you to track to help her in the evaluation of the effectiveness of treatment
• Record any testing recommended by the doctor

Body Weight and Death

    A new study suggests that obesity and maybe being underweight increases the risk of death. 

   The increased death noted in the underweight group was likely related to underlying disease states that caused the weight loss.  Therefore being underweight by itself does not increase death rates, unless there is an underlying disease that caused the weight loss. 

     Having a body mass index over 30 is associated with an increased risk of stroke, heart disease and cancer.  The link to these diseases and being overweight (BMI between 25 and 29.9) is less clear.

    In the current study, which followed individuals over 10 years showed lower death rates in those who had a BMI between 20 and 24.9.  The risk of death was highest among those with BMI over 40.

    The chart below allows one to estimate the risk of death based on body weight.  Individuals with a body weight between 20 to 24.9 have a relative risk of death of one.  For example, if you have a body mass index of 35 your risk of death is 1.88 times as great as those who have a body mass index of 24. 

BMI	Relative risk
15-18.4	1.47
18.5-19.9	1.14
25-29.9	1.13
30.0-34.9	1.44
35.0-39.9	1.88
Over 40	2.51

Fast and Easy Health Tips

1. Know your body mass index.  Determine it at the website: http://www.nhlbisupport.com/bmi
2. If you are underweight – talk to your doctor about possible diseases that may be present contributing to you being underweight.
3. Lose weight if overweight
4. Talk to your doctor if you or obese, especially if you are morbidly obese
5. Exercise – even a little bit of physical activity reduces your risk of death

 

Berrington de Gonzalez, et al.  Body-Mass Index and Mortality among 1.46 Million White Adults. N Engl J Med 2010; 363:2211-2219

Exercise and Fitness in the Prevention of Cardiovascular Disease

Exercise is critical in the prevention of disease, particularly heart disease.  Twelve percent of all deaths in the United States is related to physical inactivity.  A few other key statistics include:

• Physical inactivity doubles  the risk of heart events
• Higher levels of physical fitness are linked to reduced rates of cardiovascular fitness
• Individuals who perform 30 minutes each day have a 23 percent lower risk of death.  

Studies have shown that exercise: 

• Lowers the risk of heart disease and cardiac arrest

• Aids in weight control – reduces fat
• Lowers blood pressure – 5-15 mm Hg
• Reduces triglycerides
• Lowers blood sugar
• Increases HDL cholesterol
• Reduces blood clotting
• Improves the function of the blood vessels
• Reduces the risk of heart rhythm problems
• Improves blood flow to the heart
• More intense exercise is linked to reduced cardiac risk

 Fast and Easy Health Tips

• Get moving
• Aim for 30 minutes of physical activity most days of the week
• Try to read something about exercise everyday - it will keep it at the forefront of your mind
• Review the benefits of exercise - they will help motivate you  

Diabetes on the Rise

     By 2050, about 33% of Americans will have diabetes, which is well up from current statistic of about 14%.  The main reason for this increase is the increase in obesity that is sweeping America and will continue to increase.  Other reasons for the increased prevalence of the disease include people living longer, the disease being diagnosed earlier and there are more non-Caucasians living in America, who are at higher risk for diabetes.

    Individuals need to be more proactive to prevent obesity and hense diabetes.     The Center for Disease Control goals to prevent diabetes include reducing body weight and increasing physical activity.                                                                                                                                                                                                                                                                                                                                                               Fast Fast and Easy Tips to Prevent Diabetes

1. Maintain or attain a healthy body weight
2. Increase physical activity to at least 150 minutes of moderate physical activity each week
3. Know you are at risk for diabetes (risk factors include: family history, obesity, elevated blood pressure and older age)
4. Talk to you doctor about getting screened for diabetes
5.  If you develop diabetes, learn the disease and become an active member in the management of your disease.

Calcium: Its not All Good

Calcium has long been known to improve bone health, but new research suggests that calcium supplements may increase the risk of heart disease. The use of calcium supplements increases the risk of a heart attack by 30%. It possibly does this by increasing the thickness of the blood and making blood vessels less compliant as calcium may build up in the artery wall. The study suggests that giving calcium to 1000 people will cause 14 more heart attacks and prevent 26 fractures in five years. High levels of calcium may also increase the risk of kidney stones and affect the absorption of iron, zinc and magnesium. Despite these facts, calcium is still an important nutrient and needs to be ingested to maintain health of the bones, heart and other organs. Ideally, it should be consumed naturally and not in excessive doses.

Fast an Easy Health Tips

1. Try to get calcium intake through food Get Vitamin D – about 1000 IU each day – not only is it healthy on its own, but it helps the body use the calcium more efficiently
2. Know foods that are high in calcium: dairy products (milk, cheese), green leafy vegetables, broccoli, sardines and calcium fortified juice
3. Know how much calcium you need: men and women age 9-18 – 1300 mg; 19-50 – 1000 mg; over 51 -1200 mg
4. Use calcium supplements only if unable to get the total amount of calcium from the diet and do not exceed the recommended allowance

Reference: Bolland MJ, Avenell A, Baron J, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2010; 341:c3691.

Coffee and Stroke

 A new study suggests that coffee increases the risk of stroke.  Those who drink one cup or less per day were the ones with increased risk for stroke, not those who drink coffee regularly.   Intermittent drinkers are at greater risk from the effects of coffee than regular drinkers.  The risk of having a stroke was noted to be twice as great in the hour after having a cup of coffee – the risk went back to baseline after two hours.  The same effect of stroke was not noted with the intake of cola or tea. 

     It is not clear what the triggering factor is, but caffeine is the most likely candidate. Caffeine is associated with increase in blood pressure and heart rate which may provide a physiological explanation for the increase in stroke. 

    Other studies have shown coffee is associated with an increase risk on cholesterol, insulin and homocystine.  Interestingly some studies show that coffee reduces the risk of type II diabetes. 

Fast and Easy Health Tips

1. Coffee is not bad to drink – for most people
2. Know if you are at high risk for stroke or heart disease.  You will know this because you have risk factors  such as: high blood pressure, older age, you smoke, high cholesterol, diabetes, obese and you are inactive. 
3. If you are at high risk and do not regularly drink coffee, do not have an occasional cup.
4. If you are at high risk, coffee has the theoretical possibility of increasing the risk of stroke so moderate your intake.

E. Mostofsky, et al. Coffee and acute ischemic stroke onset Neurology. 2010; 75: 1583-1588.

Aspirin and Death

     New research suggests that the use of long-term aspirin reduces the risk of dying from a multitude of cancers and this effect is greater in older individuals. 

This recent study showed:

• Aspirin from 75-300 mg a day lowered the risk of colorectal cancer by about 25% and the risk of death by about 33%. 
• After 20 years low dose aspirin lowers the risk of cancer death by 20% and 35% for gastrointestinal cancers.  Esophageal cancer was lowered by 60%, colorectal cancer by 40%, lung cancer by 30% and prostate cancer by 10%. 
• The protective effect is more noticeable over time with 15 years needed before a reduction in prostate cancer was noted, 10 years for stomach or colorectal cancer and five years for esophageal, lung, brain and pancreatic cancer. 
•  A reduction in esophageal and lung cancer was most noticeable in nonsmokers. 

     Negative effects of aspirin are generally an increase risk of bleeding; most commonly from the gastrointestinal tract or the brain. 

     In current day medicine, the main use of aspirin is to reduce the risk of cardiovascular disease but this benefit is weighed against its risk of bleeding complications.   Future guidelines may change – by promoting a more widespread use of aspirin - based on this study.  More research will be needed to determine the risk of long-term aspirin versus the new found benefits before doctors make any new official recommendations. 

Fast and Easy Health Tips

1. Determine if you have risk for bleeding (blood clotting disorder, frequent/heavy alcohol use, frequent use of anti-inflammatory medications [Motrin, Advil, Aleve, naproxen or ibuprofen], liver disease or a history of stomach ulcers or bleeding into the brain).
2. Talk to your doctor about this new study and if aspirin may be more beneficial than harmful for you to lower your risk of both cardiovascular disease and cancer.
3. If you are going to use aspirin use low dose aspirin and monitor for any bleeding complications. 

 

Rothwell R., et al.  Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials.  Lancet December 7, 2010

How to Create a Personal Health Care Record

Medical records are complex and contain multiple pieces of personal and medical information.  It is a vital that every health care provider has full knowledge of your medical history.  

     The personal health record, which is similar to a medical chart that a physician or health care system would keep on you, guarantees you are receiving the best health care possible.   With the fragmentation of the health care system it is important to have all health care information in one spot.  Maintaining your health record allows you to stay organized and transmit accurate information to your health care providers.  

    All of your physicians and every health care setting, such as hospitals, nursing homes and surgical clinics, keep a copy of your medical record.  Your medical record contains items that pertain to your health such as doctor’s notes, lab work, surgical reports, and radiological exams.    Your personal health record contains all things contained in a medical record – but more.  The personal health record assures that all of your health record is stored in one place.  No more worrying about if your primary care doctor did not get a copy of a lab test or diagnostic procedure – you will have a copy that you can share.  

     Medical records are often incomplete.  If you receive services from another health care provider or health care system, this information is likely not known to your doctor.  Communication within the health care system is not optimal; each individual must take that responsibility upon himself or herself.

     Using the worksheets provided in the attached links will allow you to set up your personal health care record.  The first step involves getting a three ring binder to place the forms needed to complete your record.  In the front page of the three-ring binder you should place the personal health care record table of contents to help you organize your information.  The three ring binder should be broken down into five sections.  Get five dividing sheets with tabs so the three ring binder is neatly organized.  Here is a list of sections you will create. 

1. Health History 
2. Medications 
3. Preventative Health Care 
4. Diagnostic Testing 

a)    Laboratory

b)    Radiology

c)    Procedures

d)    Surgeries

1. Health Care Encounters

a)    Doctor Visits

b)    Specialty Doctor visits

c)    Hospitalization/Nursing Home 

Forms are available to print off at: https://sites.google.com/site/fastandeasyhealthtips    Many other companies offer medical records on the internet in the electronic form.  Utilizing the link above will allow you to create a personal medical record that will significantly aid in the quality of your health care.  

 

 

Free Ebook: Antibiotics

      Here is a free ebook on your guide to common antibiotics that are used in the doctor's office.  Read this book before you take another antibiotic.  They are not as safe as your think. 

Download Guide to Understanding Antibiotics

 

10 Preventative Tests for Every Man

“Time is generally the best doctor.” – Ovid

     Preventative health care is a key to good health.  Unfortunately, many tests are not done in America.  Taking responsibility to assure that you get proper tests is a team effort between the doctor and patient. 

     As a patient you have more to lose if one of these tests are missed – take responsibility to assure that these tests are done.  The best way to do this is to print off a copy of the preventative health care worksheet at (https://sites.google.com/site/fastandeasyhealthtips  ) and record the dates that each one of these tests or screens is done.  Discuss each test that has not been done with your primary care doctor. 

    Below is a list of key preventative tests that each male should have or at least discuss the risks and benefits with your doctor.  Future blog entries will discuss further details about each of the screens. 

1. Cholesterol test - every 5 years starting at age 35, some say start at age 20
2. Diabetes screen – every 1-3 years after age 45, those with blood pressure more than 135/85 mm Hg or overweight individuals
3. Thyroid screen - at age 35 and then every five years
4. STD screen - testing for syphilis and HIV in high risk people.  Everyone should be screened for HIV at least once.
5. Bone density test – after age 50 in high risk individuals
6. Blood pressure screen - every 1-2 years
7. Prostate cancer screen –blood test every 2-4 years starting at age 40-50 
8. Colon cancer screen -  at age 50.  This can come in the form of checking for blood in the stool every  year, a sigmoidoscopy every five years or colonoscopy every 10 years
9. Depression screen – annually
10. Height and weight - annually