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When Is an Annual Stress Test Necessary?
Tweet Share on Facebook January 26, 2009 Comment (1)For a healthy, active person in his 60s, is it necessary to have an annual stress test and echocardiogram?
It is not necessary to get a yearly stress test and echocardiogram unless specifically indicated. If you are able to perform moderate to strenuous exercise without any symptoms such as chest pain or shortness of breath on exertion (e.g. swim a mile most days a week or any other form of substantial exercise) it tells us that even if you have atherosclerosis or blockage in your blood vessels to the heart, they are not significant to cause symptoms. However, the greater focus should be to continue living a healthful lifestyle including daily exercise, healthful eating habits (low saturated fat and diet richer in complex carbohydrates, whole grains, fruits, and vegetables) and modification of any cardiac risk factors such as hypertension and smoking. If you have elevated cholesterol and blood pressure based on your risk factors, then you should discuss with your physicians the role of starting any medications to control them. -
How Do Doctors Determine a Woman's Chances of Breast Cancer Recovery?
Tweet Share on Facebook January 26, 2009 Comment (1)So many women have had breast cancer and seem to be fine. If an individual woman turns up with breast cancer, can doctors figure out what her own chances are? And, does that information affect how she is treated?
Oncologists routinely use clinical risk-profiles, including tumor size, hormone receptor content, extent of involvement of the axillary nodes, and other factors discerned only when a pathologist examines the tumor cells under the microscope (sometimes referred to as the grade of the cancer cells). These factors can be used to provide a general clinical profile that estimates the risk of a future relapse, and thereby helps doctors and patients weigh the pros and cons of adjuvant ("helping") chemotherapy as an additional option. Such adjuvant therapy itself has recognized risks and quality-of-life issues, and the physician and patient must discuss these topics in order to personalize breast cancer management. However, some risk factors are open to subjective interpretation and may vary from one observer to another. -
Are We Overprotecting Our Kids From Infection?
Tweet Share on Facebook January 26, 2009 Comment (1)Some physicians think that we are overprotecting our kids from infection and that, as a result, they grow up with allergies and with poor immunity. Is it a good idea to let a young child play in the dirt and get all the routine diseases?
Over the past 20 or 30 years, many things have changed in the lives of families and children. Probably the best change has been that our children are protected from most bad infections like polio, measles, and bacterial blood infections. This is a direct result of the great advances in medicine and public health, especially antibiotics and vaccines. Other things have changed, too, like earlier enrollment in day care and, somewhat surprisingly, the increase in allergies. -
How Can Parents Keep Their Kids From Becoming Obese Without Triggering an Eating Disorder?
Tweet Share on Facebook January 26, 2009 CommentA growing number of children in the United States are obese. How can parents keep their kids from becoming obese without triggering an eating disorder, particularly in young girls?
Walk the talk. Without question, the best way to prevent or treat obesity in children is for parents to set the example themselves—eating healthfully and increasing physical activity. Parents must focus on healthful behaviors, not weight or looks. Teach the 80/20 concept: Make healthful choices 80 percent of the time and treat yourself 20 percent of the time. While caloric reduction is mandatory, deprivation and rigid restrictions of food do not work as a healthful long-term strategy for children.Here are some additional recommendations to prevent obesity and inactivity in children:
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Do Triglyceride Levels in the Blood Matter to the Heart?
Tweet Share on Facebook January 26, 2009 Comment (4)
Almost everyone knows his or her cholesterol level and understands the importance of this laboratory test as a predictor of the risk of heart disease. However, when physicians measure cholesterol, they almost always also measure a fatty substance known as triglycerides, the same kind of fat that's in foods and gets stored on our bodies. When high levels of triglycerides circulate in the blood they become a health and heart risk.Normal levels of triglycerides are less than 150 mg/dL. Levels greater than 500 mg/dL are particularly concerning because they are associated with development of pancreatitis, a serious and painful inflammation of the gland that gives us digestive enzymes and insulin.
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Should Patients Get Vitamin D Levels Checked During Periodic Physicals?
Tweet Share on Facebook January 26, 2009 Comment (9)
Vitamins are substances we ingest that our bodies need but which we cannot make ourselves. Hormones are substances our bodies can produce in one location which act at other sites in our bodies. Since sunlight acts on a precursor in our skin to produce vitamin D3,25, this is really a hormone rather than a vitamin. This molecule is hydroxylated at the one position to become vitamin D3 1-25, which is the active molecule in our body. Vitamin D3,25 levels are more stable and more accurately reflect actual vitamin D levels in our bodies than the 1-25 molecule. Now that this test is more widely available, we have discovered that vitamin D does far more than build strong bones, preventing rickets in children and osteoporosis in older adults. It may also enhance our immune system, and prevent infections and possibly malignancies including breast, prostate, and colon cancer. -
Can Fighting With My Spouse Affect My Health?
Tweet Share on Facebook January 26, 2009 CommentIs marital strife bad for your health? And is there a difference between women and men in their marital strife risk?
Marital strife can do more than make you heartsick. In studies from our lab where we asked couples to discuss a disagreement, those couples whose disagreements were more nasty or hostile showed much larger increases in stress hormones like epinephrine and norepinephrine during and after the argument, with wives showing much bigger changes than husbands. In one of our projects we created small blister wounds on our participants' arms to study how interpersonal stress affected wound healing. The wounds of couples who were nastier to each other while trying to resolve a disagreement took longer to heal than those of couples who could discuss their differences amiably. -
If I Want a Preventive Medicine Doctor, Where Can I Find One?
Tweet Share on Facebook January 26, 2009 Comment (3)A preventive medical examination is the best health insurance and life insurance you can buy. Today's health insurance is actually "disease" insurance and life insurance is "death" insurance.Ideally, you would find a doctor or clinic whose practice focuses on preventive medicine. However, any physician can work with you in a good preventive medicine program if he/she has the time, the interest, and the knowledge. Since preventive medicine is not routinely covered by health insurance, it may have to be paid for out of pocket. To help determine whether the physician can give you what you need, here are some possible questions. The answer to many of these questions depends on a patient's age, gender, and medical history:
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Is Yoga Good for Everyone as a Stress Reliever?
Tweet Share on Facebook January 26, 2009 Comment (5)
Yoga can absolutely be a great way to reduce stress and anxiety, and no—it is not necessarily for everyone. Forcing yourself to do something because "it is supposed to be good for you" is almost certain to fail in the long run and can actually increase your stress and anxiety in the short term. There are many paths to stress reduction, including other forms of exercise; myriad mind-body techniques such as meditation, prayer, and visualization; and other forms of expression such as journaling, art, music, and talking to a friend.I have two pieces of advice for you: 1) Be open to new approaches. Do not assume something new to you would not work for you. Often, approaches that you are unfamiliar with are the most interesting, and most surprising. 2) Pay attention to what you love. If you try yoga and give it a fair shot (a month or two), and you find yourself dreading the class, try something else. Self care should be fun and nurturing, not something you dread—especially when your goal is to reduce stress and anxiety. One of the best ways to do this is to find something you love, and enjoy it. You will also be much more likely to sustain these activities across time. So relax, and enjoy the exploration.
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Is it True That Chronic Depression Can Affect Your Immune System?
Tweet Share on Facebook January 26, 2009 CommentChronic depression has many negative effects on health, and the immune system is a primary pathway. Depression boosts production of interleukin 6, a chemical messenger for the immune system; high levels of IL-6 have been linked to long-term inflammation, which, in turn, is implicated in a spectrum of age-related diseases including heart disease, type II diabetes, arthritis, osteoporosis, Alzheimer's disease, periodontal disease, and even frailty and functional decline.
