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Monday, May 9, 2016

well Balanced

health screening can be your best medicine

Telemedicine, a quick diagnosis over the Internet, relies on information the patient shares and has potential for privacy invasion and inadequate or inaccurate diagnoses. And, something else is missing. A May 2016 Consumer Reports article, “What Makes a Great Doctor?” states: “Many of us yearn for a wise, empathetic doctor who knows us, and our loved ones, inside out.”

Also, in the event of a major problem, “It is always best to have a discussion with the family early in the treatment course to establish what each patient’s preferences are,” said Dr. Christopher Cefalu, a urologist with Regional Urology.

His most difficult question to answer?

“‘How long do I have to live?’ Luckily, most of these patients still have curable disease and are just scared; so I am able to reassure them that there is a good chance of cure in their situation,” he said.

Dr. Cefalu often treats an annoying problem that increases in aging – frequent urination, which he said is usually caused by an enlarged prostate in men and an overactive bladder in women. After an individual evaluation, “medical management with a variety of medicines is the first step” in helping patients with bladder control issues.

Another focus of his practice is treating kidney stones, a health problem that is increasing in women. Mistakenly cutting back on calcium can actually “cause an increase in the absorption of oxalate from the bowel and make stone disease worse,” he said.

“I advise people to avoid supplements for urinary health” because production of these supplements is not FDA regulated, “so you never know exactly what it is you are getting … the active ingredient can vary greatly, and even worse, other chemicals can slip their way in,” Dr. Cefalu said.

The Journal of the American Medical Association reported that two-thirds of people between ages 62 and 85 take either herbal or vitamin supplements.

“For women on balanced diets with all food groups including a variety of fruits and vegetables, it is not necessary to take multivitamin supplements,” said Dr. Saimah Talukder, who practices with OB/GYN Concepts.

Many people take 81 mg. aspirin as a supplement. Dr. Sally Ball, an internist with Internal Medicine Associates of Willis- Knight Health System, said, “Aspirin is a touchy subject because it can cause problems,” such as internal bleeding. But, for someone who has had “a cardio situation, it’s a lifetime” regimen.

The Department of Health and Human Services advises women age 18 be tested for blood pressure, chlamydia, HIV and get a Pap test. Cholesterol testing should begin by age 20. Between ages 40-49, testing becomes more specific and more frequent.

DHHS guidelines factor in breast cancer screening, HPV, diabetes, HIV (at least once or if you are pregnant) and possibly syphilis. At ages 50-64, add a bone density test for osteoporosis and colorectal cancer screening.

If you make it to 65 (congratulations, by the way), you should definitely have had a bone density test and plan on possibly a couple more colorectal cancer screenings in your future.

Early screening is important in setting a base line for comparison over time. Sometimes the need for frequency in the screening process required is linked to another issue, as in increased blood pressure and diabetes.

Most women opt for a wellwoman exam annually.

“A lot of people don’t have a primary care doctor, so when a woman comes for a well woman exam I talk to them about any health issues,” said Dr. Talukder.

Menopause is the subject brought up most by women around 40.

“The average age in the USA is 51 years, but (menopause) can occur anywhere between 45 and 55 years. If your mom or sister had an earlier or later menopause, you may also,” said Dr. Talukder. “Most women won’t need hormone replacement therapy, but will transition with none to minimal symptoms.”

All three doctors stress diet as the most important factor for good health at any age.

“We are moving away from treatment to address” staying healthy as a first defense, Dr. Talukder said. She recommends taking supplemental calcium and Vitamin D.

“The biggest risk factor for kidney stones is dehydration, and the number one diet change is increased fluids – preferably water, but any fluids are better than none. Decrease the amount of salt in your diet and eat a moderate amount of protein. Do not consume massive amounts of meat,” said Dr. Cefalu.

Dr. Ball says avoid processed foods that contain trans fats, listed as partially hydrogenated oils on labels and widely used by manufacturers and fast food companies because it is cheap and has a long shelf life. It also plays havoc with your cholesterol. A quick way to determine whether a fat you are cooking with is the right one: “Healthy fats are liquid at room temperature, not solid,” reports Harvard Health Publications.

“Of course, [quit] smoking and limit alcohol to one drink a day.” In short, said Dr. Ball, “If God made it, we should eat it. If God didn’t make it, we should not eat it.”

– Kathleen Ward

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