Thursday, October 8, 2015

Is the PCP a partner or a stranger?

In the case of devastating news, cancer or the like, is your Primary Care Physician, your family doctor who may have diagnosed the problem and sent you to the specialist, included in the healing process, or relegated to reviewing forwarded reports without being allowed any input?  Is that familiar hand not an important part of the treatment as well?  Here is an article which looks at this issue, with opinions from others as well as myself.

Sunday, September 20, 2015

Lies my patient tell me

You might think that people would be honest with their doctors, after all, their lives may depend on the information they relate.  But they are not.  Almost always, the truth is altered, shaded, omitted, or otherwise just a lie at some point.  Here is a little piece with an interview with WebMD where I added to the picture, with a plea to always be honest in the exam room.  It is that serious!

Tuesday, September 15, 2015

It hurts when I touch that

If you're like me, you have had the occasional ache or pain without apparent cause.  While you should not ignore symptoms that are troubling, often those little pains are of little concern, and go away as mysteriously as they appeared.  Here is a little piece on the Scary Symptoms site looking at the little tender spot that shows up on your head.  Remember though, that bad things do happen sometimes, so if there are any questions about a pain or such, see your physician for an evaluation.

Saturday, September 12, 2015

A Cup or More in the Morning?

Morning would not be complete for me without that cup of coffee, but the controversy continues about just how much you can have, and what can it do to you.  Here is a little calming article on the Scary Symptom site, where I was asked about just how much coffee one can have safely.

Friday, September 4, 2015

Is that a wink or are you ptotic?

People can have all kinds of infirmities, and many of them are visible to others.  But with the belief that the eyes are the windows to the soul, abnormalities of the eyes are quickly noticed, and frequently cause for comment.  When there is a drooping lid, or a constricted pupil, it may be quite obvious, to onlookers or the affected individual.  It may be serious, it may not be, and here is a little piece that looks at these conditions.

Wednesday, September 2, 2015

Healthy woman needs for 30,000 mile checkup

I got an interesting question from a website devoted to health about the requirements for a 30 year old well woman's periodic physical.  Truth is, the points here, allowing for some gender specific information, can benefit men as well, and older folks can also use this as a starting point.  So, no matter who you are, your age or gender, have a look at:

Just to expound on this a bit more than in the article, here are my full thoughts on the subject.

For the healthy woman in her 30s, there are at least a few items which should be screened on an annual basis, in the interests of good health. These may be part of a Women's Wellness examination by a gynecologist, or shared with a primary care physician dealing with the non-gynecologic parts of the examination.

With that Primary Care Physician in mind, I would start with the visit, itself. Having a physician who knows you, your history and yourself, is vitally important. During the conversation of the visit, evidence of anxiety, depression, abuse of multiple types, and social ills may be evident. While you may not want to think about it, these non-physical illnesses are very common, and need to be screened for and acted upon when present.

Turning to the more “routine” physical issues, certainly women in their 30s should have an annual gynecologic screening, to include breast examination and education for breast self-examination, a Pap smear and pelvic examination. Having said that, breast self-examination has come under fire recently as not being effective, and even the annual pelvic examination is seen as unnecessary in some recent studies. See the posting on my blog about this at:  Are routine pelvic exams indicated?

If there is a history of breast cancer before 50 years old in a first degree relative, such as mother or sister, one might consider beginning mammography earlier than the usual starting age of 40 years old. While colonoscopy is not normally started until age 50, the same considerations would be given to an early start if a close relative developed colon cancer at an early age.

General health measures, such as weight, blood pressure, and body mass index should be evaluated as part of a basic examination which should include listening to the heart, lungs, and examining the abdomen for abnormalities. Attention should be paid to any part of the body which demonstrates anything unusual, in form or function. With many spending time in the sun, a good skin check should be done to evaluate for dangerous lesions, potentially cancerous, over the entire surface of the body.

Minimal laboratory evaluations should include a hemogram, to screen for anemia, blood sugar and cholesterol. Many would also screen for thyroid disease, particularly postpartum, as hypothyroidism can be seen often in that population.

One other item that should be checked on an annual basis is an eye examination. Best done by an ophthalmologist, not a local store that sells glasses, your should be examined for any changes to the retina or lens, including those caused by systemic diseases and sun exposure.

Monday, August 31, 2015

Numb is numb, and common is common

Pressure on a nerve can disrupt its function, and it can be in just about any sensory nerve and does not take that much pressure.   Sitting on the throne can yield a numb leg, or sleeping in the wrong position may result in your thinking that a stranger's hand is hitting you, when it's your own.  The problem comes when your mind starts to run away, and you turn to Dr. Google only to come away fearing for your life.  But, to recycle a famous saying, the only thing you have to fear is fear itself.  So take a step back, and read this little article.