Very Short
How to Talk to and Understand Your Doctor
Ultimately, health care is first and foremost an individual responsibility. In this age of managed care and ten-minute assembly-line doctor’s visits, it is more important than ever to play a conscious role in your own physical well-being. This includes staying in close touch with your body so that you can recognize any new symptoms or changes immediately and report them to your doctor as soon as possible.
All well and good, except for one thing so important that it cannot be emphasized enough. Most patients consistently fail miserably at perhaps the most crucial skill needed to carry out any successful health plan -- the ability to satisfactorily communicate with their doctor. If you are like the majority of Americans — no matter your age, gender, economic status, nationality, race, or level of education — you often leave your doctor’s office confused about what he or she has just said, and with many unanswered questions. (Studies show that the typical patient remembers only half or less of what the doctor has or at least has tried to explain only moments before; other studies indicate that more than 90 million Americans are unable to grasp basic health information.)
The inability to talk to and understand your doctor directly impacts on your health. It leads to the innocent misuse of prescription drugs, the tendency to neglect available preventive services, poor control of chronic diseases, increased hospitalizations and visits to the emergency room … and higher death rates. This “health literacy” learning gap is not so much the fault of the patient as of a medical culture that places speed at a premium, puts the doctor on a pedestal as a seemingly unapproachable authority figure; and churns out doctors who speak mostly in medical jargon that most non-doctors find it hard if not impossible to decipher.
The good news is that doctor-patient communication is a skill, and one that can be learned. Here are some initiatives that you can and should take:
• Always bring a pad and pen with you to the doctor’s office so you can make lists of your questions and symptoms in advance. Use this pad during the appointment to jot down new questions that occur to you during your visit, and things the doctor says that you don’t understand. At the end of the visit, sit with the doctor and read off items on the pad. Have him/her answer all your remaining questions and explain things he or she said that you didn’t understand.
• Don’t be shy about asking the doctor to slowly and clearly repeat him or her self. If that doesn’t work, ask the doctor to tell you again in non-medical language. Take notes while the doctor talks. You can also ask the doctor to write down the important things he or she said. Don’t be put off if the doctor acts rushed or impatient. It’s your appointment and your right not to leave until you are satisfied.
• Bring a friend with you whenever possible -- that way, if you forget to bring something up your friend can remind you, and can also spark your memory later if you block out certain details of the visit.
• If the doctor doesn’t bring up something that’s on your mind, speak out and bring it up yourself. Don’t be embarrassed or ashamed to bring up intimate topics – doctors have heard it all before and they are sworn to keep what you tell them a secret, even from your family.
• If you forget to ask a question during your visit or have new questions afterward, call the office right away and ask to speak to the doctor so that you can get answers.
• Below are some general questions that many people write down ahead of time. Go through them and write down the ones that apply to your situation. Add more as they occur to you.
— What’s wrong with me? What’s causing this problem?
— Will I need tests? If so, what will they tell us?
— What treatments are available for my condition? What are the pros and cons of each such treatment? Are there side effects, and if so, what?
— Do I need medicines? Which drugs or medicines will I need, and what are the side effects? What does each drug do? Will the new medicines interact with medicines I am already taking?
— Do I need a follow-up visit? Do I need to see a specialist, and if so, how do I find one?
For a couple of articles that stress the importance of talking to your doctor, see: “The Importance of Knowing What the Doctor is Talking About,” by Jane Brody, New York Times Website, and “Checkups and Prevention: How to Talk to Your Doctor,” on the AARP Website.
Calculating Your Calorie and Nutrition Intake
Have you ever wondered how many calories and nutrients you need each day, as well as how many calories you will need to cut or add daily in order to reach your weight and health goals? There is an easy-to-use Website that calculates your caloric and nutritional needs in a matter of minutes. It is interactive, meaning that it requires you to supply some basic data (your gender, your current weight, your ideal weight, your height, your age), but the minimal effort required is well worth the result -- a pages-long detailed personalized report customized for each individual user.
In addition to citing the quantity of calories and nutrients you should be ingesting each day, these reports provide a list of which specific vitamins and minerals are mandatory for you and in what dosage; provide information on how much fat, carbohydrates, and protein you should be consuming (or not consuming) daily; detail which food groups you should be choosing from and in what proportions; offer advice about which nutritional supplements you should consider taking according to your profile; even tell you exactly how you need to adjust your daily caloric intake as well as how many minutes of exercise you need to add each day to meet your weight goals.
You can find the “Calorie and Nutrient Guide” at http://nutrition.about.com/od/changeyourdiet/a/calguide.htm; simply click on the appropriate hyperlink for “Calorie and Nutrient Guide for Women” or “Calorie and Nutrient Guide for Men” found directly below the opening paragraph, and you’re off and running!
Necessary Tests for 50+ers
Part of taking responsibility for your own health is aggressively practicing preventive health measures. Knowing and monitoring your over-all health status, identifying and reporting any changes or problems right away so that you can get effective and immediate care, and doing everything in your power to control chronic conditions – all this needs to be a lifelong activity built into your health regimen. One important step in that direction is to make sure you receive regular screenings for certain conditions, particularly those that you know you’re at risk for.
At minimum, all people above the age of 50 should be tested for the conditions listed below. If your doctor hasn’t done or discussed these tests with you, don’t let them slide: raise the issue yourself at your earliest opportunity. Remember: Being proactive about your health empowers you, and a little bit of power over your own path is always a good thing.
Tests Recommended for Women Over 50
— breast cancer (mammogram, self-breast, and clinical breast exams)
— diabetes
— high blood pressure
— high cholesterol
— tuberculosis
— osteoporosis (bone-density test)
— colorectal cancer (digital rectal exam, fecal occult blood test, sigmoidoscopy, colonoscopy, barium enema)
— skin, ovarian, cervical, and other types of cancer
— vision and hearing
Tests Recommended for Men Over 50
— diabetes
— high blood pressure
— high cholesterol
— tuberculosis
— colorectal cancer (see above)
— prostate cancer
— skin and other types of cancer
— vision and hearing
Vaccines Recommended for all 50+ers
— yearly flu shot
— hepatitis B vaccine
— chickenpox vaccine
— tetanus/diphtheria shot (every ten years)
— pneumonia vaccine (for those 65 and over)
For a select list of some preventive health resources and advice, see “Stay Healthy-Practice Prevention,” on the AARP Website, http://www.aarp.org/health/staying_healthy/
Most Diabetics Don’t Exercise as They Should
A new study of more than 22,000 patients with Type 2 diabetes or at high risk for it found that fewer than 40 percent of them exercise, despite strong advice from their doctors to do so. Especially depressing is the fact that fully three-quarters of participants in the study had reported that their doctors had stressed to them the importance of incorporating regular physical activity into their daily routines. People with Type 2 diabetes who don’t exercise face complications ranging from high blood pressure to nerve damage, and worse.
The Centers for Disease Control estimates that more than 20 million Americans are diabetic, about 90 percent of them with Type 2 diabetes. Regular exercise is almost always prescribed for diabetics, even for the moderately disabled. Experts advise a step-by-step approach, especially for exercise beginners. The American Diabetes Association advocates at least 30 minutes per day of aerobic exercise (walking, biking, swimming, etc.) at least five times a week for all diabetics, but says those who are not at this level can benefit from even five minutes of aerobic exercise a day and/or partaking in everyday activities like walking to work or gardening. So if you’re a diabetic who falls more into the couch-potato category, it’s not too late. Every little movement helps protect your overall health.
For more on the above-mentioned study, see USA Today’s Website for “Study: Most Diabetics Don’t Exercise” at http://www.usatoday.com/news/health/
Recognizing and Preventing Strokes
Strokes – a nationwide health crisis -- are the third-leading cause of death among Americans, exceeded only by heart disease and cancer. More than 700,000 Americans suffer from strokes each year; around 150,000 die from strokes each year. Strokes are also the No. 1 cause of adult disability in America (between 15 and 30 percent of stroke survivors are left with a permanent disability). For reasons still being studied, strokes are curiously more prevalent among Americans of certain races and even geographic regions: African-Americans have significantly higher death rates from stroke than do people of other ethnic groups, and African-Americans as well as others residing in the southeastern U.S. are more likely than other Americans to be hit by a stroke. Chances of getting a stroke seem to increase in relation to age: they occur most often in people 65 and older. Other particularly vulnerable groups include smokers, persons with high blood pressure and/or high cholesterol, those with a family history of strokes, and those with a prior stroke history.
What Strokes Are and What Causes Them:
A Quick Layman’s Guide
Strokes occur when a vessel feeding blood to the brain bursts or is blocked by a blood clot. About 80 percent of strokes are “ischemic” – caused by a blood clot that prevents blood from flowing to the brain. These clots can travel from the heart (or another part of the body) or be caused by the narrowing of an artery that supplies blood to the brain. Other factors that can cause clots include congenital heart defects, heart attacks, hardening of the arteries, and certain heart problems like irregular heartbeats, heart disease, or infection. The remaining 20 percent of strokes are “hemorrhagic,” occurring when a blood vessel breaks and blood leaks into the brain. Researchers estimate that 2 million brain cells per minute die during a stroke, and that areas of the brain, damaged within minutes of the onset of a stroke, can die within hours.
Because of the swift and devious ways in which strokes attack the body, identification and early treatment of strokes is key and can literally make the difference between life and death. Yet a disturbing new study indicates that the majority of Americans routinely ignore stroke symptoms, and fewer than half of those who have experienced strokes or stroke symptoms have sought medical care for their condition.
Stroke Symptoms
It is crucial that we all familiarize ourselves with common stroke symptoms so as to immediately recognize a stroke in progress and seek emergency care. These symptoms include:
· Sudden numbness or weakness of the face, arm, or leg, especially if it occurs on one side of the body only
· Sudden confusion, trouble speaking or understanding speech
· Sudden difficulty seeing in one or both eyes, and/or double vision
· Sudden dizziness, trouble walking, or loss of balance and coordination
· Sudden severe headache with no known cause
· Sudden drowsiness, nausea, or vomiting
Anyone experiencing these symptoms should be taken to a hospital emergency room at once; this is one case where the adage “Better safe than sorry” really applies.
Stroke Prevention
According to the National Stroke Association, approximately 80 percent of strokes are preventable. To guard against strokes, individuals should follow the same basic practices that are commonly advised for healthy living in general: Don’t smoke; exercise regularly; keep cholesterol and blood- pressure rates down; follow a diet low in fat and sodium.
Information and Resources
To learn more about strokes, you can call on the American Stroke Association at 1-(800)-STROKES or log on to their Website at http://www.strokeassociation.org/presenter.jhtml?identifier=1200037.
You might also want to consult two Web articles which provide basic background information: Live Science’s “Majority of Americans Ignore Stroke Symptoms,” at http://www.livescience.com/healthday/601699.html
and CBS News’s “Strokes: Causes, Symptoms, and Treatment” at http://www.cbsnews.com/stories/2007/01/03/fyi/main2326849.shtml?CMP=ILC-SearchStories.
