Get what's important from your doctor visit

Part of my article in EzineArticles.

The most important thing you should get out of your appointment with the doctor is an adequate explanation to the problem which prompted your visit.

Write down your questions in the order that you feel is the most important. Write down, or ask your doctor to write down, the answers to your questions, including instructions for the use of prescription and over the counter medications, medical devices, and lifestyle changes. If there isn't enough time to have all of your questions answered, then you will have had the most important ones addressed, and could save the rest for the next visit.


Carry with you, at all times, a legible, up-to-date list of all the medications you take. Include in it all prescribed and non-prescribed medications by all of your physicians. Also include in the list the dose, reason for use, frequency of use, and the date you started taking the medication. Examples might include:

1) Digoxin.25 mg. every evening, for control of heart rhythm, started 6/2009.
2) Buffered aspirin 650 mg. as needed for mild headache, started 2007, Dr. XYZ.

This list will be useful to you during your visit and in case of an emergency. Don't assume that your physician knows all the medications you are taking!

During your visit, try to be as specific about your symptoms as you can. Telling your doctor "I had a fever last night with shaking chills and a temperature of 101" is much more meaningful and leads to a faster diagnosis than saying "I have been feeling sick since last night." Telling the doctor "I have been taking amoxicillin 500 mg. every eight hours since I became sick" is much more meaningful than "I took those yellow horse pills you gave me two years ago for two days."

Remember: In order to derive benefit and satisfaction from your visit to the doctor, both you and your physician must work together. You are the principal source of information about the way you feel. The more detail your doctor has about your condition, the more will he be able to help you, and you will feel better having accomplished what you started out to do. It takes teamwork!

Be an active partner in your own health care. Let's do it together!

Do you have COPD?

If you develop shortness of breath faster than you should, you cough frequently, and are also a smoker, you may indeed have Chronic Obstructive Pulmonary (Lung) Disease, or COPD. The term COPD refers mainly to chronic bronchitis and pulmonary emphysema. More than 80% of COPD is caused by cigarette smoking, with the remainder caused by genetic factors (alpha 1-antitrypsin deficiency), industrial exposure (e.g., coal mining) and questionably air pollution.

COPD is a progressive disease, responsible for an enormous strain on the national healthcare budget, on the work place, and on one's personal well being. More than 12 million Americans are now known to have COPD, and many more have the "hidden" disease. COPD is the fifth leading cause of mortality in the US, and its economic burden is even higher.

The sooner COPD is diagnosed and treated, the better it is. Lives can be saved, jobs can be spared, and extra medical expenses avoided.

So, if you have shortness of breath, smoker or not, make sure COPD is not a factor. Don't delay, see your doctor, you won't regret it!

Think twice before indulging…

Are you planning to exercise away the extra calories of your next meal? Think again.

A typical McDonald double cheeseburger has approximately 440 calories. Add large French fries at 500 calories and you're at more than 900 calories (we won't count the soda because I know you chose the zero calorie one…).

If you weigh about 155 lbs (what used to be the typical adult male weight in the US), and you like to walk, you'll burn 76 calories for each mile.

So the meal you just had would cost you an 11.8 mile walk. No problem, it's still less than a half-marathon distance.

Incidentally, if you were to stop by the Cheese Factory for a cheese cake portion, that will only cost you an additional 9 miles.

Of course, you could do the un-American thing, and have a good portion of no-skin chicken and salad (you can even have a little oil and balsamic vinegar dressing) plus fruit, at less than 400 calories for the meal. Still hungry? Have an apple plus another fruit later.

Do the right thing, your body will thank you for it.

Control your calorie intake

What you see here is just a small sample of what's now available at our Health Extenders practice as part of our newly designed weight loss program. For more information, you may contact us by email. If you live in our area (Fairfield County, CT) and want to have a comprehensive evaluation of your weight loss needs, contact us by phone at (203) 853-1919.

This will help you lose weight and remain thinner

Many of you have been aware of our weight loss programs at our practice for years. At home, Sandy and I find it helpful to control our breakfast calorie intake by using HMR shakes. We prefer the HMR 70 vanilla mix. Try it if you wish. This is how we use it:

1 packet of HMR 70 vanilla mix
1 glass filled ½ with crushed ice & ½ with water
1 tsp Hershey’s powdered cocoa (sugar-free)
Place HMR packet in bottom of blender.
Then add ice, water and cocoa and blend.

Optional additions:
½ banana or,
½ cup berries
extracts (calorie free)

Add to partially-blended shake and blend again for an additional minute.

Enjoy!

Calories:
HMR 70 110 calories
Banana/berries 50 calories (approx)
Hersheys cocoa 5 calories

Total 165 calories (approx)

You may use 1 ½ to 2 packets of HMR, but remember to count your calories. You may experiment with other fruits and extracts to create a special shake for yourself.

Share your experience with us. Selected recipes will be published with full credits (and 6 free packets of the mix with your next order of HMR shakes).

Weight loss 2011 – How we handle it at our practice

So you decided to lose weight, but you're not sure you're doing it the right way?

Know that you are not alone. More than two thirds of adult Americans need to lose weight. Of these, more than half are severely overweight (BMI, body mass index, greater than 30; normal is 20-25), and are at significant medical risk. A major reason why Americans don't live as long as they should is obesity.

Here is some of what we do to help:

• Evaluate your need for weight loss
• Assess reasons why you're having difficulty in losing weight
• Make sure there is no medical abnormality responsible for your increased weight
• Measure (not guess) your metabolic rate, and calculate your daily calorie requirement
• Design a diet-exercise program that meets your specific requirements, taking into account any medical condition thou may have
• Assess your ability to do exercise and prescribe an exercise/physical activity program (and you don't have to be an athlete to do it…)
• Identify and reduce overeating triggers
• Provide calorie-specific meal replacements and snacks
• Prescribe medication to control appetite, where applicable

Don't try to lose weight too fast. One-to-two pounds a week is good.
Don't wait, just do it!

New Year's Resolutions... Will You Keep Them?

As 2011 approaches, many of us will be making New Year’s resolutions. Some of the most popular resolutions will follow the usual tradition: to make a commitment to fitness, stop smoking, and lose weight. But times are changing, and so do the resolutions. Now, with economic stress and job pressure, many people may choose to "shoot" for a less stressful life.

In reality, 50% of those who start an exercise program drop out within less than 6 months and their treadmills become dust collectors; too many lost pounds are rapidly regained, and cigarettes continue to be a big seller. And soon after you enjoy a few days of rest, daily stresses resurface. So how do you succeed?

Don’t try to make too many changes. Identify the issues most important to you, and concentrate on the top two. For most people, this translates into increasing exercise, and managing stress.

Exercise: For beginners, it's extremely important to make realistic goals. Trying for a six minute mile on the first day is not realistic, and potentially dangerous. Cardiovascular exercise is the most important, with stretching and moderate muscle strengthening next.
Start exercising slowly. Gradually increase the intensity and duration in small increments until a relatively high level of exercise can be tolerated. Even if you are a regular exerciser and took a “holiday break,” restart at a lower level, and progressively return to your usual level. If you’re sedentary or over 35 years old, or are not known to be in excellent health, see your health care provider before strenuous exercise.

Stress: What is stressful to one person may not be stressful to another. Stress is best defined as a situation which requires a behavioral adjustment (Dr. Herbert Benson, Mind/Body Medical Institute). Stress increases the body's adrenalin production, and with it physiologic changes occur, including a rise in heart rate and blood pressure. This was the flight-or-fight response of the cave man, frequently unsuitable for dealing with “modern” stress. Some stress is important as a motivator for daily function and long-term achievement, but excess stress takes away from life’s enjoyment and productivity, and can make hypertension and other medical conditions permanent.
The Relaxation Response is an effective antidote to stress, which can be learned and practiced by almost anyone. It can be elicited by many techniques, including meditation, diaphragmatic breathing, imagery, yoga, and progressive muscle relaxation. All techniques involve a brief, intense focusing of attention, and the passive disregard of everyday thoughts. Many books have been written on the subject, and a copy of a progressive muscle relaxation routine can be obtained from our office (just give us a call or request it on your next visit).

There is a wonderful synergism between exercise and stress management. With regular exercise, the body produces its “relaxation hormones,” endorphins; and with relaxation management, the likelihood to succeed in exercise increases remarkably.

People who exercise regularly and practice stress management say that, to them, these habits have become an addiction. What a great “addiction” to have…