Where Do you get your health information, part II

In an earlier post I asked where people get their health information. In this post I’m just listing some more websites people can get some unbiased health information:

Medline Plus

Talking to Your Doctor

Talking with your doctor

NIAID Community Immunity

Centers for Disease Control and Prevention

If you’d like to look up some medical terminology and abbreviations: Understanding Medical Words Some Common Abbreviations

If a couple of the links sound familiar, it’s because I used the phrase ” Talking with your doctor” as a title of a much earlier blog post. Of note, I wasn’t aware of the above links when I wrote my original blog post.

Older Athletes Have a Strikingly Young Fitness Age – The New York Times

Older Athletes Have a Strikingly Young Fitness Age – The New York Times.

For me this is an exiting and interesting story.  As I have said in earlier posts, exercise is important.  This just reinforces the notion that exercise, even if started later in life, does help health.  I won’t wax poetic about how exercise is a “veritable fountain of youth” as I try to avoid being overly dramatic with health care claims.

Surviving Old Age (AKA: Aging Well, part two)

One of my first posts in this blog was titled “Aging Well”. In that post I wrote mostly about staying healthy and how to (hopefully) age well and arrive at being an older adult being relatively healthy. In this post I’m  going to talk about things to think about or do once you get there  – and perhaps people to think about family members that are older. For the purposes of this post, the definition of older is 65 and above, despite the line that “65 is the new 40”.

Initially I would like to summarize a bit of what I said in the first post:

1) Be active! Both socially and physically (more on this later).
2) Control as best you can the health problems you do have.
3) Keep mentally active as well. Whether it’s taking adult education classes, daily crossword puzzles or playing cards with people often, do it!
4) Use a healthy eating pattern. For a fuller summary, go here to see the original post: aging well

For he remainder of this post I’ll talk about other things worth doing.

Firstly, if you haven’t already, sign a health care proxy form, and give copies to your primary care physician as well as a friend/relative. You may never need to use it but it is important to have if you develop a health issue that prevents you from making decisions about health care.  I have seen too many people admitted to the hospital with dementia that is so advanced that they were unable to make competent decisions for themselves in any capacity and did not have any family or friends who could speak on their behalf (legally I think family is given precedence over friends unless noted in the health care proxy or other similar legal document). There is a form called “five wishes” that not only, once filled out and properly signed, acts as a health care proxy but also gives your health care proxy and physicians more knowledge about your wishes regarding your wishes/goals/etc should you not be able to speak for yourself. Find the link here : aging with dignity – five wishes 

Secondly, take a good look at your finances. Long term care is expensive and if you have a lot of assets, such as owning your own home, medicare/medicaid might not pay for living in a nursing home should that be what you need. Long term care at home might also be out of your reach. Hence it is important to talk to a financial planner or lawyer with experience in elder affairs or elder law respectively. If you have a disorder like dementia , it’s even more important to do this because you’re more than likely to need someone to make decisions for you at some point.

Elder abuse is also a concern, especially if there are cognitive or  severe mental health issues. This also makes it important to have someone to talk to or know where to go (for more information, go here: National Center on Elder Abuse ).

Thirdly, as I mention above and in my earlier post, be socially active. This is potentially helpful in a number of ways. one is that people are social animals. There are likely multiple benefits to mental and cognitive health by having a lot of social interaction. Also, being part of a community means there are people who could be called upon to help with food shopping, transportation to and from doctors offices (among other things), and so forth if you happen to be unable to do these things yourself – even temporarily such as due to an illness.

Men’s Health

My previous post was about women’s health. In this post I am going to review a couple of aspects of Men’s health. Most of the things men should be doing are things  people of both genders should be doing to stay healthy: stop smoking, exercising, eating a healthy diet, maintaining a healthy weight (or loosing weight if overweight).  Staying up to date with immunizations, such as yearly flu vaccination, is also important. Getting screened yearly for hypertension is important. Skin cancer screening is also important, though this might only need to be done every 2 years depending on whether you have any suspicious moles or lesions, prior history, you and your dermatologist’s comfort levels for yearly vs every other year screening. Cholesterol screening at appropriate intervals is important (a healthy male in his 20’s with no risk factors for heart disease only needs his cholesterol checked every 5 years or so. Older men and those with risk factors require monitoring more frequently and perhaps yearly if risk factors are present or if on treatment to lower cholesterol). I won’t get into more details about screening or other issues covered already in other posts.

Perhaps the biggest controversy in mens health is prostate cancer screening. The U.S. Preventive Services Task Force actually recommends against routine screening for prostate cancer in healthy men of all ages. Even the American Urological association recommends against screening for prostate under the age of 64 and in men with life expectancy of less than 10 years. For screening, a conversation with your primary care doctor is warranted before getting the test. The main reason it is controversial is that one runs the risk of finding a prostate cancer which is indolent (slow growing), non aggressive that one is likely to die with than of – meaning one is likely to die of some other disease before the prostate cancer becomes a problem. At this time we don’t have enough information to know what low grade/early prostate tumors are going to become aggressive and turn into problems. One therefor runs the risk of over treating something that would not be a problem.

Occasionally I’ve had patients ask for testosterone levels and had to talk to patients about testosterone replacement. Testosterone levels are not something  routinely checked unless there is a clinical reason (if there is loss of libido, erectile dysfunction, and so forth, then it’s worth getting). Testosterone replacement has been associated with an increased risk of heart disease so replacement benefits needs to be worth the increased risk.

Although I probably run the risk of repeating myself by saying this, but reducing the risk of heart disease, lung cancer, colorectal cancer by exercising, watching what one eats and getting appropriate screening applies to men’s health as well.

Random Thoughts on Women’s health

I’m dividing this post into two parts. The first is on the recommendations for screening in females. The other part is some general thoughts on women’s health in general (and are somewhat generalizable to anyone’s health, male or female). The recommendations are taken from USPSTF related sites.

If you’ve read any or all of my earlier posts, you know I’m into screening and catching diseases early, especially if there is treatment for the particular disease.

Women should get pap smears every 3-5 years with HPV testing. The frequency depends on a woman’s age, whether the pap smear is negative and the results of HPV testing. It is important that the HPV testing be done via one of the five tests that are FDA approved: the unapproved tests from what I understand are more prone to error. Ask your doctor if he or she knows whether the lab he or she uses is FDA approved.

Screening for STIs (sexually transmitted infections) is suggested. This includes syphilis and HIV in high risk individuals.

Breast cancer screening (mammography) is done every 1-2 years starting at 50 (the old recommendations were every two years starting at 40, then yearly after age 50). BRAC testing should only be done if there is a family history of breast, ovarian, peritoneal cancer.

Bone density should be done at least once after age 64. However one can consider doing bone densitometry at an earlier age.

As much time and energy that people put into screening for breast cancer, cervical cancer, etc I think there a tendency forget about screening for heart disease and colorectal cancer, things I think people tend to see as “a man’s disease”.   However in 2010, 23.5% of deaths in women were due to heart disease,  and 22.1% were due to cancer deaths (this includes all cancer deaths, not just breast cancer).  Lung cancer killed 70,000 women whereas breast cancer killed 40,000 women that same year. These are  for the most part “lifestyle diseases” in as much as most lung cancer is caused by smoking; diet, lack of exercise, obesity contribute to heart disease. These are all things that are modifiable to a  great extent.