Health Tips 40’s – 50’s

Your Prescription for Health Forty’s & Fifties

Eat Right -5 a day of fresh fruits and vegetables, lots of fiber, lean meats, chicken, turkey and fish. No junk food, no fast food . If you do not feel well, chances are you are not eating well!! Do not underestimate the power of healthy eating, or the ability of eating the wrong thing to make you feel badly!! Please visit Healthy Approach Market for nutritional counseling with Bryan Bradford CN (817-399-9100). Read the Eat Clean Diet book. It is awesome at explaining nutrition and helping with weight loss. (www.eatcleandiet.com)

Drink lots of water – it should be your main beverage of the day. Limit caffeine to one a day if you must. Avoid artificial sweeteners, they are thought to increase PMS as well as other health problems

Exercise – For weight loss you need 45-60 minutes a day, 5 times a week. To maintain weight and bone health, 30 minutes a0 day 5 times a week. Yoga and Pilates are great, I like Leslie Sansone walking for weight loss; fun and easy to fit in a busy schedule. Exercise On Demand with cable and satellite – lots of great options for quick workouts.

Weight loss – If you are doing the top 3 you WILL lose weight. In a nutshell, eat protein at EVERY meal, moderate carbohydrates and fats, and fruits, veggies and water at EVERY meal. If you can do this, you will lose weight.

Hormone Balance – In the female body, balance of hormones is key. Women need a balance of estrogen, progesterone, testosterone, thyroid hormones and cortisol. When this balance is not in place, women can feel symptoms such as hot flashes, night sweats, forgetfulness, foggy thinking, unwanted weight gain, declining interest in sex, PMS, sleep disturbance…. the list is endless.

Do you have any of these symptoms? Lab tests are not very sensitive for detecting these hormone levels because hormones are protein bound and not free floating in your plasma, therefore we recommend saliva testing for detecting hormone imbalances. This testing includes estrogen, progesterone, testosterone, DHEA and cortisol. Saliva testing can accurately measure your free and available hormone levels, eliminating the guessing from your treatment. If we discover a deficiency or imbalance we can monitor your hormone levels after starting bio-identical hormone treatment, which allows us to individualize your hormone therapy. Blood testing can evaluate your thyroid hormone, fasting sugar, insulin and cholesterol. There are 2 options for treatment, non-hormonal relief such as soy, black cohosh and other herbs, or estrogen and progesterone. You can use synthetic hormones, or bio identical hormones compounded at the pharmacy. These are personal as well as medical decisions, and the facts keep changing as studies are being conducted. Hormones won’t give you cancer, but if you have one, it will cause it to grow and sometimes aid in earlier detection. If you decide on hormone therapy, there are a lot of options, pills, patch, ring, creams, which we can discuss and try. We work with several compounding pharmacies that can make your hormone preparation based on your individual needs. • Decreased libido is also a common complaint. If intercourse is painful due to vaginal dryness we can treat that with lubrication or vaginal estrogen. There are also some creams available at the compounding pharmacy that can help increase sensation down there. If hormones are out of balance, this could be a symptom. I don’t have a magic pill for libido itself, I think today’s woman is very stressed with work, husbands, kids…and this is the area we put on the back burner. I think attitude is key here. • Safer sex – Based on your personal situation, remember to protect yourself if you are sexually active. There are numerous STD’s out there. • HPV – Human Papilloma Virus. It is sexually transmitted. Over 100 strains of the virus. A few strains cause abnormal pap smears, a few cause genital warts. A vaccine is available for women ages 9-26. It takes 3 injections over 6 months. Tested every year with your pap smear in women over 30. Together a pap and HPV status predict your risk for pre cancer of the cervix. • If you are done with children and experience heavy or painful periods please talk to us about options such as an endometrial ablation. • Pap smears every year. Papsure is optional; it allows us to look at your cervix with a special light and microscope. It can pick up things a pap smear can miss. Probably worth the money. • Mammograms yearly after 40. Breast self exam monthly. • Fasting lab work every few years. Have a good family doctor or internist follow your high cholesterol, high blood pressure or diabetes. They are more familiar with changes in research and medication options. • Bone Density every 1-2 years after 50 or menopause (sooner if smoker, history of asthma, or thyroid disorder). If you have normal bones, continue your weight bearing exercise and calcium 1500 mg a day. If you are on Fosamax or Actonel, we probably don’t need to check your bones every year, as changes of improvement are very subtle. • Colonoscopy – begin at 50 unless family history dictates earlier, and repeat every 3-10 years. Your GI will tell you when to return. • Vitamins – a good multivitamin, calcium 1500mg a day total (diet and supplements) in divided doses, Fruits & Veggies if not obtained from diet (Juice Plus, Nature’s Way). B Complex good for energy and cholesterol, essential fatty acids (fish oil). Vitamin C 1000mg a day for anti-oxidant. • Recommended Reading: You, The Owner’s Manual by Dr Michael Roizen & Dr Mehmet Oz is a must read. It really hits the high points on every body system, how it works, and what to do to help your body feel great. Also Dr. John Lee’s Hormone Balance Made Simple is an easy read and makes sense of complicated hormone explanations. The Eat Clean Diet by Tosca Reno is a must read. Also, CW Randolph’s From Belly Flat to Belly Fat is a great, easy read and hits on vitamins, eating right, thyroid balance and hormone balance for weight loss and feeling great. The 30 day diet plan in this book is a guarantee to lose weight.

Health Tips 20’s-30’s

Your Prescription for Health

Twenty’s – Thirty Somethings

Eat Right – 5 a day of fresh fruits and vegetables, lots of fiber, lean meats, chicken, turkey and fish. No junk food, no fast food. If you do not feel well, chances are you are not eating well!! Do not underestimate the power of healthy eating, or the ability of eating the wrong thing to make you feel badly!! Please visit Healthy Approach Market for nutritional counseling with Bryan Bradford CN (817-399-9100). Read the Eat Clean Diet book. It is awesome at explaining nutrition and helping with weight loss. (www.eatcleandiet.com)

Drink lots of water – it should be your main beverage of the day. Limit caffeine to one a day if you must. Avoid artificial sweeteners, they are thought to increase PMS as well as other health problems

Exercise – For weight loss you need 45-60 minutes a day, 5 times a week. To maintain weight and bone health, 30 minutes a day 5 times a week. Yoga and Pilates are great, I like Leslie Sansone walking for weight loss; fun and easy to fit in a busy schedule. Exercise On Demand with cable and satellite – lots of great options for quick workouts.

Weight loss – If you are doing the top 3 you WILL lose weight. In a nutshell, eat protein at EVERY meal, moderate carbohydrates and fats, and fruits, veggies and water at EVERY meal. If you can do this, you will lose weight.

Fertility – If trying to conceive, make sure you are taking a prenatal vitamin, or a multi vitamin and extra folic acid (total 800 mcg a day). If your cycles are regular, you ovulate about 14 days before your cycle starts, so a perfect 28 day cycle this is day 14, 30 day cycles it is day 16…The egg is there for 24 hours, sperm live about 48, so timing is key. Home ovulation kits are very helpful for timing. If you have not conceived in 1 year of timed intercourse, or you are not ovulating by the kit, please come see us.

Safer sex – Based on your personal situation, remember to protect yourself if you are sexually active. There are numerous STD’s out there.

HPV – Human Papilloma Virus. It is sexually transmitted. Over 100 strains of the virus. A few strains cause abnormal pap smears, a few strains cause genital warts. Guys pass it to you not knowing they have it. A vaccine for four strains of the virus is available for women ages 11-26. It takes 3 injections over 6 months. Tested every year with your pap smear in women over 30. Together a pap and HPV status predict your risk for pre cancer of the cervix.

Pap smears every year – Papsure is optional; it allows us to look at your cervix with a special light and microscope. It can pick up things a pap smear can miss. Probably worth the money, it just depends on your risk factors.

Screening mammograms baseline at 35, yearly at 40, or 10 years prior to your mother or sister’s age at breast cancer diagnosis. Breast self-exam monthly.

Birth Control Options – The pill, patch, ring and shot can be used for birth control or to help control heavy or painful periods, or acne. This is a personal as well as medical decision. Side effects also can include weight gain, breast tenderness and headaches. The weight gain is caused from increased eating, so if you eat right, you won’t necessarily gain weight.

If you are done with children and experience heavy or painful periods please talk to us about options such as an endometrial ablation.

Labs– Depending on your family history, get fasting labs to check cholesterol and sugar at least every few years. Women need a thyroid test as well. Every year is great if you have insurance coverage.

Vitamins – a good multivitamin, calcium 1200mg a day total (diet and supplements), Fruits & Veggies if not obtained from diet (Juice Plus, Nature’s Way). B Complex good for energy and cholesterol, decreasing PMS and essential fatty acids (fish oil). Vitamin C 1000mg a day for anti-oxidant.

Recommended reading: What to Expect When You Are Expecting, What to Eat When You are Expecting, You, The Owner’s Manual. Also Dr. John Lee’s Hormone Balance Made Simple is an easy read and makes sense of complicated hormone explanations. The Eat Clean Diet by Tosca Reno is a must read. Also, CW Randolph’s From Belly Flat to Belly Fat is a great, easy read and hits on vitamins, eating right, thyroid balance and hormone balance for weight loss and feeling great. The 30 day diet plan in this book is a guarantee to lose weight.

Excessive Menstrual Bleeding

Excessive Menstrual Bleeding If your periods are so heavy that they disrupt your normal daily activities, you may have excessive menstrual bleeding. The medical term for periods that are very heavy, prolonged or both is menorrhagia. Symptoms of menorrhagia may also include cramping, pelvic pain, and in severe cases, anemia. Excessive menstrual bleeding is a common condition that occurs for many of reasons. Two of the most common causes are: a hormonal imbalance and uterine growths. Hormone Imbalances Your menstrual cycle is controlled by hormones, including estrogen and progesterone. When these hormones are out of balance, they can cause heavy periods or bleeding between periods. Causes of hormonal imbalances may include:

  • Hormonal changes in teens and in women nearing menopause
  • Diabetes
  • Thyroid Disease
  • Obesity
  • Stress
  • Strenuous exercise
  • Anorexia (eating disorder) Types of Uterine Growths
  • Fibroids
  • benign (non-cancerous) growths in or near the uterus
  • Polyps – growths that attach to the inner wall of the uterus and protrude into the uterine cavity
  • Adenomyosis
  • endometrial tissue normally lining the uterus grows into the muscular walls of the uterus
  • Endometriosis tissue that normally lines the inside of your uterus grows outside your uterus
  • Endometrial cancer – an uncontrolled growth of cells of the uterine lining
  • Hyperplasia – an abnormal proliferation of cells (cell division or growth) that may result in enlargement (growth) of the uterus. This term is sometimes used to refer to a benign tumor or fibroid.

Treatment Options for Excessive Menstrual Bleeding Excessive menstrual bleeding can be treated with hormone therapy, surgery or a combination of both. Your doctor can diagnose your condition and provide treatment(s) to relieve your symptoms. Hormone Therapy Your doctor may recommend you take hormones such as progesterone or the birth control pill to control and regulate your period. Hormone therapy can limit the swelling of your endometrium (uterine lining that sheds each month during your period) and extra endometrial tissue (implants). This treatment may be used before, instead of, or after surgery. Surgery Surgical procedures to treat excessive bleeding include endometrial ablation and hysterectomy. Endometrial Ablation Energy is used to destroy the endometrial lining of the uterus with the goal of lightening or stopping your periods. This technique is usually done on an out patient basis at the hospital or in your physicians office. This procedure is not recommended for women who may still want to become pregnant. Hysterectomy The surgical removal of your uterus. Depending upon your condition, your fallopian tubes, ovaries and any visible growths may also be removed. A hysterectomy can be performed using traditional open or laparoscopic surgery. Open surgery involves a large abdominal incision and a four to six week recovery. Laparoscopic surgery is minimally invasive, with only a few small incisions. Your hysterectomy can also be done using the da Vinci Robotic procedure. This procedure requires only a few tiny incisions, less pain and a quicker recovery time.

Essure Post Op

Essure® POST-PROCEDURE INSTRUCTIONS

Going Home

  • Obtain a completed ID card before you leave. Keep your ID card with you at all times and present it to other doctors involved in your present or future care.
  • Schedule your Essure Confirmation Test (see below) for 3 months from now.

When You are Home

  • If you are experiencing cramping, follow your doctor’s instructions regarding pain medication.

You may feel faint or nauseous. Follow your doctor’s recommendations regarding activity during the first 24 hours following your procedure.

  • Spotting or light bleeding is normal. If bleeding becomes heavy, you suspect you may be pregnant, or you become concerned, please contact your doctor.
  • You must use alternative contraception until your physician verifies that the inserts are in the correct location and your fallopian tubes are blocked. You may resume intercourse on .
  • Please call your doctor if your period is more than 5 days late or you suspect you may be pregnant.

3-month Essure Confirmation Test

  • You will need to schedule the Essure Confirmation Test for 3 months post-procedure. The test is performed to make sure that both of your Essure inserts are in the correct location and that your fallopian tubes are blocked so you can rely on Essure as permanent birth control.

You must use alternative contraception until your 3-month Essure Confirmation Test confirms that your Essure inserts are in the correct location and that your fallopian tubes are blocked. Only at that point can you rely on Essure for birth control.

If you rely on the Essure device for birth control before completing the Essure Confirmation Test, you may get pregnant or have an ectopic pregnancy (pregnancy outside of your uterus, but inside the body). Ectopic pregnancies can be life-threatening; so if you think you might be pregnant, please call your physician.

Indication

Essure is a permanent birth control procedure that works with your body to create a natural barrier against pregnancy.

Important Safety Information

WARNING: You must continue to use another form of birth control until you have your Essure Confirmation Test and your doctor tells you that you can rely on Essure for birth control.

  • You can rely on Essure for birth control only after your doctor has reviewed your Essure Confirmation Test results. Your doctor will confirm that the inserts are properly placed and both of your fallopian tubes are blocked. If you rely on Essure for birth control before having your Essure Confirmation Test, you are at risk of getting pregnant.
  • Talk to your doctor about which method of birth control you should use for the 3 months after the procedure. Some women can remain on their current birth control. Other women, such as those using an intrauterine device or contraceptive (IUD or IUC), will need to switch to another method.
  • It can take longer than three months for the Essure procedure to be effective. In rare cases, it has taken up to 6 months. Make sure to continue using an alternate form of birth control up until your doctor has reviewed your Essure Confirmation Test results and confirmed that you can rely on Essure for birth control.

WARNING: Be sure you are done having children before you undergo the Essure procedure. Essure is a permanent method of birth control. The younger a woman is when she chooses to end her fertility, the more likely she is to regret her choice later.

Depression

Depression is more than just feeling sad for hours or a few days. It’s a feeling of ‘the blues’ or hopelessness that makes it hard to get through the day.

You may be depressed if you:

Have felt sad for a long time.

Do not enjoy things that you used to

Sleep more or less than usual

Had a change in your appetite causing you to lose weight or gain weight.

Thought about death or killing yourself.

Your doctor wants to help you with your depressions!

Depression is very serious.

Your depression can also be painful for your friends and family members.

If you like hurting yourself, call 911!

What I can do for my depression?

Get help.

Talk with a counselor, a friend or someone in your place of worship.

Exercise or walk every day.

Stop smoking, stop drinking alcohol;

Make an appointment with your doctor’s office or clinic.

If you are given medicine:

Take the medicine every day. It can take several weeks for the medicine to work.

Even if you are feeling better, do not stop taking your medicine.

Sometimes you may need two medicines.

Reference: Heath TiPS from the ACP Foundation. American College of Physicians. Internal Medicine. http://www.acponline.org/patients_families/products/health_tips/

CT INFO

What is CT Scanning of the Body? CT scanning,sometimes called CAT scanning,is a noninvasive medical test that helps physicians diagnose and treat medical conditions. CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. These cross-sectional images of the area being studied can then be examined on a computer monitor, printed or transferred to a CD. CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams. Using specialized equipment and expertise to create and interpret CT scans of the body, radiologists can more easily diagnose problems such as cancers, cardiovascular disease, infectious disease, appendicitis, trauma and musculoskeletal disorders. top of page What are some common uses of the procedure? CT imaging is.

One of the best and fastest tools for studying the chest, abdomen and pelvis because it provides detailed, cross-sectional views of all types of tissue.

Often the preferred method for diagnosing many different cancers, including lung, liver, kidney and pancreatic cancer, since the image allows a physician to confirm the presence of a tumor and measure its size, precise location and the extent of the tumor’s involvement with other nearby tissue.

An examination that plays a significant role in the detection, diagnosis and treatment of vascular diseases that can lead to stroke, kidney failure or even death. CT is commonly used to assess for pulmonary embolism (a blood clot in the lung vessels) as well as for abdominal aortic aneurysms (AAA).

Invaluable in diagnosing and treating spinal problems and injuries to the hands, feet and other skeletal structures because it can clearly show even very small bones as well as surrounding tissues such as muscle and blood vessels. In pediatric patients, CT is rarely used to diagnose tumors of the lung or pancreas as well as abdominal aortic aneurysms. For children, CT imaging is more often used to evaluate:

Lymphoma

Neuroblastoma

Contacting Our Office

Contacting Our Office

We ask that you use our website to contact our office for all routine matters such as appointment scheduling or requests, prescription refill requests, billing questions and other non-urgent questions. We will make every effort to respond within one day. If you have not seen a physician recently, we ask that you make an appointment for all medical problems. If you need to cancel a scheduled appointment, please give our office 24 hours notice. If you need to call our office, our staff is available from 8:30 a.m. to 4:30 p.m. Monday through Thursday and 8:30 to 12:00 on Friday. We are at lunch from 12:30 to 1:30.

In the event of a life-threatening emergency, please go directly to the nearest emergency room, (by ambulance if appropriate), and advise the staff that you are our patient. If you are having a medical problem after hours or on Weekends and Holidays, please call the regular office number. A doctor will then be contacted through the answering service.

Transferring of Records

You will need to request in writing if you want to have copies of your records sent to another doctor or organization. You will need to include the specific dates of service, medical information requested and the reason for this request. Your signed request for release of records will need to be received before records are sent. We use a copying service, Photostat, which copies records weekly. There is a $32.50 charge for copies of records sent to the patient.

Updating Your Information

Patients are responsible for providing accurate, up-to-date information. You can update your insurance, personal and medical information from within “My Health Record” in this website. As you may have several physicians, this information can change without the treating doctor being aware of these changes. We ask that you login prior to any scheduled appointment to keep this information current.

Returned Check Policy

There is a fee of $20 for any check returned by the bank.

Cancellation Policy

If you need to cancel your appointment with us, we ask that you give at least 24 hours notice. For appointments that are cancelled within less than 24 hours or for “no show” appointments, you will be assessed a $10 cancellation fee. This will be payable prior to your next visit.

Cancellation Policy

If you need to cancel your appointment with us, we ask that you give at least 24 hours notice. For appointments that are cancelled within less than 24 hours or for “no show” appointments, you will be assessed a $10 cancellation fee. This will be payable prior to your next visit.

Acknowledgement of Online Interaction Policy

PATIENT ACKNOWLEDGEMENT AND CONSENT TO ONLINE INTERACTION POLICIES

I wish to use Internet-based communications, registration and other Internet-based modes of interaction to facilitate my receipt of health care from this practice.

Benefits and Risks

I understand that the benefits of Online Interaction include being able to take advantage of the expertise of a physician who may not be physically available to provide health care, and access to sources of information suggested by my own physician. I understand that there are potential risks associated with receiving health care through Online Interaction, including for example, timeliness of the interactions and the inability of a physician to give me a complete physical examination. Consequently, there is a risk that a physician may not be able to determine the proper diagnosis and treatment based upon Online Interaction. I understand that the practice specifically reserves the right to withhold conclusions of diagnosis and/ or recommendations for treatment based upon information obtained via Online Interaction in the absence of an in-person encounter, and that I am not to interpret any comments of my physician(s) or the staff as a diagnosis or specific treatment instruction under those conditions, unless my personal physician specifically indicates that I should. I understand that general information to which my physician(s) may refer me, or that which may be available on their Web sites, is not to be used for purposes of self-diagnosis or self-treatment, and to the extent that I do so I release my physician(s) and the practice and hold them harmless.

Confidentiality and Security of Information

I understand that all state and federal rules and regulations governing confidentiality of my medical records and access to my Personally Identifiable Health Information (including my ability to obtain copies of my records) will apply to services provided through Online Interaction and to the electronic transmission and storage of my Personally Identifiable Health Information.
I understand that my physician(s) and the practice will not give any images or information that identifies me and was obtained through Online Interaction to other entities without my consent unless permitted to do so under applicable laws or unless required to do so as part of a legal action. I have read and understand the privacy policy of the practice as published on its website.
I understand that for purposes of Online Interaction the practice uses programs and technical services provided by the following third parties:
1. athenahealth, inc. for billing and claims management.
2. TimeTrade Systems Inc. for online appointment scheduling.
3. Waiting Room Solutions, LLC for website registration and secure messaging.
I understand that when I conduct Online Interaction with the practice.s staff, I am subject to the privacy, confidentiality, and information security policies of those third parties and I have had the opportunity to review said policies.
I understand that despite best efforts of all involved parties, there remains some amount of risk of inappropriate disclosure of my personal information, and I agree to hold the practice harmless for such disclosures when they occur as the result of acts or omissions of third parties.

Use of .Electronic Mail.

I understand and agree that I am not to use the secure messaging service in emergency or other time-critical situations. I understand that the practice and its physicians discourage the use of standard e-mail for communicating about personal health issues, because standard e-mail is not a secure communications mechanism and does not provide structured forms of communication. Instead, the practice uses a secure, healthcare-oriented messaging service from Waiting Room Solutions, LLC. I understand that while I should not use regular e-mail to communicate to my physician and his/ her staff about personal health matters, standard e-mail may be used by the practice for purposes such as sending me notification of new messages that have been sent to my secure mailbox, or non- personal types of communications such as informing me of changes to office policies

I understand and agree that I am to use appropriate language and tone in my messages and other Online Interaction, and in particular I am to avoid any language that abuses, mocks, belittles, or attacks the recipient or is in any way libelous to third parties. According to the Privacy Act of 1974 and court rulings, employers generally have the legal right to access any e- mail received or sent by a person at work. I understand generally that I should not communicate with the practice (including my physician(s) and staff, and including via standard e-mail) using computers or networks of my employer.
I understand that online communications alone are not sufficient for proper medical care. I understand that my physician may refuse to continue online discussion of a condition when he or she believes an in-person encounter is appropriate. I understand that in no case should I expect my physician to deliver a conclusion of diagnosis, a recommendation for treatment, or a prognosis regarding a complaint or symptom for which I have not been seen in person, or regarding a condition for which I have not been seen in person within the previous 20 days.
I understand that I am to keep copies of messages received from my physician. I understand that my physician will retain copies of our communications within my medical record.
I understand that if my username and password is obtained by another individual, including an unauthorized family member, I am to notify the practice immediately and at the earliest opportunity should return to the practice or its website to establish a new username and password.

Physician May Discontinue the Online Relationship

I understand that my physician may discontinue his or her Online Interaction with me under any circumstance in which he or she believes that I have used Online Interaction in a manner that is inconsistent with his or her policies as stated herein. I understand that I will be notified of such termination of Online Interaction

Ownership of Information

I understand that neither the practice nor my physician(s) make any claim of legal ownership of the electronic information that is exchanged via Online Interaction and stored by third- party providers of online services. I also understand that there are no current conclusions of law that would hold that the information is legally owned by me, by the practice, my physician(s), or the vendors of the online services used to create and store the information. However, I understand that I do have rights of access to the information, and rights of refusal to disclosures of the information.

Consent

I hereby consent to obtaining some aspects of my health care from the practice using Internet-based communications or other Internet-based modes of interaction (.Online Interaction.), and I further consent to the electronic transmission and storage of my Personally Identifiable Health Information. I understand that I may withdraw this consent at any time without affecting my right to future care or treatment or risking loss or withdrawal of any program benefits to which I would otherwise be entitled. My physician has provided me with the opportunity to discuss and to question the issues, risks, and policies set forth in this consent form. I fully understand the information provided.

Patient Login

Logging in is easy as 1 2 3

  • 1 Log in with your user name (email address) and password (hit Change/reset password link to create a password for your account. Do not register for an account, this will create a duplicate)
  • 2 Under personal information, select "additional content". Under Reports and Tools click view Recent Test Results to see a digital copy of your lab results.
  • 3 Select the message icon in the header to access messaging.
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