You are the Center of Your Medical Team...

Sometimes it can seem very daunting when you go to your doctor It is important to remember that you are the one who can best describe what is going on with your body.  You are the one who knows the history of your health. You hold so many of the clues that your doctor needs to help with making a correct diagnosis, and determine what course of treatment is needed. You also are the one that needs to understand as much as possible about your health care. What do you want to accomplish? When you go to the doctor, what is the purpose of your appointment?  Are you going with a specific problem that you want to get taken care of?  Is this a periodic wellness check?  Do you need to have a check of your medicine?  It is very important to plan for your appointment.  Go with a list of questions that you want to ask your doctor, or things you want to talk about. Write these down – go with a plan, and with questions. Take information with you that will help the doctor. If you take medications, vitamins, and any other supplements, your doctor needs to know about all of them.  If you have any allergies to medications, be sure to let your doctor know. Take a list of what you use, listing the dosage, strength, and what time(s) of the day you take them. Sometimes patients take the actual bottles with them to the doctor, which could work for you. Be sure to include everything you take.  Sometimes vitamins and supplements can interact with certain medications, and the doctor can adjust the medications accordingly.  Ask about side effects of any medicines, and if there are...

Your Doctor Will Skype You Now...

Your employer may soon let you have virtual medical visits, but should you? If you work for a big company, odds are you’ll soon be offered a new health benefit (if you haven’t been already): Telemedicine, sometimes called telehealth. It’s the ability to see a doctor on a video call or confer through text, email or by phone, rather than an in-person visit. The question is: Should you? I was floored to see in the National Business Group on Health’s Large Employers’ 2016 Health Plan Design Survey how much this benefit has grown lately and is expected to balloon. Soaring Growth for Telehealth In last year’s survey, 48 percent of employers made telehealth options available to employees in states where it was legal (more on that last part shortly), up from 28 percent the year before. But a stunning 74 percent of employers will offer telehealth in 2016, according to the new survey of 140 employers — mostly with 10,000 employees or more. Often, the firms contract out with telemedicine firms such as Teladoc, Doctor on Demand, MDLive, NowClinic and American Well. “Small and medium-sized employers are offering telemedicine, too,” said Brian Marcotte, president and CEO of the National Business Group on Health. “What you’re seeing is employers continuing to look for ways to engage employees and move to a consumer-centric model.” If employers expect employees to ask questions as medical consumers, Marcotte added, they need to offer more consumer services. “Telehealth neatly fits into that,” he said. And these days, “consumers are starting to ask for it,” said Jon Linkous, president of the American Telemedicine Association. “Health care is a late adopter of technology, but once it’s proven, it’s a permanent change.” Right now, there’s growing buzz over...

What Everyone 50+ Should Know About Their Thyroid...

Disorders of this small gland are common, especially in older women Catherine Horvath, 51, was feeling no symptoms five years ago when her doctor ordered a routine blood test to check, among other things, how her thyroid was doing. (Your thyroid is the butterfly-shaped gland low in your neck that influences metabolism, growth and development and body temperature.) The results showed astoundingly low levels of thyroid hormone — a sign her thyroid function was, as she puts it, “pretty close to being nonexistent.” If untreated, she was at risk not only for bothersome symptoms but for other serious diseases as well. The fix was simple: One pill a day to replace the thyroid hormone she wasn’t making. Within a year, Horvath’s levels were back to normal. “It doesn’t really affect my life,” says Horvath, who lives in Santa Cruz, Calif. “I manage it by taking a pill every day.” A Common Disease Horvath is one of the estimated 24 to 28 million Americans who likely have some form of thyroid disease, many of whom develop the disorder later in life. Yet according to American Association of Clinical Endocrinologists, nearly half of those with thyroid disease don’t know they have it or are misdiagnosed. That’s because thyroid disease — particularly among older adults, when the disorders can become more common — often masquerades as other ailments. Hypothyroidism, an underperforming thyroid and the most common of thyroid diseases, may be overlooked by older people who dismiss its symptoms of fatigue, constipation, dizziness or weight gain as simply the price of getting older. An overactive thyroid, or hyperthyroidism, can look like heart rhythm problems, muscle weakness, anxiety or age-related osteoporosis. Thyroid lumps are much more common among older people, yet often can’t...

When Should You Push For a Geriatric Assessment?...

Taking a team approach can net the best results for your parents Navigating the maze of eldercare options can be challenging. A geriatric assessment can help you figure out the level of care your loved one needs. “The phrase geriatric assessment is a bit confusing,” says Norbert “Bert” Rahl , director of mental health services at the Benjamin Rose Institute on Aging. Sometimes an assessment looks at just one issue that’s causing problems for a loved one. For instance: If you are concerned about your mother’s physical status, the medications she is taking or how she is (or isn’t) managing a chronic condition, a physical assessment may be in order. If your father has mobility issues and you’re worried about how well he is (or isn’t ) getting around on his own, he may need a functional assessment. If you are worried about the psychological and emotional well-being of your loved one, a mental health assessment could be helpful. If your aging relative is displaying issues with memory, decision making and financial management skills, a cognitive assessment should be scheduled. Or, to get the whole-person “picture” of what’s going on, Rahl suggests a comprehensive assessment, which looks at all those things and how they are interacting and overlapping in your older loved one’s life. A comprehensive assessment could be coordinated by your loved one’s primary care physician. However, since these assessments require the skills and expertise of a team of specialists, they are best coordinated by a geriatrician: a physician who has trained and specialized in the care and treatment of older adults. Ask for a referral from the primary care physician or click here to find a geriatrician in your area. Who’s On Your Team? The composition of...

How One Patient Researched Her Own Cure...

She’s cracking her DNA code for answers to a life-threatening problem Kim Goodsell is relentless. An extreme athlete, she kite-surfs, climbs mountains and cycles up to 50 miles a day on a high-performance carbon fiber bicycle. She also happens to be at the epicenter of a growing digital medical revolution. The 56-year-old self-financed and conducted genetic research on her own life-threatening health problem — and discovered a genetic mutation linked to her disease. Goodsell has also invented a device to help others live with debilitating conditions. Her doctor — cardiologist, geneticist and researcher Eric J. Topol, of La Jolla, Calif. — has dubbed her “the patient of the future.” Discovering What Was Wrong A former world-ranked endurance athlete who dropped out of University of California San Diego to live more closely to nature, Goodsell started to notice problems in 1997 while running a triathlon. Something did not feel right. “I began presenting with a particularly lethal cardiac arrhythmia, ARVC,” she says. Goodsell received the most powerful implant on the market, an internal cardiac defibrillator. When it kicks in to correct arrhythmia, the shock it delivers is so violent it “lifts me and my bike off the ground,” Goodsell says. “It’s like a bomb exploding in my chest.” This kind of traumatic shock often results in post-traumatic stress disorder (PTSD) that patients experience for months and even years. Goodsell describes her relationship to the medical device in her chest as ambivalent. “On the one hand, it is my lifeline. On the other, it is a terrorist,” she says. DIY Genetic Sequencing Soon after the defibrillator was implanted, Goodsell began to experience motor dysfunction and systemic arthritis, which over more than a decade deteriorated into crippling pain and neurological dysfunction.  ...