Understanding Your Thyroid

Did you know that fatigue, constipation, weight gain or loss, and even depression can indicate a thyroid condition, yet some other individuals are asymptomatic? January is Thyroid Awareness Month, and to encourage people to learn more, the American Association of Clinical Endocrinologists, launched the Power of Paisley campaign with a blue paisley tie as the new symbol of thyroid awareness.

According to AACE, 30 million Americans have thyroid disorders, but half remain undiagnosed and untreated. Thyroid disorders are more common than diabetes, heart disease and breast cancer; affect women more than men; and, run in families. Also thyroid cancer is one of the fastest growing cancers in America, but the most curable.

This small butterfly-shaped gland, in the base of the neck below the Adam’s apple, is vital to your well-being because it affects the function of every cell, tissue and organ. Thyroid conditions can occur at any age and if untreated can cause high cholesterol, infertility, osteoporosis, and even death.

There are a few ways to detect this condition.  Ask your healthcare provider to examine your neck during routine exams because early detection is the key to successful treatment.  If you have symptoms of a thyroid disorder your doctor will perform a TSH (thyroid-stimulating hormone) blood test to measure the gland’s function.  The results will indicate if you have hypothyroidism (insufficient thyroid hormone) or hyperthyroidism (overproduction of thyroid hormone).

Doctors also recommend an at-home “neck check,” using a hand-held mirror and a glass of water, which can be effective in detecting a lump. If you see a bulge or protrusion in the area around the thyroid when you swallow the water, you may have an enlarged thyroid that will need testing.

Ask your physician for more information if you have questions about your thyroid.

Cancer Vaccines

With all of the recent information about cancer vaccines, here is a good site to help clarify some of the confusion.

http://www.cancer.gov/cancertopics/factsheet/Therapy/cancer-vaccines

 

 

Birth control pills

There has been some recent controversy about the newer oral contraceptives.   It is felt that they may have a higher risk of causing blood clots in women compared to some of the older pills.   The risk goes from 6 of 10,000 women to about 10 in 10,000 women.   However, we know that there are some people who are at higher risk of blood clots due to genetic factors, and it is well known that smoking increases your risk of blood clots, even without the pill.  In addition, most blood clots are not fatal.

ALL medications have some potential risk in certain people, but so does not taking medications in some cases.  The risk of dying due to pregnancy in the US is about 1.3 out of 10,ooo, and the risk of the infant dying is almost 68 out of 10,ooo.

If you have questions on the birth control method you are using, please discuss it with your doctor or other medical provider before stopping or changing medications.

IS IT THE HOLIDAY BLUES OR DEPRESSION?

By: Sandra Hoenig, M.D

Once again the holiday season is in full swing and it may appear that everyone is smiling and happy shopping and preparing for their friends and family. It may be that you are not experiencing these joyful feelings and it is starting to cause concern.

This time of year stress can be the result of holiday overload and culminate in sleepless nights, anxiety, over eating and drinking, and mood swings from highs to lows. These signs could be typical of holiday blues or the early signs of depression.  There is no doubt that this time of year is hectic and it is not unusual for individuals to experience mixed emotions, however it is important to recognize that depression is not the same as feeling sad or blue.

So how do you tell the difference between sadness and depression?

• With sadness, a person experiences the emotion for a finite period of time; e.g., a few weeks for a job loss or a few months for a family death.  Through this period of feeling blue the person can cope and function with daily activities.
• Depression lingers for weeks, months, and even years. A person may feel overwhelmed, helpless and has problems with their daily routine.  Other things include: lack of appetite, sleeping too much, no interest in activities they used to enjoy, diminished sexual desire, inability to concentrate, feelings of guilt, and decreased energy.

One thing to keep in mind is that the signs and symptoms of depression are sometimes similar to other conditions.  It can be confused with fibromyalgia, hypothyroidism or chronic fatigue.  Alcoholism and drug usage can mask the symptoms. Depression can be diagnosed with a thorough history and physical exam, including a blood test to rule out any underlying medical conditions.

If you are experiencing any of these feelings, talk to your family physician who knows you and your medical history.  Remember your physician is the first line of defense for determining your medical diagnosis and then suggesting the proper treatment.

For more information read this article from WebMD, which offers some great tips for coping with the holiday blues.

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The risks of not vaccinating

There recently have been multiple stories about the rising rates of many vaccine preventable diseases.  As of October of 2011, European health officials have reported more than 26,000 cases of measles this year, with 9 deaths.  This is triple the cases from the same period in 2007.  The U.S. has had 205 cases so far (we normally have about 50 per year). 

Last year, California had the most cases of whooping cough, also known as pertussis, since 1958.  Nine infants died during this recent outbreak.  China is seeing an outbreak of polio, which most likely started in Pakistan, and is starting to affect the rest of the continent.

What do all of these diseases have in common?  They all started in areas where vaccinations are either not mandated, or in areas where the exemption rate are the highest.

What will keep these diseases from affecting our children?  Vaccinating everyone, both adults and children, against the diseases that we can prevent.  We wiped out smallpox through vaccination.  We should be able to wipe out the rest of these diseases.

How to Avoid Overeating During the Holiday Season

By: Sandra Hoenig, MD

With the holiday season now upon us it is easy to get distracted from our regular eating habits. The American Diabetes Association has declared November Diabetes Awareness month and has ample tips on healthy eating especially during the most wonderful time of the year.  The key factor is to avoid overeating at one particular meal, causing the body to go into overdrive.

• Do not skip breakfast with the thought that you will be eating a large meal later on in the day. It will allow you to be less ravenous when the feasting begins thereby making better food choices.
• Portion control, portion control, portion control.  You should certainly enjoy your food but be mindful of not over indulging.
• Avoid the vegetable trap. Just because a food is green does not mean it has not been cooked in butters and creams thereby deeming it unhealthy.
• Beware of appetizers. It can be a small food but still be packed with calories and fats.
• Eat slowly and give your body time to recognize that it is full before getting another helping. Try putting down your fork between bites or going to another area that does not contain the food. We all tend to eat more when lingering around the food table.

When all is said and done it is okay to slightly indulge during the holidays as long as you do not put your body over the top and know when to stop.  Increasing your exercise routine can also be very beneficial. For further questions on healthy eating you can visit the American Diabetes Association or speak with your physician. Happy Holidays!

TIPS FOR TRAVELING WITH MEDICATION

 

Taking a vacation away from home and work is fun; yet the planning involved can cause stress. It is helpful to plan ahead and pack early so you do not forget anything–especially medications.

When you have to travel with medications make sure to take precautions because some are susceptible to temperature and dampness and can lose their effectiveness if not stored correctly. Another important thing to remember is that special care should be taken when packing medications so that they are kept safely out of reach of children and pets.

Here are some additional safety tips for traveling with medications reported by eHow[1] include:

• Store medications in tightly closed, original pharmacy-labeled containers for protection from heat and light
• Place medications in carry-on luggage for easy access and to prevent loss if luggage is lost
• Bring extra medications and keep them in a separate bag in case the first set is misplaced
• Carry a duplicate prescription in the event a refill is needed
• When carrying syringes, carry a copy of the prescription from the doctor
• Have on hand in your carry-on bag a schedule and complete list of all medications, which includes name, dosage and purpose for taking each prescription
• Keep a list of your doctors and pharmacist with complete contact information

Another good tip is to pack medications first so that it is out of the way, and then don’t forget that carry on! Enjoy and Bon Voyage.

Take a look at this video for more some good advice for storing medicine at home, too!

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[1] eHow; “How to Travel With Prescription Medication,” http://www.ehow.com/how_2096152­travel-prescription-medication.html

TRAVELING THIS WINTER? DON’T FORGET YOUR VACCINATIONS!

The holiday season is right around the corner, and we are getting into the planning mode for shopping, cooking, party planning, baking, and making travel arrangements. These activities require attention and focus. If international travel is on your list this winter, do not forget to check with your family physician about the need for travel vaccines. Even if you cannot find your vaccine records, odds are that your physician will know the inoculations you will need based on your travel destination.
The alarming fact is that according to the Center for Disease Control(CDC) more than half of overseas travelers this year will forgo vaccinations against diseases prevalent in their destination countries. Depending on the country of travel, that oversight will leave them vulnerable to a number of serious diseases including cholera, polio, yellow fever, rabies and Legionnaires. Destinations on the CDC’s recent disease Outbreak Notice list are Asia and other Indian Ocean countries, Brazil and other areas in South America, the Dominican Republic, Haiti, Africa, and Russia. Even if the country you are visiting is not on the CDC’s list you should check with your family doctor to be on the safe side. The CDC Travel Destination Map offers a list of vaccinations recommended before traveling for every country in the world.
In addition here are travel vaccine-related questions to ask your family physician:
• Which travel vaccines do I need?
• Are travel vaccines really necessary?
• When should the immunizations start?
• When is it too late to get shots?
• Can I travel abroad if I have a chronic illness?
• Is it a problem if I cannot remember my vaccination history?
Check out the CDC’s travel vaccine advice video for more information.

How Do You Choose Your Family Doctor?

By: Dr. Arnold I. Pallay. F.A.A.F.P., medical director, Changebridge Medical Associates

With approximately a half billion Americans seeking primary care physicians every year, family doctors are on the “front lines” of medical care. Finding the right medical home for your family involves finding one that can provide general medical exams, as well as intervene in more complex health concerns.

Family physicians that provide continuity of care can recognize life-saving subtle signs because they know the nuances of your medical history not just information in a chart.

There are many criteria to consider when looking for a group that will match your family’s needs including: areas of medical concentration, relationships with specialties, convenience, hospital affiliations, and insurance. Asking for recommendations from your other medical providers, co-workers, neighbors and friends can be a good start.

Here are questions to ask a potential provider:
• Do you prefer a male or female doctor?
• What is your philosophy of care? Are you treatment oriented or prevention oriented?
• Where do patients go for lab work, X-rays, ultrasounds and other diagnostic tests?
• Whom do I call when I have a problem after office hours?
• Where did you do your medical school and residency training?
• Which specialists will come to your office to make complex medical treatment more convenient for me?
• Which doctors are on your insurance company’s plan?
• Does the office offer to process insurance claims or do patients pay upfront for services and send in the forms themselves?
• Does the practice go to bat for you when insurance requests are denied or testing is refused?
• In which hospitals do the physicians have privileges?
• Is there convenient parking or accessibility by public transportation?
• Do you need a doctor with weekend or evening hours?
• Is the office staff friendly and courteous?
• Does the office offer reminders about routine screenings?
• How long has the practice been engaged in electronic medical record keeping of patient files?

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TURN BACK THE CLOCKS AND USE THAT “EXTRA HOUR” WISELY

This weekend we will “fall back” one hour when we change the clocks early Sunday morning. As we move the clocks back one hour we might expect to wake up more rested. For those suffering with sleep disorders this change will make no difference.
Sleep disorders come in many forms including insomnia and narcolepsy which will not improve with the time change. In reality it might cause more stress and symptoms as the result of more tossing, turning and snoring. The National Institutes for Health reports that 40 million people in the U.S have chronic sleep disorders causing many hours of sleeplessness resulting in headaches, dizziness, memory loss, trouble focusing and muscle weakness.
If you are losing sleep the cause could be an old mattress, room temperature, excessive light or many other contributing factors. If you are concerned that you may be one of the millions of Americans suffering from a sleep disorder, ask yourself:
->Do I have excessive snoring?
->Am I waking up with a dry mouth?
->Does it take me a long time to fall asleep at night?
->Do I wake up still tired?
If you answered yes to several of these questions, do not hesitate to report this to your physician, as a medical condition may be the underlying cause.
As Daylight Saving Time ends this weekend, take stock of your sleep habits. If you are concerned that poor sleep can be affecting your overall health, do not hesitate to contact your doctor.