Doc Lisa Says

Health advice from Dr. Lisa McTavish

[doclisasays]

Is no news really good news?

I am a physician, but I am also a patient. I recently had a X-ray test and did not hear about the results. Two weeks passed since I had the test and I assumed that the test must be normal.  Fortunately, I contacted my physician just to check. I was told that the test was not read by the radiologist (Xray specialist) so my physician had not reviewed the results. The specialist read the Xray and my physician reviewed the report and contacted me. The result was in fact abnormal. Fortunately the delay in notification did not affect my health.

When I first started to practice medicine many years ago I would tell my patients that if they did not hear anything about their test results, they could assume that they were all normal.

As I became a more mature physician and did additional training on applying manufacturing quality principals to health care,  I soon determined that no news is not always good news. I always ask my patients to contact me if they don’t hear about their test results within a specified time frame. I ask them to review the actual report themselves and let me know if they have any questions.

There is much information that is assimilated by your physician after you see him or her. This information includes lab and X-ray results as well as reports from the hospital, specialists and pharmacies. Much of this work is done at the end of the physician’s day when they may be fatigued.  Although the computer medical record has been helpful it also makes it easy to miss a result with a click of a button. Physicians need their patients to be active participants by ensuring they get their test results even if they are normal. Ask your physician to make a copy of those results available for you to review yourself. Schedule an appointment to ask questions if something your physician says about those results does not make sense to you. Another good strategy is to get your tests before your regular visit with your physician so you can review them together in person.

Trust is important in a physician/patient relationship but so is mutual accountability.  You need to be accountable by following instructions and the physician needs to be accountable to you by making your test results available and helping you make sense of them. This type of relationship will help you maintain your health.

[doclisasays]

The Balloon Pill

I was asked recently about a weight loss method called the balloon pill.  I had not heard of this pill before, and I was skeptical, but I decided to check it out.

I did some research and found out that the Obalon weight loss balloon pill was released in the UK just recently.  It is already being used in some European countries, but is being studied in the United States. The pill is swallowed and then inflated reducing the volume of the stomach and the amount of food eaten to feel full. There is another weight loss device called the Aspire-assist pump that allows one to empty out the stomach twenty minutes after eating so that the calories digested are reduced by a third. 

I do think there is more to weight gain and obesity than excess caloric intake and lack of exercise.  There has been one study linking bacteria in the intestinal system to weight gain and obesity.  Diabetics tend to have high insulin levels that make it difficult for them to lose weight.  There are certain  genetic conditions that cause insatiable appetite, such as Prader-Willi syndrome.  

I feel that treatments such as the balloon pill, stomach banding, and stomach emptying pump are just bandaids. I think of it as putting a muzzle on someones mouth so they limit calorie intake.  They do not address the root cause of the obesity problem.  The issue is that we don’t know yet what actually causes some people to gain more weight than others. 

I see patients that eat very poorly and exercise very little yet they don’t have a weight problem.  It is the same as some people that smoke like a chimney yet don’t suffer from any lung or heart problems.  We just don’t know exactly why.

We have to accept the fact that we don’t have the answers to many health problems.  We can’t control many things that happen to our bodies. Bandaid medical technologies are not a long term solution. For example, I thought that the stomach banding procedure was going to be a low risk option to gastric bypass surgery only to find that more than half the patients I know who have had the procedure have had to have the band removed.

We do know the following about diet and lifestyle. We know that regular exercise and a healthy diet rich in vegetables, lean protein and complex carbohydrates will help our health. I want you to concentrate  your efforts on something that does not involve a bandaid approach when we have tried and true strategies that help to improve your health for the long-term.

The following is a video about the balloon pill. Check it out.

http://abcnews.go.com/Health/lose-weight-ballooning-pill/story?id=22867028

[doclisasays]

FAST- Stroke

I have been off-line for the last few weeks preparing another medical student lecture  about strokes, and spending time with my visiting parents. I want to help you know what to do when someone you know is having a stroke.  A stroke is damage to the brain that causes a change in brain function. Most strokes are caused by a clot that blocks a vessel bringing oxygen to the brain. 

It is very important for stroke victims to be seen at a hospital emergency room as soon as possible. If a stroke victim is a candidate for “clot busting treatments” they need to get it within three hours of having symptoms.

How do you know if someone is having a stroke?  It is really easy if you remember the word FAST. 

F stands for face.  Look for new weakness or loss of symmetry of the face. 

A stands for arms. Check for arm weakness affecting only one side of the body.

S stands for speech. Check for slurring or inability to speak.

T stands for time. Call 911 to get that person to a hospital emergency room immediately.

How can you prevent stroke?   I know that I sound like a broken record but I want to stress that you need to eat healthy and exercise regularly. If you smoke, stop!!! See your family doctor so they can check your blood pressure and cholesterol. Remember FAST so you can detect strokes early so treatment can be started FAST. 

Please check out this great video about FAST.  

https://www.youtube.com/watch?v=wH7k5CFp4hI

[doclisasays]

Listening to Your Doctor's Advice

One of the things I feel is great is that physicians are starting to be evaluated and compensated on quality that they provide versus just being paid “piece rate.” Since I became a doctor in 1992 my salary has been based on the number of patient office visits. When I practiced in Canada I was “called on the carpet” for ordering too many thyroid tests by the Manitoba government. Other than that they did not care about the care that I provided for my patients. 

When I moved to the US in 1996, I was paid a salary for my first two years followed by a 100% productivity based salary. That is, the more patients I saw per day the more income I made.  The last two years has been a gradual transition to 10% of my income dependent on quality measures. 

I think that this is great, but I do have a concern: how is quality measured? Part of quality is based on patient satisfaction scores. Some is based on whether my patient decides to get a colonoscopy (colon cancer screening) test. Other potential outcomes are diabetes test measures, smoking rates, and body mass Index levels. 

My problem is that I alone am not powerful enough to force these changes. I cannot help if my patients cannot execute my suggestions. They may have extenuating circumstances in their lives such as lack of funds to buy the food I suggest, or lack of time to exercise, or just a severe addiction to smoking.  I as their physician cannot change these circumstances or give them the will to execute change.  I can inspire, and provide the information and support, but that is all. I can’t be by their side at all times making sure they do the things that I suggest.

I see parallels to this type of evaluation and how teachers are evaluated. The teacher can provide instruction, inspiration, and guidance, but they can’t make the student execute. They can’t influence their home environment. 

I think doctors should also be evaluated based on the instruction and support they are providing.  Are we offering the support and advice patients need? I am afraid that rewarding physicians on the results of lab tests, patient weights, or the completion of lab tests will promote the discharge of some patients from a physician’s practice. Maybe this is a good thing because patients will have added incentive to listen to what their physician suggests. I just don’t know yet. I do know that I am happy that I am not being purely rewarded on how many patients I see in a day. Patients, please listen and act on your doctor’s advice It will benefit you and your doctor. 

[doclisasays]

Preparing For Your Doctor Visit-Communicating Your History

A medical history is the story of your health. It includes your past surgeries, medical problems, allergies, medications, family and social history. Your family doctor will also ask you about your history of present illness, which is the details about your chief complaint.

You are the historian, the relayer of this information. Your doctor is the sponge that listens and records what you tell them. He or she will then take this information, process it, and use it to keep you healthy or return you to good health. 

There are three main steps that will enable you to accomplish this important communication.

The first step is to bring all your medications to your visit. A list is not good enough.  You can’t bring them in a candy container or pill box. The actual medicines in their original bottles are required. Why? Sometimes the pharmacy may incorrectly fill the prescription, or another doctor may make a change to your medication. The bottles are used by your doctor or their assistants to compare and correct your medication list to reflect what you are actually taking.

The second step is to be clear about what exactly you want to accomplish at your visit.  Your doctor wants to know up front what your real concern is. Is it just getting a regular complete check up. Is it to review your medical problems such as diabetes or high blood pressure.  Do you have new health concerns? Notify the doctor’s assistant immediately if you need to have a form, prescription or letter completed. Be specific about what is your most important concern and limit your concerns three or less. There is limited time for each visit. Squeezing more than three health concerns into one visit leads to rushing and mistakes.  

The final step is to be focused when communicating your symptoms. This information is very important and forms the history of present illness. Some important questions to think about when preparing for your visit include the following. How long have your symptoms been present? What other symptoms are associated or occur along with the main symptom. What makes your symptoms worse and what makes them better? How severe are your symptoms?

Following these three steps will ensure a better patient doctor relationship and better health outcomes for you.

[doclisasays]

To Pap or Not to Pap

Well ladies, the new Pap Screening guidelines have been released. We can now reduce the frequency at which our Pap tests are taken, and young women can start screening at a later age. 

Now, women only need to start screening at age 21. Repeat screening is at least every 3 years for those who do not have multiple sexual partners or Sexually Transmitted Illnesses (STI’s).  A pap is needed every five years for women who have had three normal paps in the last ten years and a negative test for the Human Papilloma Virus. No paps are needed for those over 65 and for those with hysterectomy and removal of cervix for non- cervical cancer causes.

The Human Papilloma Virus (HPV) has many subtypes. Some of which cause genital or skin warts.  It also has some sub-types that can lead to cervical cancer. Fortunately there is a vaccine for young ladies and men that can prevent the types of HPV infections that cause genital warts and cervical cancers.

In the past, doctors started doing pap tests when young women became sexually active. This recommendation has changed because they can recover from the Human Papilloma Virus. Many women were having procedures on their cervix for abnormalities that would heal on their own. These cervical procedures could even cause premature delivery later in life when they were pregnant. 

The ability to heal from the Human Papilloma Virus decreases as a woman ages; therefore regular screening is required. The screening frequency used to be every year, but now it is every 3 years for women aged 21-31 and every 5 years for women aged 31-65–provided they had a negative screenings for HPV and no other abnormalities in the past.

Most women are probably happy that they can decrease their pap test frequency. I know I am! 

I still feel you should see your family doctor once a year for your health maintenance and internal pelvic exam to screen for uterine or ovarian masses. You also should have a yearly breast exam and review of your general health. You take your cars in for regular maintenance, and in the same way, you need to take care of your body for general review and check!!

Next week I will discuss how you can prepare for your visit with your doctor.

[doclisasays]

Are We Carbing Ourselves to Death?

I was reviewing my blogs and realized that I have not written about carbohydrates.This topic takes on special relevance to me since I have changed my carbohydrate intake over the last few weeks to help reset my body from all of the cookies I ate over the Christmas break. I have to say since making the change I feel so much better!

Carbohydrates are a component of many of the foods that we eat. They are found in pasta, sugar, fruits, juices, vegetables, corn, bread, rice, and milk.  They are burned by our muscles to produce energy and can be converted and stored in our body as fat. In a previous blog I discussed Fatty Liver. In order to understand how this disease occurs we need to know about Insulin in the body.

Insulin is a major hormone that helps our body use the carbohydrates we eat. It helps our muscles absorb the sugars that come from the carbohydrates we eat and use them as energy. When we overload on carbohydrate intake we make our muscles resistant to the insulin in our body. As this happens our pancreas compensates by producing more and more Insulin. Higher insulin levels cause us to crave more carbs and converts the sugars to fat. The fat tends to surround the heart muscle and invade organs like the liver. It is dangerous fat that takes control of the body like a monster out of control, causing inflammation, and cravings for more carbohydrates.  

We all need to eat foods with carbohydrate to make energy for our bodies to work. The problem occurs when we eat too much and do not balance this intake with proteins and fiber. An analogy would be burning paper versus burning a piece of hardwood or coal. Plain paper is not good as a sole energy source. It burns too quickly and not long enough. Hardwood and coal burns long and steady. 

The same is with our bodies. If I eat just a plain doughnut in the morning I feel kind of drowsy as my sugar quickly soars followed by feeling shaky and hungry within an hour of eating it. If I eat an egg, some granola and Greek yogurt I feel full and energetic for a few hours because the the granola is high in fiber and the carbohydrate in the yogurt is paired with protein. It provides a slow steady flow of sugars instead of a flood so my Insulin levels remain at a lower level. Over the months my muscles remain sensitive to the action of the Insulin, and the energy is not converted to dangerous fat. 

Examples of foods that have carbohydrate and protein include milk, yogurt, and nuts. Those that contain high amounts of carbohydrate and fiber include fruits such as apples, and oranges, and whole grains. 

I tell my patients that have trouble losing weight to cut out juices and eat fruit.  Cut out white rice and pasta and eat quinoa or couscous.  Eat yogurt, cheese and nuts. Eat more vegetables and protein, and reserve only a quarter of your plate to carbohydrate foods. Instead of eating potatoes, substitute cauliflower. Save cakes and cookies for a special treat. Broaden your horizons so you feel great and stay healthy!

[doclisasays]

Is it worth taking Fish/Flax seed oil Supplements?

My husband ran out of his his fish oil capsules. He takes them to improve his cholesterol levels and prevent heart attacks. I have also taken this supplement in the past and have instructed my patients to do the same. Is taking Fish oil or Flax seed oil supplements worth the cost?  I decided to research it in detail.

Earlier scientific studies indicated that taking Fish Oil may help decrease the chance of having a heart attack or stroke for those at high risk or have had previous heart problems as it contains Omega-3a fatty acid. However, newer studies are indicating that   the supplements do not show this effect. It is very confusing. What is it about Omega-3a  that potentially can keep our heart’s healthy?

This fatty acid is a Polyunsaturated Fatty Acid or PUFA (what a fun acronym) and seems to have protective effects on arterial blood vessels, as well as making the blood clotting blood cells called platelets less likely to stick together to clog an artery. They are also proven to decrease Triglycerides (Terrible type cholesterol), up to fifty percent, but may elevate LDL (Lousy type cholesterol). Both these cholesterols can block arteries. 

Fish oils are different than flax seed, canola, soy and olive oils. These seed oils contain  Omega-3 PUFAs, which is different than Fish oil. They also have different health effects.  Omega-3 fatty acids in the seed oils lower LDL (Lousy type cholesterol), and increase Triglyceride (Terrible type cholesterol). However, the Omega-3 fatty acid in English Walnuts may increase the levels of HDL  (Happy type cholesterol) that can keep heart and brain blood vessels open. Omega-3’s don’t appear to protect the arterial blood vessels or effect blood platelets like Omega-3a’s do.

What is the bottom line? Should my husband buy the Fish or Flax seed Oil caplets?  The answer to both these questions is NO. It is better to eat 3-4 ounces of fatty fish such as Tuna or Salmon two times per week, cook with Canola or Olive Oil and throw in a few English Walnuts for good measure. Taking Fish Oil Capsules, or Flax Seed capsules is not going to make you sick, but the cost may outweigh the benefit. 

[doclisasays]

Are We Working Ourselves to Death?

I took a vacation from writing this blog and being a family doctor, leaving Lafayette Indiana for sunny Mesa Arizona. 

 I did not post a blog last week.  I just took a break from work and my usual routine.  I am so blessed to be able to take this kind of vacation.  I do feel that a break from our usual routine is good for our health even if we do not travel far from home, but I wanted scientific evidence to support my view. I did some research.

Does a vacation help us from working ourselves to death?  I did find one study done in 2002 by Dalia Etzion from the Tel Aviv University.  This study compared the burnout and stress rates between those who took their annual vacation versus those who did not.  They found that those 51 workers who took a vacation had lower burnout and stress questionnaire scores compared to those who did not take the vacation.  They also reported that after three weeks the ameliorative effect of the vacation wore off and the pre vacation stress and burnout rates recurred. They also found that the stress and burnout rate reduction was the same for short vacations 7-10 days versus longer vacations of more than ten days.

Since moving to the Midwest from Canada in 1996, I found that the people working in Indiana take very few vacations.  Americans use less than two thirds of their allotted vacation time, according to Expedia’s thirteenth annual vacation deprivation study.  I really think it is good for anyone to take a vacation even if it an extra day for a long weekend.  I myself try to take an extra day off every one to two months.  I find I feel much more refreshed after having a little break. 

My health advice this week is to take a break from your work routine.  You don’t need to go far. Maybe it is a trip to a bookstore, the zoo or the park. Change up your routine.  It does not need to cost a lot. Just take some time off from your usual work routine at least once every two months.  Reset your selves and you will find you will have more energy to take on your work commitments when you return.

[doclisasays]

Does Vitamin C prevent the common cold?

My husband takes Emergen C every day.  It contains 1000 mg of Vitamin C per pack.

My daughter first told us about his supplement. She said her music student friends would take it as soon as they felt a cold coming. One day when I was visiting her,  I thought I felt like I was starting to get a sore throat.  I took one of her packets and mixed it with water and drank it quickly.  It was very sour and fizzy tasting but my sore throat vanished.

Does taking this supplement keep us healthy and is it safe to take?

Most animals don’t need vitamin C in their diet, because they make their own vitamin C. Human’s are not so fortunate. The  recommended daily intake according to the U.S. Food and Nutrition Board of the Institute of Medicine is 90 mg for men and 75 mg for women older than 18 years. Breastfeeding women are to get 120 mg daily.

I did some research and found that taking up to 2000 mg /day is likely safe. High doses can cause intestinal upset and diarrhea. Children need to take far less than these amounts. 

I found that Vitamin C is likely effective for:

treating Age related Macular Degeneration(age related visual loss)  in combination with multiple vitamins;

preventing Coronary Artery Disease (blocked heart arteries), and Peripheral Vascular disease (blocked arteries in a leg, or arm);

reducing the risk of mouth cancer;

decreasing blood pressure;

decreasing the risk of stomach inflammation from the bacteria H. Pylori and preventing acid related precancerous changes in stomach tissue;

prevention of Gallbladder disease;

decreasing the duration of the common cold by 1-1.5 days;

decreasing kidney damage potentially caused by Xray dyes;

preventing pre-eclampsia (pregnancy related hight blood pressure);

reducing transmission of HIV;

preventing Reflex Sympathetic dystrophy (complex pain syndromes) after a broken wrist;

preventing respiratory illnesses after intense exercise;

preventing sunburns, and decreasing wrinkles (when used topically); and 

preventing lead toxicity.

I could not believe all that Vitamin C can possibly do to keep our bodies healthy.  We can easily get adequate Vitamin C from our diets.  It is found in  fruits,  green vegetables, peppers, and tomatoes. Deficiency was seen in sailors and pirates in the past since these fruits could not be stored for a long voyage.  Deficiency can cause spots in the inside of the mouth, weakness, skin wounds, loss of teeth, and nerve malfunction.  Fortunately I have never seen this illness in my practice. We definitely know that Vitamin C can cure this illness.

Please check out the link below on the top food source and how much Vitamin C they contain. 

I may still continue to take Emergen C when I start to feel a cold starting. At least I know that it is likely effective in shortening the duration of a cold.  Although I am not entirely sure it can help prevent a cold, I definitely know that it will not hurt me.

http://www.healthaliciousness.com/articles/vitamin-C.php

[doclisasays]

Psychiatric Illness and the Holliday Season

There is a lot of stress that can occur during this Holliday season.  For example their  stress of buying gifts if you are financially strapped, planning that perfect party, and trying to get to all of the events that are planned.  This stress is on top of all the other issues people are facing at the end of the year.  Company’s plan their budgets for the next year, which sometimes lead to job lay-offs.

As I mentioned in previous blogs, predisposition to medical problems can be inherited.  Psychiatric illnesses are medical problems. Environmental stresses listed above can trigger the occurrence of these medical problems. 

Some  believe that these medical problems are in “their head”.  They should be able to will them away and if they can’t they are weak. It is true that they are illnesses that can affect how one thinks, and talking to a trained therapist about how to change your thinking and behavior is important. Equally important is seeing your family doctor. If your family doctor cannot help you they can refer you to a psychiatrist and recommend a therapist.

The illnesses that I most commonly see are Depression, Anxiety, Panic Disorder, Depression, Obsessive Compulsive Disorder,  Attention Deficit Disorder, Eating disorder and Bipolar disorder.  These illnesses can be very debilitating to you and may include the following symptoms:

Depression- feeling hopeless, sad, loss of interest, sleep problems and feeling like life is not worth living.

Anxiety and Panic Disorder- constant worry , heart palpitations, shortness of breath, and feeling like you are going to die.

Obsessive Compulsive Disorder- constant repetitive irrational thoughts, feeling compelled to do certain behaviors to an extreme, such as checking locks, or repetitive hand washing.

Eating disorders- Excessive unhealthy dieting or binging and purging because of a distorted self image.

Attention Deficit Disorder- Impulsive behavior, trouble focusing.

Bipolar Disorder- Extreme mood swings from feeling very sad, tired hopeless to being angry, overly energetic, and engaging in risky behaviors.

If you are feeling these symptoms and you have family, friends, or co-workers telling you that you need help, PLEASE GET HELP.  Your are hurting your family and friends severely if you do not get the help you need.  

Attached is a great website that includes many screening quizzes and information about some of the illnesses I described above.  Even if you feel you are fine it is interesting to complete these quizzes. Be humble, listen to your family and friends and get help!!!

http://psychcentral.com/quizzes/

[doclisasays]

Thankfulness and Your Health

I had a great Thanksgiving holiday.   I am grateful for shelter, plentiful food and family.  I feel blessed to live in a country where I am free to practice my religion, state my views, and be able to make a living helping people.

Giving thanks brings us hope, makes us happier, and makes us healthier. The Three H's!!

Giving thanks forces us to focus on the positive and gives us hope to carry on during hardship.  A perfect example is the story of the Pilgrims. My husband I were watching a television program on the Pilgrims and their first thanksgiving.  Out of the 110 pilgrims that landed on Plymouth Rock only 53 lived through the first winter.  Can you imagine living in those conditions?  The Native Americans taught them how to get sap from the Maple tree and how to plant corn with fish as fertilizer.  Their first year they were successful and they celebrated with the natives that helped them.  Despite the great loss of life and hardships they celebrated and gave thanks. This gratefulness gave them hope to carry on and persevere despite their hardships. 

Brother David Steindil- Rast Author of the book Gratefulness, the Heart of Prayer 

States the following:

Happiness cannot be traveled to, owned, earned, worn or consumed. Happiness is the spiritual experience of living every minute with love, grace and gratitude.

Being grateful provides the framework for a positive attitude. It allows us to focus outward instead of inward, and what we have instead of what we don’t have. 

As a physician I see many people with debilitating chronic conditions.  Some will say to me, "I may not be able to walk or breath very well but I am so blessed to have such a good family." Thankfulness separates those that are happy and thrive versus those that I dread to see as they remain negative and continue to suffer despite anything I try to do to help them

With hope and happiness it is easy to understand why the third H, healthiness follows.  

Two psychology professors have studied the health benefits of gratefulness. Dr Robert A. Emmons from the University of California and Dr Michael McCullough from the University of Miami have made the following observations about those who exercised gratitude through journals, and lists:

Reported fewer physical symptoms, felt better about their lives as a whole, and were more optimistic about the upcoming week compared to those who recorded hassles or neutral life events;

Were more likely to have made progress toward important personal goals (academic, interpersonal and health-based) over a two-month period compared to subjects in the other experimental conditions. 

 Furthermore in a sample of adults with neuromuscular disease, a  21-day gratitude intervention resulted in: greater amounts of high-energy positive moods; a greater sense of feeling connected to others, more optimistic ratings of one’s life, and better sleeps duration and sleep quality.

A positive attitude allows our immune system to work better and helps us to fight off infection.

My pitch to you is to exercise gratefulness through some type of practice such as journaling, meditation or prayer.  Focus your thoughts and outward instead of inward  It will bring to you the 3 H’s hope, happiness, and healthiness.

[doclisasays]

Thigh Gap

My Daughter Briagha wanted me to write about a health issue for young women called Thigh Gap.  I had not heard about this before so I researched it.

Thigh Gap is a space between the upper thigh bones.  It is something that young women want to attain because of seeing other young women with it in magazines,  TV, and social media sites. 

Healthy and even overweight women have a thigh gap because they inherit a certain thigh bone (femur) or pelvic bone structure from their parents. 

Some young women will starve themselves to make their legs too skinny, just so they can have the coveted gap.  This problem is known as an Eating Disorder, which can be a deadly illness.

I have young beautiful women who come to the office who feel they are fat, when they are healthy weight. It is even sadder when girls as young as ten feel they are fat when they are not. 

We need to stop buying what the social media, TV and magazines are selling  on how we should look. Stop laying around and watching TV, reading unhealthy articles in magazines,  and spending time on unhealthy areas of social media sites. Ride a bike, have fun with friends, and walk a dog. Don't skip breakfast; stop eating junk food; and eat more protein fruit, and vegetables. Don't compare yourself to others. You don't need a Thigh Gap!!

[doclisasays]

How to check a Temperature

We are reaching the high season for colds and other infections.

We are closer together because of the weather and we spread our germs.

When my patients come into the office with a possible infection, I always ask if they have a fever.  It is very frustrating when they say they have a fever and then I ask what is their actual temperature, they tell me they have not checked it  Why? Sometimes they do not have a thermometer. What is the easiest way to check a temperature and what is the best device to check it?

I did some research on this topic because my Braun ear  thermometer is over twenty years old.   We purchased it when my daughter was born and it has served us well.  I want to purchase a new device.

Our family subscribes to Consumer Reports.  They tested a variety of thermometers and determined that the easiest to use device in those older than three months is the temporal scan thermometers. These thermometers read the infrared heat waves from an artery in the forehead.  They are quick, easy and painless to use. Consumer Reports rated them on price, accuracy, repeatability, and failures. They found that the highest rated thermometer was the Vicks 4977 at $37.00. 

I researched this thermometer on Amazon and found that it was given 3/5 stars with about 100 reviews.  The highest rated forehead thermometer was the Exergen Temporal Artery Thermometer Model #2000C TAT-2000C Battery. It was the second highest rated thermometer on Consumer Reports.  

The main difference in the thermometers is the display and cost . The Vick's thermometer has a big lighted display which may be easier to use when you are checking a baby's temperature in the middle of the night. The Exergen is a little more costly. I think you can't go wrong with any of these thermometers.  The old fashioned thermometers work as well, but they take longer to get the reading. 

I have used the temporal artery thermometers at work and I find it a bit tricky  to use so I did some research on how to use it.  Here is a video on how to use it correctly from Fab Grandma. Enjoy and please get yourself a thermometer because then, when your doctor asks for your temperature you will have the answer!!!

http://www.youtube.com/watch?v=Swlgm68scyE

[doclisasays]

Fatty Liver

i love the metaphor of health like a gun.  You inherit much of your health.  Your genetic predisposition represents the cocked trigger of the gun. You pull the trigger when you expose your body to stress it cannot handle. THE CONSEQUENCES CAN BE DEADLY.

We eat too many carbohydrates now and some people are prone to this disease that can lead to end stage liver failure (Cirrhosis).  A more common disease that occurs with eating too many carbohydrates  when someone is genetically predisposed,  is Type 2 Diabetes.  

We will talk about carbohydrates next week.

I am a visual person. Today I will share an images of fatty liver. 

[doclisasays]

Too much to do and not enough time...

My parents are visiting from Winnipeg Canada, and my daughter, Briagha,  and my husband are off to a songwriter's convention in Los Angeles.

I just finished reviewing lab reports and prepping my charts for tomorrow.  Did you know that much of my time as a family doctor is spent on my computer instead of with patients? I  review  labs and determine what labs need to be done in the future for my patients.  I also research their illnesses, and communicate with other specialists about their illnesses as well.

One new deadly disease I want to write to you about in the future is Fatty Liver Disease.    A deadly type of fat called visceral fat invades the liver and damages it greatly. It can cause end stage liver disease (Cirrhosis).  This illness occurs because genetically susceptible people eat too many carbohydrates (bread, corn, pasta, sugar). I will explain to you how you can avoid this deadly disease.

Please don't overdue it on the Halloween candy!!! 

Please enjoy my daughter's Youtube videos.  Music is therapeutic!!

http://www.youtube.com/user/briaghamctavish?feature=watch

[doclisasays]

Don't let FEAR ruin your life. Get the Flu Shot.

I can’t stop thinking about germs. This is the season when we are all more susceptible.  We tend to huddle more closely together in the winter and therefore are more likely to share our germs.  Our noses become dried out our lips chapped and the germs can pass into our bodies more easily.

The nurse that works at my family practice office had a virus that gave her diarrhea and vomiting. She missed a few days of work in our office.  She came in even when she was sick because she was concerned that our office did not have a replacement nurse.  I told her go home.  First of all I wanted her to get better by resting. Second of all I did not want her to spread the germs in the office.  Don’t go to school or work when you are sick!!!

One major germ is the influenza virus.  It is a deadly germ that can kill you. I try to remember to offer all my patients a flu shot, but many just don’t want to get it because of FEAR.  I just found another reason to get the flu shot especially if you have heart problems. I was speaking to my my mother and she said that my dad’s doctor told him that getting the flu shot can prevent heart attacks.  I told her that I would look it up and sure enough there is scientific evidence to back up this claim.

Researchers recently reported in the Journal of the American Medical Association , that there was an association between influenza vaccination and a lower numbers of heart attacks, stroke, heart failure, unstable angina (chest pain due to blocked heart arteries), and need for treatment to open blocked heart arteries. They looked at multiple good scientific studies with many patients with a past history of heart problems.  Those with the most severe history of heart disease were protected the most when given the vaccine versus those who did not receive the vaccine.  Five studies showed that only 58 people needed to be given the flu shot to prevent one bad heart outcome.  

Why be so scared? Don’t let your FEAR keep you from staying healthy!! Get the flu shot this year!!!!

Here is another link from our friend Bill Nye the Science Guy about germs.  Enjoy!!!

http://www.youtube.com/watch?v=GQFUziWNj2c