In the best health: what four individuals learned about visiting their doctor's, asking questions, and getting a second opinion.Managing your health involves more than just schedulings a yearly physical. It requires doing research, knowing your family, history and keeping up with new test a and screenings for your age and risk categories. It's also important to find a doctor with whom you feel comfortable discussing your questions and concerns. We feature bout individual of various ages who have learned the importance of being proactive about their health needs. Camille Abrahams was no stranger to the doctor's office. Having been diagnosed with ITP ITP - Intent to Package (Immune Thrombocytopenic Purpura immune thrombocytopenic purpura n. See idiopathic thrombocytopenic purpura. immune thrombocytopenic purpura Idiopathic thrombocytopenic purpura, see there ), a rare blood disease that hinders her blood's ability to clot, she knew how important it was to maintain her health and see her doctor regularly. So when she was diagnosed with osteoarthritis osteoarthritis or osteoarthrosis or degenerative joint disease Most common joint disorder, afflicting over 80% of those who reach age 70. It does not involve excessive inflammation and may have no symptoms, especially at first. at 26, Abrahams was determined to get a second opinion. Her diligence paid off. "I was a very active person and I just felt myself slowing down and I didn't know why," says Abrahams, who works for a New York-based nonprofit agency that provides technical assistance to HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. programs. Early this year, during her regular workouts at the gym, Abrahams noticed that her knuckles would swell and hurt. She also noticed other symptoms such as hair loss, chronic fatigue, skin rashes on her elbows, and sensitivity to sunlight. She sought advice from her hematologist he·ma·tol·o·gist n. A physician specializing in hematology. Hematologist A medical specialist who treats diseases and disorders of the blood and blood-forming organs. , a specialist she had been visiting since her teens because of her blood condition. He referred her to a rheumatologist rheumatologist /rheu·ma·tol·o·gist/ (roo?mah-tol´ah-jist) a specialist in rheumatology. rheu·ma·tol·o·gist n. A specialist in the diagnosis and treatment of rheumatic disorders. , who ran more blood tests. The result was lupus. Abrahams' white blood cell count white blood cell count, n a diagnostic clinical laboratory test to determine the number and types of leukocytes present in a measured sample of blood. Overall the normal number of leukocytes ranges from 5000 to 10,000/mm3. was high and her A&A (anti-nuclear antibody) was positive. Over 90% of lupus patients have a positive A&A. Dr. Dina Strachan, a New York-based dermatologist, says that black women should pay close attention to lupus symptoms. "Black women who suffer with lupus are much more likely to have problems or even die from [complications caused by the disorder]," she explain s. Early symptoms include scaly scal·y adj. 1. Covered or partially covered with scales. 2. Shedding scales or flakes; flaking. scaly skin condition characterized by scales; scalelike. patches, scarring, and lesions. Lupus is an autoimmune disease autoimmune disease, any of a number of abnormal conditions caused when the body produces antibodies to its own substances. In rheumatoid arthritis, a group of antibody molecules called collectively RF, or rheumatoid factor, is complexed to the individual's own gamma that affects various parts of the body, particularly the skin, kidneys, joints, and blood. Antibodies that usually attack foreign agents like bacteria start to attack healthy cells. The disease is approximately two to three times more prevalent in people of color Noun 1. people of color - a race with skin pigmentation different from the white race (especially Blacks) people of colour, colour, color race - people who are believed to belong to the same genetic stock; "some biologists doubt that there are important and almost exclusively affects women. Abrahams was not aware that her blood condition could be considered a precursor for lupus. Since being diagnosed, she joined an online support group, Sisters with Lupus. Because stress can incite To arouse; urge; provoke; encourage; spur on; goad; stir up; instigate; set in motion; as in to incite a riot. Also, generally, in Criminal Law to instigate, persuade, or move another to commit a crime; in this sense nearly synonymous with abet. a flare-up of symptoms, Abrahams tries to keep stress to a minimum by practicing yoga. She also takes medication. "[The] 20s is typically when people are feeling like they're healthy and invincible," says Dr. Andrea Pennington, founder of the Pennington Institute for Health and Wellness. However, young men and women should enforce good health habits as early as possible to maintain a high quality of life. Kat Carney only visited a doctor when she absolutely had to. When back pain forced her to pay her doctor a visit seven years ago, what she learned forced her make lifestyle changes that completely transformed the way she lives today. Weighing in at 240 pounds, the former anchor for CNN CNN or Cable News Network Subsidiary company of Turner Broadcasting Systems. It was created by Ted Turner in 1980 to present 24-hour live news broadcasts, using satellites to transmit reports from news bureaus around the world. Headline News was reluctant to admit there was a problem. But the doctor insisted that obesity was contributing to her back pain. "I told the nurse, 'there's something wrong with your scale,'" Carney jokes. The excess weight was not the only problem. Her inability to lose it was just one sign that something else was wrong. Carney also noticed hair shedding from her head. Simultaneously, she was developing hirsutism Hirsutism Definition Excessive growth of facial or body hair in women is called hirsutism. Description Hirsutism is not a disease. The condition usually develops during puberty and becomes more pronounced as the years go by. , excessive growth of body hair. Her menstrual cycle menstrual cycle n. The recurring cycle of physiological changes in the uterus, ovaries, and other sexual structures that occur from the beginning of one menstrual period through the beginning of the next. was also irregular. Her doctor said that there was nothing seriously wrong, but Carney was determined to understand the problem behind her ailments. After seeing several doctors, one finally suggested that she might have Poly-cystic Ovary ovary, ductless gland of the female in which the ova (female reproductive cells) are produced. In vertebrate animals the ovary also secretes the sex hormones estrogen and progesterone, which control the development of the sexual organs and the secondary sexual Syndrome, a hormonal disorder that affects approximately 10% of women of childbearing age. In PCOS PCOS polycystic ovary syndrome. Polycystic ovarian syndrome (PCOS) A condition in which the eggs are not released from the ovaries and instead form multiple cysts. Mentioned in: Oophorectomy, Ovarian Cysts sufferers, the pituitary gland pituitary gland, small oval endocrine gland that lies at the base of the brain. It is sometimes called the master gland of the body because all the other endocrine glands depend on its secretions for stimulation (see endocrine system). sends the wrong hormonal signals to the ovaries Ovaries The female sex organs that make eggs and female hormones. Mentioned in: Choriocarcinoma ovaries (ō´v , which in turn, will not release eggs as they would during a normal menstrual cycle. The ovaries become enlarged and develop several fluid-filled cysts, which contain mature eggs. "Carney did the right thing by seeking more than one medical opinion," says Pennington. "As African Americans, we have to be willing to tell all the symptoms we are experiencing. It could be a signal that something bigger is going on inside that could become a big deal later on." Women with PCOS also have higher levels of insulin, which increases their risk of developing diabetes. "When your blood sugar is elevated, it damages the lining of the coronary arteries Coronary arteries The two main arteries that provide blood to the heart. The coronary arteries surround the heart like a crown, coming out of the aorta, arching down over the top of the heart, and dividing into two branches. ," says Dr. Jennifer Mieres, director of nuclear cardiology nuclear cardiology Imaging The use of nuclear imaging techniques in the noninvasive study of cardiovascular disease–eg, myocardial perfusion imaging, planar imaging, SPECT–single-photon-emission computed tomography, infarction imaging. at North Shore University Hospital in Manhasset, New York Manhasset is a hamlet (and census-designated place) in Nassau County, New York on the North Shore of Long Island. As of the United States 2000 Census, the population was 8,362. Manhasset is a Native American term that translates to "the island neighborhood. , and spokesperson for the GE Healthcare Women's Heart Health campaign. These elevated insulin levels also result in excess testosterone production by the ovaries, which causes excessive facial hair growth that women with PCOS often experience. Other symptoms include male pattern baldness male pattern baldness n. A progressive, diffuse loss of scalp hair in men that begins in the twenties or early thirties, depends on the presence of the androgenic hormone testosterone, and is caused by a combination of genetic and hormonal factors. , thinning hair, acne, oily skin, and infertility. PCOS sufferers are also at greater risk for high cholesterol Cholesterol, High Definition Cholesterol is a fatty substance found in animal tissue and is an important component to the human body. It is manufactured in the liver and carried throughout the body in the bloodstream. and high blood pressure. Whether obesity is a cause or result of PCOS is not clear. What is known is that weight gain is one of the main symptoms. Carney had poor eating habits that compounded her difficulty with losing weight. "My eating habits were absolutely atrocious and I got zero extracurricular physical activity," she says. There were, and still are, no FDA-approved drugs for the treatment of PCOS. As with many sufferers of PCOS, Carney was prescribed birth control pills to regulate her hormone levels, but they caused Carney to gain weight and suffer from excessive sweating. Carney decided to research her best medication options. She found a French study about a drug called Flutamide. In the United States, the drug had been approved to treat prostate cancer prostate cancer, cancer originating in the prostate gland. Prostate cancer is the leading malignancy in men in the United States and is second only to lung cancer as a cause of cancer death in men. . But several doctors refused to prescribe it to her for PCOS. Eventually, she found a physician who consented but insisted on monthly liver checkups and swore her off alcohol. "It ended up being the perfect medication for me," says Carney. "Whatever physician you're working with, it's a partnership," she continues. "The doctor--patient relationship should not be adversarial." Carney also adopted an exercise regimen that resulted in her shedding 90 pounds in 14 months. She also changed her diet by reducing her intake of refined carbohydrates and eating more fresh vegetables. Carney is now a spokesperson for NutriSystem. She also started a Website to educate women about PCOS, www.soulcysters.com, and another support Website for those struggling to control their weight, www.fitatanysize.com. What Ben Green didn't know almost killed him. His chronic headaches weren't just stress-related. They were crucial warning signs that would have prompted him to seek medical attention sooner if he had known how close he was to death. Green, an electronic data interchange See EDI. (application, communications) electronic data interchange - (EDI) The exchange of standardised document forms between computer systems for business use. EDI is part of electronic commerce. administrator for FOX Cable Networks Group, was concerned about developing asthma, which ran in his family. He wasn't as concerned about his eating habits. He loaded up weekly at his favorite fast-food restaurant. "It was a ritual," he says. "Fried chicken, fried fish, lots of hot sauce. I ate a lot of the wrong foods." In 2000, a particularly stressful year for Green, he began to experience severe headaches. He put off going to the doctor because he didn't have health insurance and opted to take aspirin instead. His headaches, however, became unbearable. "I started going to sleep with headaches and waking up with headaches that wouldn't go away," Green explains. In January 2001, he finally visited a clinic for a checkup. The triage triage Division of patients for priority of care, usually into three categories: those who will not survive even with treatment; those who will survive without treatment; and those whose survival depends on treatment. nurse took his blood pressure twice, then quickly summoned the head nurse. Green knew something was wrong. "The head nurse took my pressure and she told me I had to be hospitalized." He was admitted that same day and was assigned a doctor who checked on him every 30 minutes to make sure he remained conscious. With a blood pressure of 220 over 190, Green could have had a stroke at any moment. A healthy blood pressure is usually at or below 140 over 90. "In general, African Americans do not seek out medical care unless something goes wrong," says Pennington. If Green had known that he fit the profile of someone who suffers from high blood pressure--African American, mid-40s, and a sedentary lifestyle with a family history of high blood pressure--he might have paid attention to his headaches earlier. Unfortunately, Green did not learn his full family history until his hospitalization. "Very often, African Americans can have undiagnosed hypertension," says Mieres. "Hypertension is a powerful risk factor for heart disease. The 40s is usually when heart disease starts manifesting in men." Mieres advises both men and women to have an Electrocardiogram electrocardiogram /elec·tro·car·dio·gram/ (-kahr´de-o-gram?) a graphic tracing of the variations in electrical potential caused by the excitation of the heart muscle and detected at the body surface. (ECG or EKG ECG or EKG A record of the waves that relates to the electrical impulses produced at each beat of the heart. Mentioned in: Electrocardiography ), a test that measures the electrical activity of the heart, by age 40, in addition to a routine physical exam to screen for any signs of heart disease. Green was put on Lotrel to keep his blood pressure down and Lipitor to control his cholesterol. He brought his weight down from 265 to 235 in three months by exercising regularly and removing salt and junk food junk food n. Any of various prepackaged snack foods high in calories but low in nutritional value. junk food from his diet. He limits salt intake and reads food labels for sodium and sugar content. "When I go out to eat, I check the salt limits. When I order french fries, I tell them no salt." Green was fortunate, but many African Americans are at risk for hypertension and are unaware of how serious the condition can become and what other ailments it can trigger. "African Americans have a genetic predisposition genetic predisposition Molecular medicine The tendency to suffer from certain genetic diseases–eg, Huntington's disease, or inherit certain skills–eg, musical talent to hypertension," says Mieres. Heart disease and stroke are the No.1 and 3 killers of African American men and women. She adds, "having an elevated blood pressure destroys the lining of the vessels that supply the heart and the vessels that supply the brain. The heart has to work much harder." Preventative measures literally can be the difference between life and death. "In the military, they make you do a physical every year," says David Dunham, a retired non-commissioned Air Force officer, who always asked to be tested specifically for diabetes. Dunham has a family history with the disease, but through 23 military physicals, the tests were always negative. Dunham was also in good physical condition, working out regularly and staying active. "I used to go to the gym, play basketball, and play softball. I was always on the go," he says. After retirement, his pattern of physical activity changed. He became more sedentary and gained 25 pounds. He also began to notice other physical changes like a continual urge to urinate urinate /uri·nate/ (u´ri-nat) to discharge urine. u·ri·nate v. To excrete urine. urinate to void urine. , extreme thirst, and very low energy. Dunham's doctor visit revealed that he had developed Type II diabetes Type II diabetes Type II diabetes is the most common form of diabetes and usually appears in middle aged adults. It is often associated with obesity and may be delayed or controlled with diet and exercise. Mentioned in: Diabetic Ketoacidosis . When compared with other ethnic groups, "an African American person who gains weight and has a sedentary lifestyle is twice as likely to develop diabetes," says Mieres. Type II diabetes is particularly prevalent in the African American community and Dunham's profile fit into a cluster of risk factors. Diabetes is also a huge risk factor for heart disease. Elevated blood glucose levels destroys the lining of the heart and promotes a build up of plaque in the arteries, which blocks blood flow. At first, Dunham's doctor prescribed oral medication. He is now taking daily insulin shots. "It was very hard. The first couple of times, I couldn't bring myself to stick myself," he says. He is also taking a low dosage of pills to keep his cholesterol and blood pressure under control. Now Dunham stays active by doing yard work for cardiovascular exercise cardiovascular exercise Sports medicine Any vigorous aerobic exercise, which near-maxes the heart rate–eg, basketball, bicycling, cross-country skiing, dancing, hiking, jogging, race-walking, racquetball, running, skating, soccer, stair-climbing, volleyball. . He takes his medicine regularly and visits his doctor every six months. Name: Camille Abrahams Age: 26 Health concern: lupus Symptoms: fatigue, skin rashes, arthritis in fingers, hair loss Degree of involvement: Abrahams was diagnosed with a blood disorder at 16 called ITP (Immune Thrombocytopenic Purpura), which caused her platelet count Platelet Count Definition A platelet count is a diagnostic test that determines the number of platelets in the patient's blood. Platelets, which are also called thrombocytes, are small disk-shaped blood cells produced in the bone marrow and involved in to be very tow and made her prone to hemorrhaging, so she was used to visiting her hematologist and other doctors regularly. Abrahams recently noticed other symptoms that led to a diagnosis of lupus. Results: She is on medication (steroids that cause her to gain weight), goes to the gym regularly, and eats a healthy diet. Medical Tests and Screenings For Those in their 20s * Annual physical exam, which checks blood pressure and weight * General blood tests: fasting blood glucose blood glucose Diabetology The principal sugar produced by the body from food–especially carbohydrates, but also from proteins and fats; glucose is the body's major source of energy, is transported to cells via the circulation and used by cells in the presence , complete blood count, and cholesterol * Urinalysis * Vision exam * Rectal exam, which checks for hemorrhoids hemorrhoids (hĕm`əroidz) or piles, dilatations of the veins about the anus (external hemorrhoids) or those higher up inside it (internal hemorrhoids). and prostate cancer * Women should get an annual Pap smear Pap smear or Papanicolaou smear Sample of cells from the vagina and cervix of the uterus for laboratory staining and examination to detect genital herpes and early-stage cancer, especially of the cervix. Developed by the Greek-born U.S. to check for cervical cancer or other disorders, as well as a regular breast exam. * Men should examine their testicles Testicles Also called testes or gonads, they are part of the male reproductive system, and are located beneath the penis in the scrotum. Mentioned in: Testicular Cancer, Testicular Surgery, Vasectomy for lumps or other abnormalities Name: Kat Carney Age: 35 Health concern: Polycystic Ovary Syndrome Polycystic Ovary Syndrome Definition Polycystic ovary syndrome (PCOS) is a condition characterized by the accumulation of numerous cysts (fluid-filled sacs) on the ovaries associated with high male hormone levels, chronic anovulation (absent ovulation), (PCOS) Symptoms: obesity, hirsutism, hair loss, irregular menstrual cycle Degree of involvement: Carney was reluctant to visit a doctor unless something was seriously wrong. She was forced to go because of back pain. Results: She began a drastic fitness regimen, educated herself, and took medication. In 14 months, she lost 90 pounds and saw a reduction in all symptoms of PCOS. Medical Tests and Screenings For Those in Their 30s * Annual physical exam, which checks blood pressure, weight, cholesterol, and vision. Women should get a Pap smear. * EKG EKG: see electrocardiography. to check heart rate * Screening for diabetes and cholesterol levels * Urinalysis Name: Benjamin I. Green III Age: 45 Health concerns: hypertension and high cholesterol Symptoms: constant headaches, irritability, and tightness in the head Degree of involvement: Green went for annual physicals and only when his headaches became unbearable. Results: In January 2001, he was treated in the hospital for hypertension headaches only to find that his blood pressure was at the cardiac/stroke level. A change of eating habits, medication, along with exercise, has improved his health. Medical Tests and Screenings For Those in Their 40s * Annual blood pressure check * Cholesterol check * EKG * Annual physical exam * Bone density scan (women) * Mammogram mammogram /mam·mo·gram/ (mam´o-gram) a radiograph of the breast. mam·mo·gram n. An x-ray image of the breast produced by mammography. (women) * Vision and blood tests * Urinalysis * Prostate cancer screening Prostate cancer screening is an attempt to identify individuals with prostate cancer in a broad segment of the population—those for whom there is no reason to suspect prostate cancer. * Colonoscopy (for people with a family history of colon polyps) cancer or * Glucose screening (Type II diabetes affects many African Americans after age 40. Early screening is crucial.) Name: David Dunham Age: 58 Health concern: diabetes Symptoms: thirst, frequent urination urination Process of excreting urine from the bladder (see urinary system). Nerve centres in the spinal cord, brain stem, and cerebral cortex control it through involuntary and voluntary muscles. The need to void is felt when the bladder holds 3. Degree of involvement: Dunham always went for a physical each year and asked his doctor to check for diabetes because of family history. Results: He was diagnosed with Type II diabetes two years after his retirement. He now takes prescribed medicines and daily insulin shots. Dunham also began an exercise regimen. Medical Tests and Screenings For Those in Their 50s * Routine physical exam * Blood pressure reading * Cholesterol test * Prostate cancer screening * Colonoscopy to check for polyps Polyps A tumor with a small flap that attaches itself to the wall of various vascular organs such as the nose, uterus and rectum. Polyps bleed easily, and if they are suspected to be cancerous they should be surgically removed. and colon cancer * EKG to check heart rate and rhythm HOW TO TALK TO YOUR DOCTOR Find a good match The doctor-patient relationship should not be adversarial. Use referrals from friends, family, and colleagues to find a doctor with whom you feel comfortable talking to and asking questions. Know your medical history To get a thorough analysis, come to your checkups armed with full knowledge of your personal medical history as well as your family's history. Ask questions Doctor's seem to have less and less time to speak in depth with patients during visits. Maximize your time by coming prepared with specific questions or specific exams you would like to request. Get a second opinion Don't be afraid to seek out doctors or specialists to get a second opinion or more information about a medical exam or condition. Follow up Always call for test results and follow up with specialists. Sometimes, follow-up exams can reveal crucial information missed the first time around.
Gift Giving Worksheet
The old adage "an ounce of prevention is worth a pound of cure"
certainly pertains to holiday spending. Budgeting and planning out
expenses will help prevent falling deeply into debt during the season
of giving. Consider using these gift-giving and holiday spending
worksheets to help avoid the post-holiday blues.
Name Amount: Amount: Actual Other Amount: Actual
Holiday Birthday Month Events Other Month
Due Happening * Events Due
$ $ $
PARENTS/SELF
-- -- -- -- -- -- --
CHILDREN/GRANDCHILDREN
-- -- -- -- -- -- --
SISTERS/BROTHERS
-- -- -- -- -- -- --
GRANDPARENTS
-- -- -- -- -- -- --
FRIENDS/WORK/OTHER
-- -- -- -- -- -- --
CHILDREN'S FRIENDS
-- -- -- -- -- -- --
TOTAL AMOUNTS
-- -- -- -- -- -- --
* Other: anniversaries, weddings, showers, births, Mother's Day,
Father's Day, graduations, religious events.
Christmas/Holiday Expense Worksheet
Already Actual
Item Estimate Have Cost
Tree/Wreath -- -- --
Lights--House/Tree -- -- --
Baked Goods -- -- --
Parties/Food/Liquor/Beverage Host Gifts -- -- --
Poinsettias/Candles Decorations/Crafts -- -- --
Gift Wrap Greeting Cards -- -- --
Postage Shipping/Boxes -- -- --
Film Processing/Family Portraits -- -- --
Clothes/Shoes/Jewelry -- -- --
Meals Out -- -- --
Movies/Ballet/Plays/Galleries/Travel/Tour -- -- --
Workplace Events -- -- --
Donations -- -- --
Batteries/Misc. (Gifts) Other -- -- --
TOTAL AMOUNT -- -- --
Source: The Budget Kit
Source of Money for Gifts & Holiday Expenses
Total Amount of Gifts:
(See Gift Giving Worksheet) $--
Total Amount of Expenses:
(See Worksheet at left) $--
TOTAL AMOUNT NEEDED: $--
List how much is available from the following
sources to cover these holidays expenses:
Source Amount Notes
Current Income -- --
Overtime/Part-time job -- --
Savings Account(s) -- --
Gift Money/Bonus -- --
TOTAL AMOUNT AVAILABLE TO COVER EXPENSES
AMOUNT SHORT/EXTRA *
* Total Amount Needed--Total Amount Available to Cover
Expenses = Amount Short or Extra
Outline a plan for covering amount that is short for
holiday expenses:
Source Amount Notes
Charge on Credit Cards -- --
Borrow -- --
Other -- --
TOTAL AMOUNT NEEDED TO BORROW
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