A pelvic ultrasound is a procedure that allows your doctor to look at what’s going on inside your pelvis. This is the space between your hip bones that contains the large triangle-shaped bone at the bottom of your spine (sacrum), your tailbone, bladder, sex organs, and rectum.

Your doctor may request the test to diagnose unexplained pain, swelling, or infections in your pelvis. A pelvic ultrasound is the best test to examine a growth in your pelvis. It helps your doctor determine if the growth is a fluid-filled cyst, a solid tumor, or another kind of lump.

A pelvic ultrasound is a safe procedure that can be a little uncomfortable. The test is performed on men and women of all ages. The ultrasound looks at different things for men and women.

During the test, a trained medical technician will squirt a small amount of warm gel on your skin over your pelvic area. The technician will move a handheld device (called a wand) through the gel and across your pelvis. The technician will monitor the images on a nearby screen and record the images for the doctor. The probe is connected to an ultrasound machine. As the device moves across your pelvis, it produces high-frequency sound waves. Those sound waves create real-time photos and video of the inside of your pelvis. The images look like an X-ray. However, ultrasound technology picks up things that aren’t seen by an X-ray.

Path to improved health

A pelvic ultrasound can be done one of three ways:

• Abdominally (the outer stomach)
• Vaginally (inside a woman’s vagina)
• Rectally (the area between the bottom of your large intestine and your anus).

The approach your doctor recommends for your ultrasound depends on the reason for your test and whether you are a man or a woman. A pelvic ultrasound can be used to look at the bladder for both men and women. Your doctor may recommend a pelvic ultrasound of your bladder if you are having difficulty going to the bathroom. It is used on men and women to guide a doctor during a biopsy procedure (inserting a needle into the pelvis to take samples of fluid or tissue).

A transabdominal ultrasound is commonly used to monitor the development of a baby in pregnant women at or before 14 weeks in their pregnancy. For this type of ultrasound, the technician will squirt a small amount of warm gel onto your stomach and move the probe or wand back and forth over your stomach. It will check the baby’s growth, such as height, the length of the baby’s arms and legs, head size, and more.

This type of ultrasound can check several factors during pregnancy, including:

• How far along the pregnancy is
• The baby’s position in the uterus
• The number of babies the mother is carrying
• The amount of amniotic fluid that surrounds the baby
• The baby’s heart

In some cases, it may be used to screen for certain conditions, such as Down syndrome. A transabdominal ultrasound also can be used to look for tumors in your uterus and other issues related to the female body, whether you are pregnant or not.

A transvaginal ultrasound is only used on women. It uses a specially shaped probe that can fit inside a woman’s vagina. The probe is covered with a latex condom. If you are allergic to latex, tell your doctor. The probe will be inserted into your vagina. If it makes you more comfortable, you can ask to insert it yourself.

This kind of ultrasound is used in early pregnancy to determine how far along a mother is and a due date. This method brings the probe closer to the uterus. This provides a clearer view of a fetus during a mother’s first trimester.

Your doctor may recommend a transvaginal ultrasound for other reasons, including:

• Locating an intrauterine device used for birth control
• Determining the cause of infertility (or to guide your doctor during a fertility treatment or procedure)
• Looking for (ovarian) cysts or other growths in your pelvis
• Determining the cause of abnormal vaginal bleeding or problems with your menstrual period
• Diagnosing unexplained pelvic pain
• Looking for an ectopic pregnancy (when a fertilized egg begins to develop outside of the uterus)

A transrectal ultrasound is used on men. The end of the probe for this type of ultrasound is shaped to partially fit inside a man’s rectum. The end of the probe is covered with a latex condom. This can be used to examine problems with the prostate (the gland that makes semen). It can also look at the glands that secrete some of a man’s semen (seminal vesicles).

Depending upon the type of pelvic ultrasound you are having, preparing may be different. For example, a transabdominal ultrasound to view your bladder requires a full bladder. Your doctor will tell you to drink four to six glasses of water one hour before your test. A full bladder moves your intestines aside to give the technician a better view.

If you are a woman, your only preparation for a transvaginal ultrasound is to let your doctor and technician know if you are allergic to latex. The same applies to transrectal ultrasounds for men.

Men also may need to take an enema one hour before a transrectal ultrasound to empty their bowels or intestines. This will improve the quality of the ultrasound pictures. For a prostate biopsy, men may be required to take an antibiotic to protect against an infection.

Tell your doctor if you had an X-ray that included a dye two days before the pelvic ultrasound. The dye will remain in your intestines and prevent the technician from getting quality photos and videos.

In all pelvic ultrasounds, you will be asked to put on a light hospital gown. This makes it easy for the technician to access your pelvis. You will lie on your back unless the technician needs you to turn to get a better picture. The procedure usually takes about 30 minutes. Your doctor or doctor’s office will call you with the results one to two days after the procedure. You might have mild discomfort from the pressure of the probe on your belly or near where the probe was inserted. Your body is not exposed to radiation during a pelvic ultrasound.

Things to consider

A pelvic ultrasound involves time and expense. It’s possible you may have to repeat the procedure because the first test didn’t produce clear photos. This can happen for several reasons:

• Being severely overweight may prevent the ultrasound from seeing deep enough into your pelvis
• Not having a full bladder
• Not having empty bowels, intestines, or rectum
• Having excess gas in your intestines (which blocks the view of your pelvic organs)
• Moving too much during the procedure
• Having an open wound in your belly

You may also have to repeat the procedure if you are undergoing fertility tests and treatment, which requires regular ultrasounds.

Repeat ultrasounds may also be needed if your doctor discovers a lump in your pelvis that requires further testing. Your doctor may require you to repeat the test in six to eight weeks to see if the lump has changed in size or appearance.

If you are a man, you may have to repeat a pelvic ultrasound of your prostate if your prostate is larger than normal. In that case, an ultrasound may not be an option. You may have to undergo a digital rectal exam (when your doctor inserts his glove-covered finger into your rectum), a blood test, or a biopsy.

Because they are done inside your body, there is a slight risk of infection with transvaginal and transrectal ultrasounds. See your doctor if you have abnormal discharge or fever after your ultrasound.

Questions for your doctor

• Will the probe from a transvaginal ultrasound harm my pregnancy?
• Should I take an over-the-counter pain reliever before I have a transvaginal or transrectal ultrasound to ease the discomfort?
• What else do I need to know to prepare for the test?

Resources

National Institutes of Health, MedlinePlus: Pregnancy Ultrasound

National Institutes of Health, MedlinePlus: Transvaginal Ultrasound

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Prostate cancer, the growth of abnormal cells in a man’s prostate gland, is a leading cause of death in men. Your doctor can perform a screening. The screening includes a prostate-specific antigen (PSA) test (blood test) to check the PSA level in your blood. PSA is a substance produced by the prostate gland. A high PSA level may indicate a prostate problem. A digital rectal exam (DRE) is still widely used by many physicians. This is a physical screening in which your doctor inserts their gloved finger into your rectum to feel the size of your prostate. If you doctor needs more information, they may use imaging tools, such as ultrasound or MRI to get a more detailed look of your prostate.

Path to improved health

The goal of prostate screenings is to find cancer early. Cancer is easier to treat and more likely to be cured if it is caught early.

However, most cases of prostate cancer are not aggressive. More men have a slow-growing form of prostate cancer. This means they may not have symptoms or even require treatment. This approach is called “watchful waiting” or “active surveillance.” Prostate cancer treatment can have long-term side effects. These include loss of bladder control and erectile dysfunction. There is a rare chance of problems occurring in surgery to get a biopsy. This is the only way to confirm a prostate cancer diagnosis.

PSA test results aren’t always accurate or are “false positives.” This means that the PSA test result suggests that you might have cancer when you do not. A false-positive test result can lead to unneeded tests, such as a biopsy, and side effects from testing. It also causes worry for you and your family.

For these reasons, the American Academy of Family Physicians and U.S. Preventive Services Task Force have issued clinical recommendations. For men 55 through 69 years of age, they do not recommend routine PSA screening. Instead, they recommend having a conversation with your doctor about the risks and benefits of periodic screening. They do not recommend PSA screening for prostate cancer in men 70 years of age and older.

Other organizations have different screening recommendations. These include the American Cancer Society and the American Urological Association. Their guidelines depend on your age and state of health.

Things to consider

Ultimately, the decision to be screened for prostate cancer is between you and your doctor. Talk to them about your specific concerns. They can weigh the pros and cons with your personal health and risk factors.

Doctors and scientists perform ongoing and new research. These studies, or clinical trials, help to learn more about the benefits and risks of prostate cancer screening. Ask your doctor about the most recent study results. Try to stay up to date on new progress in prostate cancer screening and treatment.

Questions to ask your doctor

• How do I know if prostate screening is right for me?
• What are the symptoms of prostate cancer?
• If I have a high level of PSA, what problems could I have?

Resources

American Academy of Family Physicians: Clinical Preventive Service Recommendation: Prostate Cancer

American Cancer Society: Recommendations for Prostate Cancer Early Detection

American Urological Association: Prostate Cancer Guidelines

National Cancer Institute: Prostate Cancer—Patient Version

National Institutes of Health, MedlinePlus: Prostate Cancer

U.S. Preventive Services Task Force: Prostate Cancer: Screening

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Genes are found in chromosomes and are made up of DNA. We inherit genes from our parents. Our gene structure dictates how our body grows and regulates. When genes are normal, they work properly. When genes are abnormal or damaged, they can lead to disease. These are called gene mutations, or changes. Some changes run in families. These happen by chance and are called hereditary or inherited diseases and conditions. A gene mutation can be the sole cause of disease. However, most diseases occur from a mix of genetic and environmental factors.

Genetic testing looks at your genes to check for any mutations. The test is done with a blood, saliva, or tissue sample. There are several reasons why you might do genetic testing.

• To diagnose a disease or a type of disease
• To determine the cause of a disease
• To determine treatment options for a disease
• To find your risk of getting a certain disease that possibly can be prevented
• To find your risk of passing a disease to your children
• To screen your embryo, fetus, or baby

Path to well being

Talk to your doctor if you think you are at risk for an inherited disease. They may refer you to a genetic counselor, who can review your family history and provide advice. They will ask you questions about your health and the health of your blood relatives. This information can calculate what your risk may be. It can help you decide whether you want to get testing. It also may determine if your insurance will pay for the testing.

If one of your family members already has the disease, they should get genetic testing first. This will show if their disease was passed down or occurred by chance. People from different ethnic groups are often more at risk of certain diseases.

A positive test result means that you have the gene mutation. This increases your risk of the disease. However, it does not guarantee you will get the disease. It does mean you could pass the mutation to your children.

A negative test result means that you don’t have the gene change. This may mean the disease doesn’t run in your family or wasn’t passed down to you. A negative result does not guarantee you won’t get the disease. It means that your risk of the disease is the same as it is for other people.

Common conditions and diseases that benefit from genetic testing include:

• Colon cancer (Lynch syndrome)
• Breast cancer (BRCA gene)
• Down syndrome
• Cystic fibrosis
• Tay-Sachs disease
• Sickle cell disease
• Spina bifida
• Turner syndrome
• Von Willebrand Disease
• Albinism
• Duchenne muscular dystrophy

There are others and more are becoming available as research advances.

Things to consider

Genetic testing has pros and cons. These can change depending on your situation. Keep in mind that genetic testing is a voluntary choice. You should not feel forced to do it.

Some benefits of genetic testing include:

• You might be less worried about getting a certain disease.
• You might be able to change your lifestyle to reduce your risk.
• You might know how to move forward with family planning.
• You might be able to get treatment to prevent the disease. This could include medicine or surgery.
• Your doctor will know how often to screen for the disease.

There also are reasons you might not want genetic testing done. These are mainly emotional or financial.

• You might be more worried about getting a certain disease.
• You might feel angry, guilty, or depressed.
• It could lead to problems with your employer or insurance company.

Questions to ask your doctor

• How do I know if I should see a genetic counselor?
• If my genetic testing result is positive, what is my risk of getting the disease? What can I do to prevent or treat it?
• Should my genetic testing be done in a clinical setting or can I do it from home?

Resources

Centers for Disease Control and Prevention: Genetic Testing
National Cancer Institute: Genetic Testing for Inherited Cancer Susceptibility Syndromes
National Human Genome Research Institute: Genetic Testing FAQ

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A biopsy is a procedure to remove tissue or cells from your body. This sample is sent to a lab for testing. Using a microscope, a biopsy provides your doctor with a closer look at the sample to see if it is normal or if it indicates a disease or medical condition. Sometimes, a biopsy is used to find a treatment for a disease or to see if a person is a match for an organ transplant.

Most of the time, a biopsy is ordered by your doctor to find out if a tumor is cancerous or to further examine an unexplained lesion, lump, mole, infection, or inflammation. Typically, biopsies are performed in a doctor’s office or a hospital. Your doctor will tell you how to prepare for a biopsy.

The most common biopsy locations on or in your body include: 

• Bone marrow
• Brain
• Breast
• Stomach and intestines
• Liver
• Lung
• Lymph nodes
• Skin
• Thyroid

When the biopsy is performed, it will either involve a local anesthetic (injected in the area around the sample location) or a general anesthesia, in which you are sedated (sleeping).

Types of biopsies

There are multiple methods of collecting a sample through a biopsy. Your biopsy type will depend on why you are having it done. Your doctor will call you with the results.

An endoscopic biopsy involves inserting a fiberoptic endoscope with a tiny camera at the end into an incision, your mouth, your rectum, or another natural opening in your body. Once it’s in, it can be inserted into other areas inside your body, such as an abdominal organs, tissues, bones, or joints. This helps your doctor examine a suspicious area.

Fine Needle aspiration (FNA) uses a longer needed through the skin. This biopsy method is often used if your doctor suspects breast and thyroid tumors, or to test the lymph nodes near a suspicious mole. Imaging (CT or CAT scan) is used to guide the needle into the tumor or an organ.

A core biopsy is similar to an FNA biopsy but involves the use of a larger needle for a larger sample collection.

A shave biopsy involves the use of a razor or small blade to scrape away a part of a skin growth or sore on your skin. It’s a method that is commonly used to diagnose basal or squamous cell skin cancer, but not melanoma. A local anesthetic is used to numb the area.

A punch biopsy uses a special device to remove a deeper sample—usually all or nearly all of a suspicious skin lesion. The device resembles an apple core tool and will likely require stitches. This method can cut through multiple layers of skin and will involve the use of a local anesthetic to numb the area.

A reflectance confocal microscopy (RCM) biopsy is only sometimes used in the United States. It allows your doctor to look at a section of suspicious skin to a certain depth without a deep incision or tissue removal.

A Mohs biopsy is a technique used for diagnosing skin cancer on your eyelids, nose, ears, lips, or hands.  Mohs protects the healthy skin around the cancer. Your doctor will cut a little of the cancer at a time. They will examine it under a microscope while you wait on the procedure table. Your doctor will cut more of the growth until they no longer see cancer in the outer borders.

You may experience brief pain for all biopsies (because of the procedure or the anesthesia injection). Your recovery time from the procedure is based on the type of biopsy you had. Also, it depends on whether you needed local or general anesthesia during the procedure, how large the area being biopsied was, and where the biopsy was taken from. Recovery also will depend on whether you needed stitches.

Things to consider

Before your procedure, tell your doctor if you are pregnant, are allergic to latex (rubber gloves), and about any medicines, vitamins, supplements, and herbal remedies you are taking. Certain medicines act as blood thinners, which makes it difficult to stop bleeding.

With all biopsies, there is a risk of infection, bleeding, and scarring. Call your doctor if you have a fever following the procedure (it could mean you have an infection), if the site of your biopsy won’t stop bleeding, or if there are signs of redness, swelling, or drainage from the biopsy site.

Questions to ask your doctor

• What are needle biopsies used for beyond diagnosing cancer?
• Is the risk of biopsy complications worse for patients with Type 2 diabetes?
• What if my child is having a biopsy and won’t be still for the procedure?
• How long does it take to get the results?
• Is there a way to reduce scarring?

Resources

National Institutes of Health, MedlinePlus: Skin Lesion Biopsy

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A lipid panel is a simple blood test to check your cholesterol levels. Cholesterol is a soft, sticky substance found inside your body. Total cholesterol is made up of three parts: good (HDL) and bad (LDL) cholesterol as well as triglycerides (a certain type of fat). A lipid panel test is important because cholesterol can clog your arteries. This can lead to heart disease and stroke.

The blood test can be done in a doctor’s office, laboratory, or hospital. A nurse or lab technician inserts a needle into a vein in your arm to collect a small sample of blood. Sometimes the blood can be collected through a prick to your finger. Your blood will be collected into a tube and sent to a lab for testing. The results will be sent to your doctor and your doctor’s office will notify you of the results. The test can be done at any time of the day. Your doctor may ask that you get the test performed while you are fasting.

There are also other similar tests your doctor may perform to better understand your cholesterol.

Path to improved health

Your doctor will use the results of your lipid panel to calculate an ASCVD (atherosclerotic cardiovascular disease) risk score. This score reveals if you are a high or low risk for heart disease. If your risk score is high, your doctor will recommend diet and lifestyle changes. They may prescribe medicine to lower your cholesterol. Statins are a class of medicine most often prescribed to lower cholesterol.

The American Academy of Family Physicians (AAFP) supports the U.S. Preventive Services Task Force (USPSTF) clinical preventive service recommendations for lipid screening. The USPSTF recommends that healthy men have their first lipid panel test at age 35 and women at 45. Adults may be tested earlier if they have certain diseases (diabetes, heart disease) or if they smoke. According to the USPSTF, there is not enough evidence of the benefits of lipid panel testing in adults 21 to 39 years old.

Your lipid panel test will provide individual results for your good and bad cholesterol and triglycerides.

• Good (HDL) cholesterol: Your body needs good cholesterol to lower your risk of heart disease. This is one test where you want high numbers. Aim for a good cholesterol of 40 to 60 mg/dL. You can increase your good cholesterol through a healthy diet and exercise.
• Bad (LDL) cholesterol: Your goal is to lower your number for your bad cholesterol. A reading of 100 mg/dL or less is considered normal. Between 100 and 129 mg/dL is near normal. Between 130 to 159 mg/dL is borderline high. Above 190 mg/dL is considered high. Results between 70 and 189 mg/dL are considered too high if you are between the ages of 40 and 75 and have diabetes, a medium-to-high risk of heart disease or both conditions. Your doctor will prescribe a cholesterol medicine based on your results and health history.
• Triglycerides: Between 150 md/dL or less is considered normal. Between 150 and 199 mg/dL is considered borderline high. Between 200 and 499 mg/dL is considered high. Anything higher than 500 mg/dL is considered very high. Things that affect your triglycerides include liver damage, a high carbohydrate/low protein diet, underactive thyroid, a kidney disorder called Nephrotic syndrome, some medicines (hormone replacement medicines), uncontrolled diabetes, and genetics. Treatment includes a combination of prescription medicine, a healthy diet and exercise. If your results are higher than 500 mg/dL, you may have an increased risk of pancreatitis. This is a chronic or acute disease of your pancreas.

Things to consider

• You may have brief pain during the blood test as the needle is inserted. You may have a bruise at the site a day or two after the test.
• If you are dehydrated (your body doesn’t’ have enough fluids), it may be difficult to find a good vein for the test. Drink plenty of water one to two days before the test.
• People who have suffered a recent heart attack, surgery, infection, injury, or pregnancy should wait two months before having their cholesterol checked.
• Depending on your cholesterol levels and other chronic diseases, your doctor may test you more frequently than a person who is otherwise healthy.

Questions to ask your doctor

• Are there any risks to having a lipid panel blood test?
• Can lipid panel results be affected by a cold or the flu?
• Should I take my prescription pills before having the test?
• How soon will I find out my results?
• How do I prepare for the test if I have a latex allergy?
• What if I mistakenly eat something within the 8 to 12 hours before I take the test?

Resources

Centers for Disease Control and Prevention: Get a Cholesterol Test
National Heart, Lung, and Blood Institute: What is Blood Cholesterol?
National Institutes of Health, MedlinePlus: Cholesterol testing and results

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Mental illness is a common health problem and nothing to be embarrassed about. It happens because of a change in your brain. It includes a range of conditions, such as depression, anxiety, and bipolar disorder. Mental illness affects people’s thoughts, feelings, and behavior. Most often, people have and show early signs of illness. Learn what these signs are so you or someone you know can get help.

Path to improved health

Warning signs of mental illness vary by person and problem. Below are some of the most common signs. Talk to your doctor if more than one of these occur. Also note if they happen suddenly.

• Changes in mood. Your feelings may alter over time or all of a sudden. In addition, they can shift back and forth. For instance, you may feel happy or excited one day or in a certain situation. Then, you may feel sad or upset the next day or in a new situation.
• Changes in sleep.You may be sleeping too much and feel like you can’t get out of bed. Or you may feel like you don’t need to sleep much at all.
• Fear or uneasiness. You may start to feel afraid, anxious, nervous, or panicked.
• Decreased performance. Your work suffers. You may find it harder to complete things that once were easy or enjoyable. If you’re in school, you may notice your grades begin to drop.
• Lack of interest. There are several things that can cause you to lose interest in certain things or people. This can lead to broad or complete withdrawal.
• Altered senses. Your basic senses—sound, smell, touch, or sight—may become more or less sensitive.
• Lifestyle changes. You may sleep longer than usual or have a hard time sleeping. You also could develop an eating disorder, where you eat more, less, or not at all.
• Troubled mind. It’s possible to have clouded thinking that makes it hard to focus, remember, or process things.
• Changes in behavior. Your actions may alter in ways that are abnormal for you.
• Loss of control. Over time, you may lose the ability to manage stress, tasks, or life’s demands.
• Out of touch with reality. Mental illness can cause you to become detached from your surroundings. You may feel lost, distant, or numb. You may have hallucinations or nightmares. You may forget how to relate to others or show care or concern.

Other possible warning signs include:

• Alcohol or drug abuse
• Sexual abuse
• Feelings, thoughts, or actions of anger or violence
• Unexplained physical symptoms, such as stomach pain and headaches

Things to consider

It’s important to know the signs of mental illness because it affects so many people. You or someone you know may have a problem at some point in your life. If you know the warning signs, you can detect them early. The sooner you see a doctor and get diagnosed, the sooner you can begin treatment.

Don’t ignore these warning signs. It can make mental illness worse and cause harm to others. When you learn about mental illness, share information with others, and talk about your story, you help stop the stigma.

When to see your doctor

Contact your doctor if you have multiple warning signs. They will do an exam and discuss your state of health. Only a doctor can diagnose mental illness. If someone you know displays these signs, talk to them about your concerns. Suggest that they visit a doctor to find out what’s going on.

Seek help right away if you have thoughts of murder or suicide. Call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). As of 2022, you can also dial 988 for the Suicide and Crisis Lifeline.

Questions to ask your doctor

• How can I tell if I have a mental illness?
• How can I tell if someone I know has a mental illness?
• Are there other warning signs I should look for?
• What are the best resources to use if I want to learn more about mental illness?

Resources

American Academy of Family Physicians, Mental Health Myths

Mental Health America: Mental Illness and the Family: Recognizing Warning Signs and How to Cope

U.S. Department of Health & Human Services, mentalhealth.gov: What to Look For

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Are you at high risk for heart disease? Take a moment to consider your lifestyle, family history, and general health. You and your doctor can use this information to tackle potential problems and maybe even lower your risk.

Path to Improved Health

The following factors may impact your risk of heart disease.

Age

Men older than 45 years of age and women older than 55 years of age (or who have gone through menopause) are at greater risk for heart disease. Also, the rates of heart attack over the last 20 years have been increasing for women 35 to 54 years of age.

Family history

It is important for you to know what diseases and conditions run in your family and to tell your doctor. Talk to your parents, grandparents, siblings, aunts, and uncles. Ask them who in your family has had a heart attack, stroke, or other serious health problem. With this information, your doctor can recommend the best kinds of screening tests and preventive treatments.

Cholesterol

If you don’t know your cholesterol level, ask your doctor if you should have it checked. There are good (HDL cholesterol) and bad (LDL cholesterol) types. To reduce and prevent high levels of bad cholesterol, eat a healthy diet and exercise regularly. Some people who have high cholesterol levels may also need to take medicine to keep their levels under control.

Blood pressure

If your blood pressure is high, there are things you can do to lower it. Try:

• Losing weight
• Exercising
• Not smoking
• Cutting down on sodium (salt)
• Cutting down on alcohol

Many people may also need to take medicine to control their blood pressure.

Smoking

Quitting smoking is the single best change you can make for your health. Talk to your family doctor about how to quit and stay tobacco-free. If you live with a smoker, breathing their smoke can also affect your health. Encourage the smoker to quit.

Diet

A healthy diet includes vegetables, fruits, lean meats, fish, beans, whole grains, and healthy fats. Limit the amount of processed foods (such as hot dogs), white flour (such as crackers and white bread), and sweet or sugary foods (such as soda and dessert foods) you eat. You may also need to avoid foods that are high in sodium, which can increase blood pressure. Sodium is found in table salt and many prepared foods, especially canned foods.

Although some research suggests alcohol can help protect against heart disease, moderation is the key. Limit how much alcohol you drink. This means no more than one alcoholic drink per day for women, and two alcoholic drinks a day for men.

The Mediterranean Diet is one good example of a heart-healthy diet that follows these guidelines. If you have questions about making changes to your diet, talk to your doctor. They can help you make better choices or refer you to a dietician.

Weight

Being overweight puts extra strain on your heart and blood vessels. A healthy diet with portion control, wise food choices, and regular exercise can help you lose weight gradually and safely. It can also help you keep it off. Talk to your doctor about the best ways for you to lose weight.

Exercise

Exercise can help prevent heart disease and many other health problems. You’ll also feel better and help keep your weight under control if you exercise regularly. If you haven’t exercised for a while or have health problems, talk to your doctor before you start an exercise program. Exercising 30 to 60 minutes, 4 to 6 times a week is a good goal, but any amount is better than none.

Things to Consider

Heart disease can lead to heart attack or stroke. Often there are warning signs of heart disease. These can include elevated “bad” cholesterol levels and high blood pressure. But these warning signs don’t always have symptoms. That is why it is important to work with your doctor to assess your risk.

Questions to Ask Your Doctor

• What are the warning signs for heart disease?
• Is my blood pressure in the normal range?
• Do I have high cholesterol levels?
• Can I be at risk for heart disease even if I have no family history of heart disease?
• How often should I be monitored for heart disease?

Resources

American Heart Association: What is Cardiovascular Disease?

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Rh incompatibility is a mismatched blood type between a pregnant mother and the baby she is carrying. It is rarely serious or life threatening, thanks to early diagnosis and treatment during pregnancy.

Rh factor is a protein located in red blood cells. People who have that protein are Rh-positive. Most people are Rh-positive. People without the protein are Rh-negative. You inherit your blood type from your parents.

If an Rh-positive baby’s blood passes to its Rh-negative mother during pregnancy (or delivery), the mother’s body will attack the baby’s red blood cells. Typically, this is not a concern for a live birth with a first pregnancy. It poses a greater risk in later pregnancies. This is because the mother develops antibodies to attack Rh-positive blood types in future children.

Rh incompatibility isn’t harmful to the pregnant mother. However, it can cause mild to serious medical problems for the baby. Doctors treat the condition by injecting the mother with a Rh incompatibility medicine that protects the baby’s red blood cells.

Path to improved health

In most cases, Rh incompatibility is avoidable with preventive care. Your doctor will check your blood type during your first pregnancy visit. If you have Rh-negative blood, you will be given an injection of Rh immunoglobulin. This happens at around week 28 of your pregnancy. It will be done again within 72 hours of your baby’s birth. It may also be done after a miscarriage, an abortion, or an amniocentesis (a gene screening test done during pregnancy). These are all cases in which the mother and baby’s blood could mix.

According to the American Academy of Family Physicians (AAFP), all pregnant women should have blood typing and Rh testing on their first visit to their doctor for pregnancy care. AAFP recommends retesting between the 24th and 28th weeks of pregnancy.

Rh immunoglobulin will not harm your baby. The injection may cause you to have mild soreness around the injection site. For some pregnant women, common side effects of the medicine include

• Headache
• Mild fever
• Mild pain
• Swelling or redness at the site of the injection

More serious side effects include:

• Severe allergic reaction
• Back pain
• Problems with your urine
• Rapid heartbeat
• Nausea
• Fever
• Trouble breathing
• Unexplained weight gain
• Swelling
• Fatigue
• Yellowing of the eyes or skin

Things to consider

Most Rh-positive babies born from a first-time pregnancy to an Rh-negative mother are not affected by Rh incompatibility. This is because the baby’s blood doesn’t usually pass to the mother’s bloodstream until the time of the birth (vaginal or cesarean section). Exceptions may occur if the mother:

• Had a previous pregnancy that ended in miscarriage or had an abortion.
• Had pregnancy screening tests, such as amniocentesis or chorionic villus sampling (genetic tests that require inserting a needle into the mother’s womb to sample the baby’s cells).
• Had bleeding during her pregnancy.
• Had to have the baby manually rotated from a breech position before her labor started.
• Experienced a blunt trauma injury to her abdomen during her pregnancy.

Once an Rh-positive baby’s blood enters an Rh-negative mother’s bloodstream, a mother’s future Rh-positive babies are at risk for certain medical problems (unless the mother received an Rh immunoglobulin injection). Without that preventive treatment, Rh incompatibility destroys your baby’s red blood cells (hemolytic anemia) during pregnancy. Red blood cells are filled with iron-rich protein (hemoglobin) that supplies oxygen to your baby. Your baby’s red blood cells die faster than his or her body can make new ones.

Without enough red blood cells, your newborn baby won’t get enough oxygen. The baby could suffer from mild conditions, such as anemia (low blood count) and jaundice (yellowing of the eyes and skin). It could also lead to more serious conditions, such as brain damage and heart failure. It’s possible for a baby to die during the pregnancy if too many of their red blood cells have been destroyed.

Questions to ask your doctor

• Does my unborn baby’s blood have to be tested during pregnancy or just mine?
• Does the father’s blood type matter?
• Is blood typing done on pregnant women of all ages?
• What happens if I do not receive the final Rh immunoglobulin injection before my baby is born?

Resources

National Institutes of Health, MedlinePlus: Rh incompatibility

National Institutes of Health, National Heart, Lung, and Blood Institute: Rh Incompatibility

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Cystic fibrosis (CF) is a genetic disorder. It causes thick mucus to collect in your lungs and intestines. This causes problems with breathing and digestion. The damage is permanent. CF gets worse over time. People who have CF have a shorter life expectancy. However, thanks to modern medicine, people who have CF are living longer, healthier lives than ever before.

Two parents who have the CF gene can pass it on to their baby. Children have a 25% chance of having CF if both parents have one copy of the gene. Your doctor may perform a prenatal screening to test for CF if both parents know they carry the gene. This is performed while you are pregnant. It checks for any health problems with your baby before they are born. The screening also can detect other genetic disorders. This includes birth defects, and neural tube defects.

Path to improved well being

At your first prenatal visit, your doctor will talk to you about screening and tests. Although they may offer suggestions, it is your choice to do the screenings or not.

Carrier screening

If you don’t know if you have or carry CF and would like to find out, you may choose to do carrier screening test first. This is a simple method to test you or your partner for the CF gene.

Your doctor will collect a blood, saliva, or tissue sample from inside your cheek. Carrier screening is done one person at a time. It can be done before or during pregnancy. The possible results are:

• You (or your partner) test negative as a carrier. The other person does not need to be tested.
• You (or your partner) test positive as a carrier. The other person should be tested.
• You and your partner both test positive as carriers. If you are pregnant, you should consider the prenatal testing to see if your baby has CF. If you are not pregnant but are trying, talk to your doctor about your options. You may consider adopting or using fertility treatment to avoid the CF gene.

Prenatal screening

Screening for CF in a baby can be done one of two ways.

• Chorionic villus sampling (CVS). Your doctor collects a sample of tissue from your placenta. This test is done between 10 and 13 weeks of pregnancy.
• Your doctor collects a sample from your amniotic fluid. This test is done between 15 and 20 weeks of pregnancy.

Diagnosis

If the prenatal screening is positive for CF, you have two options.

• You can continue with your pregnancy. The diagnosis does not affect ongoing prenatal care. In the remaining months, do research to learn more about CF. Talk to your doctor about treatment options. You may consider joining a support group.
• You can end your pregnancy. This decision consists of legal and moral considerations.

At your first prenatal visit, your doctor will talk to you about screening and tests. Although they may offer suggestions, it is your choice if you want to do the screenings or not.

Things to consider

Although screening can be helpful, it also can create added worry or concern. If you choose not to screen during pregnancy, most states check for CF during newborn screening. This is a series of tests your baby undergoes in the hospital after birth. These include blood, hearing, and heart tests. Talk to your doctor to see what your state’s testing includes.

Keep in mind that no screening is 100% effective. Carrier and prenatal screenings cannot check for all gene mutations. If the tests are negative, there still is a rare chance you carry CF or your baby could have CF.  Talk to your doctor if:

• You and your partner both have CF.
• You and your partner are known carriers for CF.
• You and your partner have a family history of CF.
• You and your partner are pregnant or trying to become pregnant and want to learn more about genetic testing.

Questions to ask your doctor

• What are the risks and benefits of CF prenatal screening?
• Does my state test for CF during the newborn baby screening?
• If my partner or I test negative in the carrier screening, what is the chance our baby could still have CF?
• If we have a child with CF, what are the chances our other children will have CF?
• Are there other prenatal screening tests that I should consider?

Resources

American College of Obstetricians and Gynecologists: Cystic Fibrosis: Prenatal Screening

March of Dimes: Cystic Fibrosis and Pregnancy

National Institutes of Health, MedlinePlus: Cystic Fibrosis

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Finding out that you are infected with HIV (human immunodeficiency virus) can be frightening. One way to fight your fear is to learn as much as you can about the disease. Remember that HIV is manageable. It can be treated with medicines. Knowing about HIV and AIDS (acquired immunodeficiency syndrome) will also help you take the best care of yourself.

You can fight your worry about HIV infection with reliable information. Your friends and family may give you advice. The best information comes from your doctor or counselor, or from local, state, or national AIDS resources.

Path to improved health

The good news is that early treatment is helping many people with HIV live longer, healthier lives. It’s normal to feel sadness, anxiety, and fear when you first learn that you have tested positive for HIV. However, if you have trouble sleeping, eating, or concentrating, or if you have thoughts of suicide, tell your doctor right away.

If you’ve been told you have HIV, give yourself permission to be afraid. But don’t let this fear keep you from doing all you can to help yourself. Here are some things you can do:

• See your doctor as soon as possible after being diagnosed, even if you don’t feel sick. Your doctor will have you start taking HIV medicines right away.
• Ask your doctor how often you should have a check-up. Always keep your appointments.
• Always use a latex condom during sex.
• Help your body fight infection by not abusing alcohol and by quitting smoking.
• Eat a balanced diet. Get regular exercise. Get enough sleep.
• Find out what causes stress in your home and work life. Do whatever you can to reduce this stress.
• Don’t share needles for drugs, steroids, piercing, or tattooing.
• Get regular dental check-ups. Bleeding gums can increase your risk of infecting someone else.
• Volunteer to work for an AIDS organization. Facing your fears directly can be a good way to cope with them.

Things to consider

If you have tested positive for HIV, you must tell your past and present sexual partners. They should get tested, too. You must also tell any future sexual partners that you have tested positive for HIV. If you are now in a relationship, ask your doctor about how to explain your positive test results to your partner.

Let your doctor and dentist know that you have HIV. This will help them give you the care you need. Your privacy will be respected. Your doctor and dentist can’t refuse to treat you just because you have HIV.

Consider setting up an advance directive and medical power of attorney. Advance directives are written guidelines that tell doctors your wishes for different kinds of treatment if a time comes when you can’t make those decisions yourself.

The medical power of attorney is a legal document that names someone in your life to make decisions for you if you are seriously ill. A lawyer can draw up these documents.

Questions to ask your doctor

• If I have HIV, what are the chances that I will get AIDS?
• How did I get HIV?
• How can I prevent passing HIV to others?
• How can I avoid getting other infections?
• Do I have to tell my employer that I am HIV positive?
• Are there support groups for people with HIV?

Resources

Centers for Disease Control and Prevention: HIV/AIDS

Centers for Disease Control and Prevention: Resources for People Living with HIV

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