Real Health Chats

AFIB is short for Atrial Fibrillation. AFIB is an irregular heartbeat causing palpitations. AFIB can effect both the rhythm and the rate. Other symptoms include weakness, fatigue, shortness of breath, dizziness and chest pain. Biggest risk factor for AFIB is age. Other chronic illnesses like heart disease, high blood pressure can contribute to having AFIB. Obesity and family history of AFIB could contribute. If you are diagnosed with AFIB from your provider listening to your heart, you will likely have an EKG to confirm the diagnosis. Treatments include, but are not limited to, medications and shock treatment to get back into rhythm. Biggest complication with AFIB is the development of clots that can travel to the brain and cause a stroke. If you or a family member have any of these symptoms, please see your provider. --- Send in a voice message: https://anchor.fm/realhealthchats/message

What medical information is a must when sending your kid to college? 1. Kids should know how to check in at a doctor's office and they have the information they need for completing forms. 2. Kids should have and their insurance card with up to date insurance information; primary and secondary insurance carrier information; as well as current contact information for you and any other emergency contacts. Tip: Take a picture of the card and put all the information in their phone for safe keeping. 3. Kids should know what facilities they can go to, i.e. doctor's office, hospital, urgent care. If your child has a condition that will require consistent care, you should try and have providers in place before or when they go. 4. Kids should know what pharmacy to use and where it is. Make sure they have their prescription information for any medicines they take regularly and have a full supply when they leave. 5. If you want your kid's providers to be able to talk with you regarding their care, you need to complete a HIPPA authorization form that allows facilities and providers to discuss their care with you. The HIPPA requirements differ in each state, so you should check the state you are in and that your child will be in college in. You can search and download the appropriate forms. Another form you might consider is a Power of Attorney. Other things to consider: 1. Get a pair of flip flops if your kid shares a shower and bathroom 2. Talk to your kid about anxiety and depression that often presents in college kids. 3. Talk to your kid about safety and problems they may face including alcohol, sex and drugs. 4. Kids leaving will affect you, too! It's 2020 when we did this podcast, so we had to include Covid19 pandemic safety measures including masks, distancing and hand hygiene. --- Send in a voice message: https://anchor.fm/realhealthchats/message

Have you ever wondered about flatus (farts), burps, hiccups and yawns? Dr. D and Becky attempt to talk about these bodily functions (between all the laughs) and answer a few common questions. Enjoy! Be sure to watch for Dr. D & Becky on social media as they test themselves with the Yawn-O-Meter! Share your experiences with it as well! --- Send in a voice message: https://anchor.fm/realhealthchats/message

Dr. D and Becky discuss Covid 19 as the United States begins to open back up again including topics like when will it end, the use of supplements and video visits with your provider. --- Send in a voice message: https://anchor.fm/realhealthchats/message

This is an update since our last episode. Most places continue to be in some level of shelter in place. Masks are recommended, and in some places required, when out in public. We should all maintain hand hygiene and other practices to stop the spread of Covid 19. Mitigation, especially by social distancing, is proving successful to decrease the number of people sick with the disease at one time. Some areas are beginning to "open up", but most schools continue to be closed for the remainder of the school year. Anxiety and depression is more common. Some helpful practices to alleviate the anxiety and stress are to maintain a schedule, limit your news consumption, and reach out to others. Seek help from your medical provider if needed. Take the time to begin or renew hobbies, interests and family activities. Below is a helpful link. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/index.html --- Send in a voice message: https://anchor.fm/realhealthchats/message

April 3, 2020 The coronavirus continues to spread and is very contagious. Dr. D & Becky answer questions about the pandemic. Ventilators: Why are there not enough ventilators? There are enough ventilators for the usual amount of patients who need them. The system is being overwhelmed by the number of covid patients at one time and the length of time those patients stay on the ventilator. Many corporations are helping to meet the need of ventilators in hospitals. Personal protective equipment (PPE): Why is there not enough PPE? Possible hoarding as things started getting worse. What is happening now is that every time a possible covid patient is seen, the medical staff has to wear a gown, mask, gloves and face shield. There are about 330,000 positive cases in the United States. With between 4 and 10 percent of every test (depending on area) being positive. The other 90 + percent of tests given have required medical staff in PPE. PPE can only be used once, so the volume of PPE being used is causing shortages in many areas. Again, many companies, corporations and individuals are making an effort to fill the need of PPE in the medical community. Testing: New tests are being developed and should start arriving at facilities soon. Test results can take a week or more to get get back due to high demand. What is the risk to the baby if I am pregnant? The risk is still unclear, but there have been babies born to mothers with covid who have tested positive for the illness as well. When can we take our kids in for regular check ups again? What can I do if I have a non covid related issue I want to see the doctor about? If you or your child is sick or injured, contact your doctor. They will give you instructions on what to do. Masks: Masks offer a small layer of protection from the virus, but are most useful to contain respiratory droplets from anyone who could possibly have the illness. Other protective measures: obsessive hand hygiene is your best defense. Wash your hands frequently and well. Use hand sanitizer between handwashing. Sterilize all common surfaces like door knobs and cabinets. Only go out for necessities and as little as possible. If you are feeling anxious as you are sheltered in place, try and maintain a schedule, communicate with others as often as needed, get some exercise and fresh air, and contact your doctor if you feel you need more help. Send information on companies or groups who are going above and beyond to help during this pandemic. Also send us any questions you may have. --- Send in a voice message: https://anchor.fm/realhealthchats/message

Covid 19 is the disease that is caused by SARS Corona virus 2. It is a respiratory illness that can easily spread from person to person. The virus that causes COVID-19 is a novel coronavirus meaning that it is a new strain of the coronavirus and humans have no immunity built up to it. This virus can be very serious and potentially life threatening in patients over 65 or in those with underlying health problems. Symptoms are similar to cold or flu symptoms and include fever, cough, shortness of breath, body aches, fatigue. If you have questions about symptoms, call your doctor’s office to ask what you should do. Many offices are limiting patients coming into the clinic and have a protocol for being seen or sending patients to a specific testing site. For those with symptoms, call your doctor and remain isolated. Keep in contact with your doctor, they will let you know when to be tested or when to seek care. Testing is available but has become more limited because of test and personal protective equipment availability. Currently testing is recommended for the most at risk and the sickest patients. This may change as more tests become available. The incubation period is 2-14 days. It is important to self quarantine if you have been exposed or have a high potential of being exposed. Patients with Covid 19 can be contagious before symptoms are present. The disease is transmitted by respiratory droplets, but is likely also transmitted by touching surfaces that have been contaminated. This is why it is important to wash your hands frequently and avoid touching your face where the virus can easily transmit through your nose or mouth. The most effective way to slow the transmission of Covid 19 is social distancing. The proper way to social distance. When outside or in places where you have contact with others, remain at a distance of 6 feet or more and avoid going out in public when it is not necessary. Don’t panic! The majority of people who get sick with this virus will recover. Many may contract the disease and never know it. We will all get through this if we follow the recommendations and guidelines from local health and government officials. More information can be found at the following links. https://www.cdc.gov/coronavirus/2019-ncov/index.html https://www.who.int/emergencies/diseases/novel-coronavirus-2019 Are your kids anxious about this disease? Here are some tips for talking to them about it. https://www.pbs.org/newshour/health/10-tips-for-talking-about-covid-19-with-your-kids Next episode: Dealing with being home ALL the time! --- Send in a voice message: https://anchor.fm/realhealthchats/message

A few generalGeneral nutrition guidelines: Eating a balanced diet of carbohydrates, proteins, and fats is optimum for healthy eating and minimally processed foods are best. Persons weight X 100 = average maintenance daily caloric need (calories needed to maintain weight) This will change based on activity level Ex 200lbs X 100 = 2000 cal daily need to maintain weight Things to consider when trying to lose weight: A calorie deficit is needed to lose weight (less calories in than out) We need a calorie deficit of 500 per day to lose one pound per week There are many factors involved in losing weight in addition to calories, so that is why strictly counting calories is not always effective. Some of these factors include amount of regular exercise you get, your age, general health and metabolism all play a part. Metabolism slows as we age, about 2% per decade, so it can be more difficult to lose weight as we get older. Developing healthy habits of eating and exercise is helpful long term. There are many diet plans and programs. Some plan types we discussed on the program include: Low carb Ultra low carb like Keto Low fat Balanced nutrient, low calorie Ultra low calorie (commercial plans) Paleo Mediterranean DASH Intermittent fasting All of these types of plans can help lose weight if followed correctly, but they may not all be best or effective for each individual person. Some benefits of choosing a specific plan include: The upfront work is done for you. The plan has a system in place that you follow. There is typically a support system and often an accountability aspect. These may involve an online group, a coach or a meeting to attend. How can you decide what is right for you? Talk with your doctor and consider your allergies, overall health, medications, and time you are willing to spend in planning, preparation, tracking and accountability efforts. If you try a certain plan and it doesn’t work, it’s ok. Some will work and some won’t. They are not all one size fits all. How can you eat more healthy right now? Eat less processed food Have a colorful plate Balance Reduce sugar Chew your food well and slowly, pausing between bites Stop eating when you feel full If you have questions send them to us through the contact page at realhealthchats.com Be sure to subscribe to the Real Health Chats podcast and share with your friends! --- Send in a voice message: https://anchor.fm/realhealthchats/message

Meeting goals of exercising better is best achieved when you know and start with the essential information on exercise. A sedentary lifestyle is an independent risk factor of early onset of cardiovascular disease. To avoid this risk factor, physical activity is important. Exercise is defined as a subcategory of physical activity that is planned, purposeful and repeated on a regular basis in order to improve and maintain fitness. 150 minutes per week (30 minutes a day, 5 days a week) of moderate intensity exercise is recommended. Moderate intensity means something similar in intensity to a brisk walk that increases your heart rate. A good exercise program incorporates the following four essential components... Cardio: examples include walking, jogging, swimming, hiking and biking. Resistance: examples include weight training, resistance bands, and body weight exercises like push ups. Balance: examples include Tai chi and heel-toe walking Flexibility: examples include stretching and yoga* *yoga is an example of an exercise that uses each of the the four components. When starting an exercise program visit with your doctor about any concerns you have; start slow; listen to your body; do what you enjoy that is sustainable; and prioritize making the time to do it. Soreness is common, but consistent pain or injury should be addressed quickly. If you want someone to be accountable to as you work toward your fitness goals, send us a message from the contact page of www.realhealthchats.com and put accountability in the subject line. --- Send in a voice message: https://anchor.fm/realhealthchats/message

Set yourself up for success with your 2020 goals and resolutions. why, why, why?: Get to the deep, personal reason for why you set that particular goal. Ask why until you can’t ask why anymore and hold onto that reason. This makes it personal and meaningful. Set SMART Goals S – Specific: Be specific about what you want to accomplish with this goal. Think about this as the mission statement for your goal. The “W” questions will help you detail your goal. Who? – Who needs to be involved to achieve the goal. Who can help you accomplish it. What? – Think about exactly what you are trying to accomplish and don’t be afraid to get very detailed in your planning. When? – Schedule and prioritize your time for your goals. Where? – Where will you work on the goal? Where will you get your information and resources? Which? – Make choices. I.e.: which program to use, which advice to follow. Which obstacles are in my way? M – Measurable: Good goals need to be measurable. How will you measure your progress? Set milestones, but focus on PROGRESS, not PERFECTION or absolutes. A – Achievable: Goals should be achievable, but also stretch you. Consider what will help make the goal achievable and attainable. What tools, skills or resources do you have or are available to hlep you. R – Relevant or Realistic: Set goals and steps along the way that are realistic and relevant to what you are doing. Don’t limit yourself, stretch beyond what you think is possible. Consider your big goal, then set small achievable goals and focus on PROGRESS. T – Time-Bound, Time-based: Set time parameters and target dates. Time constraints helps in focusing on a goal, provides a place to measure, and evaluate. Pushing through until an end date takes strength and resolve and hitting that mark often is a confidence booster that prepares you for the next milestone. Set your long game time goal. Then start breaking this down into smaller, measurable, achievable, realistic goals. We want you to succeed!! We want to help you and be a part of celebrating your success and also want to accountable to you! So, if you would like to be part of our accountability program, please go to our website to the contact page. Send us a message with “accountability” in the subject line. We’ll be supporting each other in setting SMART goals and share successes, setbacks and celebrations!! --- Send in a voice message: https://anchor.fm/realhealthchats/message

Dr. D and Becky answer listeners questions about both themselves and medical topics. --- Send in a voice message: https://anchor.fm/realhealthchats/message

Aligning your goals for visiting a doctor with the doctor’s goals for your appointment will help make the most out of every appointment. Know what type of appointment you need. Common appointment types include new patient, annual wellness, follow up, pre operative consultation, and procedure. New patient appointments may take longer as the doctor will take time to learn your history and get to know you. Annual wellness appointments may also be called yearly check ups, health maintenance visits, annual physical, among others. Follow up appointments may include a follow up after an illness, a regular follow up and check for maintenance of diseases, or a follow up from a procedure like stitches or a cast. Often when preparing for surgery it is required to be screened to make sure a patient is healthy enough for the surgery. This is done in a pre op consultation appointment. Procedure appointments are scheduled to focus on specific procedures that can be done in the office. Common examples include wart removal, removal of a toe nail, etc. Appointment types allow the office to schedule the appropriate amount of time, as well as know appropriate coding and billing. When scheduling an appointment, understanding the type of appointment you need can be helpful to make sure you get what you need out of your appointment. Being as specific as possible when scheduling will also help to prepare the office staff and doctor to better serve you in your appointment. If you have issues that arise prior to your appointment that you would like to discuss in addition to what you have already scheduled for, it is sometimes helpful to contact the office to let them know. You can say that the reason for your appointment is private if is of a more personal nature. Understanding your provider’s office procedures for scheduling and communication can be helpful in getting the most out of your experience with that office. Working with your provider and the provider’s office, you can have more positive experiences and maintain a common agenda for your visits. --- Send in a voice message: https://anchor.fm/realhealthchats/message

Dementia is characterized by progressive decline in cognitive function from baseline and causes significant impairment. Types of dementia Alzheimer- most common, up to 80% of cases Vascular Frontal Lewy body Parkinson Many people have a have combination of types of dementia. Most people who think they are having some memory loss are not developing dementia. People with dementia don’t know they are having problems. They are usually brought in to the doctor because of concerns of family. Concerns that arise: Personal memory loss and progression of disease. Who will be caretaker. Don’t want to be a burden. What will be the cost? Family and caretaker concerns include how to deal with the memory loss. Who will care for the patient? Where will they be? Will they be safe? How will we pay for this? Ideas for dealing with the symptoms and issues of memory loss: Family and caretakers should be positive, agreeable and redirect. The person with dementia does not remember what they have done, not done, or said. They will argue that they did not do that thing that they did. They don’t remember. It does no good to argue with them because they won’t remember the argument either. The best plan is to agree, pacify and redirect. Get to the physician early to discuss concerns. There is testing that will be done to rule out treatable cause of cognitive dysfunction like dementia, hypothyroidism, B12 deficiency. There is testing that should be done to determine the cause of dementia and the severity. Have early discussion with family to determine wishes for treatment. Get living will, power of attorney, etc There is no definite treatment but there is hope in current research. There are some medications available that might slow the progression. These have side effects that are sometimes worse that the disease. Enlist the help of your doctor as needed when hard conversations have to happen. Consider what is best for the patient first when making decisions. Seek out community resources for help, including respite care. Caregivers need to take care of themselves as well. https://alz.org/ https://alzfdn.org/ https://www.wvnews.com/fairmontnews/news/historic-breakthrough-wvu-rockefeller-neuroscience-team-first-to-use-ultrasound/article_7b95c0b8-c307-5cda-ab00-51ca0ddfb41f.html --- Send in a voice message: https://anchor.fm/realhealthchats/message

COPD is chronic obstructive pulmonary disease (also called chronic obstructive lung disease) It is the 4th leading cause of death in the US. Anatomy Lungs composed of airways that branch smaller and smaller like a tree and end in tiny air sacks called alveoli where oxygen and carbon dioxide are exchanged. When we breathe, air moves in and out of our lungs, delivering oxygen and giving off carbon dioxide. COPD results in obstruction of this air flow. COPD has 2 categories, chronic bronchitis and emphysema. Chronic bronchitis is caused by inflammation, mucous production and stiffening of the airways. Common symptoms are productive cough, congestion, wheezing and shortness of breath with exertion. Emphysema is caused by destruction of the air sacs where oxygen and carbon dioxide exchange occurs. This leads to shortness of breath, air hunger, weight loss and chronic fatigue. Smoking is the leading cause of COPD although there are some other minor causes. Chronic uncontrolled asthma can lead to COPD and there is a genetic enzyme (alph 1 antitrypsin) deficiency that leads to lung tissue destruction and emphysema. Smoking damage is estimated in “pack years”. 1 pack year is one pack daily for one year. Increased pack years increases the risk of developing COPD. It is very important to diagnose COPD correctly because there are other diseases that can cause similar symptoms and treatments might be different. Testing for COPD might include pulmonary function testing, xrays, CT scans and tests to rule out or diagnose other problems. Treatment for COPD is aimed at managing symptoms. It is very important to stop smoking. Inhaled medications help open airways and decrease inflammation. Once damage has occurred, it cannot be repaired, but lung function can improve. Please stop smoking and don’t start. Help loved ones quit, but they have to be ready. It is important to have end of life discussions if your family is facing issues with COPD. --- Send in a voice message: https://anchor.fm/realhealthchats/message

In this episode, we discuss some basics of cardiovascular anatomy, physiology, disease states, testing and treatment. This is meant to provide basic information that will help in discussing cardiovascular health with your physician or your family. Anatomy and physiology. (Remember this is basic) The heart is a muscular organ that is the pump of the circulatory system. Blood comes into the heart from the lungs where it is resupplied with oxygen that is needed by all of our cells. The blood then goes back to the heart where this freshly oxygenated blood is pumped to the rest of the body. Arteries are the blood vessels that carry the fresh blood to the body and veins are the blood vessels that carry the blood that is now out of oxygen back to the heart. The heart, just like the other organs of the body, needs fresh blood to maintain health and function. The first arteries that leave the heart are called coronary arteries and these supply fresh oxygenated blood to the heart. Disease states (there are many others, remember this is very basic) When arteries of the circulatory system become diseased (narrowed and blocked due to plaque build up) the organs that are fed by these arteries suffer from poor circulation and are unable to function normally. Coronary artery disease (CAD), also called heart disease occurs when the coronary arteries become narrowed or blocked by plaque buildup. This leads to chest pain with activity, myocardial infarction (heart attack), and heart failure. Cerebrovascular disease is this process in the brain and leads to strokes. Peripheral arterial disease (PAD) is the same process in the legs and leads to pain with activity that improves with rest, poor wound healing, and amputations. Heart failure occurs when the heart cannot pump enough blood to keep up with the needs of the body. Testing EKG or ECG- electrocardiogram. This is a test and measure of electrical activity as it goes through the heart. It gives information about heart rate, heart rhythm, heart size, and blood supply. ECHO- echocardiogram. This is an ultrasound of the heart. It uses sound waves to evaluate how well the heart pumps and how well the valves work. It can also give indirect information about the pressures in the heart. Heart cath. This test is used to evaluate the blood supply to the heart, how well the heart is pumping and can measure the pressures in the heart. A catheter is placed in an artery in the groin and is threaded up to the heart. When in the right place, dye is injected and xrays are used to take images. Treatments Angioplasty or stent placement. This is used to treat coronary arteries that have decreased blood supply. Angioplasty is used to stretch area of narrowing and a stent is used to permanently open it. This is done through the heart cath procedure. Coronary artery bypass graft surgery, also called CABG. When a blockage of a coronary is too severe or there are multiple arteries affected a bypass surgery is performed. This is done by using blood vessels that are harvested from a different part of the body (usually the leg) and then surgically placing that piece of vessel above and below the blockage to go around or bypass it. Heart transplant. This is done to treat severe heart failure. --- Send in a voice message: https://anchor.fm/realhealthchats/message

Vitamin supplements are not necessary for the general population if eating a well balanced diet. Most health issues associated with vitamin deficiency can be solved with a well balanced diet. Some conditions such as Crohn's and Celiac disease can cause problems with the absorption of vitamins. Restrictive diets, including vegan, may limit intake of some essential vitamins, especially B12. Advancing age may also be a factor in limiting vitamin absorption. Talk to your personal physician if you are concerned about the need for vitamin supplementation. Liver is a prime source of multiple vitamins. There are several causes of vitamin D deficiency, including decreased intake from vitamin D rich sources like milk, decreased absorption, and reduced sun exposure. Individuals at risk for vitamin B12 deficiency include those on a restrictive diet like vegan and those post gastric or bariatric surgery. They should receive oral vitamin B12 supplements. Folic acid supplementation is recommended in pregnancy, but not for the general population unless at risk. Risk factors for folate deficiency include malnutrition, chronic alcohol use, chronic hemolytic anemia. Those individuals should receive folic acid supplementation. Most infants should have an iron supplement while breastfeeding. Children will also get the proper nutrients from a well balanced diet. Calcium and vitamin D supplements can be helpful in reducing the risk of osteoporosis. Talk to you personal physician for specific recommendations to meet your needs. https://www.fda.gov/consumers/consumer-updates/fortify-your-knowledge-about-vitamins --- Send in a voice message: https://anchor.fm/realhealthchats/message

This show we discussed thyroid disease. The thyroid is a gland that is located in the front of the neck that produces thyroid hormone. Thyroid hormone is important for metabolism in all of our cells. There are 2 main classes of thyroid disease other than thyroid cancer (we did not talk about thyroid cancer). Hyperthyroid means that the thyroid gland is overproducing thyroid hormone. Hypothyroid means that the thyroid gland is underproducing thyroid hormone. Most common cause of hyperthyroid is Graves disease. This is caused when the body makes antibodies that falsely stimulate the thyroid to produce hormone. Symptoms include weight loss, palpitations, fast heart rate, heat intolerance, fatigue, protruding of the eyes. Hypothyroid has a few causes but the most common is Hashimotos thyroiditis. This is occurs when the body makes antibodies that destroy the cells that make thyroid hormone. Symptoms of hypothyroid include fatigue, weight gain or difficulty losing weight, dry skin or hair, hair loss, depression, memory and cognition decline, among others. Thyroid hormone is produced in two forms, T3 and T4. The thyroid gland produces mostly T3 and less T4. The hormones are released into the circulation and go to all the cells of the body. Inside the cells, T3 is converted to T4, which is the active form. Thyroid hormone production is regulated by other hormones. TSH (thyroid stimulating hormone) is produced in the pituitary gland and stimulates the thyroid to make thyroid hormone. This process is regulated by a negative feedback loop which means when thyroid hormone is low, TSH production is increased which stimulates the thyroid gland to produce more thyroid hormone, as the levels normalize, TSH levels go back down. Because of this feedback loop, we monitor TSH levels for adequate thyroid hormone production or when people are treated with thyroid hormone replacement. Hypothyroidism is treated with thyroid hormone replacement. It is usually treated with levothyroxine (T4) which is a synthetic bioequivalent form. It is converted to T3 in the cells where it is needed. --- Send in a voice message: https://anchor.fm/realhealthchats/message

Dr. D and Becky share personal colonoscopy experiences. --- Send in a voice message: https://anchor.fm/realhealthchats/message

Diabetes is the 7th leading cause of death 1.5 million new cases diagnosed every year 30 million people with diabetes, about 7.5 million don’t know they have it 84 million with pre diabetes 327 billion dollars in diabetes care in 2017 Diabetes is a chronic disease whose hallmark is elevated blood glucose (sugar) above normal. Normal fasting blood glucose values for diabetes are 70-100 Pre diabetes 101-125 Diabetes greater than 126 Type I diabetes is usually early or childhood onset, we did not talk about this, we will save it for a later episode. Type II diabetes is also called late or adult onset because it usually is diagnosed in middle age It is associated with insulin resistance. Insulin is a hormone made in and secreted from the pancreas and is responsible for keeping blood glucose in a normal range. Insulin resistance is a state in which the cells of the body become resistant to the effects of insulin, making it harder for the glucose to get from the blood to the inside of the cells of the body where it is needed. This results in higher blood glucose levels which leads to all of the complications of diabetes. Risk factors for Type II diabetes include obesity, family history, hispanic or African American decent. There are others, these are most common. Symptoms of diabetes are not common early in the disease. As it progresses and blood sugar gets higher symptoms can include excessive urination and thirst, recurrent urinary tract infections (UTI), recurrent yeast infections, fatigue, weight loss. Interesting note, when these symptoms occur, the urine has excess sugar and before lab testing was available, doctors would taste urine to see if it was sweet. Consequences of untreated or poorly controlled diabetes include cardiovascular disease, heart attack, strokes, peripheral arterial disease which can lead to poor wound healing and amputation, blindness, kidney disease, neuropathy. These consequences are related to the damage that long term high glucose levels cause in small blood vessels which then leads to end organ failure. There is no cure for diabetes so management is very important to prevent the above problems. Management strategies include lifestyle changes like healthy diet that includes low sugar intake and adequate exercise. Dietitians and diabetic educators play a vital role here. Medications are very important. It is important to check blood sugar regularly and keep follow up appointments with your doctor. Please follow doctors advice. Very useful resources can be found at www.diabetes.org --- Send in a voice message: https://anchor.fm/realhealthchats/message

Cold and upper respiratory infection mean the same thing. It is caused by different respiratory viruses that cause sore throat, cough, nasal drainage and congestion, low fever and mild body aches. It will usually last about a week and gradually gets better after 3-4 days. This does not require antibiotics for treatment. A slight cough may persist for two or three weeks with a cold. Flu is caused by influenza virus and has similar symptoms to a cold, but the symptoms start more suddenly and is associated with high fevers, severe body aches and fatigue. You feel awful, worst cold ever. Antibiotics don’t treat this but there is treatment available that might shorten the length of illness and decrease symptoms. There are some people who need to be treated, but it must start within the first one to two days. Sore throats are usually caused by viruses and don’t require antibiotics unless it is strep throat. This needs to be treated with antibiotics to prevent certain complications. Sinus infections and ear infections are usually caused by viruses. If a bacterial source is suspected based on length of illness or symptoms, antibiotics are needed. If symptoms last 7-10 days, get worse or there is a second illness that presents (getting better then suddenly get worse) this might be an indication for further evaluation and treatment. See your doctor if: You are worried it is worse than a cold (it is still probably a cold and does not need antibiotics) Early, if you think you have the flu and would need to be treated. If you were getting better, then got sicker Fever more than 3 days Very young or old are more susceptible to serious infection Inappropriate use of antibiotics leads to antibacterial resistance strains of bacteria, possible serious adverse reactions, c.diff infections, and the perception that antibiotics are necessary when they are not. To help prevent and stop the spread of colds and flu: wash your hands, stay home if you have the flu, cover your cough and sneeze, and wash your hands again. Also, get your flu shot. --- Send in a voice message: https://anchor.fm/realhealthchats/message

Osteoporosis is low bone density associated with increased risk of fracture. There are no symptoms. It is most often discovered often after a fracture, especially a low trauma fracture. Osteoporosis is most often associated with women, but men can also be at risk. What are risk factors of osteoporosis? Postmenopausal women: bone density decreases at a more rapid rate Advanced age: 80’s and 90’s Low trauma fracture: break a bone without a trauma Long term glucocorticoid therapy: steroids Low body weight: less than 127 lbs, especially if body weight has always been low Family history of hip fracture Smoking cigarettes Excessive alcohol intake Caucasians are at higher risk What is peak bone mass? Peak bone mass is the maximum amount of bone developed (bone mass) in a person's life, typically around age 30. The stronger the bones at age 30, the less risk of osteoporosis. What screening tests are there for osteoporosis? Dexa Scan: x ray that evaluates the density of the bone usually at the hips and lumbar/low spine. This also includes a statistical analysis that compares the results with what is considered normal. Given a score called a T Score that will estimate your risk of fracture in the next ten years. Women over 65 can get a Dexa Scan. Anyone with risk factors can also get a screening Dexa Scan. FRAX: (risk assessment calculator) questionnaire that takes into account a person’s risk factors and gives an estimated fracture risk for the next ten years. Anyone who shows high risk for fracture should talk to their doctor about treatment. Talk to your doctor about your specific situation, especially if you feel you are at risk earlier. Treatment Options: Medication: discuss with your doctor to find out what is best for you The best option is PREVENTION and lowering your risk factor early. Adequate calcium intake: teens and adults 1000mg of calcium a day Healthy lifestyle: diet, nutrition, adequate exercise No smoking No excessive alcohol use If you or someone in your family is under 30 years old, start now to help increase bone density prior to the age of peak bone mass. If you or your family member is over 30, take the same measures to help reduce risk factors. Preventing fractures affects the whole family. Fractures in elderly are life altering. Know risk, get screened Get treatment Make sure younger children are getting enough calcium intake. Teenagers, particularly females, should take added calcium. Take precautions to prevent and reduce risks of falls Handrails in bathrooms, on all steps No loose rugs Wrap up invitation If you’re over 65 and haven’t had an osteoporosis screening yet, do so. Talk to your doctor about personal risk factors, especially if you have a parent who had a hip fracture. No matter what age you are, take preventative measures by getting adequate calcium, living a healthy lifestyle, not smoking, and no excessive alcohol intake. Ensure young kids and teens get adequate calcium. Get rid of loose rugs and add plenty of handrails as needed for elderly family members. Subscribe to the Real Health Chats podcast! Find us at realthealthchats.com, on Facebook, Instagram and Twitter --- Send in a voice message: https://anchor.fm/realhealthchats/message

A Health Screening is a test that looks for a problem or disease when no symptoms are present. We recommend everyone have a yearly wellness visit with your personal physician and ask them about any screenings you may need. Pap Smear: looking for cervical cancer cells or dysplasia (abnormal, possible precancerous cells). Begin at 21. If normal, repeat every 3-5 years. Human Papilloma Virus (HPV): responsible for most cervical cancers. Screening starts at age 30 and continues every 5 years. Breast Cancer Screening - Mammogram: Begin screenings between age 40-50 and continue every 1-2 years. Talk to your doctor about family history of breast cancer or other risk factors. Chlamydia Screening: Sexually active women younger than 25. Men and women at any age with multiple sex partners. Screening is done with a urine sample. Prostate Cancer Screening: Some recommend PSA (prostate-specific antigen), but some do not. We will have a full episode on men’s health to discuss this. Men should talk to their doctor about recommendations. Colon Cancer Screening: Options include colonoscopy, fecal occult blood test and barium enema with flexible sigmoidoscopy. Most common and accurate is the colonoscopy which is recommended at age 50 unless at higher risk. You are at higher risk if you have a relative who had colon cancer and should discuss that with your doctor. During a colonoscopy polyps can be removed. Clear colonoscopies can be done every 10 years. Lung Cancer Screening: Low radiation dose CT scan for people older than 65 who smoke or quit smoking less than 15 years ago and who have a 30 pack year history (1 pack a day for 30 years or 2 packs for 15 years) Abdominal Aortic Aneurysm Screening: This screen is looking for symptoms of an aneurysm in the largest blood vessel, the aorta. Men 65 or older who have ever smoked need an abdominal ultrasound to check the size of the aorta. If enlargement of the vessel is found, your doctor will follow up with more tests. Lipid screening: Lipids are Cholesterol, Total Cholesterol, High Density Lipoproteins (HDL), Low Density Lipoproteins (LDL), and Triglycerides. Everyone should be screened for lipid disorders in adulthood and continue screenings every 5 years if normal. Keeping these levels in check will help reduce the risk of heart disease and stroke in the future. Hypertension Screening: at each doctor visit, vital signs checked, including blood pressure. Treat if it is high. Diabetes Screening: Have a screening early in adulthood to get a baseline blood glucose level. If level normal, check again every 5 years. If there is a family history of high cholesterol, hypertension or diabetes, testing more frequently may be appropriate. When any of these are high it can contribute to heart disease and risk of stroke. Hepatitis C Screening: All baby boomers (currently 55-75 years old) should be screened. People at higher risk include IV drug user or someone who has had blood transfusions. This is rare today because of improved blood screening practices. HIV Screening: Everyone should be screened at some point, especially if you are at risk Depression Screening: It is a questionnaire that you complete at your doctor visit that helps determine risk. You can also find and do a questionnaire on your own and talk to your doctor if you score high. Also, if you have any concerns without a questionnaire, if you have been feeling symptoms of depression or if you have a family history, please talk to your doctor. --- Send in a voice message: https://anchor.fm/realhealthchats/message