Monday, October 6, 2014

Family Health: Continuity of Your Care

Your family's health is of utmost importance.  Continuity of care is disrupted all to often due to lack of communication and follow-up.  Make sure your family members have accurate information for each person,  These suggestions will help you continue your health care communication continuous with less stress:
  • call your doctor's office, testing center prior to appointment to be sure all is on time as scheduled
  • reschedule appointments that are over an hour late especially if it jeopardizes your health conditions (e.g. persons with diabetes, hypertension, arthritis)
  • read often on your health condition
  • use email, fax, postal mail if unable to reach your doctor by phone
  • get copies of your medical records and reports from all doctors you see
  • contact your doctors for your test results, specialists reports if you fail to get contacted within 1 week
  • tell your doctor what other doctors have told you as these reports often arrive after your visit, if at all
Best health!

Monday, September 22, 2014

Family Health: Abuse Awareness

Family and domestic violence affects many millions of women, children and men worldwide.  More females and children are affected than men.  In 2011 statistics revealed that over 1.5 million women and 800,000 men were involved in intimate partner violence (IPV) in the United States alone.  Studies estimate the lifetime risk for women is an astounding 1 in 4. 

As more accounts of domestic violence are made public, one would think contact for help would be more prevalent as well.  It is in the real world.  Repeated public disclosure (video, discussion of incidents, etc.) with negative implications is less than desirable for anyone especially victims and their families. This lends to more harm than help possibly generating ideas for potential new and recurring events.

Doctors in Florida are required to complete domestic violence course to maintain licensure.  This ensures that anyone who is faced with this situation will get proper guidance and assistance.  Many doctors include questions about this on routine wellness exams.  Help and prevention of further occurrences from qualified medical professionals is of utmost importance.

Domestic violence is a very sensitive issue that affects health and well being.  It is a private matter regardless of those involved. Seeking help is of utmost importance.  Prevention, intervention and early detection are essential.  This can start in the primary care doctor’s office before it escalates to family violence and ER visits. 

Patient safety is a primary concern as is developing a safety plan. Referral to appropriate health care professionals and community-based programs helps patients with the psychological, emotional, and physical aspects of family violence.  Other resources can be found by phone or Internet as follows:

·       National Domestic Violence Hotline
        1-800-799- SAFE (7233)
          www.thehotline.org


·       National Sex Assault Online Helpline
         1-800-656-HOPE (4673)
www.rainn.org/get-help/national-sexual-assault-online-hotline

·       Institute of Safe Families
          www.instituteforsafefamilies.org

·       National Coalition Against Domestic Violence
    www.ncadv.org

·       Academy on Violence & Abuse
          www.avahealth.org

·       American Bar Association
    http://apps.americanbar.org/tips/publicservice/safetipseng.html


Keep you and your family healthy and aware that IPV and family violence is avoidable.  Educate and inform seeking help when it is needed. Abuse be it verbal or physical is harmful and unhealthy.

Wednesday, September 3, 2014

Asymptomatic Symptomanic Static on Routine Pelvic Exams

Guidelines for pelvic exams in women has been "updated" again.  Avoiding pelvic exams in asymptomatic, non pregnant adult women is the newest "recommended" guideline.  Could this mean that a woman who meets these criteria should refrain from routine exams until she becomes symptomatic and/ or pregnant?  If this were the case, how many women would be left out of possibly being diagnosed with a disease that was indeed asymptomatic until diagnosed on a routine pelvic exam?

In asymptomatic non pregnant females, my diagnoses have included cervical cancer in an 80 year old, ovarian cancer in a 20 year old, massive uterine fibroid tumor in a 40 year old.  The routine pelvic exam was able to detect these malignant and pre-malignant conditions before they became life threatening.  Early detection allowed these ladies to escape the perilous pitfalls of cancer.  In these cases simple surgery was the cure.  They remained asymptomatic and cancer free by continuing with their routine pelvic exam and checkup.

Without symptoms may appear to indicate a disease free state, but often times it reveals disease.  It is up to patients and their health care providers to include routine exams in their health care plan.  Routine can be yearly, every other year or two, or less frequently depending on the patients medical history.  Routine evaluation and assessment is based on each individual.

Routine pelvic exam guidelines are just that, suggested recommendations that should be considered.  For this doctor and many others, especially women, routine pelvic exams will still be part of a well woman visit as deemed necessary.  The schedule is as follows:
  • 18 - 20 first pelvic exam, sooner if sexually active and/or symptomatic
  • 20 - 60 pelvic exam every year to every other year unless symptomatic
  • 60 - life pelvic exam every 2-3 years unless symptomatic
Routine pelvic exams and pelvic/ transvaginal sonograms together offer earlier detection and diagnosis of more gynecological diseases that can be treated effectively before they affect a woman's quality of life.  In addition, they help avoid "all in your head" misdiagnosis, and can be lifesaving.  As for the concern of "false positives" and unnecessary tests...forget about the asymptomatic symptomatic static.  Most abnormal exams and tests can be repeated and followed on a closer routine schedule that may prevent riskier intervention.  Talk with your doctor about what is best for you.  Best health!