Tag Archives: health

Scan for heart-disease risk before symptoms

The coronary calcium scan is a screening test to evaluate risk for future coronary events. It uses a state-of-the-art computerized tomography (CT) scan to detect calcium deposits found in atherosclerotic plaques in the coronary arteries. It is a sensitive way to detect atherosclerosis before symptoms develop.

Main risk factors for coronary artery disease are:

  • Personal/family history of coronary artery disease
  • Males over the age of 45, females over 55
  • History of smoking (past or present)
  • Overweight
  • High cholesterol
  • Diabetes
  • High blood pressure
  • Inactive lifestyle

Your doctor can use the results of the scan to help make treatment decisions on how to lower your risk for heart disease. This test is most helpful for patients who do not have known heart disease but are at medium risk for disease after evaluating the main risk factors listed above.

Some studies have shown that a cardiac calcium scan might be a motivational factor for people at moderate risk to follow treatment plans and to make lifestyle changes.

The screening test is NOT for you, if

  • you don’t have any risk factors for heart disease
  • you are at high risk for heart disease
  • you have already been diagnosed with heart disease – since the information obtained from the scan will not impact your recommended treatment.

The result of the test is a number called the cardiac calcium score, or Agatston score.

The score is calculated from the total area of calcium deposits and the density of the calcium.

  • A score of zero means no calcium is present in the coronary arteries, which suggests a low likelihood of having a heart attack in the future.
  • A score of 100-300 is indicative of moderate plaque deposition in the arteries and is associated with a relatively higher risk of heart attack or heart disease over the next three to five years.
  • A score greater than 300, is considered very severe with high risk of heart attack or heart disease.

What are the concerns of getting a scan?

  • You are exposed to a low dose of radiation.
  • False positives are possible leading to further testing or treatment that you don’t need.
  • Not all arteries with heart disease have calcium “soft plaque atherosclerosis,” so it is possible to get a low score and still be at risk.
  • The scan is not covered under most insurance plans and Medicare, so the cost is out-of-pocket.

Many people do not know that they have heart disease until they have a heart attack. A coronary calcium scan is one way to find out if you have early heart disease, but other risk factors must be evaluated along with the score to give you a truer assessment of your cardiac risk. Your doctor can use your score to help you make lifestyle changes and/or to decide to treat high cholesterol or high blood pressure with medication.

SUSAN LOCKE is Healthnetwork Foundation’s medical director

Catholic rehab makes all the difference

People recovering from serious injuries, strokes, life-changing illnesses, and catastrophic accidents often need more than just physical rehabilitation.

Their spirits also need to be uplifted. That is an important insight the staff at Madonna Rehabilitation Hospitals in Nebraska understands infinitely well.

Rehab involves much more than physical adjustment

“Our patients and our families are sometimes struggling to understand the reason for their condition, not only just the physical aspects of it,” said Paul Dongilli Jr., the president and CEO of Madonna Rehabilitation Hospitals.

Dongilli, a speech pathologist by training who is a member of Legatus’ Lincoln Chapter, said people come from 24 different states, as far away as Alaska and Washington State, to be treated at one of Madonna Rehabilitation Hospitals’ two locations, in Omaha and Lincoln.

Physicians and nurses in those other states often refer their patients to Madonna because of the cutting-edge, first-rate rehabilitative care that is matched by the psycho-social and spiritual care offered at the facilities.

“When those individuals are paired with our social workers and our psychologists, they’re able to deal with the psycho- social aspects of a devastating injury or illness,” said Dongilli, who has been with Madonna since 1983.

Whereas most hospitals and care centers have small rehabilitation units on-site, Dongilli said Madonna Rehabilitation Hospitals are one of the only, if not the lone, freestanding Catholic rehabilitation facilities in the country.

“We’re not part of a larger acute care system, and in most acute care systems, rehabilitation is a small part of what they do,” Dongilli said. “Maybe they don’t invest in the technology and have the resources that are needed to treat patients who have had devastating spinal cord injuries, brain injuries, children as well as adults, where we have, because that’s all we do.”

Founded by Benedictine nuns – with a priest in residence

Benedictine nuns founded Madonna Rehabilitshort-term recovery and room for another 125 individuals who have chronic conditions and require longer-term care. The Omaha facility opened in 2016 and has room for 110 patients.

The facilities today are sponsored by the Diocese of Lincoln, Nebraska, and they retain a distinctive Catholic identity.

Madonna has a Catholic priest in residence, and offers daily Mass and access to the sacraments for patients, their families, and staff. Both locations have beautiful chapels and sacred art throughout the facilities.

“When you come into the facility, the look is such we think that it reinforces that Catholic identity,” Dongilli said, adding that spiritual care is offered for people of different religious and denominational backgrounds.

Patients come from afar

From its beginnings 60 years ago, Dongilli said Madonna Rehabilitation Hospitals has evolved into a health care system that serves patients from around the country, primarily from an eight-state region in the Midwest.

“When individuals and their families are faced with these horrific injuries and they’re looking for a facility to help them, in most areas they’re told that they don’t have those resources,” Dongilli said, adding that trauma centers in other states that work with Madonna are quick to refer their patients to the Nebraska facilities.

“So people are willing to travel to access a resource that they can’t get in their immediate community,” Dongilli said.

Madonna has a dedicated pediatric unit and long-term care for patients who require ventilators. The staff specializes in complex medical, traumatic brain injury, spinal cord injury, pulmonary conditions, severe stroke, other neurological conditions, and pediatric rehabilitation.

Offering hope, spiritual recovery

Dongilli, who worked in Madonna’s brain injury and stroke units and worked his way up to chief operating officer and then CEO three years ago, said Madonna offers hope and healing to thousands of patients every year.

“What we provide is a more holistic approach to care, balancing the more physical aspects of medicine, nursing, and therapy with more of the psycho-social and spiritual aspects of recovery,” he said.

In addition to the chapel, Dongilli said Madonna has a large therapy gym and carefully manicured grounds that contribute to the peaceful, spiritual, and mentally healing atmosphere.

“We have been very careful over the years to have green space and nature and some beautiful settings that are part of God’s creation that our families and our patients can access to have some quiet time or for reflection,” Dongilli said. “Those things, we think, very much make a difference and aid in the recovery process. It helps provide hope.”

In addition to focusing on the mental and spiritual healing, Madonna’s team of specialized physiatrists, hospitalists, therapists, rehabilitation nurses, clinicians, and researchers work with advanced technology and equipment to help each patient achieve the highest level of independence possible.

Research institute developing new technologies

Dongilli said Madonna has “a small but mighty” research institute that has been successful in developing technology to support rehabilitation efforts, and added that the technology is now being commercialized and sold to other health care facilities in the United States and abroad.

“We think we have the opportunity now in working with the University of Nebraska to expand our research efforts and develop equipment and technology that will help advance the field of rehabilitation and the outcomes of the patients that we serve,” Dongilli said.

Dongilli added that Madonna started a department to train physicians, and recently accepted the first group of residents from the University of Nebraska’s College of Medicine who will be trained in physical medicine and rehabilitation.

“I think what the future holds for us is to be a regional center, not only for the treatment of patients, but also a training facility for physicians and other professionals specializing in rehabilitation,” Dongilli said.

Founded with Mary’s blessing

The founding Benedictine Sisters named the facility after the Madonna because 1958 was a Marian year, said Dongilli.

“They had a vision that if individuals could have good nursing care and therapy care, that folks who previously had to be institutionalized could return back to their homes and to their communities,” Dongilli said. “They really established a vision for rehabilitation. They recognized the blessings that Mary would provide for their efforts and for hopefully sustaining the hospital and the facility.”

Despite changes in medicine and technology over the decades, Dongilli said Madonna’s core philosophy remains the same.

“That notion of doing God’s work, a vision for doing rehabilitation under the guidance of the Blessed Mother, has really been a core tenet for us,” he said.


BRIAN FRAGA is a Legatus magazine staff writer.

Marijuana – why bother going to pot?

Rebekah (not her real name) was admitted into drug rehab, not her first time around the block. She was typical of over half the patients I saw that day, typical of any treatment center across the nation. The common denominator? Smoking marijuana was her first experience of intoxication.

Marijuana contains two major substances. One is delta-9 tetrahydrocannabinol (THC), the substance responsible for the “high.” It causes most of the adverse effects of marijuana: elevated heart rate and blood pressure, distortions in time perception, anxiety, psychosis, and addiction. Along with alcohol and other potentially addicting substances, THC is a “false messenger,” signaling the brain that something wonderful has happened when, in fact, the only “wonderful thing” has been a fleeting experience of something much less than God. It is also a “virus,” taking control of the parts of the brain that process experience, plan, and strategize for the future. In vulnerable people, there follows a steady progression from pleasure or relief of suffering, to addiction.

The second major substance in marijuana is cannabidiol (CBD). CBD is responsible for many of the medicinal effects of marijuana such as: lowering of the blood pressure and heart rate, reductions in anxiety, anti-seizure effect, and protection from psychosis. (The FDA recently approved a pharmaceutical preparation of CBD (without THC) for use in some seizure disorders.) CBD is not part of the marijuana “high,” and does not produce addiction. In fact, CBD protects against many of the adverse effects of THC, possibly including addiction.

Time marches on and marijuana in the U.S. today is quite different than what was used by “flower children” of the past. Marijuana is now an $11 billion industry and, perhaps in response to industry pressures, the THC content of today’s marijuana has increased significantly. In 1995, THC content was approximately 4%. In 2014, THC content was approximately 14%, a more than three-fold increase from 1995. In contrast, from 1995 to 2014, the CBD content of marijuana decreased by more than 50%. This means marijuana today is a more potent psychoactive substance, containing less of the protective CBD. It’s a small wonder that emergency room visits due to marijuana increased by 50 percent between 2004 and 2011. Studies also show that adolescents using marijuana show impaired IQ, less satisfaction with life as adults, and 16 percent of them become addicted to it.

Rebekah’s childhood was long on suffering and short on supervision, important risk factors in developing addiction. In high school she experimented with alcohol and tobacco. Then came Xanax and concentrated marijuana (hash oil). By age 22, she was using cocaine and at age 23, heroin along with the cocaine. At age 24, Rebekah has survived (four people die every hour in the United States of a drug overdose) without a major health complication. She is hoping for long-term treatment, her best chance for recovery, and a brighter future. May God be with her.


DR. JEFFREY BERGER is the medical director of Guest House, the Residential Catholic Addiction Treatment Center in Lake Orion, MI. As well, he is contingent staff at Brighton Center for Recovery in Brighton, MI and has been practicing addiction medicine for over 30 years. He is an active member of the Catholic Medical Association.

Talk to parents early about aging

As our parents get older, it is often difficult to speak with them about issues they will confront in the aging process. The most important thing is to start the conversation early. Begin the dialogue when your parents are in good health. Do not wait until they develop a serious illness or are unable to make decisions for themselves. Here are some tips to help with the dialogue.

Enlist other family members to participate in the discussions. First, find out what their opinions are before you start the conversation with your parents. It is best to present a united front, so try to reach a consensus before you include your parents in the discussion.

Use good communication skills. Do not offer advice, but present your parents with options. Listen to their needs. Ask open-ended questions to better assess their views and enhance the discussion. • Understand your parents’ need to control their own lives. A sense of losing control is very frightening. Parents have a right to make decisions, but often you need to balance their need for independence with safety issues.

If you and your parents disagree, allow their wishes to prevail until their health or safety is an issue.

Address competency to drive before it becomes too late. This is a huge issue for the elderly because it affects their independence and their sense of control. If you have concerns that your parents are not safe to drive, it is often better for the family physician to address this issue, to avoid your parents blaming you if they are not allowed to drive anymore. There are ways to assess driving ability using simulators which provide objective data that the physician can use. Be forewarned that even with objective data, your parents will struggle with giving up their car. This is an extremely sensitive issue.

Ask your parents details about their finances. While this may be a difficult topic to discuss, it is important to know about insurance policies, trust documents, tax returns, bank records, investments, etc. Find out where they keep their paper work and organize the papers if necessary.

Ask about living wills and health care proxies. Understand your parents’ wishes concerning their medical care. It is important to have this in place before there is a medical crisis.

Gather information for your parents about their Medicare benefits. Medicare does not usually cover long-term care, so it is helpful to explore whether long-term care insurance is appropriate.

Identify community resources. Find out what services are available for your parents should they decide to stay in their home as they age.

Re-evaluate the situation on a regular basis. Your parents’ needs can change rapidly.

If you are having trouble with these conversations, consider involving a third party such a family physician, financial planner, attorney, or geriatric care manager. Most importantly, always treat your parents with love and respect and let them know you will be there for them as they age and confront any difficulty.


SUSAN LOCKE is Healthnetwork Foundation’s medical director.

Taking a second chance at heroic choice

Women who change their minds after taking mifepristone, the first pill in the medical abortion process, have a safe and effective way to reverse an abortion, and which is now supported by more scientific evidence. There is definitely a second chance at choice! My colleagues and I published a new study in Issues in Law and Medicine, looking at the use of progesterone to reverse mifepristone (RU-486) medical abortions.

Progesterone is the hormone essential to the maintenance of a normal, healthy pregnancy. Mifepristone is a progesterone receptor blocker; the blockade of progesterone receptors leads to the separation of the placenta from the wall of the uterus and death of the preborn baby. Mifepristone has been used for medical abortion in this country since the year 2000.

Currently, the FDA approves it for abortion up to the 10th week of pregnancy. In the U.S., 30 to 45 percent of abortions are mifepristone medical abortions (total of about 300,000 to 400,000 abortions annually). In some European countries, they comprise 75 percent of abortions.

The study looked at 261 successful mifepristone reversals and demonstrated reversal success rates of 64-68 percent with the protocols, significantly better than the 25 percent survival when no treatment is offered. There was no increased risk of birth defects or preterm births. Progesterone has been used safely in pregnancy for over 40 years. Further, the American College of Obstetricians and Gynecologists has declared that mifepristone does not cause birth defects in babies who survive it.

One of our clients wrote, “I just wanted to say, thank you from the bottom of my heart!!!” Another stated, “Changed my entire world by helping me that night. This is the best feeling in the world and nothing else matters. Thank you.”

We started the Abortion Pill Reversal network in 2012 as a project of Culture of Life Family Services. It has since grown into an international program. In April, Heartbeat International formally assumed control of the network.

Though abortion pill reversal research will remain under my direction, the partnership with Heartbeat allows the network to grow to serve more women who change their minds after taking mifepristone, while permitting us to focus on our ongoing research.

My immediate plan is to conduct a randomized controlled trial (RCT) that will compare the different progesterone protocols, in a head-to-head fashion. The next step will be the founding of a pro-life research institute that will be called the Steno Institute, after Blessed Nicolas Steno, a 17th-century Danish anatomist, physician, geologist, and convert to Catholicism who eventually gave up his scientific pursuits to devote himself to the study of the Faith. He was later named a bishop.

The Steno Institute will focus initially on furthering research in the area of abortion pill reversal. More scientific evidence is needed to counter pro-abortion critics who dismiss our findings out of hand. We will eventually widen our areas of interest because pro-life research, in general, is desperately needed to balance the anti-life bias that is so prevalent in medicine and the life sciences.

GEORGE DELGADO, M.D. is the founder of Abortion Pill Reversal and the medical director of Culture of Life Family Services in San Diego County, CA. He is a member of the Catholic Medical Association, and can be contacted at gdelgadomd@yahoo.com.

Listen to informative and fun-loving CMA doctors discuss health matters important to you on Doctor, Doctor – online at www.redeemerradio.com

The Catholic Medical Association is a national, physician-led community of over 2,400 health care professionals consisting of 103 local guilds. CMA’s mission is to inform, organize, and inspire its members, in steadfast fidelity to the teachings of the Catholic Church, to uphold the principles of the Catholic faith in the science and practice of medicine.

Hip-check on new replacement option

Total hip replacements, also known as total hip arthroplasties (THA), are one of today’s most successful orthopedic procedures. Over 300,000 total hips are replaced annually in the U.S.

The most common approach to hip replacement has been the “posterior approach.” More recently, an “anterior approach” has become popular. Let’s look at the differences between the procedures, and pros and cons of the newer anterior approach.

During a posterior approach, a curved incision is made on the side of hip, just behind the greater trochanter. This approach requires surgeons to cut muscles and soft tissue at the back of the hip to access the hip joint. These muscles are repaired and reattached at the end of the surgery.

During the anterior approach, the incision is made at the front of the hip, with the incision starting at the pelvic bone and ending toward the top of the thigh. The surgeon works between the muscles with minimal or no muscle cutting. The surgeon has a limited view of the hip joint which makes this surgery more technically challenging. The anterior approach has been referred to as a “minimally invasive” approach. This is because there is less muscle cutting which for most patients speeds the recovery.

Advantages of the anterior approach:

• Less damage to major muscles;

• Less post-operative pain;

• Faster recovery – in general, anterior approach patients walk unaided sooner than posterior approach patients;

• Decreased risk of hip dislocation, since muscles and soft tissues surrounding the hip are kept intact;

• Better range of movement – patients can cross legs and bend over after surgery (posteriorapproach patients usually must wait 6-8 weeks);

• Shorter hospital stays, depending on the patient and access to on-site physical therapy.

Disadvantages of the anterior approach:

• Obese or very muscular patients may not be good candidates;

• Very technically demanding surgery; steep learning curve for surgeon; • Potential for nerve damage – surgical area is close to the lateral cutaneous femoral nerve which supplies sensation to the outer thigh; potential for numbness in the thigh;

• Wound-healing issues — surgical incision can become irritated especially in very overweight patients.

Success of a total hip replacement depends on many factors beyond surgical approach. The most crucial factor is the knowledge and skill of the surgeon. In addition, the type of hip prosthesis, the patient’s weight and build, and his or her willingness and ability to participate in post-surgical rehabilitation are all important considerations.

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a health care “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a nonprofit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

Gender ideology – perilous to parents’ rights, kids’ well-being

Gender ideology, which has infiltrated American medicine, psychology, and public education from preschool forward, teaches children that they may be trapped in the wrong body. Some teachers ask students – without parental knowledge – to choose their name, gender, and preferred pronouns for classroom use. One mother told me her 10-year-old daughter was being addressed with a boy’s name and male pronouns by teachers and classmates, at her daughter’s request after a gender lesson. Only when her daughter announced, “One day I’ll grow a penis,” did her mother discover what was happening in the classroom.

Dr. Michelle Cretella

Biological sex is innate. You either have a Y chromosome at conception, and develop into a male, or you don’t, and develop into a female. There are at least 6,500 genetic differences between men and women. Clothing, name changes, hormones, and surgery cannot change this. An identity, in contrast, involves thoughts and feelings which are not biologically hardwired, and which can be factually wrong.

Ten years ago I had a five-year-old patient, “Andy,” who insisted he was a girl. I referred the family to a therapist. Child abuse, or a parent’s mental illness, may cause gender identity confusion in a child. More commonly, however, the child has misperceived family dynamics and internalized a false belief. The latter was the case for Andy. During one session he said, “Mommy and Daddy, you don’t love me when I’m a boy.” After a year of family therapy, Andy became securely attached to both parents and his false belief was corrected.

Today, Andy’s parents would be told, “This is who Andy really is. Let’s affirm him as a girl, or he will commit suicide.” As Andy approaches puberty, the “experts” would put him on puberty blockers so he can continue to impersonate a girl. It doesn’t matter that we’ve never tested puberty blockers in biologically normal children, or that these drugs cause problems with memory in adults. We need to arrest Andy’s physical development now, or he will kill himself.

But this is not true. In the past, when supported in their biological sex through natural puberty, 80 – 95 percent of genderconfused children got better. Today, rather than help confused children embrace bodily reality, gender-confused children are chemically castrated with puberty blockers, often sterilized by cross-sex hormones, which also put them at risk for heart disease, strokes, diabetes, cancers, and even the very emotional problems gender experts claim to be treating.

Additionally, if a girl who insists she is male has been on daily testosterone for a year, she is cleared to get a bilateral mastectomy at age 16. Mind you, the American Academy of Pediatrics (AAP) recently released a report urging pediatricians to caution teenagers about tattoos because they are essentially permanent and can cause scarring. But this same AAP is 110 percent in support of 16-year-old girls getting double mastectomies, even without parental consent, if they believe they are boys.

The “trapped in the wrong body” lie disrupts the foundation of children’s reality-testing, and may result in their chemical castration, sterilization, and surgical mutilation. Gender ideology in pediatrics and education is child abuse. It is time for parents and professionals to unite for children’s protection.

DR. MICHELLE CRETELLA is president of the American College of Pediatricians (ACPeds), the natural-law alternative to the American Academy of Pediatrics (AAP). She is also a member of the Catholic Medical Association. Under her leadership, the ACPeds has become the primary medical voice critical oftransgender medicine. https://www.acpeds.org/.Dr. Cretella may be contacted at admin@acpeds.org

Averting breast cancer risk supports Catholic credo

Not only is breast cancer the most common female cancer, expected to affect 1 in 8, and increasing alarmingly at 3.5 percent annually, but it afflicts more women under 50 with more aggressive and more difficult-to-treat forms of the cancer. Only 10 percent of breast cancer is hereditary (genetic); therefore environmental causes have great effect and can be modified by habits and decisions. When detected early, breast cancer has an excellent prognosis.

Risk factors, prevention

Environmental risk factors include smoking, obesity, excess alcohol consumption, and possibly toxins ingested by girls during breast development. As lifetime estrogen exposure increases, so does breast cancer risk, and women in modern Western cultures start menses at younger ages than in developing countries. This partially explains the cancer’s higher incidence in wealthier countries.

Artificial hormones increase its risk, particularly oral contraceptives. A recent whole-country prospective study of the 1.8 million women of reproductive age in Denmark demonstrated an average 20 percent increased risk of breast cancer with contraceptive use. This risk was lower (under 10 percent) with one-year use, but increases to just under 40 percent with 10 years of use. An estimated 140 million women worldwide take hormonal contraceptives including 15 percent of women between 15 and 49 years old.

Many are shocked to learn the link between abortion and breast cancer. To date, around 30 of 40 studies have shown that abortion is a significant risk – and potentially causative factor for breast cancer, particularly if it occurs before the first full-term pregnancy. In this circumstance, there is up to 50 percent increased risk of breast cancer and this risk increases with multiple abortions (references available on www.polycarp.org ).

Habits that decrease risk

Healthy eating and exercise provide multiple health benefits and decrease the risk of breast cancer. Eating a healthy diet rich in natural vegetables and fruits as well as getting good nightly sleep are protective.

Alcohol is a known toxin associated with breast cancer. Women should limit alcohol consumption, since more than 1 or 2 daily alcoholic drinks routinely increases the risk of breast cancer.

Artificial hormones use should be avoided or reduced.

Full-term pregnancies and lactation decrease the risk of breast cancer as well as providing benefits to the newborn.

Routine annual mammography is still the primary method of secondary prevention (early detection). For women without a strong family history, annual mammography starting at age 40 is recommended.

Modern culture, science and faith

Today’s culture promotes patient autonomy and providing more information for making health-care decisions. This trend supports giving patients information on abortion and contraception risks. Many aren’t duly informed of these grave dangers. A recent documentary Hush is available and discusses them. In a culture that values patient autonomy and shared decision making, such serious risks should be included in informed consent.

Recent studies are encouraging since they lend scientific support to the Catholic viewpoint. Contrary to the myth, faith and science are not necessarily in conflict since ultimately truth cannot contradict truth.

DAVID J. HILGER M.D. is a diagnostic radiologist practicing in Omaha, Nebraska, with an expertise in women’s imaging and breast cancer detection. He is on the national board of the Catholic Medical Association and is a member of Legatus, having served previously as president of the Omaha Chapter.

Playing by 7 ‘healthy’ numbers tips the advantage

Knowing your “healthy” numbers is a great way to establish baselines and determine what you may need to change to maintain optimal health.

Susan Locke

7. Blood lipid values

Triglycerides are the chemical form in which most fat exists in food as well as in the body. A person’s total cholesterol score is calculated by adding his HDL and LDL cholesterol levels and 20 percent of his triglyceride level.

Penn Medicine reminds us that it is important to work with your health care provider to set your cholesterol goals. Newer guidelines steer doctors away from targeting specific levels of cholesterol. Instead, they recommend different medicines and doses depending on a person’s history and risk-factor profile. General targets are:

LDL: 70 to 130 mg/dL (lower numbers are better)
HDL: More than 50 mg/dL (high numbers are better)
Total cholesterol: Less than 200 mg/dL (lower numbers are better)
Triglycerides: 10 to 150 mg/dL (lower numbers are better)

6. Body mass index (BMI) & waist circumference

BMI is used as a screening tool to identify possible weight problems for adults. The normal range for an adult is 18.5 – 24.9. Here is how you calculate BMI:

BMI = ( weight in pounds / (height in inches) x (height in inches)) x 703

With a cloth measuring tape, measure waist circumference just above hipbones. Circumference for males should measure less than 40 inches; females less than 35 inches. Increased girth can signify increased risk of cardiovascular disease and diabetes.

5. Daily fat intake

Not all fats are bad – the key is moderation. Cleveland Clinic recommends a dietary reference intake (DRI) for fat in adults is 20% to 35% of total calories from fat. That is about 44 grams to 77 grams of fat per day if you eat 2,000 calories a day.

4. Minutes of physical activity

Physicians at Houston Methodist recommend regular aerobic activity, such as walking, biking, or swimming to help lower blood pressure and cholesterol. The preferred amount is 30 minutes of moderate physical activity, at least five days per week.

3. PSA screening (men) | mammography scans (women)

Johns Hopkins recommends that you discuss with your physician the optimal time to start testing for prostate cancer in men, and breast cancer in women. Previous guidelines recommended testing at age 40; however, you and your physician should set your schedule depending on multiple factors, including your age and family history.

2. Blood pressure

University Hospitals in Cleveland shares this explanation: The systolic, or higher number, reflects the pressure the blood vessels are under while the heart is actively pumping. Diastolic is the pressure during the resting part of the cycle.

Generally speaking, you want your BP to be less than 140/90. Otherwise, you run the risk of developing high blood pressure, a “silent killer” that affects one out of every three adults over age 20. New American Heart Association guidelines suggest that you should start to treat hypertension with lifestyle changes starting at 130/80.

1. Important “healthy” number to keep handy – Healthnetwork’s phone number!

1-866-968-2467 | 1-440-893-0830 OR help@healthnetworkfoundation.org

When you need access to medical information or to the best hospitals, one call to Healthnetwork will provide you connections to the most respected hospitals in America.

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a health care “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a nonprofit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

“No-fun-parenting” wins in ADHD treatment

Some 11 percent of U.S. children have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) by a healthcare professional, according to the Centers for Disease Control and Prevention. About two-thirds of them take a medication to treat their ADHD. Medications are effective for treatment of it, but any ADHD treatment plan has to include “behavioral interventions,” in other words, no-fun-parenting. Yes, we have to teach our kids to pay attention. How?

Kathleen M. Berchelmann, M.D.

Make time for parenting. ADHD kids need a full-time secretary—someone to give constant gentle reminders. When you are the parent of an ADHD kid, that’s your job. All these reminders take time. Double the time you think you need to ready for school or do chores. It’s usually easier and faster to pack your child’s backpack for him, rather than remind him six times to do it. But keep reminding him until you sound like a broken record. Yes, this takes twice as long as it should. But when we teach kids to pay attention, we teach self-control, a virtue that will last them a lifetime.

Tame your own anger. ADHD kids need a secretary, not a policeman. It seems reasonable to raise your voice when they drop their coat on the floor for the two hundredth time. But it’s your job to ask them nicely for the 201st time.

Get an electronic secretary. Adults with ADHD typically use smartphones as a secretary and caffeine as a stimulant. Kids with ADHD use parents for reminders and prescription stimulants. Why not let your smartphone be your child’s secretary, too? Set the smartphone alarm every day, even for things like getting ready for bed. Of note—your child does not need his own cell phone—set alarms on your cell phone or on an electronic home assistant such as Amazon Echo or Google Home.

Get a chore chart and use a reward system. Put all your kid’s daily tasks on the chart, not just chores. Include things like “hang up coat,” “brush hair,” and “stay in chair at dinner.” Chore charts won’t work without reward systems to motivate kids to actually check things off themselves. For rewards, use computer time, time with friends, or privileges like picking the family dinner.

Routine, routine, routine. Try to do as much as possible the same way each day. Talk about the schedule every morning and evening.

Don’t be afraid of medications. Most parents wouldn’t give a child with attention deficit hyperactivity disorder (ADHD) a caffeinated drink, for fear that their hyperactivity would only worsen. So why do doctors give stimulants to kids with ADHD? It seems so counterintuitive. Here’s another way of thinking about it:

Kids with ADHD are constantly self-stimulating. They wiggle, talk out of turn, and their mind doesn’t seem to turn off. Their thought processes are nonlinear. They talk while brushing their teeth and wiggling their foot at the same time. They seem to do everything except follow directions. When you give a stimulant to such a child, they no longer have such an urgent need to self-stimulate. ADHD kids usually have no problem paying attention to video games, which provide constant visual, auditory, and tactile stimulation. Reading books and following directions, however, are not stimulating activities — ADHD kids will try to get through these experiences by self-stimulating through wiggling, talking, etc.

If you give them a stimulant medication, they won’t need to self-stimulate. Stimulants are a tried-and-true treatment for ADHD. Ritalin has been used to treat ADHD since the 1960s and is still in use. Many brand-name ADHD medications such as Concerta are just long-acting/slow release formulations of Ritalin. Stimulants increase both fine- and gross-motor control as well as cognitive performance and executive function. In other words, stimulants can improve handwriting and sports performance as well as behavior and attention.

KATHLEEN M. BERCHELMANN, M.D., is a pediatrician at Mercy Hospital in St. Louis, Missouri, a member of the Catholic Medical Association, and a mother of six children ages one to 13.