Tag Archives: susan locke

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

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.

New shingles vaccine 97% effective for middle-aged

Shingles is a painful rash that is caused by the varicella-zoster virus, the same virus that causes chickenpox. After you have had chickenpox, the virus lies inactive in the nerve tissues near your spinal cord and brain. Shingles is the result of reactivation of the virus. For most patients, an episode of shingles is self-limited.

Susan Locke

Susan Locke

According to the CDC, the infection strikes about 1 million people in the U.S. each year, and nearly one in three adults will experience an incidence of shingles in his lifetime. About 2 percent of patients over 60 can go on to develop post-herpetic neuralgia, which is defined as pain which persists beyond four months after the initial onset of the rash.

Now the preferred vaccine…

A new shingles vaccine Shingrix is now recommended as the preferred vaccine over Zostavax for the prevention of herpes zoster and post-herpetic neuralgia. The CDC recommends two doses of Shingrix (separated by 2-6 months) for adults over the age of 50.

The vaccine should be given:

  • Whether or not you have had a previous shingles outbreak
  • Whether or not you have had a prior dose of Zostavax
  • To patients with chronic medical conditions

It can be used in patients who are taking low-dose immunosuppressive medication, have recently recovered from an immunocompromising illness, and in patients who may become immunocompromised. It should not be given during an acute episode of herpes zoster or within two months of receiving Zostavax.

Even if you do not recall ever having chicken pox, 99 percent of adults age 50 and older have been exposed to the varicella zoster virus and persons born after 1980 are considered immune to varicella.

…because it works so well

  • In adults 50-69, Shingrix was 91 percent effective in preventing post-herpetic neuralgia. Over the age of 70, 89 percent effective.
  • In adults 50-69, Shingrix was 91 percent effective in preventing post-herpetic neuralgia. Over the age of 70, 89 percent effective.

Side effects of the vaccine are mild. Most patients get a sore arm and some get redness or swelling at the injection site. Occasionally people feel tired, have muscle aches, shivering, fever, stomach pain, or nausea. Symptoms may last 2-3 days. Severe allergic reaction is very rare.

Modest cost, readily available

The total cost of the vaccine is $200-300. No prescription is needed. It is recommended that you check with your insurance or Medicare plan regarding reimbursements.

Medicare Part D covers the vaccine, although there may be some cost to you depending on your plan. Since this is a pharmacy benefit, most plans require that you get vaccinated at the pharmacy, not at your doctor’s office. Medicare Part B does not cover this vaccine.

Contact your insurer to find out if this vaccine is covered under “prescription” or “medical”:

  • Prescription coverage requires you to get the vaccine at your local pharmacy.
  • Medical coverage means that you can get your prescription at your doctor’s office.

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “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 non-profit 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.

Stopping IBS from creating daily lockdown

Irritable bowel syndrome (IBS) is a chronic disorder of the digestive system. Its primary symptoms are abdominal pain and altered bowel habits (constipation and/or diarrhea).

Susan Locke

IBS is the most commonly diagnosed gastrointestinal disorder. It is estimated that 10-20% of people suffer from IBS, although only 15% of those affected seek medical attention. It is twice as common in women in the U.S. and western countries, and often starts in young adulthood. IBS does NOT increase risk of colorectal cancer.

Causes: Though definitive causes are unknown, these factors play a role in the development of IBS:

  • Spastic colon theory (overactive contractions cause cramps, bloating and diarrhea; weak contractions cause constipation)
  • Nervous system theory (poorly coordinated signals between the brain and intestines cause the body to overreact)
  • Inflammation of the intestines (increased number of immunesystem cells)
  • Severe infection or gastroenteritis
  • Changes in bacteria in the intestines (microflora)

Triggers:

  • Food (dairy products, wheat, citrus fruit, beans and carbonated drinks)
  • Stress – (stress is not a cause of IBS, but an aggravator)
  • Hormones (may worsen around menstrual period)

Diagnosis: There is no single diagnostic test for IBS. Symptoms can be similar to malabsorption, inflammatory bowel disease, celiac disease, and microscopic colitis.

Treatment: Primarily aimed at relieving symptoms, treatments are often used in combinations.

  • Identify factors that worsen symptoms
  • Modify diet accordingly to relieve symptoms
  • Reduce stress and anxiety
  • Exercise daily
  • Medications (traditionally used for treatment of symptoms). These include:
    • Anticholinergic medications (e.g., Bentyl, Levsin)
    • Antidepressants (tricyclic antidepressants, serotonin reuptake inhibitors)
    • Antidiarrheal drugs (e.g., IMODIUM®, Lomotil)
    • Antianxiety drugs (e.g., Valium, Ativan)
    • Herbal remedies are UNPROVEN

We asked Dr. Ali Rezaie, medical director, GI Motility Program at Cedars-Sinai Medical Center in Los Angeles about the IBS medications that have been heavily marketed on TV.

Are these medications helpful and should they be used as a first-line medications?

Currently, the FDA has approved five drugs for management of IBS:

  • Diarrhea-predominant IBS (IBS-D) XIFAXAN®, VIBERZI® and LOTRONEX®
  • Constipation-predominant IBS (IBS-C LINZESS® and AMITIZA

The efficacy of these medications has been shown in large multicenter clinical trials, with thousands of patients. They should be reserved for use when dietary and lifestyle modifications are not fully helpful in controlling IBS symptoms.

What is the difference between IBS, IBD & lactose intolerance?

Patients with lactose intolerance specifically develop symptoms of bloating, abdominal pain and diarrhea when they consume dairy products. IBS patients experience symptoms unpredictably which significantly affects their quality of life. Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, are associated with ulceration of the bowel which can further lead to bleeding, weight loss and bowel obstruction.

It is very important to note that these diseases are not mutually exclusive and can overlap. For example, up to 30% of IBD patients have overlapping IBS.

As the role of gut microbiome (microorganisms living in our bowels) is becoming clearer in IBS, multiple medications are being developed to modify the gut microbiome for treatment of IBS. There are also several drugs in the pipeline that aim to target the motility of the bowel to improve IBS symptoms.

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.

Helps for healthy campus living

For many new college, living at school is the time when they first become responsible for their wellness. Preparing for this transition is best shared between parents and student.

Susan Locke

Susan Locke

VACCINATIONS FOR NEW STUDENTS:

Seasonal influenza vaccine (Annually)

Meningococcal Conjugate Vaccine

  • Many colleges require this for incoming college students.
  • If your child received the vaccination before age 16, a booster should be given for maximum protection.

Tdap Vaccine (Tetanus, Diphtheria, Pertussis)

  • A single dose of Tdap is usually given to preteens/ teens. If your child is 19 or older and did not receive Tdap earlier, a single dose of Tdap is recommended.
  • Tdap can be given regardless of when your child received his/her last Td booster.

Human Papillomavirus Vaccine (HPV) (Series Of 3 Shots, typically given at age 11 or 12)

  • Recommended for teens and young adults (women under 27 and men under 22) who did not receive or finish the HPV vaccine series
  • Young adults should complete the series if they only received one or two doses, even if time has elapsed. The HPV series does not need to be restarted, but outstanding doses should be given.

PREPARING FOR LIVING AWAY

Consider making a first-aid kit:

  • OTC pain telievers
  • OTC gastrointestinal distress relievers
  • Band-aids, gauze
  • Hydrogen peroxide
  • Bacitracin cream or Neosporin
  • Cortisone cream
  • Benadryl 25 mg tablets – 1-2 tablets for an acute allergic reaction

If your child takes prescription medications:

  • Prescriptions should be kept in original containers
  • If your child is on medication for ADHD, ensure the medication is kept in a secure place. Unfortunately, abuse of ADHD medications is common on college campuses.

Remind your child that when he has a persistent fever, severe pain or other unusual symptoms, he/she should not self-medicate, but seek treatment at student health facilities.

AND THEY DON’T ALWAYS TELL YOU…

For children with ongoing health issues

  • Explain the importance of ensuring his primary physician knows what the campus doctor is doing – which minimizes the chance of prescription conflict, or of important medical trends being overlooked in the crossover.
  • Have a game plan for prescription fulfillment.

Discussions Before College

  • Danger of combining medications with alcohol.
  • OTC medications are not risk-free; must follow dosage instructions and contra-indications.
  • Excessive caffeine (over 100 mg per day for adolescents; over 400mg for adults) can have serious consequences.
  • When-to-see-the-doctor basics (such as a “cold” that lasts a certain number of days without symptoms-relief), and knowing differences between viral and bacterial infections (how fever is often indicative of the latter).

Summer To-Do List

Since your kid’s phone is often his “wallet,” take screenshots of these and send them to him

  • Insurance card
  • List of current medication names and dosages
  • List of known medical or other allergies

Semesters Abroad

International study is an exciting experience, so protect your child’s health options with these tools:

  • Pre-travel vaccinations/health-risk reviews based on destination.
  • Research and enroll him in an air medical transport insurance membership. Domestic air-ambulance medical evacuations typically exceed $10,000, while international air ambulance medical evacuations can exceed $100,000. Peace of mind in having a paid membership prior to travel for emergencies is priceless.

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “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 non-profit 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.

Risk and treatment of stroke

Brain damage from a stroke can be temporary or permanent. Early treatment and preventive measures can reduce the impact. Outcomes of strokes depend upon how much of the brain is damaged and how quickly treatment begins – which ideally should be within 4-6 hours of symptoms.

Susan Locke

Susan Locke

Know symptoms – and react quickly

  • Face drooping on one side or numbness. Ask the person to smile.
  • Arm weakness or numbness. Ask the person to raise both arms. Does one drift downward?
  • Speech difficulty, slurred or garbled speech. Ask him to say “The sky is blue.”
  • Time – Call 911, the faster a patient gets help, the lower his chances of permanent damage.

IN CASES OF A SUSPECTED STROKE, CALL 911 AND PROCEED TO THE NEAREST HOSPITAL, ideally one with a specialized stroke center.

Early diagnosis can save vital tissue

In addition to clinical symptoms, diagnosis is made usually by CT scan or MRI.

With new imaging modalities like CT perfusion, not only can diagnosis be made early but doctors can assess the degree of tissue damage as well as the degree of tissue that can be saved.

Treatment aim is to restore blood flow

For patient with an Ischemic stroke, the goal is to restore blood flow quickly, ideally within the first few hours of symptoms – with either intravenous thrombolytic treatment with the IV medication alteplase; or mechanical intra- arterial thrombectomy to open the blocked artery.

Longterm prevention:

  • Antiplatelet medications: aspirin 50-325 mg/ day, Clopidogrel (Plavix), or combination of aspirin and extended-release dipyridamole (Aggrenox)
  • Anticoagulant therapy: Coumadin, Pradaxa, Eliquis, Xarelto
  • Revascularization by angioplasty and stenting or by carotid endarterectomy (although not in an acute situation) are procedures that open a narrowed carotid artery

For patient with a Hemorrhagic stroke, treatment depends upon cause of bleeding, so it is crucial to identify the cause.

Medical treatment:

  • Control blood pressure.
  • Stop any medications that could increase bleeding.
  • Measure the pressure within the brain with a ventriculostomy tube. If pressure is elevated, cerebrospinal fluid or blood can be drained. This procedure is done in an ICU or in an operating room.

Surgical treatment:

  • The goal of surgical treatment is to prevent or stop bleeding and reduce the pressure in the skull.
  • If an aneurysm (ballooning) of a blood vessel has caused the bleeding, the aneurism can be clipped surgically. More recently, surgeons are doing a Coil embolization where a tiny flexible tube is guided up through the body into the vessel in the brain at the site of the aneurysm. The coil is advanced into the weakened area and diverts the blood ow to a more normal path.
  • Arteriovenous malformation (AVM) treatment depends on the patient’s age, AVM location and size and the abnormalities of the veins that drain. Treatment options include surgery, radiosurgery or embolization.
  • Decompressive craniotomy is a procedure where the skull is open to relieve the pressure on the brain.

 

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “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 non-profit 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.

Parenting a child with depression

Depression is on the rise in American teens and young adults. Adolescent girls seem most vulnerable, per research published in the Journal of Pediatrics. Data collected between 2005-2014, by Johns Hopkins University School of Public Health, concluded that “the 12-month prevalence of major depressive episodes in adolescents increased from 8.7% to 11.3%.” The reasons remain under discussion. However, cyberbullying is hypothesized to be a trigger, particularly for girls.

Susan Locke

Susan Locke

How can parents support their child or adolescent suffering from depression? Here are some general guidelines:

Observe your child’s behavior for changes. Children with depression may demonstrate low mood, irritability, anger, fear or anxiety, mood swings, disruptive or risk-taking behavior, disobedience/ defiance/ illegal behavior, isolation, lack of self-care/ hygiene, decreased interest in previously enjoyable activities, decreased energy, increased or decreased sleep, increased or decreased appetite, and changes in friendships or family relationships. Some children turn to drugs or alcohol. Others turn to the internet for support or socialization. School performance may deteriorate, or attendance may decrease due to physical complaints or blatant truancy. Some children engage in self-harming behaviors or talk of death and dying.

Engage your child in daily conversation or other activities to open communication. Gently ask questions about your child’s change in mood, daily life/issues. Find ways for your child to communicate his or her feelings.

If your child expresses suicidal thoughts or wishes, please take him or her to the local emergency room for further evaluation.

Talk to your pediatrician or family doctor about your child’s mood or changes in behavior. They can arrange timely assistance for your child and provide you with qualified mental health professionals.

Monitor and limit phone, computer and electronics time. Watch internet history, texting, and social media. Kids often scout in the wrong places and meet the wrong people.

Ascertain healthy and consistent sleep schedules. Children and teens need about 8-10 hours of sleep per night. A regular presleep routine that does not include electronics, along with a scheduled bedtime/wake-up time encourage healthy sleep habits.

Encourage healthy eating habits. Observe behaviors at meals, such as restricting calories,  or leaving the table to go to the restroom and hiding/throwing food away. Watch for weight loss, excessive exercising, or obsessive concerns with body image that may indicate an eating disorder.

Be consistent and firm with limit-setting. Maintain the same or even slightly more stringent rules with your child to maintain structure. Treat all children in the family equally. Be aware of your child’s whereabouts and safety at all times.

Safety-proof your home. Lock up all medications, alcohol and OTC medications. Secure anything that could be used as a weapon, particularly firearms.

Ensure that you are taking care of your own well-being and mental health. Depression can run in families. Resist the urge to tell your child that you know how they must feel or that you were once, or are currently, depressed. Practice listening attentively and reassuring your child that you will get them whatever help is needed. Be sure to get help for yourself as well.

Identifying child and adolescent depression and dealing with it can be overwhelming. The key is to reach out for assistance and allow others to provide their support and expertise, so that a team approach can be utilized to its fullest.

By Jennifer L. Shoenfelt, MD
Board Certified Child, Adolescent, and Adult Psychiatrist
Lindner Center of HOPE (a partner to Healthnetwork Foundation)

SUSAN LOCKE is Healthnetwork Foundation’s medical director.
HEALTHNETWORK is a Legatus membership benefit, a healthcare “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 non-profit 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.

Advance Directives for peace of mind

Life is to be enjoyed and the thought that we may one day face a sudden health crisis due to an accident or serious illness can be very scary. What if you are unable to make your own medical decisions? Who will make these decisions for you? Will they make the same choices you would make? Fortunately, there is a legal means to addressing this potential future concern — it’s called an Advance Directive.

Susan Locke

Susan Locke

An Advance Directive is a written statement that you complete in advance of a serious illness. Within this document you will name someone to act on your behalf or you will outline how you want medical decisions to be made when you are no longer able to make decisions for yourself.

There are several advantages to communicating your wishes about treatment. You will have the opportunity to make very personal health care decisions. You will prevent arguments and you will spare loved ones from the anxiety of having to guess your wishes.

There are two types of Advance Directives and it is important to have both kinds.

1) LIVING WILL: This document specifically spells out what types of treatment you want at the end of your life or if you are unable to speak for yourself. It may include decisions about:

• The use of Cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. Do you want extraordinary measures taken or do you prefer a Do Not Resuscitate order (DNR) which is a request not to have CPR?

• The use of breathing machines (mechanical ventilation) and/or dialysis

• Sustainment by tube feeding

• Organ and tissue donation preferences

2) HEALTH CARE POWER OF ATTORNEY: This document appoints someone to make health decisions if you can’t communicate on your own. The person you designate as your Health Care Power of Attorney, also known as a Health Care Proxy, is your advocate, not only concerning life-prolonging treatments, but also for other medical treatments. This is different from a regular Durable Power of Attorney which covers financial matters.

Your Health Care Power of Attorney should be someone who knows you well and someone who is willing to carry out your directions regardless of personal feelings or influence of family and friends. An alternative Health Care Power of Attorney should also be named.

Advance Directive forms may vary slightly from state to state. State-specific forms are available on the AARP website. Your physician should also have these forms available for you to complete.

Copies of Advance Directive forms should be kept by your Health Care Proxy and given to your physician to become part of your medical record.

You can change or cancel your Advance Directives at any time, if you are considered of sound mind. These changes should be signed and notarized. Inform your doctor and family members that you have made changes to these directives.

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “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 non-profit 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.

Weekend Warrior

Current health recommendations call for 150 minutes of moderate exercise or 75 minutes of vigorous physical activity every week. Due to busy weekday schedules, many people just can’t get the exercise in during the week. The good news is that if you only get your exercise in on the weekends, you will reap a benefit just by being active as compared to those who remain inactive.

Susan Locke

Susan Locke

Making up for lost time by exercising excessively may cause sports injuries. Nonprofessional sports injuries are the second most common reason for doctor visits, with the average cost of more than $18 billion a year.

Sprains (stretching or tearing of a ligament) and strains (stretching or tearing of a muscle or tendon) are the most common sports injuries. The areas of the body that seem most susceptible to sprain or strain include the ankle, groin, hamstring and lower back.

How to prevent them?

• Warm up and stretch first.
• Start slowly and increase activity gradually by no more than 10 % per week.
• Spread out your exercise. Do not try to make up for a week’s worth of inactivity in a day or two. Ideally exercise at least three days a week.
• Listen to your body – stop when it hurts, see a doctor if it doesn’t stop hurting.
• Recognize that for most people, what you could do at age 20 is not the same as what you can do at age 50.
• Before starting an exercise program, educate yourself and develop a balanced program, or hire a professional trainer.

In addition to sprains and strains, several other injuries are frequently experienced by the weekend warrior. “Shin splints” present as tenderness, soreness or pain along the inner part of your lower leg., most commonly brought on by running. Additionally, sudden stops or turns can cause a strain or a tear of the anterior cruciate ligament (ACL) of the knee. A tear is usually heralded by a popping sound.

Patellofemoral also causes pain felt in front of your knee, and results from repetitive movement of your kneecap against your thigh bone. Iliotibial band syndrome is the cause of lateral knee pain common in long-distance runners and cyclists. Tennis elbow (epicondylitis) usually presents as pain on the outside of your elbow into your forearm and wrist with pain also occurring when you extend your wrist.

Most sports injuries are mild or moderate and can be treated with the PRICE therapy method.

P – Protect from further injury by using splints, pads, or crutches if necessary.
R – Restrict activity.
I – Ice the injury immediately after it occurs. Use ice for 20 minutes every one to two hours for the first 48 hours after the injury.
C – Compression with an elastic bandage will reduce swelling.
E – Elevate the injured area to reduce swelling.

Seek medical attention if you suspect a serious injury — like bone deformity, excess swelling, radical skin-color change, inability to bear weight, or no sign of improvement.

Supplementing a sedentary week with highly physical activity on the weekend is tempting. Just remember, the drastic change of physical stress on your body can come with a hefty PRICE tag.

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “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 non-profit 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.

Taking the guesswork out of genetic testing

A genome is the total of an individual’s genetic material. The genome consists of chromosomes made from very long strands of DNA. Each human has 23 pairs of chromosomes. Half are inherited from the mother and half from the father.

Susan Locke

Susan Locke

Chromosomes are organized into many subunits; the subunit is called a gene. There are 30,000 to 50,000 genes in an individual’s genome. The specific combination of genes that an individual has makes up his/her genetic identity known as a genotype.

By 2003, scientists were able to identify every gene in a human’s body. Scientists then began to look at the genes to try to pair them with the medical problems that they cause. There are many diseases that are thought to be caused by alterations (mutations) in DNA. These alterations can occur spontaneously or be inherited.

Some of the diseases with a genetic component include Alzheimer’s disease, breast cancer, ovarian cancer, colon cancer, leukemia, lymphoma, bone marrow disorders and others.

There are seven main reasons that genetic testing is performed: clinical testing to determine current or future disease; pharmacogenomics used to assess therapeutic drug treatment; identity testing (also known as “DNA testing”) used for criminal investigations or forensic studies; parentage testing (paternity testing); tissue typing for transplantation; cytogenetics (chromosome analysis, often performed on pregnant women); and infectious disease testing to determine how much viral material is still in the body after treatment.

Questions arise about the use of home genetic testing, such as “23andme.” The test can tell you if your odds of getting a certain condition are better or worse than the general population. The results you receive from this should be reviewed with your doctor. Data from 23andme can be helpful in its assessment of how a person may metabolize certain drugs.

Your results from a testing service like this should be carefully evaluated. Even if your results indicate that you possess a certain version of a gene, it does not mean that you will develop the disease.

These tests may tell you the chance of developing a certain genetic disorder, but not conclusively that the disease will develop. When a test detects a problem gene, it also cannot predict how severely the person will be affected if he or she develops the disorder.

Many diseases are a result of the interaction between genetics and environment. For example, lifestyle plays an extremely important role in who will develop heart disease. It is important to ask your physician about steps you can take to mitigate risk factors associated with any potential disorders.

There are a few other factors to consider before deciding whether to get genetic testing. There is a psychological component to testing. While having a negative test can be reassuring, a test indicating that you have a gene that predisposes you to an increased risk of a disease could be psychologically traumatizing. On the other hand, it could also lead to positive changes in lifestyle. Legally, it is possible that the results of the genetic testing could be used to determine insurance coverage.

If you do get genetic testing, the most important thing is to work with an expert to understand your test results. Most doctors are not trained to interpret these results. Genetic counselors and/ or a geneticist can help with the interpretation and implications of these complicated tests.

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

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