Posts made in May, 2014

What screening tests do I need for my age?

Posted by on May 16, 2014 in News | 0 comments

Doctor with clipboardA visit to an emergency room can be costly and, often time, several hours waiting period is normal for most ER if your condition is non-emergent. It is always good to know after hour urgent care centers in your area in case of minor injuries and acute care. Not only the bill will be smaller; you will get the care you needed in a shorter amount of time. The best way to prevent ourselves from unnecessary emergency room visit is to have a primary care physician even if you are a healthy individual. Many primary care physician offices have walk-in appointments for those who needed to be seen on the same day. That way you can get the care you needed in a timely manner with reasonable cost.

Preventative medicine is the key to a healthier and happier life. There are age specific screening tests for men and women as well as for kids. This article will only focus on screening tests for adults (18 or older). The purpose of the preventative screening tests is to identify and treat health problems before they get worse and assess your risk for chronic diseases. Many chronic diseases such as high blood pressure and high cholesterol do not show symptoms for many years until at later stages. Keep in mind that recommendations for screening tests may vary slightly from different organizations such as U.S Preventative Services Task Force (USPSTF), American Cancer Society, American college of Obstetricians and Gynecologists (ACOG) and etc. The guidelines for screening test are often changed whenever there is new research finding.

First, we will start with the screening tests for adults who are 18-39 years of age.
• At least two physical exams in your 20s.
• Height, weight and blood pressure screening at each visit. Blood pressure should be checked every two years if it is normal (<120/80 mmHg). Yearly if your blood pressure is between 120-139/80-89 mmHg.
• Blood glucose test if one or both parents have diabetes or your blood pressure is higher than 120/80 mmHg.
• Lipid panel for cholesterol screening (Some doctors may not do it if you have no family history of high cholesterol).
• Dental exam and cleaning yearly.
• Tetanus-diphtheria (TdAP) booster every 10 years.
• Eyes exam every two years if you have vision problem.
• Flu vaccine yearly.
• Monthly testicular self-exam for men. Ask your primary care doctor for instruction if you are not sure how to check it.
• Monthly breast self-exam for women. Contact your doctor immediately if you notice any changes in your breasts. Breast exam should be done by your primary care doctor every 3 years.
• Pelvic exam and Pap Smear 3 years after the first sexual intercourse or by age 21 whichever comes first. Every two years for women in their 20s. Every three years for women in their 30s if you have three negative results in a row.
• Screening for chlamydia infection in sexually active women (age 25 and younger).

Furthermore, the following screening tests are for adults who are 40-64 years of age.
• Physical exam every 1-5 years for both men and women.
• Height, weight and blood pressure screening at each visit. Blood pressure should be checked every two years if it is normal (<120/80 mmHg). Yearly if your blood pressure is between 120-139/80-89 mmHg.
• Blood glucose test if one or both parents have diabetes or your blood pressure is higher than 120/80 mmHg.
• Lipid panel for cholesterol screening. Recheck every 5 years if it is normal.
• Dental exam and cleaning yearly.
• Tetanus-diphtheria (TdAP) booster every 10 years.
• Eyes exam every two years if you have vision problem. Some doctors may do tonometry to check for glaucoma for those who are 45 or older.
• Flu vaccine yearly.
• Stool guaiac test yearly for colorectal cancer in men and women at the age of 50. Flexible sigmoidoscopy every 5 years. Some doctors may do colonoscopy every 10 years or CT colonography (virtual colonoscopy), which is non-invasive procedure every 5 years instead. If you have a parent or sibling with colorectal cancer, your colonoscopy will be done at earlier age (possibly at age 40 or ten years younger than the age of the relative with colorectal cancer at the time of diagnosis).
• For men who are 50 or older, talk to your doctor about prostate cancer screening. This test is based upon individual’s preference.
• For women, monthly breast self-exam. The first mammogram at age 40 for breast cancer screening and then, yearly after that. Mammogram at earlier age for those with high risk of breast cancer.
• Yearly pelvic exam and Pap Smear for cervical cancer screening in women. Every two-three years if you have three negative results in a row.

Lastly, the following are screening tests for adults who are 65 and older.
• Yearly physical exam for both men and women.
• Height, weight and blood pressure screening at each visit. Blood pressure should be checked every year if it is normal (<120/80 mmHg). If it is between 120-139/80-89 mmHg, it will be monitored closely.
• Lipid panel for cholesterol. If your cholesterol is normal, it will be rechecked every 3-5 years.
• Dental exam and cleaning yearly.
• Hearing test every year.
• Tetanus-diphtheria (TdAP) booster every 10 years.
• Eyes exam every two years if you have vision problem. Some doctors may do tonometry to check for glaucoma.
• Flu vaccine yearly.
• Pneumonia (pneumococcal) vaccine at age 65 or older.
• Stool guaiac test every year with flexible sigmoidoscopy every 5 years or colonoscopy every 10 years for colorectal cancer screening.
• For men, talk to your doctor about prostate cancer screening and bone density test.
• 65 to 70 years old men who smoke or ever smoked should get one time abdominal ultrasound for abdominal aortic aneurysm (AAA) screening.
• For women, monthly breast self-exam. Breast exam by your primary care doctor every year and mammogram every 1-2 years for breast cancer screening.
• For women, pelvic exam and Pap Smear may discontinue at age 65 to 70 if she has had three negative results in the last 10 years with the most recent test in the past 5 years.
• Bone density test (DEXA scan) for women who are 65 and older for osteoporosis screening.

Contributed by Patricia Hsiao M.D.
Sources: cdc.gov, health.nytimes.com, nlm.nih.gov, uptodate.com

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First-aid tips for nosebleed known as Epistaxis

Posted by on May 2, 2014 in News | 0 comments

Bloody noseNosebleed or medical term epistaxis is a very common medical problem and up to 60 percent of the general population experiences it once in their lifetime. But the good news is that only 10 percent of the time it requires medical attention. For majority of the cases, it would resolve with simple first-aid measures at home. Nosebleed is more common in children under 10 years of old and adults over 50 years old. Most common causes include vigorous nose picking, foreign object in the nose especially in young children, common cold, allergic rhinitis, dry, hot weather and injury to the nose. In adults, it can be due to high blood pressure, chemical irritants (cigarette smoke, cocaine and etc), some medications (aspirin, warfarin and nonsteroidal anti-inflammatory drugs) and other medical conditions.

If you or someone you know experience nosebleed, first try these simple steps to stop the bleeding:
• Sit down and lean forward slightly at the waist. Do not lie down. You want to avoid the blood going into your throat.
• Try to breathe through your mouth.
• Gently squeeze the soft part of your nose (nasal alae) and apply pressure continuously for at least 5 minutes. Do not squeeze the bony part of your nose.
• Check to see if the bleeding stops in 5 minutes. If not, you can continue applying pressure for another 5 minutes.
• You may apply cold compressor over the bridge of your nose. Do not put anything inside of your nose.
• You may use over-the-counter decongestant spray such as oxymetazolin (Afrin, Neo-Synephrine, Vicks and etc) if available. Spray into the bleeding side of the nose and apply pressure for about 5 minutes.
• Once the bleeding stops, avoid blowing or picking your nose for several hours.

When to seek medical attention:
It is important to seek medical attention in some cases. If you have followed those simple steps and your bleeding is not controlled after 20 minutes of applying pressure on your nose, go to the nearest emergency department. Also, if you have nosebleed after the injury to the face or nose, see a physician immediately.

Prevention:
Nosebleed may occur for no particular reason but there are measures you can take to reduce future episodes of nosebleed in some cases.
• Avoid frequent nose picking or blowing your nose
• Use saline nasal spray or gel to keep your nose moist especially during winter months. You may use it two to three times daily in each nostril
• Use a humidifier in your bedroom at night
• Quit smoking if you smoke. Avoid places with cigarette smoke
• Talk to your doctor if your nosebleed is related to your allergy symptoms
• Talk to your doctor if you have a nosebleed after starting a new medication

Contributed by Patricia Hsiao M.D.
Sources: aafp.org, clevelandclinic.org, nlm.nih.gov, uptodate.com

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