Here we are officially entering the time of year when most of us find ourselves immersed in activities for the holidays. If your family is like ours, nearly every weekend is filled with some sort of activity between church and kids and school and other family obligations. It can be a very stressful time of year. It can also be a very fulfilling time of year.
I've noticed many of my friends and family celebrating an attitude of gratitude by posting 30 days of thanksgiving on their Facebook pages. Each day they list something they are thankful for. I think this is an excellent idea. No matter whether you are religious or not, being thankful puts your mind on positive thoughts. Psychologists tell us that focusing on the positive is healthy for our body and mind. Keeping our thoughts toward the upside can help enhance not only our mental health, but physical health as well.
Studies have shown that people who have more positive attitudes on psychological tests have longer lives. People facing illnesses who have a positive outlook have better outcomes. People who are happy are less likely to get sick, even from the common cold. There is a direct relationship between how you feel emotionally and how you feel physically. Several studies have even shown that patients who have heart disease have lower death rates when they are happier emotionally.
We don't know for sure why this is, but scientists theorize that positive thoughts raise levels of certain brain hormones such as serotonin and dopamine. These neurotransmitters are involved in sleep, appetite, mood, motivation and concentration and many other body systems. Higher levels of dopamine, reduce other hormones produced throughout the body in times of stress and lower levels of these stress hormones means less physical stress on organs like your heart.
I encourage you to participate in this attitude of gratitude. Sometimes when things are stressful, remembering what we are thankful for helps us focus on the things we have and forget the things we don't have. So as we enter this holiday season, spend some time being thankful. Your body will thank YOU for that.
Friday, November 4, 2011
Tuesday, October 4, 2011
The Dreaded Phone Call
Hopefully none of you will ever receive this phone call from someone you love:
"My doctor felt something in my beast at my check up. I have to go for a mammogram."
Or this one:
"The mammogram does show a suspicious mass. I have to have a biopsy."
Or even worse:
"The biopsy was positive. It is breast cancer."
I received all three of these calls recently from someone I love very much. It is a shocking and horrible feeling to know that someone you care about is facing something so terrible and potentially life threatening. The only saving grace is that the person I love got her yearly check ups every year. She went for regular mammograms. Without them, this aggressive cancer might have been found too late. Fortunately, the breast cancer was detected early and chances for cure are good.
There has been a lot of confusing messages in the news lately regarding when to have mammograms and how often. It's no wonder since there are a lot of conflicts among experts in the field. In November 2009, the US Preventative Services Task Force (USPSTF) released new guidelines on using mammograms for screening for breast cancer that were radically different from the previous ones.
Their recommendations were that women should have mammogram for screening every 2 years starting at 50 and no mammograms prior to age 50. They recommended that mammograms not be done past the age of 75. They also stated that they didn't have enough evidence to recommend self breast exam or teaching women to do self-exams.
Many of us in the medical field were concerned that these new guideline would not only confuse patients about what to do for early breast cancer detection, but also influence how insurance companies pay for screening. The task force is a group of scientists and doctors and policy makers with the government. They have very strict rules about when a test should be recommended. They take into account the cost of performing a test and how many need to be done to show benefit. They concluded that the potential cost of the mammograms, both the actual cost and the cost of false positive tests, when weighed against the benefits were too much to recommend mammogram before age 50.
However, the American Cancer Society, the American College of Gynecologists, and the American College of Radiology recommend annual mammogram beginning at age 40 and continuing through age 75 or later depending on the wishes and recommendations of the patient's personal physician. All three also recommend self-breast exams and breast exams annually by a physician. My own professional society, the American Academy of Family Physicians, released recommendations in line with the current USPSTF recommendations.
So......what are we to do? Most of my colleagues are continuing to discuss screening mammogram with our patients beginning at age 40. I generally explain that those USPSTF recommendations were made because there was insufficient evidence to recommend otherwise. It doesn't mean that a women in her 40s should not have mammograms or examine her own breasts. It just means that the scientists don't have enough evidence to say that it is beneficial for the overall public health.
What do I do?
I examine my own breasts monthly. I see my physician annually for a breast exam. I get a mammogram. In fact I had my first one this year. I know there are risks in doing mammograms in younger women. There is radiation in a mammogram. There is the possibility of a false positive mammogram which might lead to other unnecessary tests. But, I still believe that early detection is important and that those risks are minimal in light of the fact that detecting breast cancer early is so important.
October is breast health month. I encourage you to talk to your physician about whether a mammogram is right for you and when to begin screening. If someone you love has not had a mammogram, please encourage her to go. And remember.....breast cancer can happen in men also. Don't ignore changes in your breasts whether you are male or female. See your family physician regularly. It really can be the difference between life and death.
"My doctor felt something in my beast at my check up. I have to go for a mammogram."
Or this one:
"The mammogram does show a suspicious mass. I have to have a biopsy."
Or even worse:
"The biopsy was positive. It is breast cancer."
I received all three of these calls recently from someone I love very much. It is a shocking and horrible feeling to know that someone you care about is facing something so terrible and potentially life threatening. The only saving grace is that the person I love got her yearly check ups every year. She went for regular mammograms. Without them, this aggressive cancer might have been found too late. Fortunately, the breast cancer was detected early and chances for cure are good.
There has been a lot of confusing messages in the news lately regarding when to have mammograms and how often. It's no wonder since there are a lot of conflicts among experts in the field. In November 2009, the US Preventative Services Task Force (USPSTF) released new guidelines on using mammograms for screening for breast cancer that were radically different from the previous ones.
Their recommendations were that women should have mammogram for screening every 2 years starting at 50 and no mammograms prior to age 50. They recommended that mammograms not be done past the age of 75. They also stated that they didn't have enough evidence to recommend self breast exam or teaching women to do self-exams.
Many of us in the medical field were concerned that these new guideline would not only confuse patients about what to do for early breast cancer detection, but also influence how insurance companies pay for screening. The task force is a group of scientists and doctors and policy makers with the government. They have very strict rules about when a test should be recommended. They take into account the cost of performing a test and how many need to be done to show benefit. They concluded that the potential cost of the mammograms, both the actual cost and the cost of false positive tests, when weighed against the benefits were too much to recommend mammogram before age 50.
However, the American Cancer Society, the American College of Gynecologists, and the American College of Radiology recommend annual mammogram beginning at age 40 and continuing through age 75 or later depending on the wishes and recommendations of the patient's personal physician. All three also recommend self-breast exams and breast exams annually by a physician. My own professional society, the American Academy of Family Physicians, released recommendations in line with the current USPSTF recommendations.
So......what are we to do? Most of my colleagues are continuing to discuss screening mammogram with our patients beginning at age 40. I generally explain that those USPSTF recommendations were made because there was insufficient evidence to recommend otherwise. It doesn't mean that a women in her 40s should not have mammograms or examine her own breasts. It just means that the scientists don't have enough evidence to say that it is beneficial for the overall public health.
What do I do?
I examine my own breasts monthly. I see my physician annually for a breast exam. I get a mammogram. In fact I had my first one this year. I know there are risks in doing mammograms in younger women. There is radiation in a mammogram. There is the possibility of a false positive mammogram which might lead to other unnecessary tests. But, I still believe that early detection is important and that those risks are minimal in light of the fact that detecting breast cancer early is so important.
October is breast health month. I encourage you to talk to your physician about whether a mammogram is right for you and when to begin screening. If someone you love has not had a mammogram, please encourage her to go. And remember.....breast cancer can happen in men also. Don't ignore changes in your breasts whether you are male or female. See your family physician regularly. It really can be the difference between life and death.
Thursday, September 8, 2011
It's a Whole New World!
This time of year has me thinking about college. Kids going off to college, college football and all the rest. It's a big transition for the whole family when one leaves the nest. Such an important time for your family. There are many things to think about.
For the student, there is a WHOLE new world to explore. The freedom to come and go and do pretty much what you want. Eat what you want. Sleep when you want and so much more. This can be such an exciting and rewarding time, but also there are many things to consider.
If you're new to college or just starting out, you might feel overwhelmed with the new routine, responsibility of being on your own, trying to keep up with your classes, and meeting so many new friends. It can make people really anxious. Sometimes the tendency is to get caught up in your new social scene and lose sight of the academics. On the other hand, some students get so focused on studying and the new burden of all the schoolwork that they forget to have fun. College students need both a social life (whether Mom and Dad like to admit it or not) and a rewarding academic life to achieve all their goals. Make sure you find the right balance for you. If you find yourself overwhelmed, ask for help from other students, parents, counselors or teachers. Most colleges have free counseling available and other services to provide you with support.
In all the chaos of starting school, health sometimes gets left behind. We always hear about "the freshman ten" or the pounds that many people starting school gain. Remember that just because you CAN run to Taco Bell in the middle of the night when you're hungry and studying doesn't mean you SHOULD. Keep healthy snacks like granola bars or fresh fruit in your room that you can grab when you are hungry. Make sure you don't forget to eat something GREEN now an then. Well....if you're eating in the cafeteria at school you might be seeing more green thatn you'd like. But, there are some things Mom and Dad say that are true (whether you want to believe it or not). Vegetables and fruits are important to your health. If you don't have decent healthy fuel in your body, it's awfully hard to keep your busy schedule.
Sleep is another thing that college students sometimes skimp on. Your brain needs sleep. It has to re-boot. Every night. Without it, your brain just won't process all the information your are trying to shove in it right now. Get plenty of sleep and try to keep a regular schedule. Staying up very late one night and oversleeping the next day can really confuse your brain about when it's supposed to sleep and when it needs to be working.
Remember that illnesses spread through college campuses quickly. Get your immunzations to be sure you are protected. Especially the meningitis vaccine. Meningitis is an infection of the nervous system that can be serious, even fatal. It is especially deadly to college students in dorms where it can be passed from person to person quickly. And don't forget your flu shot. Every year we see a campus shut down from widespread flu.
Finally some advice for the parents. It's hard letting go, but you have to. Don't be one of those "helicopter"parents you're hearing about. The best thing you can do is give your child some freedom to learn their way in their new world. But, stay close enough to give advice when asked and comfort when needed. As a parent myself, the thought of it terrifies me. But, just think of this time as your "final exam" as a parent. No pressure.(Grin.)
For the student, there is a WHOLE new world to explore. The freedom to come and go and do pretty much what you want. Eat what you want. Sleep when you want and so much more. This can be such an exciting and rewarding time, but also there are many things to consider.
If you're new to college or just starting out, you might feel overwhelmed with the new routine, responsibility of being on your own, trying to keep up with your classes, and meeting so many new friends. It can make people really anxious. Sometimes the tendency is to get caught up in your new social scene and lose sight of the academics. On the other hand, some students get so focused on studying and the new burden of all the schoolwork that they forget to have fun. College students need both a social life (whether Mom and Dad like to admit it or not) and a rewarding academic life to achieve all their goals. Make sure you find the right balance for you. If you find yourself overwhelmed, ask for help from other students, parents, counselors or teachers. Most colleges have free counseling available and other services to provide you with support.
In all the chaos of starting school, health sometimes gets left behind. We always hear about "the freshman ten" or the pounds that many people starting school gain. Remember that just because you CAN run to Taco Bell in the middle of the night when you're hungry and studying doesn't mean you SHOULD. Keep healthy snacks like granola bars or fresh fruit in your room that you can grab when you are hungry. Make sure you don't forget to eat something GREEN now an then. Well....if you're eating in the cafeteria at school you might be seeing more green thatn you'd like. But, there are some things Mom and Dad say that are true (whether you want to believe it or not). Vegetables and fruits are important to your health. If you don't have decent healthy fuel in your body, it's awfully hard to keep your busy schedule.
Sleep is another thing that college students sometimes skimp on. Your brain needs sleep. It has to re-boot. Every night. Without it, your brain just won't process all the information your are trying to shove in it right now. Get plenty of sleep and try to keep a regular schedule. Staying up very late one night and oversleeping the next day can really confuse your brain about when it's supposed to sleep and when it needs to be working.
Remember that illnesses spread through college campuses quickly. Get your immunzations to be sure you are protected. Especially the meningitis vaccine. Meningitis is an infection of the nervous system that can be serious, even fatal. It is especially deadly to college students in dorms where it can be passed from person to person quickly. And don't forget your flu shot. Every year we see a campus shut down from widespread flu.
Finally some advice for the parents. It's hard letting go, but you have to. Don't be one of those "helicopter"parents you're hearing about. The best thing you can do is give your child some freedom to learn their way in their new world. But, stay close enough to give advice when asked and comfort when needed. As a parent myself, the thought of it terrifies me. But, just think of this time as your "final exam" as a parent. No pressure.(Grin.)
Monday, August 29, 2011
Back to School
Well here we are the start of another school year. We made it through that first week and hopefully everyone is starting to settle into the new schedule. It's a very exciting time of year, but can also be very stressful for parents and for children.
Many parents are pleased to see their kids return to school. It allows for more structure in their day. Plus it allows parents to get back to their busy routines and a break from the kids. But, other parents (like me) are stressed when the kids go back to school. Forms to fill out. Homework to supervise. Lunches to make. After school activities. Emails, phone calls, PTA meetings.....it goes on and on.
If you find yourself feeling overly stressed with back to school, try to slow down. Use lists and reminders to help you manage all the things you have to do. Don't over schedule yourself or your kids. You need some downtime to relax. Be sure to exercise regularly and get enough sleep which will help relieve the stress. Finally, if you feel like the situation is not manageable or you feel overwhelmed, see your primary care provider for help.
Also keep in mind that kids can feel stressed out by school starting. Especailly kids new to school .My kindergartener complained several times last week of tummy aches, usually when getting ready for bed. We talked calmly about school and the things she likes about her new class and this helped take her mind off her nerves. Remember that tummy aches that last should be checked by a doctor.
To make your school schedule easier, be sure to allow enough time in the morning to get ready and off to school. When you are rushed, you will be more stressed and your kids will, too. Try to keep a regular school day routine with dinner, homework, baths, and bedtime at around the same time each night. This allows kids to adjust to their schedule and provide structure to their time at home. Kids will know what to expect and this will avoid battles with your kids over bedtime and homework. If you feel like their is a problem developing with your child's behavior, follow your instincts and see a doctor.
Hopefully this year will be a happy and successful school year for all of us!
Many parents are pleased to see their kids return to school. It allows for more structure in their day. Plus it allows parents to get back to their busy routines and a break from the kids. But, other parents (like me) are stressed when the kids go back to school. Forms to fill out. Homework to supervise. Lunches to make. After school activities. Emails, phone calls, PTA meetings.....it goes on and on.
If you find yourself feeling overly stressed with back to school, try to slow down. Use lists and reminders to help you manage all the things you have to do. Don't over schedule yourself or your kids. You need some downtime to relax. Be sure to exercise regularly and get enough sleep which will help relieve the stress. Finally, if you feel like the situation is not manageable or you feel overwhelmed, see your primary care provider for help.
Also keep in mind that kids can feel stressed out by school starting. Especailly kids new to school .My kindergartener complained several times last week of tummy aches, usually when getting ready for bed. We talked calmly about school and the things she likes about her new class and this helped take her mind off her nerves. Remember that tummy aches that last should be checked by a doctor.
To make your school schedule easier, be sure to allow enough time in the morning to get ready and off to school. When you are rushed, you will be more stressed and your kids will, too. Try to keep a regular school day routine with dinner, homework, baths, and bedtime at around the same time each night. This allows kids to adjust to their schedule and provide structure to their time at home. Kids will know what to expect and this will avoid battles with your kids over bedtime and homework. If you feel like their is a problem developing with your child's behavior, follow your instincts and see a doctor.
Hopefully this year will be a happy and successful school year for all of us!
Tuesday, August 23, 2011
In the Beginning..................
In the beginning I just wanted to help people. I was 9 years old when I decided I would grow up to be a doctor. Around that time, my grandmother was diagnosed with cancer. After spending many days in the hospital sitting in the waiting room and wondering what all these people where doing and seeing how they helped so many, I knew I wanted to know more and do THAT.
All through high school and college I was focused on that goal. I just knew I could help people and I wanted to learn more and more about doing it. I graduated from the University of Oklahoma in 1992 with a degree in Microbiology and minor in Chemistry. I figured I could do something in science if I didn't get accepted to medical school. But, happily, I did get accepted and I graduated with my Medical Degree in 1996. I went on to do my residency in Family Medicine at Creighton University in Omaha, Nebraska.
People often ask me how I decided on Family Medicine. There are several ways to answer that. First, I love really getting to know my patients and their families. Knowing about all aspects of patients can help you understand where patients are coming from. Patients are people who happen to be sick. I always hated it when residents referred to patients as "the diabetic in room such and such" or "the heart attack guy". I quickly learned that specialists in Family Medicine understand that best.
Second, truthfully I like variety. The last thing I could imagine was staring only at a patient's feet or talking only about noses all day. In Family Medicine we treat ALL your parts. I like to think of myself as the CEO of your healthcare. While your cardiologist may concentrate on your heart and you surgeon wants to remove your gallbladder, it's my job to focus on ALL you parts and make sure ALL of you is healthy.
Finally, Family Medicine is all about KEEPING patients healthy. Preventative care is a primary focus of what we do. Understanding your family medical history helps us direct what screening and preventative tests to do. Knowing what your social life is like helps us understand what sorts of problems you might run into. Keeping track of all your past medical problems helps us know what direction to take in treatment and evaluation of new problems. As family doctors, we don't just wait for something to happen. We try to keep you healthy and detect any health problems as early as possible.
Today, I am entering my 12th year of private practice. My practice has changed and grown in size, but my approach to what I do and my love for doing hasn't changed. I am starting this blog as just one more way to help patients or even readers who are not patients. I will use this venue as a way to share important health information for you and your family. I'll also share specific information about myself or my staff from time to time and perhaps descriptions of the kinds of services I'll offer. But, this is really about a way for me to share things about me, my life and what being a family physician is like. I hope this will be both informative and entertaining for all who join me here. Thanks for reading!
All through high school and college I was focused on that goal. I just knew I could help people and I wanted to learn more and more about doing it. I graduated from the University of Oklahoma in 1992 with a degree in Microbiology and minor in Chemistry. I figured I could do something in science if I didn't get accepted to medical school. But, happily, I did get accepted and I graduated with my Medical Degree in 1996. I went on to do my residency in Family Medicine at Creighton University in Omaha, Nebraska.
People often ask me how I decided on Family Medicine. There are several ways to answer that. First, I love really getting to know my patients and their families. Knowing about all aspects of patients can help you understand where patients are coming from. Patients are people who happen to be sick. I always hated it when residents referred to patients as "the diabetic in room such and such" or "the heart attack guy". I quickly learned that specialists in Family Medicine understand that best.
Second, truthfully I like variety. The last thing I could imagine was staring only at a patient's feet or talking only about noses all day. In Family Medicine we treat ALL your parts. I like to think of myself as the CEO of your healthcare. While your cardiologist may concentrate on your heart and you surgeon wants to remove your gallbladder, it's my job to focus on ALL you parts and make sure ALL of you is healthy.
Finally, Family Medicine is all about KEEPING patients healthy. Preventative care is a primary focus of what we do. Understanding your family medical history helps us direct what screening and preventative tests to do. Knowing what your social life is like helps us understand what sorts of problems you might run into. Keeping track of all your past medical problems helps us know what direction to take in treatment and evaluation of new problems. As family doctors, we don't just wait for something to happen. We try to keep you healthy and detect any health problems as early as possible.
Today, I am entering my 12th year of private practice. My practice has changed and grown in size, but my approach to what I do and my love for doing hasn't changed. I am starting this blog as just one more way to help patients or even readers who are not patients. I will use this venue as a way to share important health information for you and your family. I'll also share specific information about myself or my staff from time to time and perhaps descriptions of the kinds of services I'll offer. But, this is really about a way for me to share things about me, my life and what being a family physician is like. I hope this will be both informative and entertaining for all who join me here. Thanks for reading!
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