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When You Visit Your Doctor - Mitral Valve Prolapse

Mitral Valve Prolapse

Questions to Discuss with Your Doctor:

  • Have you had an echocardiogram?
  • What did it show?
  • Does your mitral valve leak?
  • Do you get chest pain?
  • What brings it on?
  • How long does it last?
  • What relieves it?
  • Do you ever get a rapid or pounding heartbeat (palpitations) for no reason?
  • How long does it last?
  • Do you feel faint or develop chest pain or shortness of breath?
  • Have you ever fainted?
  • Do you get short of breath when you lie down or exert yourself?
  • Have you ever taken any medications for your heart?
  • Did you develop any side effects from these medications?

Your Doctor Might Examine the Following Body Structures or Functions:

  • Heart rate, blood pressure, and weight
  • Heart (sometimes while you are standing, squatting, or performing other maneuvers)
  • Lungs

Your Doctor Might Order the Following Lab Tests or Studies:

 

When You Visit Your Doctor - Insomnia

Insomnia

Questions to Discuss with Your Doctor:

  • Are you particularly stressed at work or at home?
  • Are you depressed or anxious?
  • Do you have any underlying medical problems such as hyperthyroidism or sleep apnea?
  • Do you snore?
  • Do you have chronic pain or difficulty breathing at night?
  • Do you have restlessness or twitching of your legs at night?
  • Do you drink caffeine-containing beverages after noon (such as coffee or sodas)?
  • Do you use stimulants? Drink alcohol? Take sedatives? Smoke cigarettes?
  • Do you take any medications?
  • What time do you usually go to bed?
  • What time do you get up in the morning?
  • Do you eat or work before going to bed?
  • Have you noticed changes in your sleep patterns?
  • Do you wake frequently at night?
  • Do you feel tired during the day?
  • How long do you stay in bed before you fall asleep?
  • Do you have worries about not sleeping?

Your Doctor Might Examine the Following Body Structures or Functions:

  • Blood pressure, heart rate, weight
  • General physical exam

Your Doctor Might Order the Following Lab Tests or Studies:

  • Complete blood cell count
  • Thyroid function
  • Sleep study with monitoring of heart rate, respiratory rate, oxygen level, eye movements, and brain waves
 

When You Visit Your Doctor - Inguinal Hernia

Inguinal Hernia

Questions to Discuss with Your Doctor:

  • Do you have pain in the lower abdomen or groin area?
  • Have you noticed a bulge in your lower abdomen or groin area?
  • Does lifting heavy objects, coughing, sneezing, or straining increase the size of the bulge?
  • Can you push the bulge back in?
  • Do you suffer from constipation?
  • Have you had bloody stools?

Your Doctor Might Examine the Following Body Structures or Functions:

  • Careful abdominal exam
  • Groin exam (including testicular and scrotal exam in men)

Your Doctor Might Order the Following Lab Tests or Studies:

  • Stool sample
  • Abdominal/Pelvic ultrasound
  • Abdominal/Pelvic CT scan
 

When You Visit Your Doctor - Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome (IBS)

Questions to Discuss with Your Doctor:

  • Do you have pain or cramping in the lower stomach?
  • How often do you get the pain?
  • Is the pain related to meals?
  • Do you suffer from constipation and small bowel movements?
  • Do you have diarrhea that alternates with constipation?
  • Do you have frequent bloating and gas?
  • Do you have a feeling of fullness in the rectum?
  • Is there a family history of inflammatory bowel disease?
  • Do you have a history of mental illness or depression?
  • Are there any things causing unusual stress in your life?
  • Please describe your diet in detail.

Your Doctor Might Examine the Following Body Structures or Functions:

  • Careful abdominal exam
  • Rectal exam

Your Doctor Might Order the Following Lab Tests or Studies:

  • Stool testing for blood and cultures
  • Conventional abdominal X-rays
  • Endoscopy or sigmoidoscopy
  • Barium enema
  • Complete blood count and other blood tests
 

When You Visit Your Doctor - Macular Degeneration

Macular Degeneration

Questions to Discuss with Your Doctor:

  • Have you noticed a change in vision in one eye or both?
  • Do you have trouble reading, even with reading glasses?
  • Do you have difficulty seeing fine details?
  • Do you see a gray patch in the middle of the words when you read?
  • Do straight vertical lines appear "wiggly" when you look at them?
  • Is your side or peripheral vision affected?
  • Do you have diabetes?
  • Do you smoke?
  • Do you have a family history of macular degeneration?

Your Doctor Might Examine the Following Body Structures or Functions:

  • The inside of your eye, using an ophthalmoscope (see p. 417)

Your Doctor Might Order the Following Lab Tests or Studies:

  • Referral to an ophthalmologist (eye specialist) who will do a complete eye exam with drops to dilate your pupils.
 

When You Visit Your Doctor - Multiple Sclerosis

Multiple Sclerosis

Questions to Discuss with Your Doctor:

  • Do you have cloudy or double vision?
  • Do you ever have eye pain or involuntary jumping of your vision?
  • Do you have problems with clumsiness or poor coordination?
  • Have you ever had numbness or tingling in your arms or legs? Tremors?
  • Do you ever have hearing loss or vertigo?
  • Do you have difficulty concentrating or problems with memory loss?
  • Do you have any problems with bladder or bowel control?
  • Do you have constipation?
  • Do you have any family history of multiple sclerosis?
  • Are you taking any medications?

Your Doctor Might Examine the Following Body Structures or Functions:

  • Complete neurological exam focusing on reflexes, strength, gait, sensation, and vision

Your Doctor Might Order the Following Lab Tests or Studies:

  • Lumbar puncture for removal and analysis of cerebrospinal fluid
  • Magnetic Resonance Imaging (MRI)
 

Are painkillers also killing your hearing?

Image: iStock

When you think of risk factors for hearing loss, over-the-counter pain relievers probably aren't among them. But a Harvard study published in the American Journal of Epidemiology suggests that frequent use of ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may be an important contributor. In the study, women who took the pain relievers at least twice a week were more likely to experience hearing loss, and more frequent usage increased the risk by up to 24%. The findings are similar to a study of men and hearing loss, although aspirin was also found to contribute to risk in that study.

Researchers speculate that the pain relievers may be damaging the cochlea, the snail-shaped hearing mechanism in your inner ear. "Ibuprofen can reduce blood flow to the cochlea, which could result in cellular damage and cell death. Acetaminophen may deplete the antioxidant glutathione, which protects the cochlea from damage," says study author Dr. Sharon Curhan, instructor in medicine at Harvard Medical School.

Does this mean you should think twice before popping a pill for headache or back pain? These medicines do provide good pain relief for many people. "However, frequent use of these medications and use over long periods of time may increase the risk of hearing loss and may cause other adverse health effects. Therefore, it is important to take these medications mindfully and to limit their use as much as possible," says Dr. Curhan. As always, talk to your doctor before making any changes in your medication use.

To learn more about the things that can threaten your hearing, and what you can to do keep this sense sharp and clear, buy Hearing Loss: A guide to prevention and treatment, a Special Health Report from Harvard Medical School. 

Pancreatic cancer: Symptoms, treatment, and prevention

Hard to detect and quick to spread, pancreatic cancer is among the deadliest of cancers. Scientists hope that genetic research will make it more like other cancers-a treatable disease. But even if it's caught while confined to the pancreas-and it rarely is-just 16% of patients are alive five years after the initial diagnosis. By comparison, the five-year survival rate for localized breast cancer is 86%. If the cancer has spread beyond the pancreas, the likelihood of living another five years is just 2%. Only the statistics for liver cancer are as grim.

Fortunately, pancreatic cancer is uncommon compared with other major cancers. About 50,000 new cases are diagnosed every year in the United States, in contrast to about 250,000 new cases of breast cancer, and 225,000 new cases of lung cancer. But because it's so untreatable, pancreatic cancer causes about 40,000 deaths each year. It is the 4th leading cause of cancer death.

Respiratory tract infection - Is it contagious?

"Stay away from me! I don't want to get sick, too." Most of us have had to utter those words to a family member, friend, or colleague who was sneezing or coughing incessantly. But how do we know how great the chances of catching someone's cold or other illness really are? A medical review published in the New England Journal of Medicine tells us when to exercise concern over eight respiratory tract infections.

Illness

(Infectious agent)

How it gets transmitted

Places of highest risk

Percent risk of infection

Bronchiolitis

(Respiratory Syncytial Virus, RSV)

Direct contact with ill person, large-droplets from coughs or sneezes, contact with tissues, linens, or other surfaces holding the virus

Homes, day-care centers

In day-care centers, 100% of exposed children become ill, previous infection somewhat lowers the risk

Flu

(Influenza viruses)

Direct contact with ill person, large- and tiny-droplets from coughs or sneezes

Homes, schools, bars, dormitories, areas with poor ventilation or recirculated air

20%-60% from a family member, only half of those infected will have symptoms of influenza

The common cold

(Rhinovirus)

Direct contact with ill person, large-droplets from coughs or sneezes, contact with tissues, linens, or other surfaces holding the virus

Homes, dormitories

66% from a family member

Tuberculosis

Tiny-droplets from coughs or sneezes

Homes, bars, dormitories, nursing homes, areas with poor ventilation

25%-50% with close contact with a person with active disease, prolonged exposure is usually required

Upper respiratory illness

(Adenoviruses)

Direct contact with ill person, large- and tiny-droplets from coughs or sneezes

Camps, schools, military camps

10% of those exposed may become ill, 40% among children, many infected individuals show no symptoms and infection leads to immunity from future infection

Strep throat, scarlet fever

(Group A Strep)

Direct contact with ill person, large-droplets from coughs or sneezes

Homes

10% from a family member

Bacterial meningitis

(Neisseria meningitides)

Direct contact with ill person, large-droplets from coughs or sneezes

Homes, schools, camps

2%-3% for a child whose sibling has active illness, 0.2%-0.4% for household contacts of the ill child, more than 95% of the time a second case of the disease does not follow a first.

Pneumococcal pneumonia

(Streptococcus pneumoniae)

Direct contact with ill person, large-droplets from coughs or sneezes

Day-care centers, homeless shelters, camps, prisons, nursing homes

Generally not regarded as contagious, risk of infection depends on one's general health

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