Staying Healthy Archive

Osteoarthritis

Questions to Discuss with Your Doctor:

• How long have you had painful joints?
• Which joints are involved and which are most painful?
• Is the pain worse or better after walking or other exercise?
• Does the pain wake you at night?
• Does it occur at rest?
• Do you have swelling or deformities in any joints?
• What activities can you no longer do because of the arthritis?
• How long ago did you stop doing them?
• How far can you walk?
• Do you have difficulty opening jars or grasping objects?
• Do you have any other conditions, such as heart or lung disease, that also limit your ability to function?
• What have you done to treat your osteoarthritis?
• What therapies help the most?
• Do you use a cane (for osteoarthritis of the knee or hip)?
• What medications do you take (over-the-counter and prescription) to treat the pain?
• How effective are they?
• Do you know the side effects of each medication?

Your Doctor Might Examine the Following Body Structures or Functions:

• Joint examination
• Muscles
• Gait

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests if your symptoms are atypical for osteoarthritis
• X-rays of the involved joints
• CT scans of the involved joints
• MRI scans of the involved joints

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)

Parkinson's Disease

Questions to Discuss with Your Doctor:

• Do you have a tremor of the hands at rest?
• Have you noticed a slowing of your movements?
• Do you have a stooped posture or a slow, shuffling gait?
• Are you becoming more unsteady?
• Are your muscles becoming more rigid?
• Have you noticed your handwriting is getting smaller?
• Do you have any problems with speech?
• Are you depressed?
• Do you have problems with memory, concentration, or problem-solving?
• Do you have a family history of Parkinson'’s disease?
• Are you taking any medications?

Your Doctor Might Examine the Following Body Structures or Functions:

• Complete neurological exam focusing on gait, muscle tone, strength, and vision
• Mini Mental Status Exam (to test memory and concentration)

Your Doctor Might Order the Following Lab Tests or Studies:

• The diagnosis is made based on medical history and physical exam
• SPECT (Single Photon Emission Computed Tomography)
• Response to drug treatment, such as a trial of levodopa

Peptic Ulcer Disease

Questions to Discuss with Your Doctor:

• Do you have diffuse or localized abdominal pain?
• Does the pain ever travel to the back or chest?
• Do you have nausea associated with the pain?
• Does eating make the pain better or worse?
• Do you have black or bloody stools?
• Do you ever vomit blood or material that looks like coffee grounds?
• Do you take any medications (for example, pain relievers)?
• Do you smoke cigarettes or drink alcohol?
• Do you drink caffeine-containing beverages?
• Have you ever been tested or treated for a bacteria called H. pylori that can infect the stomach lining?
• Do you have a family history of peptic ulcer disease?

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
• Blood or breath test for the presence of H. pylori
• Upper endoscopy (internal examination of esophagus, stomach, and duodenum)
• Upper GI series

Peripheral Artery Disease

Questions to Discuss with Your Doctor:

• Do you develop pain, cramps, aches, fatigue, or numbness in your leg muscles when you walk?
• At what distance do you develop symptoms?
• Do they go away when you stop walking?
• Do you ever develop these symptoms at rest?
• Do you have decreased sensation in your feet?
• If you are a man, do you have erectile dysfunction?
• Are you doing everything possible to modify the risk factors that can worsen this disease (smoking cessation, treating elevated blood pressure and cholesterol, and controlling diabetes)?
• Are you exercising regularly and at progressively more strenuous levels?
• Are you taking an aspirin every day?
• If you have diabetes, do you practice meticulous foot care (cleaning, applying moisturizing lotions, and wearing well-fitting protective shoes)?
• Do you know when to seek emergency medical care for peripheral artery disease (if your leg becomes suddenly painful, pale, cold and numb)?
• Do you get chest pain or pressure with exertion or at rest? If so, you may have coronary artery disease.
• Do you have sudden brief episodes of blindness (like a shade being pulled over your eyes) or sudden episodes of weakness in an arm or leg, or difficulty speaking? These could be warning symptoms of stroke.

Your Doctor Might Examine the Following Body Structures or Functions:

• Heart rate, blood pressure, and weight
• Pulses in your feet and groin, and behind your knees
• Listen with the stethoscope over your carotid arteries in your neck
• Heart and lungs
• Neurologic exam (reflexes and sensation in your legs)
• Muscles (looking for atrophy in leg muscles)
• Skin, looking for changes related to reduced circulation

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests, including glucose and cholesterol levels
• Ultrasound of your carotid arteries
• Doppler Ankle-Arm Indices
• Exercise Stress Test
• MRI/MRA
• Angiography

Pregnancy: 1st Trimester

Questions to Discuss with Your Doctor:

• Your age and how it will affect your pregnancy.
• Have you been pregnant before? If so, what was the outcome of each pregnancy. Did you have a full-term pregnancy (your baby was born close to your due date)? Did you give birth via a vaginal delivery or a cesarean section ("C-section") surgery? If you had a C-section, what type of C-section was it? Did any of your pregnancies end in miscarriage, voluntary abortion, or an ectopic (tubal) pregnancy?
• Does this pregnancy come at a good time for you?
• When was the first day of your last menstrual period?
• What is the usual length of your menstrual cycle?
• Do you have any medical problems such as diabetes, high blood pressure, thyroid problems, asthma, tuberculosis, epilepsy, or heart disease?
• Have you ever had any sexually transmitted infections such as gonorrhea, herpes, syphilis, or human papilloma virus (HPV)?
• Do any medical problems tend to run in your family such as sickle cell anemia, cystic fibrosis, Down syndrome, or hemophilia?
• Are you taking any medications (including over-the-counter medications)? If so, what are they?
• Do you smoke? If so, how many packs per day?
• In an average week, how many alcoholic beverages do you consume?
• Do you use any recreational drugs?
• Did you have any problems getting pregnant?
• Do you eat a well-balanced diet? Are you taking any vitamins, including folic acid (folate)?
• Do you exercise regularly?
• What is your home situation like? Who do you live with? Is your partner supportive of this pregnancy? If not, has your partner hit or threatened you?
• Are you having any problems with morning sickness (that is, nausea and vomiting)?
• Are you having any bleeding from your vagina?

Your Doctor Might Examine the Following Body Structures or Functions:

• Temperature, blood pressure, pulse, weight
• Chest exam
• Heart exam
• Abdominal exam
• Pelvic exam with Pap smear and cervical cultures
• Leg exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Confirm pregnancy with blood or urine test
• Complete blood count and blood type
• Blood tests for syphilis, rubella antibodies, hepatitis B, HIV
• Urinalysis
• Portable Doppler instrument or stethoscope to measure fetal heart sounds
• Urine culture
• "Triple screen" (also known as "AFP-3" or "Enhanced AFP"
• Genetic testing

Rash

Questions to Discuss with Your Doctor:

• How long have you had the rash?
• Where did it start?
• Has it spread?
• Is the rash only on parts of your skin that have been exposed to the sun?
• Does it itch or hurt?
• Is the rash red, pink, or purple?
• Is the rash smooth or bumpy?
• Have you had sores in your mouth, eyes, or other mucous membranes?
• Have you had blisters on your skin?
• Have you had trouble breathing?
• Have you had a fever?
• Have you symptoms of an upper respiratory tract infection (for example, a cold)?
• Have you had vomiting or diarrhea?
• Are you taking any prescription drugs, over-the-counter drugs, herbs, or supplements? Did you start any of them in the past two months?
• Have you had any new exposures to foods or chemicals?
• Any exposure to insects?
• Have you had any recent sun exposure?

Your Doctor Might Examine the Following Body Structures or Functions:

• Temperature
• Examination of your skin, mouth, eyes, mucous membranes, lymph nodes, liver, and spleen

Your Doctor Might Order the Following Lab Tests or Studies:

• Skin scrapings for microscopic analysis or culture (if the rash looks infectious)
• Complete blood cell count or other blood tests (if you appear sick or have a fever)
• Skin biopsy

Pregnancy: 3rd Trimester

Questions to Discuss With Your Doctor:

• Do you have adequate support at home from family or friends?
• How do you feel? Have you had any problems since your last visit?
• Have you had any vaginal bleeding or spotting?
• Have you had any pain or uterine cramping?
• Have you had any discharge or leakage of fluid from your vagina?
• Have you noticed swelling of your face or ankles?
• Have you had any problems with your vision?
• Are you getting frequent headaches?
• Have you noticed a change in the frequency or intensity of fetal movement?
• Are you planning to breast-feed or bottle-feed?
• Have you selected a pediatrician for your baby?
• Are you taking classes on labor and delivery?
• Have you added health insurance coverage for your new baby?
• Have you purchased a special car seat to hold your baby when riding in your car?
• Have you decided on whether the baby will have a circumcision, if a boy?
• Have you talked with your doctor about the length of your stay in the hospital?
• Do you know the signs of going into labor so that you can call your doctor when labor begins? (These include uterine contractions and rupture of the membranes).

Your Doctor Might Examine the Following Body Structures or Functions:

• Breasts (to see if your nipples are inverted)
• Abdominal exam, including measurement of the height of your fundus (top of the uterus)

Your Doctor Might Order the Following Lab Tests or Studies:

• Culture of the vagina and rectum for Group B streptococcus bacteria
• Fetal ultrasound

Pregnancy: 2nd Trimester

Questions to Discuss with Your Doctor:

• How do you feel? Have you had any problems since your last visit?
• Have you had any vaginal bleeding or spotting?
• Have you had persistent vomiting?
• Have you had any pain or uterine cramping?
• Have you noticed swelling of your face or fingers?
• Have you had any problems with your vision?
• Are you getting frequent headaches?
• Have you had any vaginal discharge?
• Have you noticed fetal movement?
• Are you planning to breast-feed or bottle-feed?

Your Doctor Might Examine the Following Body Structures or Functions:

• Blood pressure, weight
• Abdominal exam including measurement of the height of your fundus (top of the uterus) and using a portable Doppler instrument or stethoscope to measure fetal heart sounds

Your Doctor Might Order the Following Lab Tests or Studies:

• Consider repeat complete blood count
• Fetal ultrasound
• Glucose tolerance test

Your Doctor Might Order the Following Treatment:

• Rhogam (Rh-Immunoglobulin), if your blood type is Rh negative (see p. 920)

Sarcoidosis

Questions to Discuss with Your Doctor:

• Have you had difficulty breathing? For how long? How far can you walk without feeling winded?
• Do you ever have chest pain or tightness? If yes, is it related to activity?
• Have you had a persistent cough? If yes, is your cough dry or do you produce sputum?
• Do you suffer from fatigue or malaise?
• Have you had any fevers?
• Have you recently lost weight? If so, how much?
• Do you have pain in your joints, bones, or muscles?
• Have you noticed any lumps in your neck, armpits, or groin?
• Have you noticed any rashes or changes in your skin?
• Have you had blurry vision or watery eyes?
• Have you ever had red or painful eyes or a past diagnosis of uveitis?
• Do you smoke cigarettes?
• Have you had an abnormal chest x-ray in the past?
• Do you have a family history of sarcoidosis?
• Are you taking any medications?
• Have you ever been on steroids or any other treatment for you sarcoidosis?

Your Doctor Might Examine the Following Body Structures or Functions:

• Temperature, respiratory rate, oxygen saturation, blood pressure, heart rate
• Heart and lung exam
• Joint exam
• Skin exam
• Lymph node exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Plain chest x-ray
• Chest CT scan
• Pulmonary function tests
• Bronchoscopy with lung biopsy
• Blood tests
• Formal eye exam