Tell me everything or tell me nothing

[Nords]

As for Alzheimer's, why not read Thomas Debaggio? He wrote two books when he was diagnosed with early-stage Alzheimer's at the age of 57. I think he would've wanted to know as soon as a genetic test could have told him.

By the way, what was that about inhaled steroids causing cataracts? I've used fluticasone about 6 months out of every 12 since 1994 - helps me cope with seasonal allergies. Nobody said anything about causing cataracts! I think I would have noticed something like that if it was mentioned in the package insert.

Same situation here with Flonase, so I went looking.

From this research paper:

An excess risk with nasal corticosteroids was not apparent for severe cataracts.
It is concluded that, among the elderly, even low doses of inhaled corticosteroids are associated with a small but significant excess risk of cataracts requiring extraction. Such an excess risk was not observed with nasal corticosteroids.

 

[Rich_by_the_Bay]

Very few elements of the routine physical have proven value for patient outcomes. It is an American (perhaps North American) ritual. For example, of the usual items which have some value, one might include blood pressure, cholesterol every 5 years or so, some type of colon cancer screen (like colonoscopy every 10 years, maybe). Even checking blood sugar in this setting is lacking in evidence. Immunizations are generally good.

Note that this refers to folks who are healthy with no symptoms or signs of the target disease. Yet, I there might be value in repetitive lifestyle counselling, establishing a good relationship with your provider for future illness management, and just the feel-good effects of a so-called "clean bill." In this case, more is not always better and the $3000 "executive physical" filled with unnecessary tests does more harm than good, IMHO, with all kinds of false alarms, wild goose chases, and distress for no reason. Many don't like to hear that.

 

[TromboneAl]

That's very useful information, Rich, thanks.

I only go when something PERSISTENTLY really is bothering me.

I'm in this camp too, because I'm a recovering hypochondriac. I used to go to the doctor for every little thing. I went because my neck clicked when I turned it. I went when couldn't line up my fingers after a long bike tour.

Now, something has to be "pain" rather than "discomfort," and it has to last a bit.

I'm not like Lance Armstrong, however, who didn't see a doctor until his testicle was the size of a grapefruit. [I know what you're going to say, REWahoo: "Isn't everybody's?"].

 

[Alan]

Thanks Rich, good to know your views on annual physicals particularly since I have my "Executive Physical" coming up next week. I don't know how much it costs the company but I hate spending their money so usually only go every 18 - 24 months. The tests don't seem excessive and apart from blood and urine include hearing, vision, and lung capacity (spirometer). It always includes either a stress test or at rest ekg plus colonoscopy every 10 years once you hit 40. (The lung capacity is important as it is a chemical facility and for folks who actually work in the unit and/or labs they get one every 3 to 6 months).

In 20 years of doing this I only had the "feel good" factor of knowing I was in good health, although last year when I had my second colonoscopy they did remove a benign polyp.

This last few months I have noticed my bp is consistently high for me and I have been checking it myself at work on a machine. Yesterday it was 135/85 so I am interested in what it will be when taken professionally by a nurse.

 

[Meadbh]

This last few months I have noticed my bp is consistently high for me and I have been checking it myself at work on a machine. Yesterday it was 135/85 so I am interested in what it will be when taken professionally by a nurse.

That'a a borderline number. One BP check is not as valuable as your observation of an upward trend. Ask if you can have a 24 hour blood pressure monitoring test. Meanwhile, think about things you can do to decrease your BP. If you are a business executive no doubt you eat out a lot. Restaurant and airline food is notoriously salty. Try to eat at home when you can, avoid processed food and sauces, and don't add salt to your food. When eating out, choose low salt options whenever possible.

I've been there and done that, and it works. I have my own BP meter and I bring the printout to my doctor.

Here is a report on the perils of excessive salt consumption:

Under pressure - The Globe and Mail

 

[vicente solano]

That's very useful information, Rich, thanks.



I'm in this camp too, because I'm a recovering hypochondriac. I used to go to the doctor for every little thing. I went because my neck clicked when I turned it. I went when couldn't line up my fingers after a long bike tour.

Now, something has to be "pain" rather than "discomfort," and it has to last a bit.

I'm not like Lance Armstrong, however, who didn't see a doctor until his testicle was the size of a grapefruit. [I know what you're going to say, REWahoo: "Isn't everybody's?"].

I have to be careful not to complain in front of my wife. it´s not the first time she frogmarches me to the proper specialist. Like now, she has forced me into seeing the urologist.....

 

[Alan]

That'a a borderline number. One BP check is not as valuable as your observation of an upward trend. Ask if you can have a 24 hour blood pressure monitoring test. Meanwhile, think about things you can do to decrease your BP. If you are a business executive no doubt you eat out a lot. Restaurant and airline food is notoriously salty. Try to eat at home when you can, avoid processed food and sauces, and don't add salt to your food. When eating out, choose low salt options whenever possible.

I've been there and done that, and it works. I have my own BP meter and I bring the printout to my doctor.

Here is a report on the perils of excessive salt consumption:

Under pressure - The Globe and Mail

Thanks for the info and link to the article. From the article:

Recommended daily intake (amount of sodium adequate to good health), by age group:
Ages 1-3: 1,000 milligrams (less than half a teaspoon of salt)
Ages 4-8: 1,200 mg
Ages 9-50: 1,500 mg
Ages 51-70: 1,300 mg
Over age 70: 1,200 mg

We don't add salt to anything but, as you say, you don't really know what you are consuming unless you start taking notes. We eat a lot of salads and I just looked at the salad dressings in our fridge and they do vary a lot, plus it is deceptive since the daily recommended intake appears to be 2,500mg, well above the table from the article. I have no idea what the salt levels are in the salad dressings at work in the cafe.

I appreciate your advice and will immediately start tracking the amount of salt I consume to see how much I am actually consuming and then try and keep below 1,300mg/day. At work I will stop adding dressing, and these days travel has been banned so I rarely eat out on business (maybe the recession will provide some benefit after all )

I'll talk to the doc next week and see what he recommends. All other factors are good except for the glass of wine/day which I will hate to give up. I regularly exercise and am not overweight. Even after walking to the building to use the BP machine my heart rate was only 47 bpm (since I upp'ed my aerobic exercise dramatically a few years ago I saw my resting heart rate drop down into the 40's).

I've also considered getting my own BP meter - any recommendations?

 

[Alan]

I have to be careful not to complain in front of my wife. it´s not the first time she frogmarches me to the proper specialist. Like now, she has forced me into seeing the urologist.....

That's exactly what my wife did to me 3 months ago. Now I am on Flomax for BPH, and when I had my BP checked it was borderline high so now I'm worried about that as well (see my post above)

 

[Meadbh]

I've also considered getting my own BP meter - any recommendations?

You're welcome. The available meters probably differ between countries. I was advised not to buy a wrist one as they are less accurate, and to ensure that I chose one with the Canadian Standards Association stamp of approval. I like to record data, so I chose one with a data download function and software for my computer. I asked my doctor for a prescription so my supplementary insurance plan covered it.

 

[Alan]

You're welcome. The available meters probably differ between countries. I was advised not to buy a wrist one as they are less accurate, and to ensure that I chose one with the Canadian Standards Association stamp of approval. I like to record data, so I chose one with a data download function and software for my computer. I asked my doctor for a prescription so my supplementary insurance plan covered it.

I wondered about that - I went to the dentist for a check-up a few weeks back and the hygienist took my bp with a wrist one - it was the only normal reading I've had since I've been checking it with the machine at work (where you put your arm in the cuff).

 

[nanannjen]

Me, too, until this post in this thread - Nanannjen expressed an alternate view which surprised me, so as someone who spends a lot of time informing patients about their maladies, I thought I'd do a reality check with a poll.

This has been a very interesting thread! I figured that I'd better jump in and justify my position.

I still maintain - for the specific ailment (cataracts) - one that is very common in our society and very easily fixed - for the doctor to tell me that I had them, without the additional information - that was wrong, and I wish that she hadn't told me. It did make a big difference when the other doctor (the next year) explained that it was fairly normal and not a big deal - that I was a long ways away from needing the surgery. Under the same circumstances, with a problem of the same type - slowly progressing, no lifestyle changes/medication fix, that many people get - (sorry, I can't think of a good comparison!) - I probably don't need to know until it becomes more relevant to me (maybe 5 years out?). If it was glaucoma - completely different issue, as that is something much more serious.

I am normally a full disclosure type - give it to me straight so that I can research it - but for some reason, this one hit me wrong. I guess it's a good thing that first doctor isn't with the practice any more!