Managing Health Care-Health

A major theme throughout this text is that you can control many factors that influence your health. An outgrowth of this attitude is the self-care movement, which is the trend toward individuals taking increased responsibility for prevention or management of certain health conditions. Armed with correct information, you can manage many aspects of your health care that were once thought possible only with the help of a physician. Answers to the following questions provide clues to the use of health-care services, providers, and products and facilitate the self-care approach to wellness: When should you seek health care? What can you expect from a stay in the hospital? How can you select a health-care professional? When To Seek Health Care Many people tend to fall into two extreme groups regarding health care: those who seek health care for every ache and pain and those who avoid health care unless experiencing extreme pain. Both groups unwisely use the health-care establishment. Those in the first group fail to understand that too much health care can be ineffective or even harmful. They also fail to recognize the powerful recuperative powers of the body. An estimated 80% of patients who seek medical care are unaffected by treatment, 10% get better, and 9% experience an nitrogen condition in which they get worse because of the medical treatment. Those in the latter group fail to recognize the value of early diagnosis and detection of disease. This is especially true for men; 30% of men have not been to a doctor in a year or more, one-third have never had their cholesterol checked, and three fourths have not been checked for prostate cancer during the previous year. Perhaps the best way to find a balance between too much and too little health care is to establish a physician-patient relationship with a general practitioner. The general practitioner may be a family practice physician or an internist who specializes in internal medicine. It is important to visit your doctor while in good health. This permits your doctor to serve as a facilitator of wellness and provides a benchmark for interpreting symptoms when they occur. A second important way to balance health care is to trust your instincts. Nobody knows when some thing is wrong with your body better than you do. Health and illness are subject to a wide variation in interpretation. If you are attuned to your body, you are your own best expert for recognizing signs and symptoms of illness. Several signs and symptoms warrant medical attention without question. Internal bleeding, such as blood in urine, bowel movement, sputum, or vomit, or blood from any of the body’s openings requires immediate attention. Abdominal pain, especially when it is associated with nausea, may indicate a wide range of problems from appendicitis to pelvic inflammatory disease and requires the diagnostic expertise of a physician. A stiff neck when accompanied by a fever may suggest meningitis and justifies immediate medical intervention. Injuries, many first aid emergencies, and severe disabling symptoms require prompt medical care. There is debate as to when medical care is needed in the case of fever. An elevated temperature may be a sign that the body’s immune system is responding to an infection and working to destroy pathogens, or disease-producing organisms. On the other hand, if left untreated for an extended time, a fever may cause harm to sensitive tissues in the body, such as connective tissue found in joints and tissues in the valves of the heart. The normal body temperature of 98.6° F was studied at the University of Maryland. Findings involving 700 temperature readings of 148 adults over a 3-day period suggest that the normal body temperature is 98.9° F. The study attributed the difference to less accurate techniques when the earlier standard of 98.6° F was established. Body temperature varies with exercise, rest, climate, and gender. Fever means a reading over 99° F. It is not usually necessary for an adult to seek medical care for a fever. Home treatment in the form of aspirin, acetaminophen, and sponge baths usually lowers fever. You should consult your physician if fever remains above 102 0 F despite your actions or, in the case of a low-grade fever (99 0 to 100 0 F), if there is no improvement in 72 hours. You should consult a physician if fever lasts more than 5 days, regardless of improvement. Symptoms, such as sore throat, ear pain, diarrhea, urinary problems, and skin rash, may be the cause of the fever and should be treated as such. Fever in young children should be discussed with a physician.

Internal Medicine Transcription

What is internal medicine transcription? It is a service offered by professional transcription companies that serves specialists/ internist and physicians from the internal transcription sector. With the demand for transcription on the increase many professionals have started specializing in the transcription in the different branches of medicine. Internal medicine has its origin in the German language. By definition Internal medicine is the branch of medicine that deals with the diagnosis and non-surgical treatment of diseases that affect the internal organs of the body, especially in adults.Internal medicine has also been called by the name of general medicine. What are the different branches of internal medicine?CardiologyEndocrinologyGastroenterology (diseases of the stomach, intestines and associated organs)Hematology (the study of blood and blood producing organs)Infectious diseasesMedical oncologyNephrology (deals with the kidneys, their functioning and disorders)Pulmonology (diseases of the respiratory system)RheumatologyIn the United States, primary health care is given by family practice physicians or general internal medicine physicians. Medical history of the patient and physical examination are of prime importance in internal medicine. Based on visible signs and symptoms, the doctor can identify the nature of disease. Internal medicine doctors depend to a great extent on blood tests, X rays, medical imaging and such other tests. Once the basic tests are conducted, the doctor will have made his diagnosis; in case he needs to make clarifications, he might order other comprehensive tests as well.Internal medicine transcription specialties include,Clinical cardiac electrophysiologyCritical care medicineGeriatric medicineInterventional cardiologySports medicineTransplant hepatologyAllergy/immunologyNuclear medicine.Even though Internal medicine treatments mainly focus on diagnosis and medication, some sub-specialties like gastroenterology, nephrology and oncology recommend non surgical procedures such as endoscopy.

You’re at your doctor’s for an annual physical. He checks your blood pressure, listens to your heart, takes some blood and may even have you cough. He tells you that you’re as healthy as an ox, but just shrugs his shoulders when you complain of low energy, joint pain and lowered libido.

The health care professionals at the December 2000 conference of the American Academy of Anti-aging Medicine stated that this type of treatment is outdated. 3100 doctors from 30 different countries listened to researchers from Harvard, Scripps, Stanford and Brown schools of medicine. Some of their views seemed revolutionary. “The stethoscope should be relegated to the Smithsonian,” says Dr. Harvey Eisenberg, former professor of Radiology at U.C.L.A. The new full body CT scan, “Can, in seconds, uncover the earliest stages of disease that traditional tests would not see for years.”

Even blood tests are taken to task. “Blood tests, as typically ordered by most doctors, checks for diseased organs but will not catch the early abnormalities seen in functional laboratory tests,” says Dr. Bradley Rachman, director of the department of medical sciences at Great Smokies Laboratory (a leading functional laboratory).

Dr. Ronald Klatz, M.D., D.O., founder of the American Academy of Anti-aging Medicine agrees with the need for functional laboratory testing but laments that most doctors, “Don’t learn functional medicine in medical schools.” Dr. Klatz continues, “If we want to keep people well, we have to test and optimize their metabolism …not just check for disease as has been done in the past.”

Samual Fink, M.D., internist and spokesman for the Los Angeles County Medical Association, disagrees with this untraditional approach. “ ‘High-tech’ and expensive procedures and tests are no substitute for spending time with the patient.” He feels that a thorough case history and such time honored protocols as colonoscopies (for those over 50 years old), chest x-rays in smokers and baseline E.K.G.’s may not be glamorous, but have proven value. He feels that much of the newer tests show many positive findings that lead to unnecessary, dangerous and expensive follow-up procedures.

Alan Mintz, M.D., director of Cenegenics, one of the nations largest anti-aging centers, is adamant about using the latest examining tools. “We are at our best around 30 years of age, having the lowest incidence of disease, accidents and other health concerns. Later our beneficial hormones drop and others may rise to our detriment.” He asserts that this leads to a decrease in muscle mass, mental alertness, bone density, libido, energy and mood. So what should one expect from their doctor when going for their yearly physical exam?

Most practitioners agree on the basics:

A. Checking the vital signs.

B. Palpation (examining) of the breasts, prostate, lymph nodes and testis.

C. Auscultation (listening) to the heart, lungs and bowel sounds.

D. A complete blood count and chemistry panel.

E. Cancer screening tests such as PSA, mammograms, testing for occult blood and colonoscopy.

But this is where the consensus ends. The use of these new “high-tech” methods often is determined by the philosophy of the doctor that you choose.

Dr. Alan Mintz feels that a comprehensive exam should include:

A. Sophisticated cardiopulmonary stress tests which includes nuclear imaging. “It is the most thorough way to check for heart disease (the number one cause of death in our country).”

B. Full body bone density and body composition analysis which are “excellent biomarkers and are extremely important indicators of overall health and possible early aging.”

C. Blood tests to comprehensively measure hormone levels. Dr. Mintz asserts that “normals change with age, but optimal levels don’t.”

D. Neurocognitive Chronometric Analysis—a computer, interactive program that detects early signs of dementia.

Jeffrey Bland, PhD., president of the Institute for Functional Medicine and Chief Science officer of Metagenics, Inc., suggests the following tests as part of your yearly examination:

A. Homocystein blood level which is an excellent predictor of cardiovascular diseasee, stroke, cancer and psychiatric illness (including Alzheimer’s and Dementia).

B. Genetic markers to find your predisposition towards various diseases allowing the patient and doctor to be more vigilant about prevention.

With the advent of such advanced and sensitive testing as full body CT scans, genetic markers and neurocognitive analysis, today’s physical examination is going through a renaissance. Whether your doctor makes use of them appears to depend more on his philosophy, education and your financial ability than probably your need.

As in all forms of consumerism, the buyer should be aware, informed and ask a lot of questions. Years from now the sensitivity and reliability of these tests will be known and others will be called into question. Our office uses the latest tests and information and makes our patient’s aware of their benefits and limitations. It’s the partnership between us our patients, and their medical physicians that guarantee their best health and longevity.

About the author: Dr. Rick Morris is the founder of the The Morris Spinal Stenosis and Disc Center in Santa Monica, Ca. You can read more of his health articles or contact him at his website and find out about his non-surgical treatment of low back pain disorders

Learning how to better communicate with your health care professional is perhaps the most important way to improve your health literacy.

“Understanding medicine’s peculiar terminology and instructions can be difficult for even the most educated patient,” says William B. Applegate, M.D., MPH, FACP, Chair, American College of Physicians (ACP) Foundation, which strives to improve the health and welfare of patients and society through initiatives that provide patients with the information they need to understand and manage their health.

“It can be nearly impossible,” adds Applegate, “for the millions who have difficulty reading, aren’t fluent in English, or have age-related vision or cognitive problems.”

It’s important to create a basic plan before meeting with your doctor of internal medicine (internist). Before your appointment, make a list of:

• your symptoms, which might include pain, fever, a lump or bump, unexplained weight gain or loss, change in energy level, difficulty sleeping, or feelings such as confusion or sadness

• your medications, including prescription drugs, over-the-counter (nonprescription) drugs, vitamins, herbal remedies or supplements, laxatives and eyedrops

• any assistive devices such as canes, walkers, scooters, hearing aids, reachers, grab bars and stair lifts.

When listing symptoms, be specific. The list should include:

• what the symptom is

• when it started

• what time of day it happens and how long it lasts

• how often it happens

• any

At the moment of writing this article, there is not an entry in the Social Security Disability Listing for Impairment for the condition Fibromyalgia. Nor is there for its other names commonly used such as fibromyositis or Myofacial Pain Syndrome. Getting denied of claims is quite common ground for Fibromyalgia patients, but this doesn’t have to be the case.

There is hope for the fibromyalgia patient who needs to claim disability. Many fellow sufferers have gone on to win their cases, you likewise can. The trick is to pursue the claim of disability through the appeal process.

After a person files at the Social Security Office, the case is transferred to DDS, an agency responsible for making the decisions on Disability. Once it is in this agency, the claim is assigned to a specialist who then makes the determination to approve or decline the disability claim.

So why is it so hard to get approved for disability when fibromyalgia is so disabling? Well, the reasons are many. SSD will generally give very little weight to this condition because the condition is not well understood. Your chances get even less when there is not another condition that is accompanying it such as arthritis or some degenerative disease.

Part of the problem is also that the causes are not fully understood and symptoms can range from mild to severe, from one patient to the next. This is why it helps if Fibromyalgia is diagnosed in conjunction with another diagnosis. This is because Fibromyalgia will be seen more legitimately and logical if it is an extension of another “more real” diagnosis.

Another factor is who makes the diagnosis. A diagnosis coming from a Rheumatologist will hold much more weight than if made by a family practitioner or an internist. The label of a specialist holds more umph when it comes to decision time.

This, of course, is no fault of the fibromyalgia sufferer, but there are some tips you can follow to increase your chances of winning your case. The chances of winning are improving as more information about fibromyalgia comes out. So let’s get to the tips for a winning case.

If you want to claim Fibromyalgia for your disability make sure that it has been diagnosed and is in your medical records. If a doctor merely mentions fibromyalgia as a possibility without diagnosing it and charting it, you could be out of luck. So, make sure it is in your medical records.

Make sure that you have been diagnosed by a specialist. If your family doctor makes the diagnosis, have a specialist such as a rheumatologist give you the same diagnosis. Like previously mentioned, diagnosis from a specialist will hold more weight.

This sounds brutal but try not to be diagnosed with Fibromyalgia by a mental health worker. Psychiatrists and those in the mental health arena sometimes overdiagnose patients with Fibromyalgia and so it does not look valid to the SSD agents. If you are diagnosed by a mental health provider, make sure that you are also seen by a specialist such as a rheumatologist to validate the diagnosis.

Be informed and know what’s in your records. Make copies of everything. It is well known that social security disability cases are decided on records. This holds true for all levels of administration that your case will flow through. By obtaining copies of your medical records before you apply, you will have an idea of how your case looks to the decision makers and help you know if you need to see another doctor before applying.

These simple tips will help you in your fight to win your disability case. Fibromyalgia disability cases can be won and the more that do the easier it will get for our fight.

Copyright (c) 2007 Hailey Harris