October 20, 2020 9:51:08 AM
Doing doctor visits -- digital and in-person -- the right way
Singer Lionel Richie and politician Jeb Bush have invested in a telemedicine startup called Heal that helps doctors interact with patients using a mobile app-based Uber-type service and digital appointments. It seems everyone is trying to figure out how to make doctor appointments more appealing to patients.
We're confident it will happen -- but right now, people aren't using telemedicine or in-office appointments for important routine checkups often enough. The number of primary care visits declined by more than 21 percent in the second quarter of 2020 compared to previous years. And there was a 50 percent decline in blood pressure checks and a 37 percent decline in cholesterol checks. Cases of undiagnosed cardiovascular disease may be brewing out of sight of docs and patients. And who knows what else is being missed?
So, make an appointment today for a telemedicine, in-office or combo visit. With masks, social distancing and other precautions, in-office appointments are safe. Be prepared for your appointment:
■ Keep a journal. Record symptoms or concerns so you remember to ask important questions.
■ For telemed: Get instructions on taking and sharing your vitals, such as heart rate and blood oxygen.
■ For telemed: Ask about monitoring blood pressure at home, sending in daily glucose readings electronically using a smart monitor and/or using similar devices to share info about atrial fibrillation.
■ In person: Get routine blood tests to check lipid, inflammation, blood cell and thyroid levels, kidney and liver function and more. Then you'll truly be protecting your health.
Eliminating 12 risk factors for dementia -- You can do it!
What do having little or no education, high blood pressure, untreated hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, low social contact, head injuries, excessive alcohol consumption in midlife and air pollution exposure in later life have in common?
They are risk factors for dementia and, according to The Lancet Commission on Dementia Prevention, Intervention and Care, if they're reduced or eliminated, that could prevent or delay 40 percent of dementia cases worldwide.
The commission upped their list of risk factors from nine to 12 recently, and they're sounding a wake-up call. So listen up. It can help you make sure you and your loved ones do not have to contend with cognitive impairment as you grow older.
They want to call your attention to lifestyle choices that damage cardio-cerebral health, increasing the risk of dementia: high blood pressure, inactivity, smoking, obesity, excess alcohol intake and air pollution exposure. Also risky are head injuries, hearing loss and psychological conditions such as depression. They can lead to poor lifestyle choices and/or neurological changes.
The good news is that you're never too young to protect yourself from dementia when you're old (don't smoke, protect your brain from sports-related injury, exercise regularly and eat healthy foods). And you're never too old either! Walk daily and do strength training, don't smoke, drink very little alcohol, eat a Pesco-Mediterranean diet, stay in contact with friends and family, volunteer, do/learn new things, meditate, sleep and laugh.
So, what are you going to do today to help protect your brain tomorrow?
Exercise: The RX for a healthy pregnancy for Mom and fetus
Actress Emily Blunt ("The Devil Wears Prada") says that during her first pregnancy in 2014, she was committed to staying active by continuing to do Pilates and, in her third trimester, taking long hikes in the Hollywood hills near her home. Her second pregnancy in 2016 saw her running after her 2-year-old while juggling fitness, work and family.
Blunt's efforts to stay active were wise. A new study in the American College of Sports Medicine's Health and Fitness Journal says when pregnant women get 150 or more minutes of moderate-intensity exercise three or more days a week, they reduce their risk of developing gestational diabetes, high blood pressure and preeclampsia by as much as 40 percent, without increasing the odds of miscarriage, early delivery or having a small baby. Bonus: Exercise also reduces the odds of developing depression during pregnancy by 67 percent.
Being sedentary, in contrast, can put a great deal of extra stress on a pregnant woman's body and increase the risk of complications, such as gestational diabetes, hypertension and preeclampsia, which can put both Mom's health and the health of a growing fetus in jeopardy.
However, some pregnant women should be careful about exercise, says the ACSM study. They include those with preeclampsia and intrauterine growth restriction or pre-existing cardiovascular or respiratory diseases. Those women need to start exercising slowly and monitor the results. And every pregnant woman, especially those who have not been active before becoming pregnant, should get advice from her doc before starting any routine.
Getting back in the saddle after a heart attack extends your life
Rumor has it that Nelson Rockefeller died of a heart attack in 1979 at age 70 while intimately romancing his secretary. The fate of the former vice president and heir to a family fortune reinforced the idea that sex is dangerous for someone with heart problems.
In the past, doctors explicitly told their patients that sexual activity could lead to heart attacks, but a new study suggests that sexual activity actually improves the prognosis for people with a history of heart attacks.
The research, published in the European Journal of Preventive Cardiology, is based on nearly 500 healthy adults (mostly men, average age of 53) with a history of heart attacks. The researchers found that maintaining/increasing the frequency of sexual activity within the first six months after a heart attack was associated with a 35 percent lower risk of death compared with those who abstained from or reduced sexual activity.
What's the link between sexual activity and improved health? Sex helps a person regain muscle tone (including the heart muscle) and lower blood pressure, just as moderate exercise or a walking routine does. Plus, it improves feelings of well-being and mental health.
How to get started? The American Heart Association says if you exercise hard enough to work up a light sweat without triggering symptoms, it's safe to have sex. You can also have your doc give you a stress test to put you at ease. Just don't deny yourself the improved health and joy that a mutually enjoyable sexual relationship can bring back into your life.
Is your dinner delivery dishing up hidden calories?
By now you've probably heard that an Irish court ruled that the dough used to make Subway's sandwiches does not get to be called "bread." It has too much sugar in it and is more dessert than dinner.
Clearly, it's easy to get tricked into thinking the food you're ordering for delivery or pickup is healthier than it is. Luscious photos and artful descriptions can disguise the nutritional reality. For example, Applebee's Oriental Chicken Salad is full of good-sounding chicken tenders on Asian greens, rice noodles and almonds with an Asian-flavored vinaigrette. But it delivers 1,440 calories. And Red Lobster's Create Your Own Combo sounds virtuous. But it delivers shrimp three ways with sides and a beverage for 3,600 calories, 37 g saturated fat and 6,530 mg sodium. We don't know what to say about that but, "Run!"
Your best shot at eating healthy food is to make it yourself. One study found that folks who eat 11-14 homemade meals per week have a 13 percent lower risk of developing Type 2 diabetes than folks who eat fewer than six each weekly. Another found home-cooked meals serve up fewer calories and fat than out-of-house meals. But takeout has exploded during the pandemic. So it's up to you to check online menus for nutritional info. And dodge anything with red meat, a creamy sauce or described as fried, breaded or sweet, honey, or maple. Decide what to order and eat based on calorie, fat, carb and sodium content, not just how food looks in enticing photos.
Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. To live your healthiest, tune into "The Dr. Oz Show" or visit www.sharecare.com.
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