What is a Family Doctor?
A family doctor is a medical doctor that specializes in the branch of medicine that focuses on health care for both genders and all ages. Family practice is a medical specialty that diagnoses and treats over 90% of all patient problems.
Family doctors specialize in treating the physical, mental and emotional well-being of their patients. As a result, they work closely with their patients and other sub-specialties to coordinate care for more complicated and special problems. Family doctors immunize children against infectious diseases such as influenza, measles, meningitis and mumps.
Family doctors spend much of their time conducting regular health care examinations, preventative medicine and general health practices. Preventative services generally include physical exams, immunizations, diabetes education and PAP tests. Family doctors consult and advise for chronic medical problems such as hypertension, weight loss management, asthma, depression and diabetes. Most family doctors offer services for walk-in urgent care for injuries and sudden illnesses.
Family doctors are well-educated and are trained in all major medical areas. Their education is ongoing in learning new treatments and medications for various diseases and ailments.
Finding a Family Doctor
Choosing a family doctor is an important decision. Thus, our goal is to assist you in making that decision. First of all, when selecting an family doctor, you may want to begin your search several different ways:
|Ask family, friends, neighbors and/or co-workers.|
|Contact your local Chamber of Commerce or Better Business Bureau for reputable family doctors.|
|Contact your city, county or state medial agencies for names of qualified family doctors.|
|Contact and ask for referrals from medical associations. Many are listed in this publication.|
We recommend that you interview the family doctor and ask the following:
|Is your staff friendly and accommodating?|
|Do you have two waiting rooms, one for sick people and one for healthy people that are just in for check-ups and vaccinations?|
|Do you take walk-in patients, or is it by appointment only?|
|What are the procedures if we need a doctor in the middle of the night or on a weekend?|
|Do you have an associate that covers for you when you are not available?|
|Do you have more than one office and if so, how is your time divided between offices?|
|What kind of continuing education do you utilize?|
|Do you accept phone calls during office hours?|
|How do you stay current on the latest drugs and prescriptions available, medical testaments, nutrition, and child development concepts?|
|What types of insurance coverage do you accept?|
|How do you handle billing? Do you require payment at the time of visit?|
|Discuss your family medical history and particular problems you are concerned about.|
After you have consulted a few family doctors you should have a good idea which one you felt most comfortable with and best answered your questions.
How Family Doctors Were Selected
Consumers’ Research Council of America has compiled a list of top Family Doctors throughout the United States by utilizing a point value system. This method uses a point value for criteria that we deemed valuable in determining the top family health care professionals.
The criteria that was used and assessed a point value is as follows:
Each year the Physician has been in practice
Education and Continuing Education
Membership in Medical Associations
Completing an approved residency program and passing a
Simply put, family doctors that have accumulated a certain amount of points qualified for the list. This does not mean that doctors that did not accumulate enough points are not good doctors, they merely did not qualify for this list because of the points needed for qualification.
Similar studies have been done with other professions using a survey system. This type of study would ask fellow professionals who they would recommend. We found this method to be more of a popularity contest. For instance, professionals who work in a large office have much more of a chance of being mentioned, as opposed to a professional who has a small private practice. In addition, many professionals have a financial arrangement for back-and-forth referrals. For these reasons, we developed the point value system.
Since this is a subjective call, there is no study that is 100% accurate. As with any profession, there will be some degree of variance in opinion. If you survey 100 patients from a particular physician on their satisfaction, you will undoubtedly hear that some are very satisfied, some moderately satisfied and some dissatisfied. This is really quite normal.
We feel that a point value system takes out the personal and emotional factor and deals with factual criteria. We have made certain assumptions. For example, we feel that more years in practice is better than less years in practice; more education is better than less education, being board certified is better than not being certified, etc.
The Top Family Doctors list that we have compiled is current as of a certain date and other family doctors may have qualified since that date. Nonetheless, we feel that the list of Top Family Doctors is a good starting point for you to find a qualified health care specialist.
No fees, donations, sponsorships or advertising are accepted from any individuals, professionals, corporations or associations. This policy is strictly adhered to, ensuring an unbiased selection.
Immunization is a method of developing resistance within the human body for specific diseases using microorganisms that have been killed or modified. Immunization is also known as vaccination or inoculation. Immunization has drastically reduced the number of serious and deadly diseases. The success of vaccines speak for themselves. In 1962, the year before measles vaccine was introduced, there were over 500,000 cases reported. Currently less than 100 cases per year are now reported. The number of cases of Meningitis in the United States for children and infants has dropped 96% since the the vaccine was introduced in 1988.
A vaccine may consist of a living organism that have been purposely weakened or altered. The microorganisms have been modified enough so that the human body will create immunity and not the actual disease. The theory of vaccinations are based on the ability of a person’s immune system to respond much faster and more effectively to a microorganism the second, third or fourth time that the immune system confronts the invading organism. Some immunizations protect a person for their entire life. Many other vaccines, such as Tetanus, require booster shots at required intervals to provide continued protection.
The American Academy of Pediatrics and the U. S. Public Health Service recommends a series of immunizations beginning at birth. For your convenience we have provided a Recommended Childhood Immunization Chart in a separate chapter. Check with your Pediatrician for any risks and side effects associated with the vaccines that could affect you child.
Hepatitis B is a disease that affects the liver. Some people who have the virus Hepatitis B never feel sick, while others have symptoms that can last for a few weeks. These symptoms include jaundice (yellowish tone to skin and eyes), pain in muscles, pain in joints, vomiting, diarrhea, loss of appetite, and tiredness. In the United States alone there are over one million chronically infected with the Hepatitis B virus. Many of these chronically-infected people will suffer from serious health problems such as Cirrhosis or liver cancer. The Hepatitis B virus is the leading cause of liver cancer in the world.
Hepatitis B is spread through contact with body fluids and blood of an infected person. This disease is also spread by sharing personal items like toothbrushes and razors with an infected person. Another way that this disease is spread is through unprotected sex and needle-sharing associated with drug use.
You can protect your child by getting them vaccinated with three doses of the Hepatitis vaccine. A newborn should get the first vaccine between birth and two months old, the second vaccine between one and four months and the third vaccine between six and eighteen months of age.
HIB (Haemophilus Influenza Type B)
HIB disease was the leading cause of bacterial Meningitis in children under five years of age. Approximately 12,000 children contracted Meningitis (inflammation of the covering of the brain) as a result of HIB. About 25% of these children suffered permanent brain damage and close to 5% died.
HIB is a bacterial disease that is spread through the air by coughing and sneezing. When the bacteria enters the blood system or lungs it is then called “invasive” HIB disease. This type of HIB can cause complications that lead to Pneumonia, Arthritis and Epiglottitis. Most of the time this type of HIB occurs in children under the age of five.
Great success has be realized with the Hemophilus Influenzae Type B vaccine. The first vaccine came out in 1985 and soon afterward the disease began to disappear. In 1985 there were over 20,000 cases of HIB and now there are only a few hundred cases per year.
Children should get three to four doses of the vaccine: The first dose is recommended at two months of age, the second dose at four months and the third dose between twelve and fifteen months of age. Children who are over five years old do not need the HIB vaccine.
Polio is caused by a virus that resides in the throat and intestinal tract. Polio is spread through contact with feces and bowel movements of an infected person. Polio was one of the worst diseases in the past century. In 1916 it had killed over 6000 people and had left over 27,000 paralyzed. Today, there is no Polio in the United States but it is still common in other parts of the world.
Some children who get Polio become paralyzed. This type of Polio is called paralytic Polio. It can start out like a common cold, and soon the victim will develop severe muscle pain. Paralysis starts within the first week and most often affects the muscles in the legs. Some children can recover but most will become permanently disabled. Once contracted, there is no treatment for Polio.
Children should get four doses of IPV (Inactivated Polio Vaccine). The first dose should be administered at two months of age, the second dose at four months, the third dose between six and eighteen months and a booster between four and six years of age.
DTaP (Diphtheria, Tetanus and Pertussis)
DTaP is three vaccines, Diphtheria, Tetanus and Pertussis, combined into one. A child needs five DtaP vaccines for maximum protection. The first three shots should be given at two, four and six months of age, the next vaccine at fifteen to eighteen months and a booster between the ages of four and six.
Diphtheria is a bacterial disease that resides in the mouth, throat and nose of an infected person. The disease is spread through the air by coughing and sneezing. This disease was a major cause of childhood sickness and death. In 1920 over 150,000 were infected with Diphtheria and about ten percent of them died. Today there are only a few cases a year.
Tetanus is a bacterial disease that can live anywhere and can be found in soil, dust and manure. Tetanus enters the body through cuts and scratches on the skin. It can get through even a tiny pin-prick but it is more common with deep puncture wounds or cuts. Tetanus produces a poison in the body that causes muscle spasms in the arms, neck, legs and stomach. It has been known to cause such powerful muscle contractions that it will actually break a child’s bones. Tetanus is not contagious.
Pertussis, also known as ‘whooping cough’, is a very contagious disease and is common in the United States. It is caused by a bacteria that resides in the mouth, throat and nose. Pertussis is spread via the air by coughing and sneezing. This disease causes such severe coughing that it can continue until the air is extracted from the lungs, causing a person to make a loud ‘whooping’ sound as they gasp for air. Children have be known to turn blue from lack of air, vomit and experience problems eating and drinking.
Pneumococcal disease is a bacterial disease that kills more people in America each year than all other vaccine-preventable diseases combined. This disease is the leading cause of bacterial Meningitis. Over 200 children die from invasive Pneumococcal disease each year.
This disease is spread through the air by coughing and sneezing. There are over 90 strains of the Pneumococcal bacterium. Pneumococcal disease is the leading cause for all middle ear infections in children. It is becoming more resistant to antibiotics, making the vaccination increasingly important.
Children should get four doses of the vaccine. One dose at two, four and six months of age and the last dose between twelve and fifteen months. It will not prevent all, but many of the ear infections caused by the Pneumococcal bacteria.
The MMR is a combination of three vaccines in one, Measles, Mumps and Rubella. This vaccine works well and should protect a child for the rest of their lives. Children should get two doses of the MMR vaccine. The first dose should be given at twelve to fifteen months of age and the second dose at any time twenty eight days or more later.
Measles is a deadly disease that kills over one million people a year through out the world. Most children get a rash and a cold and need to stay home for a few days. Approximately ten percent of children with Measles get an ear infection, and five percent will get Pneumonia.
Measles is caused by a virus that spreads very easily to any child that is exposed it. Measles is airborne and is contracted through coughing, sneezing and close-contact conversation. Before the Measles vaccine in 1963 there were over 500,000 cases reported each year and over 3 million cases went unreported. Today there are only a few hundred cases a year.
Mumps is a virus that is spread through the air via coughing, sneezing or close-contact conversation. Children get Mumps through others who are already infected. Common signs of Mumps is swelling of the cheeks and jaw and many sufferers get a headache and fever. Approximately ten percent of children who get Mumps also get Meningitis, but generally Mumps is a mild disease.
Rubella is also known as ‘German Measles’ and ‘3 day measles’. Rubella strikes children, teenagers and adults who have not been vaccinated. The Rubella vaccine was first licensed in 1969. Prior to that, in 1965, there were 12 ½ million people who contracted the disease. Today there are only a few hundred cases reported per year . The biggest threat of Rubella is to unborn babies; If a woman gets Rubella during the first few months of pregnancy there is an 80% chance that the baby will have some type of birth defect.
Varicella (Chicken Pox Vaccine)
Chicken Pox is caused by a virus and can be spread very easily from person to person. The virus is airborne and is contracted through coughing, sneezing and close-contact conversation. Chicken Pox is generally a mild disease but serious problems can still occur. The Chicken Pox blisters can become infected and as a result, some children contract Encephalitis (infection of the brain).
A single dose of the Varicella vaccine is recommended for children between the ages of 12 to 18 months. Children who miss this vaccination can still get it up to the age of thirteen. Data suggests that the vaccine is 70 to 90% effective in preventing Chicken Pox and 95% effective in preventing a serious outbreak of the disease.
Hepatitis A is a disease that affects the liver like other types of Hepatitis. Hepatitis A is a caused by a virus found in feces and bowel movements and is spread through personal contact, or drinking and eating contaminated food or water.
Unlike Hepatitus B, Hepatitis A does not cause long-term illness or liver damage. Signs of Hepatitis A include fever, vomiting, stomach pain, loss of appetite, tiredness, dark urine and jaundice (yellowish tone to the skin and eyes). Blood testing is required to determine which type of Hepatitis is present.
Hepatitis A vaccine requires two doses. The first dose can be given to children two years of age or older and the second dose should be given six to eighteen months after the first dose.
What is an Allergy?
An allergy is a reaction of the body to foreign substances such as dust, pollen, insect bites, drugs, animal fur, animal excretions, smoke, plants, feathers, cosmetics, chemical pollutants, and various kinds of foods. It is estimated that over 40 million Americans suffer from some type of allergies. It is common for people to think that they have a cold or flu, only to find out that they have an allergy. Many times the symptoms are very similar.
Symptoms generally include, watery eyes, sneezing, nasal congestion, itchy skin, rash and upset stomach. Most allergies are reactions to substances that are generally harmless. When your immune system reacts to an allergen that has been absorbed into the body, the body now treats the allergen as a harmful invader and causes the white blood cells to produce antibody molecules called Immunoglobulin E (IgE). When this series of events happens it causes the body to release Histamine, which can cause allergic symptoms such as watery, itching eyes and sneezing.
Diagnosis of Allergies
Allergies are diagnosed from the patient’s medical history, skin and patch tests to help identify the allergen. Physicians inject common allergens just below the skin in separate sections to see which substance is causing redness and swelling. This test determines which allergens the person is sensitive to.
Mold allergies are very common. The sources of mold in the home are found where there is moisture. Common places are in damp basements, closets, refrigerator drip pans, house plants, air conditioners, humidifiers, garbage pails, shower stalls, toilets, old foam rubber pillows, and plumbing leaks. Humidity promotes the growth of various molds.
Weight control is an important part of our culture. We are reminded daily in our society that being overweight is not “in” or fashionable. Just look at TV or any type of media advertising and you will soon see that being thin and in good shape is what is popular.
Your primary goal should be to have a healthy body. Healthy bodies come in different shapes and sizes. Weight control is just a part of having a healthy body. Other factors include your diet, nutrition and the amount and kind of exercising you are getting. Displayed later on in this chapter is a height/weight chart that will serve as a guideline.
When you see your family doctor they will check your height, weight, and blood pressure, blood lipids, (cholesterol, triglycerides), and blood sugar (for people with diabetes). All of these involve medical conditions related to weight. Proper weight control and weight management can help provide for a healthy body.
Obesity is basically a medical condition that signifies the excess storage of body fat. It is normal for the body to store fat tissue under the skin and around joints and organs. Fat is essential for good health because it provides energy when the body demands it and provides insulation and protection for vital organs. It is the accumulation of too much fat that poses the health problems of obesity. These health problems include diabetes, hypertension , stroke, heart disease and arthritis.
The United States has one of the highest percentages of obese adults. It is estimated that over 36% of adults in America are obese. Obesity is most common among minorities, especially minority females. Over 50% of African-American and Mexican-American women are obese. Over 20% of children between the ages of 6 to 17 fit in the obese category.
A primary concern of obesity is the risk of developing disease. Obese people are twice as likely to develop high blood pressure and over 70% of heart disease cases are linked to excess body fat. Obese women are twice as likely to develop breast cancer and 40% more likely to develop colon cancer. Close to 80% of Type II or non-insulin dependent diabetics are obese.
Obesity is partially determined by genetic makeup. Research has revealed that basal metabolic rate and the size and number of a person’s fat cells help in determining the amount of weight loss that is possible. When calories from food intake equal the amount of energy that the body requires to function the weight remains the same. However, when more calories are consumed than the body needs, the body will store the extra calories, resulting in weight gain.
Diets are the most common treatment for obesity. There seem to be countless diets that are promoted and it is recommended that your weight control diet be supervised by a your family doctor. Most health care professionals will recommend a diet that consists of 1200 – 1500 calories per day. People who are over 40 pounds overweight may require a more aggressive approach and may be put on a restricted diet of 500 to 800 calories per day.
There many types of weight loss medications on the market today but there are also many side effects that include insomnia, anxiety and irritability. Your family doctor can evaluate your particular condition, health issues and can recommend weight-loss medications under the right circumstances. Used correctly, they can be very effective in the treatment of overweight people.
Exercise should be an important part of your weight management plan. Calorie reduction alone is not a complete plan will not result in long-term weight loss. Regular exercise is a long-term plan for continuing weight reduction. Exercise will also improve some of the medical conditions associated with obesity which include high cholesterol levels, high blood pressure and diabetes.
A long-term exercise plan sometimes requires lifestyle and behavior modification, which can be hard for many obese people to accept. Successful weight management plans require strong discipline to control eating urges and to implement exercise plans. New habits need to be learned and many old bad habits need to changed, such as food types consumed and unproductive eating habits.
When choosing an exercise program, the person should consult their family doctor. The exercise program will be designed around the person’s work capacity, which will be determined by your doctor. Exercise tests using the treadmill or stationary bicycle are the most common ways to determine and measure work capacity. Once your work capacity has been determined, an exercise program can be recommended. The formula will include what your training heart rate should be and how much intensity should be expended during your work out.
An exercise program can be the most important part of your weight management program because it will give you so many other added health benefits. Many studies show a direct correlation between physical fitness and mental achievement.
The following chart provides healthy weight ranges for different body sizes and builds:
|Height||Small Frame||Medium Frame||Large Frame|
|4′ 10″||102 – 111||109 – 121||118 – 131|
|4′ 11||103 – 113||111 – 123||120 – 134|
|5′ 0″||104 – 115||113 – 126||122 – 137|
|5′ 1″||106 – 118||115 – 129||125 – 140|
|5′ 2″||108 – 121||118 – 132||128 – 143|
|5′ 3″||111 – 124||121 – 135||131 – 147|
|5′ 4″||114 – 127||124 – 138||134 – 151|
|5′ 5″||117 – 130||127 – 141||137 – 155|
|5′ 6″||120 – 133||130 – 144||140 – 159|
|5′ 7″||123 – 136||133 – 144||143 – 163|
|5′ 8″||126 – 139||136 – 150||146 – 167|
|5′ 9″||129 – 142||139 – 153||149 – 170|
|5′ 10″||132 – 145||142 – 156||152 – 173|
|5′ 11″||135 -148||145 – 159||155 – 176|
|6′ 0″||138 – 151||148 – 162||158 – 176|
|Height||Small Frame||Medium Frame||Large Frame|
|5′ 2″||128 – 134||131 – 141||138 – 150|
|5′ 3″||130 – 136||133 – 143||120 – 134|
|5′ 4″||132 – 138||135 – 145||140 – 153|
|5′ 5″||134 – 140||137 – 148||144 – 160|
|5′ 6″||136 – 142||139 – 151||146 – 164|
|5′ 7″||138 – 145||142 – 154||149 – 168|
|5′ 8″||140 – 148||145 – 157||152 – 172|
|5′ 9″||142 – 151||156 – 160||155 – 176|
|5′ 10″||144 – 154||151 – 163||158 – 180|
|5′ 11″||146 – 157||154 – 166||161 – 184|
|6′ 0″||149-160||157 – 170||164 – 188|
|6′ 1″||152-164||160 – 174||168 – 192|
|6′ 2″||155-168||165 – 178||172 -197|
|6′ 3″||158-172||167 – 182||176 – 202|
|6′ 4″||162-176||171 – 187||181 – 207|
Cholesterol is a white-colored waxy substance found in cell membranes and is required for the body to help produce other cell membranes and a variety of hormones. The majority of cholesterol is produced by the liver, and the cholesterol levels found in our blood are affected by the types of foods we eat. Excessive amounts of cholesterol can build up in the arterial walls over time, thus causing hardening and narrowing of the blood vessels. When this occurs it increases the risk of heart disease by reducing the flow of blood.
Causes of high cholesterol include:
|A diet too high in saturated fats|
|A genetic trait of high cholesterol|
|Improper liver function|
Certain foods contain high amounts of cholesterol, and people who are concerned about reducing their cholesterol intake should avoid the following foods:
|Full-fat dairy products|
|Cream, butter, cheese, ice cream, milk|
|Vegetable fats, shortening and some margarines|
|Sausage, salami and other similar meats|
|Cakes, muffins, biscuits|
|Salted nuts, crackers|
Others can be beneficial in striving to reduce cholesterol levels. These foods include the following:
|High fiber foods|
|Whole grain bread, cereals, brown rice and whole grain pasta|
|Vegetable skin items, i.e.: potatoes (with skin on)|
|Whole grain rolled oats, oat bran|
|Fruit and vegetables|
|Lean meats , skinned poultry and fish|
Most people can reduce cholesterol by 10 to 20% by watching their diet. In many cases this is not enough and therefore other remedies are necessary. Medication may be required and research has shown that new drugs can be very effective in reducing cholesterol levels.
A person is considered anemic when blood hemoglobin level is abnormal, falling below the normal range for their age and sex. Hemoglobins carry oxygen in the blood to the cells and to help fight infections. Causes of anemia should always be investigated as it could be a sign of other more serious underlying conditions.
The most common cause of anemia is an iron deficiency. It affects over one billion people throughout the world. In fact, iron deficiency affects up to 25% of three-year-olds, 20% of women and 50% of pregnant women. Treatment is especially important for children and pregnant women.
There are certain times in life when more iron is needed than others. Growing children , pregnant women, athletes and vegetarians need adequate iron intake. Women tend to need more iron due to their iron being depleted during menstruation.
Anemia can be detected with a blood test that will show if your iron levels are below normal. If your levels are far below normal your doctor may want to do further testing to see if there is could be blood loss in the bowels.
Symptoms may include a feeling of tiredness and feeling cold, problems concentrating and prone to getting infections. Children can experience learning difficulties, stunted growth, lack of appetite and lack of fitness.
Treatments include iron supplements; adults usually take iron tablets, children can ingest a syrup containing vitamin C with a drink. Iron supplements are known to cause constipation and an overdose can be deadly. Eating foods that are rich in iron can be most beneficial.
Iron can be found in red meat- the redder the meat, the higher the iron content. Smaller amounts of iron can be found in chicken, fish, bread, breakfast cereals, beans and nuts.
Latest on IBS
IBS, also known as Irritable Bowel Syndrome and Spastic Colon, has become one of the most common digestive disorders. IBS is considered a disorder of intestinal movement and sensation. In fact, the muscles in the colon do not perform normally and begin to spasm.
IBS leads to pain and discomfort, gas, bloating, irregular bowel movements and a host of other digestive symptoms. Many of the symptoms experienced include the following:
|Heartburn and stomach acid
Panic attacks and heart palpitations
Lower back pain
The pain and discomfort experienced by people who have IBS varies in magnitude from slight discomfort to serious pain.
There are many possible reasons for IBS. The colon may be more sensitive than normal and reacts unfavorably to foods, medication, caffeine and alcohol. There are other factors that can intensify the symptoms of IBS such as stress, emotional ups-and-downs and menstrual periods in women.
In order for a physician to diagnose IBS, questions must be asked about symptoms, medical history, etc., and performing a physical and rectal examination is likely. After these initial tests the doctor may want additional tests which could include X-Rays, blood tests, checking for blood in a stool sample, flexible sigmoidoscopy to examine the rectum and lower colon or a colonoscopy to examine the lining of the colon.
Treatments include making dietary changes, stress management and medication. There are certain foods that will increase the odds of irritation which includes spicy foods, foods with a high fat content, onions, cabbage, dairy foods, caffeine and alcohol. There are also foods that can reduce that chances of irritation-causing spasms, and they include fruits and vegetables, whole grain and high-fiber foods, and increasing water intake.
Diabetes is a set of diseases in which the body cannot regulate the amount of glucose, or sugar, in the blood. Glucose in the blood gives your body energy. The pancreas is an organ that creates a hormone called insulin. Insulin allows glucose to move from the blood into liver, muscle, and fat cells, where it is used for fuel. When a person has diabetes, their body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This causes sugar to build up in your blood.
Approximately, there are 20 million people in the United States, or 7% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed with diabetes, 6.2 million people, or nearly one-third, are unaware that they have the disease.
Type 1 diabetes is an autoimmune disease in which the immune system attacks the beta cells in the pancreas that make insulin. This makes the pancreas make less amount of make insulin, a hormone which helps turn blood sugar into energy. The cells become starved of energy and there is an excess of glucose in the blood. People with Type 1 diabetes must have daily injections of insulin to live. Proper diet, exercise and home blood sugar monitoring is essential to manage the disease. If your blood sugar level becomes very high, a life-threatening chemical imbalance called diabetic ketoacidosis can develop.
Type 1 diabetes can develop at any age. However, it usually develops in children and young adults, which is why it used to be called juvenile diabetes. About 5-10% of people with diabetes have type 1.
Treatment for type 1 diabetes focuses on keeping blood sugar levels within a target range. Usual treatments are:
|Taking daily insulin injections.|
|Maintaining a healthy diet.|
|Monitoring blood sugar levels at home.|
|Getting regular exercise.|
People with type 1 diabetes can live long, healthy lives if they keep their blood sugar levels as close to normal as possible.
Type 2 diabetes is a lifelong disease that develops when the pancreas cannot produce enough insulin or when the body’s tissues become resistant to insulin. Insulin helps sugar glucose enter cells, where it is used for energy. It also helps the body store extra sugar in muscle, fat, and liver cells.
When insulin is not available or is not used properly, blood sugar rises above a safe level. If blood sugar remains high for years, blood vessels and nerves throughout the body may be damaged. This puts you at increased risk for eye, heart, blood vessel, nerve, and kidney disease. Type 2 diabetes can develop at any age, although it usually develops in adults. Between 90-95% of people with diabetes have type 2.
Type 2 diabetes is caused by insulin resistance, which occurs when the body’s cells and tissues do not respond properly to insulin. An individual’s weight, level of physical activity, and family history affect how your body responds to insulin. People who are overweight, get little or no exercise, or have diabetes in their family have an increased risk of developing type 2 diabetes.
Risk factors for type 2 diabetes include older age, obesity, family history, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Pacific Islanders are at particularly high risk for type 2 diabetes.
What other complications can diabetes lead to?
|Heart disease and stroke: Heart disease and stroke account for about 65% of deaths in people with diabetes.|
|High blood pressure: About 73% of adults with diabetes have high blood pressure.|
|Blindness: Diabetes is the leading cause of new cases of blindness among adults aged 20–74years.|
|Kidney disease: Diabetes is the leading cause of kidney failure, accounting for 40% of new cases.|
|Nervous system disease: About 60-70% of people with diabetes have mild to severe forms of nervous system damage.|
|Amputations: More than 60% of non-traumatic leg amputations occur in people with diabetes.|
|Dental disease: Almost 30% of people with diabetes have severe gum disease.
A migraine is a very bad headache that tends to recur. Migraine headaches typically last from 4-72 hours and vary in frequency from daily to less than 1 per year. Migraines seem to develop from overactive electrical impulses in the brain that increase blood flow and cause widening of blood vessels and inflammation. This activates pain signals and other symptoms, such as nausea. The more inflammation there is, the more intense the migraine. Migraine affects about 15% of the population. Migraine pain can be excruciating, and may incapacitate you for hours—even days.
Two to three times as many women as men have migraine, perhaps because the fluctuation of hormone levels is a key migraine trigger. The pattern of a woman’s migraines may be affected by her menstrual cycle and is often altered when she undergoes menopause. In addition, pregnancy or the use of oral contraceptives may change a woman’s migraine symptoms or frequency. More than 80% of people with migraines have other members in the family who have them, too.
What causes migraines?
A rapid widening and narrowing of blood vessel walls in the brain and head cause migraine headaches. This causes the blood vessel walls to become irritated and cause pain. Blood vessels in the scalp are often involved. Some of events that have been reported to causes migraine headaches include: hunger, changes in weather, nuts, fatigue, avocados, chocolate, menstrual periods, emotional stress, monosodium glutamate (MSG), and alcoholic beverages.
The use of other prescription anti-inflammatory drugs may be effective for some migraines. Migraine-specific therapies are designed specifically to treat migraine attacks.
Alternatively, there are a host of choices for patients whose headaches do not respond to the first line medications. These include calcium channel blockers, a variety of antidepressants and several other medications.
Taking a combination of drugs to prevent and treat migraine attacks when they happen helps most people with migraine to limit the disabling effects of these headaches. Women whose migraines attacks occur in association with their menstrual cycle are likely to have fewer attacks and milder symptoms after menopause.
Avoiding triggers—something that activates a migraine—may be an effective way to stop a migraine before it starts. Though they will not totally stop migraines, avoiding triggers will lessen the frequency of migraines. Migraines may be triggered by food, stress, and changes in your daily routine.
Some common triggers of migraines include:
|Consuming certain substances such as chocolate, monosodium glutamate (MSG), red wine, and caffeine.|
|Getting too much or not enough sleep.|
|Fasting or skipping meals.|
|Stress or intense emotions.|
|Strong odors or cigarette smoke.|
|Bright lights or reflected sunlight.
Arthritis is not a single disorder. In fact, more than 100 different conditions can affect the joints and their adjacent bones, muscles, and tissues. They are categorized into various major types of arthritis, depending on whether or not inflammation, infection or bleeding is the major component. All of these types of arthritis are completely different, with different presentations, symptoms and treatment.
Osteoarthritis is the most common form of arthritis. It is a non-inflammatory type of arthritis, which means that inflammation is not the key component. It is completely different from the less common rheumatoid arthritis, which is an inflammatory arthritis.
Osteoarthritis is a degenerative condition because it is caused, in part, by wear-and-tear of a joint over time. Osteoarthritis occurs in both men and women and usually develops after age 45. More than 16 million Americans, including over 50% of people over 65, have some degree of osteoarthritis.
Osteoarthritis develops in a joint when cartilage—the smooth shiny tissue that lines and cushions the ends of the bones inside a joint—begins to break down. Once the cartilage is worn down, the bones begin to grind on each other. This can be very painful. This can happen from: Prolonged wear-and-tear as we age; prior injury or damage to the joint from trauma or infection; cartilage that is altered by other disease or is genetically weak. Damaged cartilage cannot heal and become normal again.
Osteoarthritis typically strikes:
|The knees (This is the area where Osteoarthritis
is most common)
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. Autoimmune diseases are illnesses which occur when the body tissues are mistakenly attacked by its own immune system. Rheumatoid arthritis can also cause inflammation of the tissue around the joints, as well as other organs in the body. Patients with these diseases have antibodies in their blood, which target their own body tissues.
The cause of rheumatoid arthritis is unknown. Even though infectious agents such as viruses, bacteria, and fungi have long been suspected, none has been proven as the cause. Some scientists believe that the tendency to develop rheumatoid arthritis may be genetically inherited. It is suspected that certain infections or factors in the environment might trigger the immune system to attack the body’s own tissues.
Rheumatoid arthritis is a long-lasting disease that can be controlled but not cured. The goals of treatment are to relieve symptoms, maintain function, and prevent permanent disability. Though rheumatoid arthritis does not normally shorten a person’s life span, it can cause disability, depending on how severe the disease is and whether it responds to treatment.
Women suffer from this affliction two to three times more often than men. Relatives of people with rheumatoid arthritis have an increased risk of developing the disease. The siblings of severely affected rheumatoid arthritis patients are at highest risk.
A wart is generally a small, rough, cauliflower-like growth, typically on hands and feet. Warts are common, and are caused by a viral infection, specifically by the Human Papilloma Virus (HPV). They typically disappear after a few months but can last for years and can recur. A few Papilloma viruses are known to cause cancer. Certain types of warts, depending on location and cause, can be contagious from region to region, but are not transferable between species.
There are also several over-the-counter options. The most common ones involve salicylic acid. These products are readily available at most drugstores and supermarkets. There are typically two types of products: adhesive pads treated with salicylic acid, or a bottle of concentrated salicylic acid. Removing a wart with this method requires a strict regimen of cleaning the area, applying the salicylic acid, and removing the dead skin with a pumice stone. It may take up to 12 weeks to remove a stubborn wart.
Treatments that may be prescribed by a medical professional include:
|Imiquimod, a topical cream that helps the body’s immune system fight the wart virus by encouraging interferon production|
|Candida injections at the site of the wart, which also stimulate the body’s immune system.|
|Cryosurgery, which involves freezing the wart, after which the wart and surrounding dead skin falls off by itself.|
|Cryosurgery followed by surgically removing the infected spot.|
|Treatment with chemical compounds, containing salicylic acid, blistering agents, immune system modifiers, or Formaldehyde|
Duct tape occlusion therapy involves placing a piece of duct tape over the affected area for a week at a time. The procedure is otherwise identical to that of using salicylic acid adhesive pads. The duct tape method was 85% effective, compared to a 60% success rate for cryotherapy
Lactose intolerance is the condition in which lactase, an enzyme needed for proper metabolization of lactose (a constituent of milk and other dairy products), is not produced. A lactose tolerance test, a hydrogen breath test, or a stool acidity test is required for a clinical diagnosis. With lactose intolerance, the result of consuming too much lactose is excess gas production and often diarrhea. Lactose-intolerant adults can drink about 250 ml (8 oz) of milk per day without severe symptoms. Lactose intolerance is an autosomal recessive trait, while lactase-persistence is the dominant allele.
Lactose intolerance is more common among members of certain ethnic and racial groups. People of Asian, African, Native American, and Hispanic descent are more likely to have a lactose intolerance than others.
In most people, lactose intolerance remains a lifelong problem. But for some kids, it can be a temporary condition that begins after they take certain antibiotics or have gastrointestinal infections and eventually goes away.
Without lactase, the lactose in milk remains uncleaved and unabsorbed. Lactose cannot pass easily through the intestinal wall into the bloodstream, so it remains in the intestines. Soon, gut bacteria adapt to the relative abundance of lactose (relative to other sugars like glucose) and switch over to metabolizing lactose. Along the way they produce copious amounts of gas by fermentation.
The gas causes a range of unpleasant abdominal symptoms, including stomach cramps, bloating, flatulence and diarrhea. Like other unabsorbed sugars, the lactose raises the osmotic pressure of the colon contents, preventing the colon from reabsorbing water and hence causing a laxative effect to add to the excessive gas production.
There is no “treatment” or “cure” to lactose intolerance. There have been some cases where the intolerance has somehow diminished with time. It should be remembered that lactose intolerance is not all-or-nothing condition. The reduction in lactase production, and hence, amount of lactose that can be tolerated varies from person to person, and may change with age. The management of lactose intolerance involves avoiding lactose-containing products, use of alternative products or artificial lactase enzyme medication (such as pills that are taken when eating or drinking a product containing lactose).
Restless Leg Syndrome (RLS)
Restless legs syndrome (RLS) may be described as uncontrollable urges to move the limbs in order to stop uncomfortable, painful or odd sensations in the body, most commonly in the legs. Moving the affected body part eliminates the sensation, providing temporary relief. The sensations and need to move may return immediately after ceasing movement, or at a later time. RLS may start at any age, including early childhood, and is a progressive disease for a certain percentage of sufferers, although it has been known for the symptoms to disappear permanently in some sufferers.
Some symptoms include:
An urge to move, usually due to uncomfortable sensations that occur primarily in the legs.
The sensations are unusual and unlike other common sensations, and those with RLS have a hard time describing them. People use words such as: uncomfortable, electrical, creeping, painful, itching, pins and needles, pulling, creepy-crawly, ants inside the legs, and many others. The sensation and the urge can occur in any body part; the most cited location is legs, followed by arms. Some people have little or no sensation; yet still have a strong urge to move.
Motor restlessness, expressed as activity, which relieves the urge to move. Movement will usually bring immediate – however often temporary – relief. Walking is most common; however, doing stretches, yoga, biking, or other physical activity may relieve the symptoms. Constant and fast up-and-down movement of the leg is often done to keep the sensations at bay without having to walk. Sometimes a specific type of movement will help a person more than another.
Worsening of symptoms by relaxation.
Any type of inactivity involving sitting or lying – reading a book, a plane ride, watching TV or a movie, taking a nap – can trigger the sensations and urge to move. This depends on several factors: the severity of the person’s RLS, the degree of restfulness, the duration of the inactivity,
Variability over the course of the day-night cycle, with symptoms worse in the evening and early in the night.
While some people only experience RLS at bedtime and others experience it all day and all night, all sufferers notice that the RLS is worst in the evening and the least noticeable sometime in the early to mid morning.
Treatment for RLS is based on how disruptive the symptoms are. All people should review their lifestyle and see what changes could be made to reduce or eliminate their RLS symptoms. These include: finding the right level of exercise (too much worsens it, too little may trigger it); eliminating caffeine, smoking, and alcohol; changing the diet to eliminate foods that trigger RLS (different for each person, but may include eliminating sugar, triglycerides, gluten, sugar substitutes, following a low-fat diet, etc.).