Topic: Health Conditions

Help for Parkinson’s Disease

Tuesday, May 28th, 2013 by American Senior Fitness Association   View This Issue of Experience!

UF&Shands, the University of Florida Academic Health Center, is the most comprehensive of its kind in the southeastern United States. The UF&Shands news release below describes a practical new resource for patients and caregivers affected by Parkinson’s disease:

University of Florida neurologist Michael Okun, M.D., has answered more than 20,000 questions from patients with Parkinson’s disease, typically not about cures or the latest treatments, but about something much simpler – how to live well with the disease. Now Okun has written a book that he hopes will help patients everywhere.

The more I talk to Parkinson’ patients, the more I realized a couple of things,” said Okun, co-director of UF Center for Movement Disorders and Neurorestoration. “Almost nothing is available to patients about basic lifestyle things in any language but English. Even in the most educated patients, who have access to everything, there are still lots of very simple things they aren’t doing. There are lots of things you can do to improve your quality of life.”

To address this need, Okun has authored a book titled “Parkinson’s Treatment: 10 Secrets to a Happier Life.” Published recently, the book is now available on Amazon and Smashwords in more than 20 languages. The e-book retails for $3.99. His goal is to reach every patient and family dealing with the disease.

Globally, about 4 to 6 million people have Parkinson’s disease, and 50,000 to 60,000 new cases are diagnosed in the United States each year, according to the National Parkinson Foundation. As people continue to live longer, the prevalence of Parkinson’s disease in the population also will increase, Okun said.

“It is really important for people to recognize this is a problem,” he said. “If you plan on living a long life, pushing up into the eighth or ninth decade, your chances of facing a disease like this are very high. You cannot escape it.”

But unlike having a disease such as Alzheimer’s, patients can live for decades with Parkinson’s — so understanding how to live well with the disease is crucial.

Some of the topics Okun covers in the book are how to prepare for hospital stays and when to take medications, as well as everyday issues such as sleeping and exercise. Chapters are also devoted to secondary problems such as depression and addiction-like symptoms in Parkinson’s patients.

“Really, these should not be secrets,” Okun said. “If you know these things, you can live a much better life with your disease.”br>
To Okun, what is perhaps most important is making the information available in languages besides English. The book was made available on both Amazon and Smashwords specifically to increase the number of possible translations. Currently, copies can be found in 20 languages, including English, Italian, German, Portuguese, Spanish, Chinese, Japanese and Arabic among others.

“There isn’t any joking with Dr. Okun about the ’10 Secrets to a Happier Life’ in Parkinson’s disease,” said Muhammad Ali, who was diagnosed with Parkinson’s in 1984, in a written statement. “This book is a critical resource for Parkinson’s disease patients and families from around the world who speak different languages but suffer from very similar and often disabling symptoms.”

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Dementia and Acting Out Dreams

Tuesday, May 28th, 2013 by American Senior Fitness Association   View This Issue of Experience!

A recent Mayo Clinic study found a link between acting out dreams and the development of dementia. For details, see the following Mayo Clinic news release:

The strongest predictor of whether a man is developing dementia with Lewy bodies — the second most common form of dementia in the elderly — is whether he acts out his dreams while sleeping, Mayo Clinic researchers have discovered. Patients are five times more likely to have dementia with Lewy bodies if they experience a condition known as rapid eye movement (REM) sleep behavior disorder than if they have one of the risk factors now used to make a diagnosis, such as fluctuating cognition or hallucinations, the study found.

The findings were presented at the annual meeting of the American Academy of Neurology in San Diego. REM sleep behavior disorder is caused by loss of the normal muscle paralysis that occurs during REM sleep. It can appear three decades or more before a diagnosis of dementia with Lewy bodies is made in males, the researchers say. The link between dementia with Lewy bodies and the sleep disorder is not as strong in women, they add.

“While it is, of course, true that not everyone who has this sleep disorder develops dementia with Lewy bodies, as many as 75 to 80 percent of men with dementia with Lewy bodies in our Mayo database did experience REM sleep behavior disorder. So it is a very powerful marker for the disease," says lead investigator Melissa Murray, Ph.D., a neuroscientist at Mayo Clinic in Florida.

The study’s findings could improve diagnosis of this dementia, which can lead to beneficial treatment, Dr. Murray says.

“Screening for the sleep disorder in a patient with dementia could help clinicians diagnose either dementia with Lewy bodies or Alzheimer’s disease," she says. "It can sometimes be very difficult to tell the difference between these two dementias, especially in the early stages, but we have found that only 2 to 3 percent of patients with Alzheimer’s disease have a history of this sleep disorder.”

Once the diagnosis of dementia with Lewy bodies is made, patients can use drugs that can treat cognitive issues, Dr. Murray says. No cure is currently available.

Researchers at Mayo Clinic in Minnesota and Florida, led by Dr. Murray, examined magnetic resonance imaging, or MRI, scans of the brains of 75 patients diagnosed with probable dementia with Lewy bodies. A low-to-high likelihood of dementia was made upon an autopsy examination of the brain.

The researchers checked the patients’ histories to see if the sleep disorder had been diagnosed while under Mayo care. Using this data and the brain scans, they matched a definitive diagnosis of the sleep disorder with a definite diagnosis of dementia with Lewy bodies five times more often than they could match risk factors, such as loss of brain volume, now used to aid in the diagnosis. The researchers also showed that low-probability dementia with Lewy bodies patients who did not have the sleep disorder had findings characteristic of Alzheimer’s disease.

“When there is greater certainty in the diagnosis, we can treat patients accordingly. Dementia with Lewy bodies patients who lack Alzheimer’s-like atrophy on an MRI scan are more likely to respond to therapy — certain classes of drugs — than those who have some Alzheimer’s pathology," Dr. Murray says.

The study’s other key researchers at Mayo include neuroradiologist Kejal Kantarci, M.D., neuropsychologist Tanis J. Ferman, Ph.D., neurologist Bradley F. Boeve, M.D., and neuropathologist Dennis W. Dickson, M.D.

The study was supported by the National Institutes of Health/National Institute on Aging, the Harry T. Mangurian, Jr., Foundation, and the Robert H. and Clarice Smith and Abigail Van Buren Alzheimer’s Disease Research Program of the Mayo Foundation.

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Anti-Smoking Campaign

Tuesday, May 28th, 2013 by American Senior Fitness Association   View This Issue of Experience!

Talk about an effective ad campaign! To learn about the current campaign to expose tragic health impacts of smoking, see the following news release from the Centers for Disease Control and Prevention:

Continuing with the success of last year’s national education ad campaign, “Tips from Former Smokers,” a second series of ads was launched recently by the Centers for Disease Control and Prevention. The ads, funded by the Affordable Care Act’s Prevention and Public Health Fund, feature compelling stories of former smokers living with smoking-related diseases and disabilities. The ads appear on
television, radio, and billboards, online, and in theaters, magazines, and newspapers nationwide.

“This campaign is saving lives and saving dollars by giving people the facts about smoking in an easy-to-understand way that encourages quitting,” Health and Human Services Secretary Kathleen Sebelius. This campaign is effective. The increase in calls to quitlines after last year’s campaign shows that more people are trying to quit smoking as a result of these ads.

The messages in these new ads are emotional, telling the story of how real people’s lives were changed forever due to their smoking or exposure to secondhand smoke. The ads feature smoking-related health conditions — including chronic obstructive pulmonary disease or COPD, more severe adult asthma, and complications from diabetes, such as blindness, kidney failure, heart disease, and amputation — and candidly describe the losses from smoking and the gains from quitting. The ads encourage smokers to call 1-800-QUIT-NOW, a toll-free number to access quit support across the country, or visit www.cdc.gov/tips to view the personal stories from the campaign and for free help quitting.

“Smoking and secondhand smoke kill — and they also harm smokers and non-smokers. The Tips from Former Smokers campaign shows the painful effects of smoking through former smokers, in a way that numbers alone cannot” said CDC Director Tom Frieden, M.D., M.P.H. “These are the kinds of ads that smokers tell us help motivate them to quit, saving lives and money."

The new ads feature Tiffany, who lost her mother when she was 16 to lung cancer, and recently quit smoking herself as her own daughter turned 16 because she did not want her daughter to suffer the way she did; Bill, a 40-year-old with diabetes whose smoking led to heart surgery, blindness in one eye, amputation, and kidney failure; Michael, who suffers from COPD, and is agonizing about how to tell his grandson he may not be around to share his life much longer; as well as Nathan, who suffered severe lung damage from secondhand smoke exposure at work. And, a new ad featuring Terrie, who appeared in last year’s ads showing what a head and neck cancer survivor has to do to “get ready for the day,” and who
wishes she had recorded her voice before she had to have her voicebox removed, since her grandson has never heard any voice but her current one.

Despite the known dangers of tobacco use, nearly one in five adults in the United States still smoke. Almost 90 percent of smokers started before they were 18, and many of them experience life-changing health effects at a relatively early age. Smoking harms nearly every organ in the body. A “tip” from Bill, the ad participant with diabetes: “Make a list. Put the people you love at the top. Put down your eyes, your legs, your kidneys, and your heart. Now cross off all the things you’re OK with losing because you’d rather smoke.”

The ads that ran last year had immediate and strong impact. Compared with the same 12-week period in 2011, overall call volume to 1-800-QUIT-NOW more than doubled during the Tips campaign, and visits to the campaign website for quit help increased by more than five times.

More than 440,000 Americans each year lose their lives to smoking-related diseases, and for every one death 20 more continue living with one or more serious illnesses from smoking. Nearly 70 percent of smokers say they want to quit. This education campaign provides motivation, information, and quit help to those who want it.

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Diabetes, Health Literacy & Antidepressants

Tuesday, May 28th, 2013 by American Senior Fitness Association   View This Issue of Experience!

Adult patients with diabetes who don’t understand basic health information are significantly less likely to take newly prescribed antidepressant medication, according to a new Kaiser Permanente study published in the Journal of General Internal Medicine.

In this study conducted by the Kaiser Permanente Division of Research and the University of Washington School of Medicine, 72 percent of the 1,366 study participants had limited health literacy, and had significantly poorer adherence to newly prescribed antidepressants, compared to patients with no limitations.

“Research shows that those with health literacy limitations are more likely to have poor control of their chronic medical conditions such as diabetes, congestive heart failure and HIV,” said Andrew Karter, PhD, research scientist at Kaiser Permanente and senior author on the study. “However, this is the first study to examine the association between health literacy and antidepressant adherence among patients with diabetes. This type of research gives our health care systems important feedback because, as providers, we often remain unsure whether the critical health information we convey to our patients is fully understood.”

The Institute of Medicine defines health literacy as the capacity for patients to “obtain, process, and understand basic health information and services needed to make appropriate health decisions.” Because nearly 90 percent of Americans have some difficulty using routine health information, the U.S. surgeon general has identified the improvement of health literacy as a national priority.

Adequate adherence for antidepressants is particularly important for patients with diabetes and other chronic medical conditions. Depression occurs twice as frequently among adults with diabetes compared to adults without diabetes, and has been associated with an increased risk of the serious diabetic complications, dementia and mortality.

In the study, health literacy was based on a self-reported scale in which participants with type 2 diabetes responded to three questions:

1. How often do you have problems learning about your medical condition because of difficulty understanding written information?
2. How confident are you filling out medical forms by yourself?
3. How often do you have someone like a family member, friend, hospital or clinic worker or caregiver, help you read health plan materials?

The study examined medication nonadherence during the 12 months after the initial antidepressant prescription, and researchers found that many patients failed to adhere to their treatment. Although most patients filled the prescription at least once, 43 percent failed to fill the prescription a second time, and nearly two-thirds had discontinued the antidepressant by the end of the 12-month period.

Poor adherence to antidepressant medications has been described previously, but what was not known is that those with health-literacy limitations were significantly less likely to take their antidepressant medications. In fact, diabetes patients with limited health literacy were much less likely to refill their antidepressant medications in a timely fashion than patients with no limitations. These patterns were not explained by other factors known to be associated with medication nonadherence, including age, race/ethnicity, English proficiency and income, which were accounted for in the study.

Depression in adults with diabetes is frequently chronic, suggesting the need for long-term antidepressant therapy. “The high rates of early discontinuation that were observed among adults with diabetes who had any health literacy limitation suggest that few of these individuals received an adequate course of antidepressant therapy. Getting that sufficient treatment is critical in preventing relapse and recurrence of depression,” said lead author Amy Bauer, MD, of the University of Washington School of Medicine. “Physicians should be aware of this. For antidepressant treatment to succeed, patients with limited health literacy may require more intensive counseling and clearer explanations about use of antidepressant medications and closer follow-up.”

The researchers said the study findings underscore the importance of national efforts to address healthy literacy, simplify health communications regarding treatment options, improve public understanding of the importance of depression treatment, and monitor antidepressant adherence.

This research was supported by funding from the National Institutes of Health.

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Exercise and Lung Disease

Monday, April 15th, 2013 by American Senior Fitness Association   View This Issue of Experience!

With medical approval, physical exercise can be very beneficial for persons with chronic lung disease. In fact, it has been shown to improve their endurance, decrease symptoms and reduce hospital stays, according to the book Living a Healthy Life with Chronic Conditions.* The authors recommend working with one’s doctor to develop a personalized exercise plan, to start out at a very low intensity level, and to progress very gradually. Over time, one’s shortness of breath at a given exertion level should begin to decrease. Following are some additional training tips specific to lung disease from the authors of Living a Healthy Life with Chronic Conditions:

Using your medicine — especially an inhaler — before exercising can help you to exercise for longer periods of time and to do so with less shortness of breath.

If you become severely short of breath upon minimal exertion, your physician may wish to adjust your medicines. For some patients, the doctor may order the use of supplemental oxygen before beginning an exercise session.

Perform lengthy, thorough warm ups and cool downs. While warming up and cooling down, breathe in through the nose, allowing your belly to expand outward, then exhale slowly through pursed lips. Establish a daily low-intensity routine on which you can build gradually.

During exercise, mild shortness of breath is to be expected. Also, prior to exercise, you may experience an "anticipatory" increase in heart rate and breathing rate. Although this is normal, it can be intimidating or tiring for some persons with chronic lung disease. A gradual warm up period including pursed lip breathing can help. Also, avoid your
personal "trouble zones" of shortness of breath by limiting exercise intensity and duration to levels well under the threshhold at which severe shortness of breath occurs.

Throughout the exercise session, breathe in deeply and slowly. Exhale through pursed lips, taking two to three times as long to exhale as to inhale. When walking, for example, if you take take two steps while inhaling, practice exhaling through pursed lips over four to six steps. Exhaling this slowly improves air exchange in the lungs and will likely increase endurance.

Note that arm exercises may cause shortness of breath sooner than leg exercises do.

Cold air and/or dry air can make breathing and exercising more difficult for persons with chronic lung disease (which is why many choose swimming as their preferred exercise activity).

With physician approval, strength training (for example, calisthenics or light weight lifting) may be especially helpful for persons who have been weakened or deconditioned due to medications such as steroids.

For exercise beginners who have low endurance or who fear exerting themselves, using a restorator can offer a greater sense of control, build self-confidence, and provide a secure, user-friendly way to get used to physical exertion. A restorator lets you stay chair-seated during exercise. You can start and stop the device as desired. It is a small piece of equipment featuring foot pedals that you place on the floor at the foot of your chair (or even attach to the foot of your bed if lying-down exercise is needed). To exercise, simply pedal. The resistance level can be adjusted, and leg length and knee bend can be accommodated by placement of the restorator. This can be particularly useful for persons who have poor balance.

*Living a Healthy Life with Chronic Conditions, Third Edition, was written by Kate Lorig, RN, DrPH; Halsted Holman, MD; David Sobel, MD; Diana Laurent, MPH; Virginia Gonzalez, MPH; and Marian Minor, RPT, PhD; with contributor Peg Harrison, MA, MSW, LCSW.

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More on Lung Disease

Monday, April 15th, 2013 by American Senior Fitness Association   View This Issue of Experience!

Not all lung disease is caused by cigarette smoking, but way too much is. And smoking can be very hard to give up. Still, there are benefits to quitting the habit at any stage of life — even after receiving a diagnosis of lung cancer or even after cancer surgery. A recent study conducted by the Moffit Cancer Center in Tampa, Florida, found that quitting prior to surgery is best.

Described by HealthDay, an affiliate of the National Institutes of Health, this study involved lung cancer patients as well as head and neck cancer patients who quit smoking either before or immediately following their surgery. The patients were followed-up for a year after surgery.

For patients who had quit smoking before surgery, the relapse rate was only 13 percent. By contrast, 60 percent of those who continued smoking during the week before surgery resumed smoking afterward. Most patients who took up smoking again did so shortly after their surgery. The researchers found that patients were more likely to relapse if they were at higher risk for depression, if they had a high amount of fear regarding cancer recurrence, and if they were less likely to trust in their ability to stop smoking.

Researchers noted that their findings underscore the importance of urging patients to quit smoking upon diagnosis and the value of offering stop-smoking programs to patients both pre- and post-surgery.

The study’s corresponding author Vani Nath Simmons stated: “Cancer patients need to know that it’s never to late to quit. Of course, it would be best if they quit smoking before getting cancer, but barring that, they should quit as soon as they get diagnosed. And with a little assistance, there is no reason that they can’t succeed.”

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Hard-to-Treat Breast Cancer

Monday, April 15th, 2013 by American Senior Fitness Association   View This Issue of Experience!

Can a diet high in fruits and vegetables reduce the risk of getting estrogen receptor-negative breast cancer?That is the question that a research team led by Seungyoun Jung, formerly of the Harvard School of Public Health, sought to answer by conducting a study recently published in the Journal of the National Cancer Institute.

Estrogen receptor-negative breast cancer is rarer than other forms of breast cancer and has a lower survival rate. The study detected a lower incidence of the disease among women who consumed high amounts of fruits and vegetables — especially vegetables. However, it failed to prove a cause-and-effect relationship. Perhaps women who eat more fruits and vegetables tend to lead healthier lifestyles overall, which would help to reduce their risks. Notwithstanding, following a diet that is rich in fruits and vegetables is clearly worthwhile.

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Fighting Obesity

Monday, April 15th, 2013 by American Senior Fitness Association   View This Issue of Experience!

UF&Shands, the University of Florida Academic Health Center is the most comprehensive of its kind in the southeastern United States. Below is a UF&Shands news release about amazing research that may lead to surprising advances in the ongoing battle against obesity:

University of Florida researchers and colleagues have identified a protein that, when absent, helps the body burn fat and prevents insulin resistance and obesity. The findings from the National Institutes of Health-funded study were published Nature Medicine.

The discovery could aid development of drugs that not only prevent obesity, but also spur weight loss in people who are already overweight, said
Stephen Hsu, M.D., Ph.D., one of the study’s corresponding authors and a principal investigator with the UF Sid Martin Biotechnology Development Institute.

One-third of adults and about 17 percent of children in the United States are obese, according to the Centers for Disease Control and Prevention. Although unrelated studies have shown that lifestyle changes such as choosing healthy food over junk food and increasing exercise can help reduce obesity, people are often unable to maintain these changes over time, Hsu said.

“The problem is when these studies end and the people go off the protocols, they almost always return to old habits and end up eating the same processed foods they did before and gain back the weight they lost during the study,” he said. Developing drugs that target the protein, called TRIP-Br2, and mimic its absence may allow for the prevention of obesity without relying solely on lifestyle modifications, Hsu said.

First identified by Hsu, TRIP-Br2 helps regulate how fat is stored in and released from cells. To understand its role, the researchers compared mice that lacked the gene responsible for production of the protein, with normal mice that had the gene.

They quickly discovered that mice missing the TRIP-Br2 gene did not gain weight no matter what they ate — even when placed on a high-fat diet — and were otherwise normal and healthy. On the other hand, the mice that still made TRIP-Br2 gained weight and developed associated problems such as insulin resistance, type 2 diabetes and high cholesterol when placed on a high-fat diet. The normal and fat-resistant mice ate the same amount of food, ruling out differences in food intake as a reason why the mice lacking TRIP-Br2 were leaner.

“We had to explain why the animals eating so much fat were remaining lean and not getting high cholesterol. Where was this fat going” Hsu said. “It turns out this protein is a master regulator. It coordinates expression of a lot of genes and controls the release of the fuel form of fat and how it is metabolized.”

When functioning normally, TRIP-Br2 restricts the amount of fat that cells burn as energy. But when TRIP-Br2 is absent, a fat-burning fury seems to occur in fat cells. Although other proteins have been linked to the storage and release of fat in cells, TRIP-Br2 is unique in that it regulates how cells burn fat in a few different ways, Hsu said. When TRIP-Br2 is absent, fat cells dramatically increase the release of free fatty acids and also burn fat to produce the molecular fuel called ATP that powers mitochondria — the cell’s energy source. In addition, cells free from the influence of TRIP-Br2 start using free fatty acids to generate thermal energy, which protects the body from exposure to cold.

“TRIP-Br2 is important for the accumulation of fat,” said Rohit N. Kulkarni, M.D., Ph.D., also a senior author of the paper and an associate professor of medicine at Harvard Medical School and the Joslin Diabetes Center. “When an animal lacks TRIP-Br2, it can’t accumulate fat.”

Because the studies were done mostly in mice, additional studies are still needed to see if the findings translate to humans.

“We are very optimistic about the translational promise of our findings because we showed that only human subjects who had the kind of fat (visceral) that becomes insulin-resistant also had high protein levels of TRIP-Br2,” Hsu said.

“Imagine you are able to develop drugs that pharmacologically mimic the complete absence of TRIP-Br2,” Hsu said. “If a patient started off fat, he or she would burn the weight off. If people are at risk of obesity and its associated conditions, such as type 2 diabetes, it would help keep them lean regardless of how much fat they ate. That is the ideal anti-obesity drug, one that prevents obesity and helps people burn off excess weight.”

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Overactive Bladder

Monday, March 4th, 2013 by American Senior Fitness Association   View This Issue of Experience!

Having an overactive bladder can interfere with one’s ability to enjoy a physically active lifestyle. Fortuitously, the drug Oxytrol (marketed by Merck) was recently approved by the U.S. Food and Drug Administration as an over-the-counter treatment for women ages 18 and older who have the condition. It remains available by prescription only to adult men.

Overactive bladder, which affects approximately 33 million Americans, may entail leakage, frequent urination and feeling a sudden, urgent need to go. Oxytrol, which is administered by applying a patch to one’s skin, helps relax the bladder muscle. During its clinical testing phase, Oxytrol’s reported side effects included dry mouth, constipation and skin irritation where the patch was applied.

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Men Who Hate Seeing the Doctor

Thursday, September 27th, 2012 by American Senior Fitness Association   View This Issue of Experience!

SFA author Jim Evans is a 45-year veteran of the health-fitness industry and an internationally recognized fitness consultant. Today Jim talks common sense to an older gentlemen who, for his own good, needs a reality check.

DEAR JIM: I’ve had a sharp pain in my lower abdomen for the past several months. It hurts like the dickens, but it comes and goes, so I haven’t been too worried about it. My wife keeps telling me to go to the doctor and have it checked, but I’ve managed to get by without seeing a doctor for the past 20 years, so why should I start now? I’m 72, and I already know I don’t take very good care of myself. I’m an overweight couch potato and proud of it, and I enjoy my TV, a good cigar and a cold beer before I go to bed every night. My wife says I’m just an old fool, and maybe she’s right, but as long as I can still tolerate the occasional pain, why should I worry? It can’t be that bad if it hasn’t killed me yet, right? Ha, ha! OLD FOOL IN FARGO

DEAR OLD FOOL: I have to agree with your wife on this one. You really are an old fool, aren’t you? Worse, a stubborn old fool. However, you’re in good company with a lot of other old fools — and young ones too. There’s a reason why women outlive men on the average, and you’re the proof.

A national survey by Loyola University Chicago Stritch School of Medicine (LUCSSM) found that women were three times more likely than men to see a doctor on a regular basis. In fact, the study indicated that "trying to get a man to a doctor can be harder than pulling teeth." Come on! I’m a guy, but even I don’t understand that kind of nonsense. Why do you hate going to the doctor so much?

"There could be as many answers to that question as male patients that I see, but more often than not it’s that it’s not a priority for them," says Timothy Vavra, DO, Loyola University Health System physician and associate professor of internal medicine at LUCSSM. "They’re not willing to make a lifestyle change, so they think it’s a waste of time listening to a doctor tell them to change the way they eat, to start exercising and stop smoking if they’re not going to do it anyway."

According to Dr. Vavra, this kind of obstinate thinking just doesn’t add up. "The longer a person puts off seeing a doctor, the more likely they’ll have to see a doctor on a regular basis," he says. "Prevention isn’t a hundred percent, but we can address issues and keep an eye out for warning signs. I have patients that, if they would’ve seen me more regularly, we could have made little changes that would have helped prevent them from having a medical crisis that resulted in a complete lifestyle change."

Are you afraid that if you see a doctor you might find out something is wrong with you? Well, the longer you wait, the more that just might turn out to be true.

"If you wait until you have a health crisis, it’s no longer preventive care," adds Dr. Vavra. "It’s secondary care, and that may include surgery and/or hospital stay. Instead of making a simple change in diet and lifestyle, a person will have to make significant changes and often be on medications. Having to see specialists, paying for procedures and taking daily medications can really affect a person’s financial health."

And, what kind of example are you setting for the young men in your family who look up to you as a parent, grandparent or relative if they see you neglecting your health and making lame excuses about not going to the doctor. My advice is to pick up the phone and schedule an appointment with your doctor as soon as possible. If you do find something wrong, deal with it. If you don’t find anything wrong, change your lifestyle and move forward so that your next appointment won’t be so traumatic. Either way, you’ll be glad you did. If you don’t do it for yourself, do it for your wife.

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