Get Better Care From Your Doctor

How old would you be if you didn't know how old you was? ~ Satchel Paige You know you're getting old when all the names in your black book have M. D. after them. ~Harrison Ford I have enjoyed greatly the second blooming... suddenly you find - at the age of 50, say - that a whole new life has opened before you. ~ Agatha Christie Gray hair is God's graffiti. ~ Bill Cosby At my age, flowers scare me. ~George Burns Don't wait for a Second Opinion Why Now? Partner? Homework? Screening? Rx for Sanity Get Better Care From Your Doctor Prezi.com -- "Get Better Care From Your Doctor", Patricia Raymond MD Patricia Raymond MD FACP FACG Rx For Sanity www.RxForSanity.com Wrinkles should merely indicate where smiles have been. ~ Mark Twain Epidemic of Centenarians 50,000 in 2000 800,000 by 2050 Scale of 1-10 Where R U? www.RxForSanity.com N=918 males(45-59 y/o), 10 year f/u Stratified to self-reported frequency of intercourse Low: Less than q month Intermediate High: BIW or more frequent Data adjusted for variables of age, social class, systolic blood pressure, smoking, baseline CAD, cholesterol N=918 males(45-59 y/o), 10 year f/u Stratified to self-reported frequency of intercourse Low: Less than q month Intermediate High: BIW or more frequent Data adjusted for variables of age, social class, systolic blood pressure, smoking, baseline CAD, cholesterol The Caerphilly Study: Smith, Frankel, Yarnell, BMJ 1997 Sexual dissatisfaction for women is an independent risk factor for MI Abramov, Psychosom Med 1976 Lack of sex associated with death in men Lack of enjoyment associated with death in women Duke Study on Ageing Palrnore, Gerontologist 1982 Sexual dissatisfaction for women is an independent risk factor for MI Abramov, Psychosom Med 1976 Lack of sex associated with death in men Lack of enjoyment associated with death in women Duke Study on Ageing Palrnore, Gerontologist 1982 Lancet 1999 8 hours verses 4 hours in normal college students glucose intolerance identical to early adult type diabetes TSH & cortisol levels like elderly Cardiovascular disease, CHF, CVA, PVD, Type II Diabetes, Obesity, Dyslipidemia, Cancer (breast, colon, prostate, pancreas, melanoma), Asthma, COPD, Osteoarthritis, Rheumatoid Arthritis, Cognitive Dysfunction Colonoscopy Greater % of total income spent on healthcare than... But: Life expectency is 48th in world (behind most developed and some developing nations) 72nd in overall health (of 191 member nations of UN) Costs $8157 per year 15 minutes?? Write down questions! Print out history Include family history Get copies of everything BMI every visit BP every 2 years, more often if > 130/85 Cholesterol q 5 years, more often if LDL high, HDL low Fasting glucose q 3 years at 45; 30 if FH, obese, Black, Hispanic, Native American Annual mammo from 40 to forever CBE (clinical breast exam) every 3 years in 20s through 30s; annual 40s and beyond Pap smear every year by age 21 Beginning at 30, after 3 consecutive negatives, q 2-3 years After 70, with three negative and none abnormal x 10 years, may stop Prostate screening- controversial Start at 50, or 40 if Black, or father/brother had prostate cancer <65 Annual DRE or PSA? What dietary suggestions do you have for my condition? What exercise recommendations? Should I see a dietician/physical therapist/chiropractor/accupuncturist? What dietary suppliments should I be taking? Should I be taking 81 mg of aspirin? Can you help me stop smoking?