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I have arthritis. How do I prevent falls around the home during the winter months? A: There are many ways to help prevent slips and falls at home, including: • Don’t rush when doing a task. Accidents are more likely to happen when you are in a hurry and not being careful. • Always wear supportive shoes with low heels and rubber soles. • Never use a chair as a step stool. • A bedroom telephone should be easy to reach, even from the floor if necessary. • Use night lights in the bedroom, bathroom and in hallways. • Remove or replace rugs or runners that tend to slip. Tack rugs and glue vinyl flooring so they lie flat. • Remove all clutter from floors and stairways. • Have your hearing and eyesight tested. Inner ear problems can affect depth perception and balance. Impaired vision makes it difficult to see potential hazards. • Exercise regularly to improve muscle flexibility and strength. • Keep ice cleared from entrances and walks. • Paint the edges of outdoor steps and any steps that are especially narrow or are higher or lower than the rest. How can I overcome my winter blues? A: Winter blues, also known as seasonal affective disorder (SAD) affects up to five percent of the population, especially in northern states. There are many effective treatments which include increasing your daily exposure to natural light, maintaining your schedule, lifestyle and a regular pattern of sleep. Light therapy has also shown to be an effective treatment. If these techniques do not help your symptoms, you should consider consulting your family physician or a mental health professional. The winter blues are a form of depression and can be readily treated with medications or psychotherapy when other self-help methods are not effective. Are the symptoms of a heart attack the same for men and women? A: Heart attack symptoms can vary. In both men and women, the major symptom of a heart attack is chest pain. However, women often experience different symptoms than men. The symptoms can be less pronounced and can include: • Chest pain or tightness that extends to other areas like the jaw, neck, shoulders, ear or inside of the arms • Extreme fatigue or loss of sleep • Shortness of breath • Nausea and vomiting Because chest pain is less common in women, they often ignore their symptoms and delay seeking immediate treatment. How often should I have my blood pressure checked? A: You should have it checked at least annually and maybe more often, depending on your medical history and risk factors. The bags under my eyes make me look older and tired. What causes them and how can I prevent them? A: Both men and women can suffer from puffiness and bags under their eyes-something most experts attribute to a normal part of the aging process. There is fat in the under-eye area that is held in place by ligaments. As people get older, the ligaments get weaker and allow the fat to push forward, creating the appearance of a puffy pillow under the eyes. As time goes by and we lose skin elasticity, those puffs turn into bags. If and when a person gets under-eye bags is largely a question of genetics-so asking your parents when they started developing bags under their eyes may help you know when you can expect to see them, as well. But lifestyle also plays a factor. Not getting enough sleep, eating too much salt and retaining a lot of water, having a chronic sinus condition or nasal allergy, or not getting enough exercise can all contribute to puffiness and under-eye bags. There are many folk remedies for these conditions-including placing cold tea bags, cucumber slices or ice packs on the under-eye area for temporary relief. Green tea bags may work especially well because the tea contains a natural anti-inflammatory chemical known as EGCG that helps reduce swelling. For longer-lasting results, one of the new injectable wrinkle fillers, like Restylane or Juvederm, can help when puffiness and bags are just starting to develop. However, for more permanent results, a surgical eyelift may be the best answer. Consult your dermatologist to find the best solution for you. I’ve been waking up in the night with severe cramps in my legs. What causes them and what can I do? A: Nocturnal leg cramps, sometimes called “charley horses,” commonly occur in the calf or the foot, come on very suddenly, and can be excruciatingly painful. Both men and women can suffer from nocturnal leg cramps, and while they can occur in childhood, their frequency tends to increase as we age. No one really knows what causes the cramps, but studies have linked them to long periods of inactivity, dehydration, over exertion, sitting improperly, vitamin deficiency, certain medications, and some medical conditions-including diabetes, peripheral vascular disease, Parkinson’s disease, and endocrine disorders. To prevent nocturnal muscle cramps, make sure you drink plenty of water, stretch your calf muscles before going to bed, keep sheets and blankets loose around your feet, and always wear appropriate shoes. If you wake up with a cramp, try walking around or stretching the muscle to relieve the pain. You might also want to take a warm bath or shower, apply ice to the muscle, or massage the area. If the pain is severe and the cramps occur frequently, speak to your family physician about other treatment options. I’ve seen weight loss ads promoting hCG. What is it, does it work, and is it safe? The abbreviation hCG (sometimes HCG) stands for human chorionic gonadotropin. Until recently, hCG was related to pregnancy. When calories are rerouted from the mom to the baby during pregnancy, this hormone is produced to help nourish the womb. As a prescription medication, hCG is used mainly to treat fertility issues. For weight loss, hCG promoters claim injecting the hormone or taking hCG supplements will help curb appetite, lose weight, burn fat, and redistribute fat away from your buttocks and stomach. The hCG diet requires you to drastically limit your calorie intake to just 500 per day. However, the National Institutes of Health says the lowest caloric intake should be 1,200 calories per day for women and 1,500 calories per day for men. Restricting calories beyond that should only be done under a doctor’s supervision because of possible health risks. The U.S. Food and Drug Administration and the American Society of Bariatric Physicians do not recommend hCG for weight loss. Although these products may be available over the counter, there are much safer and more effective methods of weight loss. Can I use tap water to mix formula for my baby? City tap water can be used to mix formula. If your home has well water, it is best to use bottled water instead. Always use cold water and let it warm up to the right temperature. To minimize levels of lead and other contaminants in tap water, let the cold water run for at least 2 minutes before using it to mix formula. What are the guidelines for getting the measles vaccine? If you were born before 1957, you do not need to be vaccinated for measles. If you were born in or after 1957, you need to be vaccinated—with two measles doses. Children are required to have had two doses to be allowed to attend school. To receive measles vaccine, speak with your doctor. My asthma always seems worse after I exercise. What can I do to prevent this? Asthma treatment is intended to help you maintain a normal and healthful lifestyle, which includes exercise and other physical activities. Following your doctor’s advice by taking medications as prescribed, avoiding known asthma triggers, and monitoring your symptoms will help you achieve this goal. If asthma symptoms prevent you from participating fully in activities, talk to your doctor. A small change may be all that is needed to provide asthma relief during and after exercise. For instance, your physician may recommend you use a short-acting asthma medication prior to engaging in physical activity, remind you to warm up prior to exercising and cool down afterwards to help prevent attacks, or tell you to restrict exercise when you have a cold or allergies because they can increase the likelihood of exercise-induced asthma. I was recently diagnosed with depression, but I am concerned about going on medication. Are other alternatives available? Depression is a disease that affects millions of people each year. In fact, an estimated 30 to 35 million American adults are likely to experience depression at some point during their lifetime. Although no single cause of depression has been identified, research has shown depression is not a personal weakness or a condition that can be willed away, but rather a serious illness that can be treated. Although antidepressants are effective against depression, treatment doesn’t always involve medication. Psychotherapy is known to be very effective when used alone or with medication to treat depression. Depending on the type of depression you have and the severity of your illness, your physician may recommend antidepressants, therapy sessions, or both. Fortunately, if your doctor does decide to prescribe medication, there are different types of antidepressants available. If your depression does not respond to the first medicine your doctor prescribes, he or she can suggest another type of antidepressant or a combination of medicines until you start feeling better. Once that happens, your physician will reevaluate you to determine if you can gradually decrease your dosage or if you need treatment that lasts longer. My coworker keeps talking about starting a raw-food diet. Is it safe? The raw-food movement is founded on the idea that plant foods in their most natural states—uncooked and unprocessed—are most wholesome for the body. As a result, most people who start raw-food diets are more likely to say they are making a lifestyle choice, not starting a new weight-loss plan. The diet itself consists mostly of fruits and vegetables, but it may also include seeds, whole grains, nuts, eggs, and unpasteurized milk and cheese. While few medical studies have been conducted on raw-food diets, plant-based diets overall have been found to lower cholesterol and improve glucose levels, and eating raw vegetables has been linked to lower rates of oral, pharyngeal, laryngeal, esophageal, and gastric cancers. However, the American Dietetic Association (ADA) cautions that despite those benefits, not cooking or undercooking food may result in foodborne illness. People on vegan, vegetarian, or raw-food diets should also make sure they’re getting enough vitamin B12, calcium, iron, and omega-3 fatty acids—most of which are found naturally in animal products My daughter rarely eats her dinner and is hungry an hour later. How do I deal with a picky eater? While she shouldn’t be forced to eat, she should learn that her main meal of the day will be served at dinner time. You should also schedule regular visits to the pediatrician to monitor her growth and development and review her eating habits. Meanwhile, the following tips may help you prevent mealtime battles with your daughter:  • Make sure she isn’t eating a big snack   after school or filling up on juice, soda, or milk before dinner. • Offer smaller portions so there isn’t as much left on her plate. • Don’t offer bribes or rewards for eating. • Encourage your child to get involved in planning and preparing meals. back to top I think I have irritable bowel syndrome. What causes it and how is it diagnosed? Irritable bowel syndrome (IBS) is a disorder that commonly causes recurrent cramping, abdominal pain, bloating, diarrhea, and constipation. IBS is often confused with inflammatory bowel disease (IBD), which is an inflammation of the intestines that can result in ulcers or other injury to tissues and the digestive tract. Crohn’s Disease disease and ulcerative colitis are common forms of IBD. Unfortunately the cause of IBS has not been clearly defined. In some people the walls of the intestine may contract stronger and longer than normal, forcing food through the intestines more quickly and causing gas, bloating, and diarrhea. Other people may experience slow food passage, which leads to constipation. Abnormalities in your nervous system or colon may also lead to IBS. If you have IBS, your body will more than likely react to triggers, such as certain foods, medications, stress, hormones, and other illnesses. Your diagnosis will depend on a complete medical history and physical exam. Although as many as one in five American adults have signs and symptoms of IBS, fewer than half seek medical help. If you experience a persistent change in bowel habits or if you have any other signs or symptoms of IBS, make an appointment to see your doctor. These conditions may indicate a more serious condition, such as IBD or colon cancer. back to top What is RSV and what are the symptoms? Respiratory syncytial virus (RSV) is one of the causes of a viral lung infection called bronchiolitis. In infants and toddlers the symptoms of RSV include nasal congestion, fever, cough, and wheezing; older children and adults typically experience symptoms of the common cold. RSV is spread by direct contact with infected droplets and environmental surfaces. Treatment of RSV requires supportive care with close monitoring of respiratory status and hydration, as well as suctioning of the nose, encouraging fluid intake, and increasing humidity. Physicians may use breathing treatments, but these are only helpful in about one-third of cases. The most common complication of RSV is ear infection, but in rare instances children may develop pneumonia or need to be hospitalized for oxygen therapy or IV fluids.    back to top What is heart failure? Heart failure, also known as congestive heart failure, means the heart is not pumping as well as it should to deliver oxygen-rich blood to the body’s cells. As a result, fluid, or congestion, builds up in the lungs and other tissues. Heart failure usually develops slowly and symptoms worsen with time; however, patients may not have symptoms for years. This slow onset and progression is caused by the heart’s own efforts to deal with its gradual weakening. The heart tries to compensate for the weakening by becoming enlarged and forcing itself to pump faster to move more blood throughout the body. Many therapies can help ease the heart’s workload—including lifestyle modification, medicine, transcatheter interventions, and surgery. back to top Will supplements such as glucosamine and chondroitin sulfate help restore damaged knee cartilage? According to the American Academy of Orthopaedic Surgeons, approximately 27 million Americans suffer from osteoarthritis, a condition in which the cartilage between bones wears away and causes pain. Patients often try supplements, such as glucosamine and chondroitin sulfate, to help relieve their pain. Glucosamine, which is found naturally in the body, stimulates the formation and repair of cartilage. Chondroitin sulfate, another natural substance found in the body, prevents other body enzymes from deteriorating joint cartilage. Although some patients have shown some improvement while taking over-the-counter glucosamine and chondroitin sulfate, there is no definite evidence that these supplements are of value in rebuilding damaged cartilage. Be sure to talk to your doctor or pharmacist before taking these or any supplements because they can interact with other medications. back to top I’ve had several nosebleeds over the last few months. Should I be concerned or are these normal? The good news is that many people have occasional nosebleeds. These events may be scary, but they are generally just a minor annoyance. The lining of the nose contains many tiny blood vessels that lie close to the surface and are easily damaged, which can lead to bleeding. The two most common causes of nosebleeds are dry air and excessive nose picking. If a nosebleed occurs, first try sitting upright and leaning forward, or try pinching both nostrils shut with the thumb and index finger. If the bleeding doesn’t stop, repeat these steps for a total of 20 minutes. If the nosebleeds occur more than once a week, talk to a doctor. Even if the nosebleed can be stopped fairly easily, determining the cause is important. back to top How can I tell if my portion is the “right” size? Research shows nearly 25 percent of Americans underestimate the amount of food they eat each day. To keep your portion sizes in check, try to visualize these items:  • Pasta: size of one scoop of ice cream • Meat: size of a deck of cards or the size of the palm of your   hand, minus the fingers • Apple: size of a baseball • Potato: size of a computer mouse • Bagel: size of a hockey puck • Pancake: size of a compact disk • Cheese: size of a pair of dice or the size of a whole thumb from the tip to the base back to top What is cervical cancer and what can a woman do to decrease her risk of developing it? Cervical cancer is a slow-growing cancer that forms in tissues of the cervix and can be detected during a regular pelvic exam and Pap test, a procedure in which cells are scraped from the cervix and examined under a microscope. To help decrease your risk of developing cervical cancer, be sure to avoid cancer risk factors, such as smoking, being overweight, and not exercising. back to top What are the signs and symptoms of a heart attack for women? Are they different from those for men? The most common symptom of a heart attack is pain, pressure, or discomfort in the chest. However, women are somewhat more likely to experience symptoms unrelated to chest pain, including these: • Neck, shoulder, upper back, or abdominal discomfort • Shortness of breath • Nausea or vomiting • Sweating • Lightheadedness or dizziness • Unusual fatigue Since women don’t always experience the obvious crushing chest pain typically associated with a heart attack, many aren’t sure what’s wrong and delay going to the emergency room. If you experience symptoms or think you’re having a heart attack, call for emergency medical help immediately. Do not drive yourself to the emergency room. back to top What is the best way to protect myself from getting the flu? Your best prevention against the flu is to get the influenza vaccine every year. Other measures, such as proper hand washing, are very effective against many illnesses, including the flu and colds. Whether you are sick or not, you should always wash your hands thoroughly after using the bathroom, changing diapers, and coughing or sneezing. You also need to wash your hands before and after preparing food and again before eating. You can either use soap and water or an alcohol-based hand sanitizer. When is the best time to get a flu shot? Getting vaccinated before the flu season reaches its peak gives your body a chance to react to and build up immunity against viruses. Although you can benefit from a flu shot later in the season, getting the vaccine earlier—in October or November—rather than later is better for protection against illness. Flu shots are available at Mercy Quick Care Clinics and Mercy Clinic locations. back to top What are growing pains and why do children get them? While many people attribute growing pains to bone growth in children’s legs, they are more likely muscle pains due to intense physical activity. The pains often occur in children between the ages of 3 and 5 and then again between the ages of 8 and 12; they are typically felt either late in the day or in the middle of the night. Children with these pains usually do not have any other symptoms—such as limping, fever, or joint swelling—and the pain shouldn’t limit physical activity. The pains can be eased with gentle massage, ibuprofen (Motrin or Advil), and rest.  back to top Do I need to contact a physician each time my child has a fever? Knowing how to recognize when your child is sick and needs medical attention is important. Not only will you be able to get your child help when he or she needs it, but you will also prevent unnecessary visits to the doctor or emergency room. If your child has a fever, it usually can be managed safely at home using acetaminophen or ibuprofen. However, it is important to keep in mind that a fever is not the only sign of a serious illness. Seek medical attention immediately if your child is very irritable, confused or lethargic (doesn’t easily wake up), has difficulty breathing, has a rapid or weak pulse, refuses to eat or drink, has a severe headache, a persistent fever for more than 24 to 48 hours, or appears ill even after a fever is brought down. back to top Why do my joints “pop” from time to time? Is there anything I can do to prevent it? Cracking and popping of the joints is usually normal and most of the time is nothing to be concerned about; however, there are several reasons why the sounds may be occurring. One theory is that the ligaments make these noises as they tighten with joint movement. An alternative theory is that nitrogen bubbles found in the fluid inside the joints is quickly released when joints are manipulated, such as when cracking your knuckles. Patients with advanced arthritis often experience cracking or popping sounds—especially in the knees—during physical activity, such as climbing stairs. Cracking, popping, or grinding noises may also be heard in joints that have abnormal or worn cartilage. Seek advice from your physician if you experience any pain, swelling, or loss of joint movement. back to top Why are annual physicals important? Annual medical physicals are helpful for a person’s overall well-being. Regular physical examinations allow you and your physician to track any changes to your health over a period of time, which provides a more complete health history so your physician can suggest changes in your personal health habits or make plans for disease prevention. back to top I want to start a new fitness program. Do I really need to check with my doctor first? For many people, starting an exercise program for the first time is quite safe. However, checking with your physician first is a good idea because it allows him or her to determine whether you have certain cardiovascular or other risk factors that may impact the level of exercise that is safe for you. Depending on your age and medical history, your physician may recommend a physical examination and possibly an exercise treadmill test. back to top Recently there has been some question about how often women should get mammograms. What are your recommendations? American Cancer Society guidelines are still recommended by most physicians and surgeons who treat breast cancer. They state that a woman should have a baseline mammogram at age 35; screening mammograms every year or two from age 40 to 49; and annual mammograms are recommended for women between the ages of 50 and 70 (frequency after age 70 should be at the discretion of the care provider). back to top What is the difference between a heart attack and sudden cardiac arrest? Sudden cardiac arrest (SCA) is not a heart attack. A heart attack—often proceeded by nausea, sweating, or pain in the chest, arm, upper abdomen, or jaw—is caused by a blocked vessel that leads to loss of blood supply to a portion of the heart. SCA is an “electrical problem” that occurs when the heart develops a fast, abnormal rhythm that prevents it from pumping blood to the brain and body. There is rarely a warning before sudden cardiac arrest, and victims always lose consciousness. Some people may experience SCA during a heart attack, and a previous heart attack can be a predictor of future risk. back to top Why is incorporating exercise into your daily life important? Exercise is vital to the maintenance of a healthy lifestyle. Numerous research studies have demonstrated the positive effects of exercise on heart health, weight control, stressmanagement, bone density, and general wellness. However, it’s also important to understand that the lack of exercise can actually magnify the effects of many diseases and health problems, including high cholesterol, obesity, and stress. Carve out some time each week to be active and put it on your calendar. Wake up half an hour earlier to walk, schedule a workout during your lunch break, or take a fitness class in the evening. You can also build physical activity into your routine chores or make family time physically active by taking a walk or a bike ride together. back to top At what age should people get tested for diabetes? Anyone who is 45 or older should consider getting tested, but people who are 45 or older and overweight should make a point of being checked for pre-diabetes. Those who are younger than 45, are overweight, and have other risk factors—including high blood pressure, low HDL cholesterol and high triglycerides, a history of gestational diabetes or giving birth to a baby weighing more than nine pounds, a family history of diabetes, or belonging to an ethnic group at high risk for diabetes—should also consider getting tested. back to top When should I go to an urgent care clinic instead of the emergency room?   Urgent care clinics and emergency rooms provide different levels of patient care. An urgent care clinic treats non-life-threatening illnesses or injuries that require professional attention to prevent them from developing into a greater threat. Examples of conditions treated at urgent care clinics include minor burns, sprains, respiratory infections, colds and flu, and minor cuts or abrasions. Emergency rooms are designed to manage more severe traumas and medical conditions that could be life-threatening if not treated immediately such as heart attack, stroke, head injuries, seizures, and broken bones. If the situation requires immediate medical treatment or there are painful symptoms requiring immediate attention to relieve suffering, the situation is an emergency. back to top