Good Health Blog

Hanging on. Bladder problems. Gotta Go...

Tue, 01 May 2012 11:24:00 GMT

Urinary incontinence - involuntary loss of bladder control - is a common problem amongst adult women and recent research has conclusively shown that a type of exercise called pelvic floor muscle training is effective for treating the condition. The report also found that drug-based treatments can be effective, but the degree of benefit is low and side effects are common.

Urinary incontinence has an impact both physically, psychologically and socially. It is extremely common in adult women, affecting approximately 25 percent of young women, up to 57 percent of middle-aged and postmenopausal women, and approximately 75 percent of older women in nursing homes. The condition can impose significant, potentially debilitating lifestyle restrictions. The cost of incontinence care in the United States averaged $19.5 billion in 2004, and by one estimate the annualized cost of women's nursing home admissions due to urinary incontinence was $3 billion. Six percent of nursing home admissions of older women are attributable to urinary incontinence.

Researchers concentrated on two kinds of incontinence: stress incontinence, or the inability to retain urine during coughing or sneezing; and urgency incontinence, which is an involuntary loss of urine associated with the sensation of a sudden, compelling urge to urinate that is difficult to defer. Both types usually occur when the urinary sphincter fails, often as a result of weak pelvic floor muscles, which support the uterus, bladder, and other pelvic organs.

Exercises to strengthen the pelvic floor muscles, similar to Kegel exercises, were found to be effective in increasing women's ability to hold their urine. Pelvic floor muscle training combined with bladder training improved mixed (stress and urgency) incontinence, the report found. Estrogen treatment was found to be effective in treating stress incontinence, but with some side effects.

A good review of the problem and exercises can be found at http://tinyurl.com/83xza7o

It can be difficult to remember to do these exercises and it is doing them daily that makes a difference. Given the statistical chance of developing incontinence I advise all my women patients to start doing pelvic floor exercises in their early 20's. How to remember? Go to the stationary store and buy a packet of small dot stickers. Put one on the mobile phone, one on your steering wheel, one on the TV remote etc. Every time you see a sticker do a few exercises. Simple prompt, life long gain. No problems hanging on!

Does Money make you feel better?

Sun, 15 Apr 2012 10:28:00 GMT

Research can answer some very interesting questions. Many international studies have shown that it is the quality of our personal relationships, not the size of our bank balance, which has the greatest effect on our state of wellbeing.

Believing that money is the key to happiness can also harm a person's wellbeing. For example, a person who chooses to work a lot of overtime misses out on time with family, friends and leisure pursuits.

The added stress of long working hours may also reduce a person's life satisfaction. Research shows that people who pursue 'extrinsic' goals like money and fame are more anxious, depressed and dissatisfied than people who value 'intrinsic' goals like close relationships with loved ones.

Wellbeing can be elusive

Wellbeing is important, but seems a little hard to come by. One American study into mental health found that, while one in four respondents was depressed, only one in five was happy – the rest fell somewhere between, neither happy nor depressed. A recent Australian consumer study into wellbeing showed that:

* 58 per cent wish they could spend more time on improving their health and wellbeing.

* 79 per cent of parents with children aged less than 18 years of age wish they could spend more time on improving their health and wellbeing.

* 83 per cent are prepared to pay more money for products or services that enhance their feelings of wellbeing.

I guess the above statistics show an interesting trend and explain the success of the 'health supplement' industry which often promises that you will feel better/less stressed/more energy if you buy their vitamin/mineral/supplement despite many medical authorities demonstrating that nutritional deficiency is quite rare in many countries.

Money does not make you feel better. Only you have the ability to make the steps to improve your feeling of wellbeing. It is not rocket science. A great start is to exercise regularly, eat and drink healthily. Spend time with family and friends.

Farming risks - for the family and farmer. Healthy Farmer, Healthy Farm!

Wed, 21 Mar 2012 07:31:00 GMT

Farming can be a wonderful lifestyle but carries a higher risk of experiencing a serious injury. Farmers also have a higher incidence of cardiovascular (heart) disease, some cancers, mental illness and suicide. Some of the challenges for farm men and women are that they often live and work at the same place. This means that some of the work place risks are present every day, even when not working.

In NSW from 2000 to 2005, there were 6798 people admitted to hospital as a result of an injury on a farm. These most commonly occur through slips, trips and falls, livestock handling, machinery use and farm vehicles. Older people are at increased risk of injury through falling.

Unfortunately, farms are amongst the most dangerous workplaces in Australia. However, many farm related accidents could be prevented if proper safety procedures and safety equipment are used by all workers at all times. Organisations such as WorkCover and Farmsafe can offer valuable advice on improving health and safety at your farm.

When considering the management of your farm, consider your own preventative health care. Healthy farmer, healthy farm!

Children who live on farms are at greater risk of injury and death than their parents or other farm workers. In fact, the under-15 age group is one of the most vulnerable to work-related farm accidents in Victoria. They account for one in seven farm deaths.

Common hazards include drowning in dams, tanks and creeks, injury from guns or chemicals, accidents with tractors, motorbikes or other machinery, animals and falls from heights. The main risk factors are inexperience with equipment or animals, and trying to perform a task that is beyond their abilities.

Young children in particular need a safe play area of their own where there are no major hazards, so fencing part of the yard close to the house for your child’s use is important. Older children can be taught farm safety, but still need to be supervised at all times. Most importantly, children learn by imitation. If you practise and value farm safety, so will your child.

The approach of the sneezin' season!

Mon, 27 Feb 2012 10:17:00 GMT

During the next month the influenza vaccine will become available. Influenza can be quite a serious disease, particularly if you have underlying medical conditions. Anyone with chronic heart conditions, lung conditions, diabetes etc is susceptible to the complications of influenza, and therefore anyone with any of these underlying conditions should be immunized every year.

In Australia the Flu Vaccine is available free to everyone over 65 years of age.

Are there any side effects?

All that can happen is that you get a slightly sore arm and you might have a touch of fever, but you really can’t catch influenza. One of the big myths about this whole thing is that people say you can catch influenza from having the vaccine but that’s not the case.

After any vaccine, it takes a couple of weeks for antibodies to develop so during that period you’re still at risk. The flu vaccine does not stop you catching the common cold and when people catch this is it common to hear them say ‘oh well the vaccine didn’t work, did it’. But that’s not the case. Colds are usually shorter in nature and much less severe that the flu.

Should well people consider the flu vaccine?

Immunization is also recommended (but not necessarily free) for people who can put vulnerable people at risk of infection. People who work with or live in close contact with people who have an underlying medical condition or reduced immunity are also recommended to be vaccinated to avoid spreading the virus and to protect themselves and their family. They include:

* Public and private hospital staff who provide direct care to patients
* Staff in long-term care facilities or nursing homes
* People who live with, or care for someone who has a chronic illness or is aged
* Carers of homeless people
* Workers, particularly those in workplaces that provide essential services
* People who work with children
* People involved in the commercial poultry and pig industry
* Workers in other ‘high risk’ industries
* Anyone traveling as part of a group

I am pregnant - does this matter?

Influenza vaccine is recommended for women planning a pregnancy and for pregnant women at anytime during the pregnancy.

So as the flu season approaches seriously consider immunization.

Varicose veins? Prevention and management tips.

Wed, 15 Feb 2012 07:58:00 GMT

Varicose veins are superficial veins swollen by ‘back pressure’ . The valves that stops this back pressure have failed and the cause can be genetic or acquired. Here are a few tips to help prevent them causing a problem or worsening.

If you are standing still, flex your calf muscles
Think of your calf muscles as the "heart" of your venous circulation. If you point and flex your foot enough to strongly contract the calf muscle, you will move one cup of blood out of the leg. You can also squeeze your feet together in your shoes, or go up and down on your toes. Shaking your leg is not very effective. You need to make your muscles work.
Avoid binding clothing, on a day to day basis
Tight girdles, knee-high nylons or socks can block the movement of blood up the leg. The vein wall has to expand to get around this barrier. As a result, the valves lose their tight fit and can start to fail, allowing blood to pool - the beginning of varicose veins.

Control your weight
Most, though not all, studies report obesity as a factor in the development of varicose and spider veins. Weight loss should be considered if overweight. Weight loss results from reduced calories and an exercise program.

Fluctuating hormones during the menstrual cycle can affect veins

Changing hormone levels, both pre-menstrual and mid-cycle (at ovulation), allow the vein wall to relax. In this relaxed state, the vein holds more blood, which puts pressure on the valves. So if you think that sometimes your veins look worse than other times, they do. For some patients, being on the pill or taking estrogen replacement hormone will have this same effect on their veins. In these situations, support hose, exercise, and weight control can all help in keeping the vein walls fit.
Pregnancy can expand veins
Pregnancy also causes an elevation of many hormones. Estrogen relaxes the smooth muscle and collagen fibres in general, which may contribute to the vein wall expanding. In addition, the amount of blood in the systems increases by up to 40%. When patients report the sudden development of varicose or spider veins, one of the first questions is, "Are you pregnant?" Veins can change rapidly when a woman is only 5 weeks pregnant and is still unaware of her pregnancy.
About 70% of women who become pregnant and who have inherited a family gene for varicose and spider veins will develop these veins. The good news is many of these veins will disappear 4 to 6 weeks after finishing breast-feeding. For many women, it is usually the third pregnancy when these varicose and or spider veins remain and require treatment. Again, support hose, exercise, and weight control are helpful.
Avoid wearing high-heeled shoes every day
High heels are not fashionable for your veins. If you wear a heel that is more than 1.5 inches high every day, your calf muscle will not be effectively pumping blood out of the leg. You can try this at home. Feel how the calf contracts when you walk in lower heels and then switch to high heels. The foot simply moves forward in high heels, and you won't feel your calf contracting as you walk.
Exercise with care
A well-toned leg muscle will pump out much more blood than a weak muscle as you walk or move - and the more venous blood you move out of the leg, the less chance the vein has to expand and cause valve damage.
You should be careful with strenuous exercise, however. Abdominal pressure can block the flow of blood back to the heart. For example, when lifting heavy weights, make sure that you blow out. Otherwise, you increase your abdominal pressure and the veins have to expand to get around this block.
Wear graduated support hose
Many pharmacies carry special knee-high socks, nylons, pantyhose, and tights that are good for your legs and come in a variety of very fashionable colours. These stockings apply a gentle, graduated pressure to the leg, from the foot upward, which helps to decrease the expansion of the vein wall.

A kids health check!

Thu, 02 Feb 2012 12:04:00 GMT

Consider doing a health check on your children. A good preventative health plan starts while the mother is pregnant!

To give you an example lets find out about a 10 year old boy whose grandparent had diabetes. The edoc recommendations include:

Dental Check-up
Most children and adults should see their dentist for a regular cleaning and check up every six to 12 months. People at a greater risk for oral diseases should have dental check ups more than twice a year. Tobacco and alcohol use, diabetes, pregnancy, periodontal and gum disease, poor oral hygiene and certain medical conditions are some of the many factors that your dentist takes into consideration when deciding how often you need your dental cleaning and check up.

Diabetes Screening
Young people who are at risk for developing diabetes should be tested every two years. Risks include being overweight, inactive and a family history of diabetes.
Most people do not have any symptoms when they develop type 2 diabetes. However, when the levels of glucose in the blood are particularly high (this is common in type 1 diabetes), symptoms can include weight loss, tiredness and lack of energy, excessive thirst, blurred vision, increased infections and frequent urination.
Occasionally, the onset of diabetes can be abrupt. This is particularly the case with type 1 diabetes. The symptoms include: Loss of appetite, weight loss, vomiting, excessive passing of urine, atered consciousness and coma.
Seek immediate medical advice if these symptoms occur.

Eye examination
A routine eye examination should be done every two years to detect early changes that you may not notice now but might lead later to vision loss.
Your best defense is to have regular checkups, because eye diseases do not always have symptoms. See an eye care professional right away if you have a sudden change in vision or everything looks dim or if you see flashes of light. Other symptoms that need quick attention are pain, double vision, fluid coming from the eye and inflammation.

Weight screening
Know your childs weight and height and check it annualy to ensure theyremain in a healthy range over the years. A healthy weight reflects a a healthy diet and exercise level.

Some good reasons to smile!

Tue, 10 Jan 2012 06:46:00 GMT

A recent published study analyzing 100,000 people from 2007 has demonstrated that regular visits to the dentist for tooth cleaning may provide more than just a brighter smile. According to the study people who had their teeth professionally scraped and cleaned at least once a year had a 24% lower risk of heart attack and 13% lower risk of stroke compared with those who had never had a dental cleaning.

The theory is that professional tooth cleaning appears to reduce inflammation-causing bacteria that can lead to heart disease.

So if you have your teeth professionally scraped and cleaned one a year you have lots of reasons to smile!

A timely reminder. The time to act is NOW!

Mon, 02 Jan 2012 10:08:00 GMT

If you were to keep one New Years resolution the one to carry into the year is to act on health issues. Knowledge is power. There are no prizes for wandering through each year hoping you will not develop an illness and ignoring the possibility of having a health risk factor that is already doing damage.

The knowledge is out there. Actually it is right here. eDoc welcomes our subscribers and members back for another 'health cycle'.

As the New Year clicks over there are always health issues to consider. This might be the year you should have that skin check or your family history might mean it is time to arrange a colonoscopy or check your cholesterol. You should know your ideal weight range . If you do not know how much exercise per day/week is 'minimal' for heart health then you should!

Update your eDoc preventative health recommendations and follow them through. There is no better time than now.

To all our subscribers and members from the team at eDoc we wish the very best in health and happiness for 2012. Thank you for your feedback and support in 2011. It was rewarding to hear the positive stories and outcomes from early intervention. Our goal is to make a difference, one person at a time. Make that person you!

Too much Christmas cheer. Use your head and plan ahead.

Wed, 07 Dec 2011 08:52:00 GMT

Christmas comes with it's own health risks so a bit of foresight is forewarned!

Emergency rooms and after hours clinics are often busy on boxing day. Try not to become a statistic...

The reasons are usually one of the following!

- Overeating. Eating too much, too fast can cause indigestion or diarrhea. It can also trigger heart and blood problems.

- Overdrinking. Too much alcohol can stress your liver. It also makes you lose control over your actions and speech, causing you to harm others physically (or emotionally). Accidents caused by drunk driving are common around the Christmas holidays

- Food poisoning. This happens a lot because platters are usually left exposed on the table until the next day. Remember to refrigerate!

- Negligence. We tend to let our guards down during the holidays because we’re too busy and stressed out. We overlook important details like giving maintenance meds to elders or keeping away knives and scissors from kids.

Christmas is something to value and enjoy with your loved ones. So don’t let health troubles get in your way. Have a healthy Christmas!

Tape the toothpast and sunblock together - become Super Sunsmart

Mon, 28 Nov 2011 13:00:00 GMT

The message might be boring but the outcome is not!

Ultraviolet radiation - Sun - damage is cumulative. The more you get the more damage is likely to occur. There is significant damage done after a day at the beach and a bad sunburn - in fact statistics show that one bad sunburn doubles your life risk of melanoma. We often forget that problems also arise with regular small amounts of exposure.

One of the common areas I remove skin cancers from is the back of hands and the right side of the face.

"But I never go in the Sun Doctor!" I am often emphatically told.

"Did you drive here?" I would ask. "Have you driven to work each day for the past 20 years?" There was usually a nod of the head in acknowledgment

"Well the sun shines on your hands and the window side of your face. Those areas have had a lot more exposure and are paying the price."

Regular sun exposure to one area leads to local areas of premature ageing, wrinkles, redness, scaling and often skin cancers.

When I first came to this now obvious realisation I decided to put sunblock on myself before driving into the office each day. Many days I would forget and remember as I looked at the back of my hands on the steering wheel.

So I decided to work out a way not to forget. I taped the sunblock and the toothpaste tube together. My teeth never got missed so putting on the sunblock on my hands followed naturally.

And for the trip home I have a second tube of sunblock under the dash in the car!

I would be interested to hear how others have solved the memory dillema and manage to block out when needed. Summer is here. Time to get sun smart.

The 100 day cough... Whooping cough outbreaks

Wed, 16 Nov 2011 06:04:00 GMT

Whooping cough (Pertussis) is a highly contagious infection of the respiratory (breathing) tract, caused by the bacterium Bordetella pertussis.

Whooping cough can affect all ages, but infants less than 6 months of age are at the greatest risk. The illness is characterised by repeated attacks of coughing followed by a 'whoop' when inhaling. However, the 'whoop' is not always present in young infants, older children and adults. Sometimes symptoms in adults can be 'fits' of coughing brought on by lying down, talking - even laughing. The complications of whooping cough can be very serious.

In Australia, whooping cough outbreaks occur every 3 to 4 years. A person's immunity to whooping cough after infection or immunisation decreases over time, placing them at risk of infection.

Whooping cough vaccination is recommended and provided free as part of the National Immunisation Program (NIP) for babies aged 2, 4 and 6 months, children aged 4 years and adolescents.

In Australia, vaccination against whooping cough is provided in combination vaccines that also help protect against other diseases.

It is important for children to complete the recommended course of vaccinations on time to help protect them against the disease.

Provided no previous booster of a pertussis containing vaccine has been received, a single booster dose of pertussis vaccine is recommended for adults planning a pregnancy, new parents, grandparents and other carers of young children. The booster dose is recommended for parents as soon as possible after delivery of an infant.

Some state and territory governments may provide subsidised immunisation for some adults in close contact with young babies.

Other individuals may also be at risk whooping cough. Please discuss your individual circumstances with your doctor.

In some cases Whooping cough can last 100 days. That's a lot of coughing!

Up, Up and away!!!!!! High Blood pressure

Mon, 07 Nov 2011 11:05:00 GMT

Every adult should have their blood pressure checked.

If your blood pressure is ‘normal’ and you have no other risk factors for cardiovascular disease, and no personal or family history of high blood pressure, a check every two years and during routine visits to your doctor is recommended.

If your blood pressure is ‘high–normal’ (or higher), or if you have other risk factors for cardiovascular disease, a personal or family history of high blood pressure, stroke or heart attack, it is best to have it checked more frequently as recommended by your Doctor.

If blood pressure remains high, it can lead to serious health problems. You will be more at risk of these problems if you smoke, are overweight, are physically inactive, have diabetes, have high blood cholesterol, are socially isolated or have depression.

Lifestyle changes are very important to help to control high blood pressure and lower your risk of cardiovascular disease. Suggestions include:

* Reduce your excess body weight. Know your BMI ( if you do not know what this means then it is time to find out!)
* Be physically active - the recommendations for your age are in the eDoc members section.
* Limit your alcohol intake
* Quit smoking - now, today, immediately!
* Decrease your salt/sodium intake
* Increase your potassium intake through eating a wide variety of fruit, vegetables, plain unsalted nuts and legumes.

Some people may also need medicine to control high blood pressure, but it is still important for them to make lifestyle changes too.

Ironmum and ironkids!

Tue, 01 Nov 2011 10:35:00 GMT

Iron is important in the health and wellbeing of ererybody but is of particular relevance to those still growing. Iron is an important dietary mineral that is involved in various bodily functions, including the transport of oxygen in the blood. This is essential in providing energy for daily life. Iron deficiency means less oxygen is delivered to the cells. This can lead to fatigue, tiredness and decreased immunity.

Babies, toddlers, preschoolers and teenagers are at higher risk of iron deficiency, because their increased needs for iron may not be met if their diet is not balanced. Treatment for iron deficiency anaemia in children starts with dietary change but may include iron supplements (under medical supervision only). Iron supplements are toxic in large doses, so keep supplements out of reach of children.

Some of the common causes of iron deficiency in adults include:

* Inadequate dietary intake – the two types of iron include haem iron (found in animal foods) and non-haem iron (from plant products). The body absorbs haem iron much more easily than non-haem iron. There are many reasons why the dietary intake of iron could be inadequate, including a poorly balanced vegetarian diet, chronic fad dieting or limited access to a wide range of fresh foods – for example, as a result of living in remote areas or having a low income.
* Blood loss – iron deficiency easily occurs in situations of chronic blood loss. Common causes include heavy menstrual periods, regular blood donation, chronic disorders that involve bleeding (such as peptic ulcers, polyps or cancers in the large intestine) and certain medications, particularly aspirin.
* Increased need – the adolescent growth spurt, pregnancy and breastfeeding are situations when the body requires more iron. If this increased need isn’t met, a deficiency can quickly occur.
* Exercise – athletes are prone to iron deficiency because regular exercise increases the body’s need for iron in a number of ways; for example, hard training promotes red blood cell production, while iron is lost through sweating.
* Inability to absorb iron – healthy adults absorb about ten to 15 per cent of dietary iron but some people’s bodies are unable to absorb or use iron from food.

Taking iron supplements when you feel tired and run down will not help unless you have actually been diagnosed with iron deficiency. There may be another cause for your symptoms. Since iron supplements are available over the counter, it can be tempting to self-diagnose but this would be a mistake for many reasons.

It is recommended that all pregnant women be tested for iron deficiency.

If you have any of the symptoms of iron deficiency your Doctor will probably do iron studies as part of their work up of your problem.

When one more may be one too many.

Tue, 18 Oct 2011 10:54:00 GMT

There a many health guides, forms, plans and charts to play with on the internet. I regularly do a search of the health websites to try and find useful tools to help patients achieve wellbeing and educate themselves about health issues. My most recent search was to find out how to explain what a 'unit' of alcohol was and how to calculate the recommendations for maximum consumption.

As a general rule any site eDoc.net recommends has to have good scientific evidence and be predominately a medical site rather one advertising a product or service.

If you drink alcohol then please visit Alcohol calculator and have a play.

It is an very visual and useful tool to seriously check your lifestyle risk regarding alcohol.

If you are to busy to do the check then consider the recommendations

For men

* No more than 28 standard drinks of alcohol over a week
* An average of no more than 4 standard drinks a day
* No more than 6 standard drinks in any one day
* One or 2 alcohol-free days per week

For women

* No more than 14 standard drinks over a week
* An average of no more than 2 standard drinks a day
* No more than 4 standard drinks in any one day
* One or 2 alcohol-free days per week

Keeping abreast of recommendations

Tue, 27 Sep 2011 11:35:00 GMT

There are varying levels of 'recommendations' that come down from the many medical bodies. Some are based on hard scientific evidence and studies (called a grade A recommendation) through those with limited and inconsistent scientific evidence (level B) to a 'consensus of expert opinion' (a grade C recommendation).

There is sometimes debate - event heated - about the grade C recommendations between various medical groups. What the public hears is usually what the press bothers to report.

Of interest this week is the most recent recommendations on breast cancer screening from the Agency for Healthcare Research and Quality.

The following recommendations are based on limited and inconsistent scientific evidence (Level B):

* Based on the incidence of breast cancer, the sojourn time for breast cancer growth, and the potential reduction in breast cancer mortality, the College recommends that women aged 40 years and older be offered screening mammography annually.

The following recommendations are based primarily on consensus and expert opinion (Level C):

* Clinical breast examination should be performed annually for women aged 40 years and older.
* For women aged 20–39 years, clinical breast examinations are recommended every 1–3 years.
* Breast self-awareness should be encouraged and can include breast self-examination. Women should report any changes in their breasts to their health care providers.
* Women should be educated on the predictive value of screening mammography and the potential for false-positive results and false-negative results. Women should be informed of the potential for additional imaging or biopsies that may be recommended based on screening results.
* Women who are estimated to have a lifetime risk of breast cancer of 20% or greater, based on risk models that rely largely on family history (such as BRCAPRO, BODACEA, or Claus), but who are either untested or test negative for BRCA gene mutations, can be offered enhanced screening.
* Breast magnetic resonance imaging (MRI) is not recommended for screening women at average risk of developing breast cancer.
* For women who test positive for BRCA1 and BRCA2 mutations, enhanced screening should be recommended and risk reduction methods discussed.

Some of the above is 'medical speak' and for a more detailed explanation the links in the subscribers area for those in the risk cateogories go further to explain the genetic risks.