YOUR BODY IN FLIGHT
“If man were meant to fly…” goes the old saying, yet for most of us, flying is a safe way to travel. But the pressurized cabin can potentially affect passengers with existing or sometimes unknown medical conditions, says family medicine physician Jennifer Turkish, M.D., and can cause problems for passengers who have recently undergone surgery or have abdominal health problems, or blocked ears or sinuses.
DEEP VEIN THROMBOSIS – A Serious Health Threat
Deep Vein Thrombosis (DVT) is a blood clot that forms in a deep vein, usually in the legs. “The clots can break loose and travel through the bloodstream to the lungs,” says Dr. Turkish, “leading to a potentially life-threatening pulmonary embolism and long-lasting vein damage.”- Have prolonged bed rest
- Have an inherited condition that inhibits blood clotting
- Have had recent surgery or injury
- Have cancer, even during treatment
- Are paralyzed from a spinal injury
- Are currently using hormone therapy
- Are pregnant or have recently given birth
- Have varicose veins
- Have a history of heart attack or stroke
- Have inflammatory bowel syndrome
- Smoke or are obese
TALKING WITH YOUR TEEN ABOUT DRUGS AND ALCOHOL
As use of drugs and alcohol by teens increases across the U.S., it’s important for parents to establish an open dialogue with their children as they explore tobacco, alcohol and prescription or illegal drugs.- Take a stance of curiosity rather than control. So often we try to convince, coerce, and control our teens, which evokes an immediate defense. Seek to ask, understand, and align with your teen’s curiosities, desires and decisions. This does not mean you agree with your teen, but you are helping to explore these life decisions.
- Be realistic as you discuss the possible consequences of substance abuse. It is tempting to use scare tactics, but keep your conversations realistic. Help your child build an attitude resistant to drug use. Create significant consequences to discourage exploration of inappropriate substances.
- Know your teen’s friends. Playing an active role in your child’s life is a proven way to help prevent underage drinking and drug use. Find ways to be involved in their daily lives. Encourage them to have friends over, but don’t allow your child to go to parties, sleepovers or other activities that aren’t supervised by an adult you trust.
- Talking with your teen early is one of the best ways to avoid problems later. The average onset of first use is 14 years old, so consider having these conversations by 12 years old.
KEEP YOUR TICKER IN TIPTOP SHAPE
If you think that heart health is something only older people need to think about, first know the numbers.
REEL IN YOUR STRESS FOR BETTER WELL BEING
Our body’s natural stress response – the “fight or flight” response – was meant to protect us against predators. Such threats are rare today, but that doesn’t mean that our lives are stress-free.
Lowering Your Stroke Risk
Risk factors are things that make you more likely to have a health problem,” says family medicine physician, Sandra Fahmy, M.D. “You are at risk for a stroke if you have high blood pressure, but your risk is even higher if you have high blood pressure and are over the age of 50.” Use the quiz to the right, from the American Stroke Association, to learn your risk factors for stroke. The more “yes” answers, the higher your potential risk for stroke. 
“By learning your risk factors, you and your doctor can devise a plan to reduce your chances of having a stroke,” says Dr. Fahmy. “There’s a lot you can do to help prevent stroke. Watching what you eat and being physically active are high on the list.”
Stroke is the fourth leading cause of death in the U.S. and the number one cause of adult disability. The most effective treatment for stroke is to prevent it from happening in the first place. High blood pressure is the top risk factor for stroke. Have your blood pressure checked regularly, advises Dr. Fahmy, and follow your doctor’s recommendations for medication and lifestyle changes. If you smoke, get help to quit.
“The consequences of stroke can be severe,” says Dr. Fahmy. “Preventative measures become the main line of defense against the conditions that invite stroke. Together, you and your doctor can form a treatment plan to reduce your risk of stroke.”
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Do you smoke?
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Do you have high blood pressure?
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Do you have high cholesterol?
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Do you have atrial fibrillation?
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Do you have diabetes?
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Are you African-American?
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Are you older than 50?
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Are you overweight?
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Do you walk or exercise fewer than three times a week?
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Do you often eat greasy, fried or salty foods?
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Do you have more than two alcoholic drinks a day?
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Have your mother, father, sister, brother or grandparent had a stroke; or your father or brother had a heart attack before age 55; or your mother or sister had a heart attack before age 65?
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Have you been told that you have carotid artery disease, or have had a stroke or TIA (transient ischemic attack); or have disease of the leg arteries, a high red blood cell count, or sickle cell anemia?
Your Thyroid: Too Much or Too Little?
The thyroid gland is a bowtie-shaped organ in your neck, below the larynx. It secretes hormones that control how fast your heart beats, how quickly you digest food, how much you sweat, the speed at which you burn calories, and many other activities, according to the American Academy of Otolaryngology. Millions of people in the U.S. have thyroid diseases. Most of them are women.
“The thyroid is one of the endocrine glands in the body;” says family medicine physician Jennifer Turkish, M.D. “Thyroid disorders can range from a small, harmless goiter to life-threatening cancer. Most frequently, thyroid disease affects the hormone levels that govern your body’s metabolism.”
“If you have a thyroid disease,” says Dr. Turkish, your body uses energy more slowly or quickly than it should. A thyroid gland that is not active enough, called hypothyroidism, is far more common. It can make you gain weight, feel fatigued and have difficulty dealing with cold temperatures. If your thyroid is too active, it makes more thyroid hormones than your body needs. That condition is hyperthyroidism. Too much thyroid hormone can make you lose weight, speed up your heart rate and make you very sensitive to heat.”
“Because the symptoms of thyroid conditions can be very subtle, I urge patients to have their thyroid checked annually as part of an annual physical,” says Dr. Turkish. “A physical exam can identify enlarged thyroids and nodules, and a simple blood test can diagnose hormone levels. Your physician can then prescribe medication to reset your body’s metabolism to its normal rate.”
Varicose Veins? Give Your Legs The Care They Deserve
Varicose veins and spider veins are common disorders affecting up to half of all adults in the U.S. over age 50.
Veins return blood to the heart from throughout the body. “Leg veins have an especially uphill battle as they must overcome the pressures of body weight and the force of gravity to do their job,” says family medicine physician Sandra Arango-Fahmy, D.O. “Normally, one-way stop valves in the veins prevent blood from flowing downward, but if the valves become weak, blood can leak backward and cause congestion of the vein, causing it to enlarge and leading to varicose or spider veins,” says Dr. Fahmy.
Varicose veins are dark purple or blue in color, protrude from the skin surface and appear twisted like rope. Spider veins are small red, blue or purple veins on the skin’s surface. Symptoms of varicose veins include pain, fatigue, heaviness, aching, burning, throbbing, swelling, itching and restless legs. While these conditions are not life-threatening, they can lead to painful eczema, inflammation and ulceration, in addition to being unsightly. In some cases, veins become swollen or inflamed, leading to a condition called thrombophlebitis.
Many factors increase a person’s chances of developing varicose or spider veins. “Increasing age, family medical history, obesity, lack of movement, hormonal changes, sun exposure and pregnancy can contribute to the development of vein disorders,” says Dr. Fahmy.
Thanks to highly effective, minimally invasive procedures, varicose and spider veins can usually be treated on an out-patient basis. Jennifer R. Syrek, M.D., a vascular surgeon on staff at Raritan Bay Medical Center, offers diagnostics, evaluation and treatment for varicose and spider veins. “Using stateof- the-art equipment and the latest laser and other techniques, we can determine the site of valve malfunctions and then help patients decide on the best individual treatment options,” she says.
Your Passport to Healthy Travel Worldwide
Passport? Luggage? Pre-travel immunizations, counseling and medication? You may not be ready to go if you haven’t consulted your physician to help protect you and your family.
“Good health is key to memorable vacations,successful business trips and other factors that mightcause you to travel, including volunteer and mission trips abroad, adoptions, and government work assignments outside the U.S.,” says family medicine physician Jennifer Turkish, M.D.
“Your physician will review your medical history and itinerary, then administer and prescribe immunizations and medications to reduce your risk of illness,” says Dr. Turkish.
Your physician can also discuss risk management during yourtrip, including travel-specific health hazards, such as food and water precautions, insect bite prevention and medications to prevent motion sickness, travelers’ diarrhea and for protection in malariaendemic areas. Some travelers might also want to take extra precautions while on a cruise, traveling extensively by air, or visiting extreme climates or high altitudes.
“Travelers can also help themselves,” says Dr. Turkish. “Take adequate supplies of prescription medications in original containers with you, along with a copy of the prescription. Anyone with a history of heart disease should carry a baseline EKG with them to facilitate onboard or overseas medical care, should it be required.”
When To See Your Physician Before You Travel
The Centers for Disease Control and Prevention (CDC) recommend that you make an appointment with your physician four to six weeks before your trip for advice on the travel medicine, information and immunizations you need before you travel.
Most vaccines take time to become effective in your body and some vaccines must be given in a series over a period of days or sometimes weeks. If it is less than four weeks before your departure, you should still see your doctor. You may still benefit from shots or medications and other information about how to protect yourself from illness and injury while traveling.
Some immunizations are routine, some are required, and some are recommended, depending on your destination. Infants and children, adults, senior citizens and anyone with altered immunocompetence due to illnesses such as diabetes or HIV have different needs. Your physician can help you decide what’s best for you.
For more information on required and recommended vaccines for travelers to specific countries, visit the Centers for Disease Control and Prevention (CDC) at http://wwwnc.cdc.gov/travel/page/vaccinations.htm.
Understanding ADHD
“If a child is exhibiting a combination of lack of attention at home and school, hyperactivity and impulsive behavior, it may indicate ADHD, or attention deficit hyperactivity disorder,” says
board certified psychiatrist Nanditha Krishnamsetty, M.D.
“Too often, difficult children are incorrectly labeled with ADHD. On the other hand, manychildren who do have ADHD remain undiagnosed,” Dr. Krishnamsetty says.
“For ADHD to be diagnosed, the symptoms must be out of the normal range for a child’s ageand development, and they must be causing significant difficulties in many settings, including home, school, and in relationships with peers.”
Inattentive symptoms can include difficulties organizing tasks and activities. Hyperactivity can include running about in inappropriate settings and constant fidgeting. Blurting out answers
before questions have been completed and interrupting others are signs of impulsivity.
“If ADHD is suspected, the child should have a thorough evaluation by a psychiatrist and psychologist as well as parent and teacher questionnaires, plus a physical check-up by the child’s pediatrician,” says
Dr. Krishnamsetty.
“Treating ADHD is a partnership between the health care provider, parents or caregiver, and the child. A combination of medication and behavioral treatment often works best.”
“You want to think long-term for your child,” continues Dr. Krishnamsetty, “providing them with the ability to finish school and maintain their self-esteem. Children with untreated ADHD can become angry and depressed. They may fall victim to drug and alcohol abuse, failure in school, and have problems keeping a job. With treatment, we can help prevent the complications of low self-esteem and depression, and put children on the path to a better quality of life. As adults, while they may continue to have troublesome symptoms of inattention or impulsivity, they can become more capable of controlling behaviors and compensating for these difficulties.”
“There is no way to prevent ADHD but early identification and treatment can prevent many of the problems associated with ADHD,” Dr. Krishnamsetty concludes.
