Life After 50 Expo

How to Talk Effectively with Your Doctor !

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You’ve finally been able to sit down with your healthcare provider at an anxiously awaited appointment to discuss a worrisome health problem. But all too soon it’s over, and you realize you didn’t quite understand the diagnosis and treatment, you have more questions and you feel like you weren’t heard. Perhaps the doctor stared at a computer screen instead of your face.

Clear communication is key when dealing with health problems, and sometimes you, the patient, need to take control. In this day of high-speed Internet, digital medical records and doctors with too many patients and too little time, planning ahead can save your health.

 

Be Prepared
The first step toward ensuring good doctor-patient communication is preparation. The National Institute on Aging offers the following essential tips for making your medical visit a success:

  • Write down a list of questions and concerns before your exam.
  • Consider bringing a close friend or family member with you.
  • Speak your mind. Tell your healthcare provider how you feel, including things that may seem unimportant or embarrassing (see below).
  • If you don’t understand something, ask questions until you do.
  • Take notes about what the doctor says, or ask a friend or family member to take notes for you.
  • Ask about the best way to contact the doctor (by phone, email or through the staff).
  • Remember that other members of your healthcare team, such as physician’s assistants and pharmacists, can be good sources of information.

 

Speak Up
“There’s no such thing as a dumb question in the doctor’s office,” says Dr. Matthew Memoli, an infectious disease doctor at the National Institutes of Health. “I try very hard to make my patients feel comfortable so that they feel comfortable asking questions, no matter how dumb they think the question is.” Here are some questions to ask (suggested by the Agency for Health Care Research and Quality, a division of the U.S. Department of Health and Human Services):

  • What is my diagnosis?
  • What are my treatment options? What are the benefits of each option? What are the side effects?
  • Will I need a test? What is the test for? What will the results tell me?
  • What will the medicine you are prescribing do? How do I take it? Are there any side effects?
  • Why do I need surgery? Are there other ways to treat my condition? How often do you perform this surgery?
  • Do I need to change my daily routine?
  • What should I do next? Ask for written instructions, brochures, videos or websites that may help you learn more.

 

Don’t Be Embarrassed
As we age, some health issues seem too uncomfortable to talk about. Bodily functions we took for granted throughout our lives have suddenly changed or become problematic. Sexual issues, incontinence or memory loss can be difficult to discuss. But most doctors are accustomed to talking frankly about such issues. The American Psychological Association offers a series of online brochures on many physical and psychological health issues affecting older adults, which can help you introduce the topic to your healthcare provider. If you have access to a printer, make a copy to take along to your appointment. Being honest about your habits, such as smoking, alcohol use, poor diet and exercise, is best for your own benefit. So, don’t try to please the doctor with the “right answers” if they’re not true. Besides your habits, describe your symptoms clearly and accurately. Before the appointment write them down, including when they occur, for how long, what makes them better or worse and how they affect your daily life. Tell the doctor about any big life changes that affect you emotionally and mentally, such as divorce or death of a loved one. These can manifest physically. For additional advice on discussing various issues, describing symptoms and making the best use of your time with your doctor, read “Talking with your Doctor: A Guide for Older People” from the National Institute on Aging.

 

What Doctors Say
To help optimize your doctor’s appointment, AARP offers ways–straight from doctors’ mouths–to make the most of your visit:

Hey, look at me. Even though electronic medical records have replaced the handwritten chart, “A doctor who focuses on the screen while talking to a patient is communicating ineffectively,” says Dr. Robert Eckel, professor of medicine at the Anschutz Medical Campus of the University of Colorado, Denver. “A doctor should look directly at a patient when he’s providing important information about the visit,” Eckel adds. If your doctor is not, try saying, “I’d feel more comfortable if you looked at me while we talked.”

Show some personal interest. “Doctors are human, and sometimes they need a little attention, too,” says Dr. Harlan Krumholz, professor of medicine at the Yale University School of Medicine. “A kind word or showing interest in your doctor can go a long way toward strengthening the personal tie between you.”

Be the squeaky wheel. If your doctor is unclear about something you asked or said, or if you don’t understand what the doctor said, don’t let it drop. Ask for a re-explanation or clarification. If it’s something the doctor seems uncertain about, ask about getting a second opinion (see below) and a recommendation for another doctor. Even if this makes you uncomfortable, it’s better than leaving unsatisfied.

Ask about long-term issues. Following a diagnosis, ask for specifics about how long it takes to heal, how long a procedure will take and when you can go back to work or resume normal activities, given your specific situation. If a serious condition or surgery is required, ask if you can continue to live independently or if there are alternatives to the doctor’s recommendations.

Start with your main concern. Discussing your main worry upfront gives you the time to focus on it, says Dr. Lisa Schwartz, professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice. If you haven’t covered all your concerns and time is running short, ask your doctor if he’d like to hear the rest now or prefer to follow up by phone or email.

Provide some background. If your medical history is complicated and you have an appointment with a new doctor, bring along a one- or two-page summary of recent tests and treatments so she can get up to speed quickly. Even if your records were transferred to her office before your appointment, she may not have had a chance to read them thoroughly. Providing a short version with only the highlights and test results for the last six months or year will save time and may help you avoid repeat tests and imaging.

 

When to Get a Second Opinion

Rita Wilson, the wife of actor Tom Hanks, credits getting a second opinion with saving her life. After two breast biopsies that came back normal, Wilson still felt something was wrong. A friend recommended a second opinion, and with it Wilson found out she had a dangerous and stealthy form of cancer often found with another condition she had. She ended up having a double mastectomy and breast reconstruction.

 

Trisha Torrey, founder of the Alliance of Professional Health Advocates and author of You Bet Your Life!: The 10 Mistakes Every Patient Makes, was diagnosed with lymphoma and told she had three months to live. But this diagnosis didn’t gel with the way Torrey felt. After a second opinion, it turned out her diagnosis was misinterpreted by a zealous medical student, which can sometimes happen at large teaching hospitals. “You have a better understanding of your body than anyone else,” Torrey says.

 

Next Avenue provides some instances when a second opinion may be warranted:

  • If the treatment your doctor recommends or your illness is at all invasive, especially difficult (chemotherapy or radiation) or likely to be chronic
  • If surgery is required
  • If the condition is inherently tricky to diagnose but strongly symptomatic, such as Lyme disease or chronic fatigue syndrome
  • If many treatment options exist for what you have and you want to figure out the best course to follow
  • If a treatment is experimental or you’re considering participating in a medical trial

 

As a final cautionary note: Don’t assume a second opinion is always right. If you see a second doctor and his opinion is radically different from the first, it may be wise to get a third opinion as a tie-breaker. And sometimes, advises Torrey, it’s best to go back to the first doctor, present what you’ve found and raise questions. Also make sure that the healthcare provider from whom you want a second opinion is part of your insurance provider network. Ask your health insurance’s customer service department for a referral for a second-opinion provider.

 

 

Reprinted by Always Best Care Senior Services with permission fromSenior Spirit, the newsletter of the Society of Certified Senior Advisors The Certified Senior Advisor (CSA

Thanks to our friends as Always Best Care Senior Services for this info !

Medicare Reminder

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Some people do not take Part B during their Initial Enrollment Period (IEP) because they or their spouse are still working and they have primary insurance from a current employer. You should talk to your employer when you become eligible for Medicare to see how your employer insurance will work with Medicare.

Your Initial Enrollment Period begins three months before your 65th birthday and ends three months after your 65th birthday. If you or your spouse are still working and you receive health insurance from that current employer, the insurance is primary if there are 20 or more employees at the company where you or your spouse work.

If you are already collecting Social Security you will be automatically enrolled in both Medicare Part A and Part B. If you are thinking about turning down Part B, you should call the Social Security Administration at 800-772-1213 and ask if you can do so without any penalties. When you call Social Security, it is important to write down whom you spoke to, when you spoke to them and what they said.

 

Water Aerobics for Your Health !

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There are many different ways that you can get healthy – doing water aerobics is something you might never have thought of. However, not only can it help you be really healthy and get the most out of your aerobic work out, it can do a lot more, as well.

When it comes to using the water to work out, there are many ways that water aerobics can work for you. You can either do some of these exercises on your own, or you can join a club or a group that will teach you how to do them. No matter what you decide to do, you’ll be able to find that water aerobics fit right in to your regular work out routine.

Basically, doing water aerobics means that you are going to be providing your body with actual exercise. You are going to be doing aerobic work outs in much the same manner that you would if you weren’t in the water – for instance you are going to be able to run, walk, and do other movements during your work out. The difference is that you’ll be doing them in the water, which adds to the work out.

By doing your workout in the water, you are getting more resistance than if you were doing it in the air. Everyone knows that when you try to move through water you have to exert more force in order to make the movements that you want to make. This means that as you do your water aerobics, you are forced to use more of your muscle groups and you are forced to get stronger.

Most of the time you can be with a water aerobics class, which will help you figure out how best to do your water aerobics. This is a great way to make sure that you know what you are doing, and to make sure that you are actually getting as much out of your exercise as you can. The instructor will guide the class through a series of movements, where you’ll be able to do the same repetitive motions over and over again. Hopefully, you’ll find that this will increase your heart rate and allow you to be able to start to work your body in a great and aerobic way. By doing water aerobics, you can get exercise and strengthen every part of your body – plus, water aerobics can be the most fun you’ve had in a pool since you were a little kid!

Dear Marci.

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Dear Marci,

I received a notice from my Medicare Advantage Plan telling me that the plan is ending as of December 31, 2015. What should I do? How will I keep getting Medicare benefits?

– Frank (St. Cloud, MN)
Dear Frank,

Since your Medicare Advantage Plan is ending at the end of this year, you will need to make a few decisions.First, you should decide if you want to switch to Original Medicare or choose another Medicare Advantage Plan. Depending on your choice, you have different options for enrolling.

Option 1: Switch to Original Medicare

If you decide you want to switch to Original Medicare, you will be automatically enrolled when your Medicare Advantage Plan ends. Your coverage will begin January 1, 2016. If you need prescription drug coverage, you will need to sign up for a stand-alone Part D plan. Choose a Part D plan by the end of 2015 to avoid potential gaps in coverage. The cut-off date for choosing a Part D plan is February 29, 2016.

If you switch to Original Medicare from your current plan, you may want to purchase a Medigap as well. Medigaps help pay for gaps in Original Medicare coverage. You will have special rights to purchase a Medigap policy because your Medicare Advantage Plan is ending; during this special enrollment period, plans cannot impose a waiting period for pre-existing conditions. Remember, you can only have a Medigap if you have Original Medicare. Contact your State Department of Insurance or State Health Insurance Assistance Program (SHIP) to learn more about the Medigap rules and regulations in your state.

Option 2: Choose Another Medicare Advantage Plan

If you decide to choose another Medicare Advantage Plan, it is best to sign up for a new plan during Fall Open Enrollment. If you choose a new plan by December 7(the end of Fall Open Enrollment), it will take effect on January 1, 2016. If you choose a new plan outside of Fall Open Enrollment, you should sign up by February 29, 2016. The new plan will then take effect on the first of the month after you sign up. However, to avoid potential gaps in insurance coverage, you should choose a new Medicare Advantage Plan by December 7.

To pay the least for your health care costs, you should make sure that your doctors accept your new plan, and that the pharmacy you go to is a preferred pharmacy.

The main point is that although your plan is not being renewed next year, you have options, and if you take appropriate steps, you will not have any gaps in insurance coverage.

– Marci

Stored fat fights against the body’s attempts to lose weight !

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The fatter we are, the more our body appears to produce a protein that inhibits our ability to burn fat, suggests new research published in the journal Nature Communication. The findings may have implications for the treatment ofobesity and other metabolic diseases.

Most of the fat cells in the body act to store excess energy and release it when needed but some types of fat cells, known as brown adipocytes, function primarily for a process known as thermogenesis, which generates heat to keep us warm. However, an international team of researchers from the Wellcome Trust-Medical Research Council Institute of Metabolic Sciences at the University of Cambridge, UK, and Toho University, Japan, have shown that a protein found in the body, known as sLR11, acts to suppress this process.

Researchers investigated why mice that lacked the gene for the production of this protein were far more resistant to weight gain. All mice – and, in fact, humans – increase their metabolic rate slightly when switched from a lower calorie diet to a higher calorie diet, but mice lacking the gene responded with a much greater increase, meaning that they were able to burn calories faster.

Further examinations revealed that in these mice, genes normally associated with brown adipose tissue were more active in white adipose tissue (which normally stores fat for energy release). In line with this observation, the mice themselves were indeed more thermogenic and had increased energy expenditure, particularly following high fat diet feeding.

The researchers were able to show that sLR11 binds to specific receptors on fat cells – in the same way that a key fits into a lock – to inhibit their ability to activate thermogenesis. In effect, sLR11 acts as a signal to increase the efficiency of fat to store energy and prevents excessive energy loss through unrestricted thermogenesis.

When the researchers examined levels of sLR11 in humans, they found that levels of the protein circulating in the blood correlated with total fat mass – in other words, the greater the levels of the protein, the higher the total fat mass. In addition, when obese patients underwent bariatric surgery, their degree of postoperative weight loss was directly proportional to the reduction in their sLR11 levels, suggesting that sLR11 is produced by fat cells.

In their paper the authors suggest that sLR11 helps fat cells resist burning too much fat during ‘spikes’ in other metabolic signals following large meals or short term drops in temperature. This in turn makes adipose tissue more effective at storing energy over long periods of time.

There is growing interest in targeting thermogenesis with drugs in order to treat obesity, diabetes and other associated conditions such as heart disease. This is because it offers a mechanism for disposing of excess fat in a relatively safe manner. A number of molecules have already been identified that can increase thermogenesis and/or the number of fat cells capable of thermogenesis. However to date there have been very few molecules identified that can decrease thermogenesis.

These findings shed light on one of the mechanisms that the body employs to hold onto stored energy, where sLR11 levels increase in line with the amount of stored fat and act to prevent it being ‘wasted’ for thermogenesis.

Dr Andrew Whittle, joint first author, said: “Our discovery may help explain why overweight individuals find it incredibly hard to lose weight. Their stored fat is actively fighting against their efforts to burn it off at the molecular level.”

Professor Toni Vidal-Puig, who led the team, added: “We have found an important mechanism that could be targeted not just to help increase people’s ability to burn fat, but also help people with conditions where saving energy is important such as anorexia nervosa.”

Jeremy Pearson, Associate Medical Director at the British Heart Foundation (BHF), which helped fund the research, said: “This research could stimulate the development of new drugs that either help reduce obesity, by blocking the action of this protein, or control weight loss by mimicking its action. Based on this promising discovery, we look forward to the Cambridge team’s future findings.

“But an effective medicine to treat obesity, which safely manages weight loss is still some way off. In the meantime people can find advice on healthy ways to lose weight and boost their heart healthy on the BHF website – bhf.org.uk.”

Adapted by MNT from original media release