Screening medical tests- desirable or distracting

To make an intelligent decision about your own screening, you need a physician who reviews your past and current medical history, your family history, and your health goals.

Both doctors and patients have mixed emotions about diagnostic tests done to screen for disease. We physicians want to help patients stay healthy, prevent disease, and treat problems early and effectively.. But the time spent counselling, ordering, performing, and reviewing these tests means less time available to manage patients’existing medical problems.

I agree with Dr. William Zinn, family physician in Boston, who wrote

“Keeping track of the ever-increasing health maintenance requirements and cancer screening sometimes make it hard to remember why the patient came to the office in the first place.”

JAMA, January 7, 2020

For patients the issues are similar. While they want to stay healthy, prevent disease, and get treated promptly, they don’t like the inconvenience, time away from work, cost, and sometimes discomfort the tests require.

What are screening tests?

A screening medical test is done to uncover a disease or disorder in a person who may or may not be a risk for it and who otherwise feels well and has a normal exam. Suppose we are considering screening a group of people for disease X. Let’s start by dividing them into 3 groups.

  • Those with no symptoms, feel fine, at average risk of health condition X.
  • Those with no symptoms, feel fine, at increased or high risk of condition X.
  • Those who have symptoms suggestive of condition X, or have had other testing that suggests they might have it

Screening for X in groups 1 and 2 might be appropriate, based on medical guidelines, physician judgement, and patient preference. For group 3, with symptoms of condition X, testing would be considered diagnostic; a doctor would test for X, and possibly other conditions that the symptoms suggest.

Diagnostic vs Screening

That might seem like a picky difference, but there are several implications for both doctors and patients.

Documentation- The medical record needs to reflect accurately why a test is being ordered and done. This is necessary for billing because inaccurate coding can make doctors and clinics liable for fraud. Also, the government and other payers are starting to judge doctors’ quality of care based on medical record audits of care given or not given, and why.

Interpretation and Follow up-A test is rarely interpreted in isolation. Patient factors, especially the history and exam together with the test ,lead to a diagnosis.

Reimbursement– Most if not all insurances, including Medicare, reimburse differently based on whether a test is diagnostic or screening. And this usually determines how much the patient pays for each. Screening tests are usually covered 100% while diagnostic testing may require a deductible or copay .

A Country Doctor Writes blog explains this dilemma in detail –

But because in the inscrutable wisdom of the Obama Affordable Care Act, it was decided that screening colonoscopies done on people with no symptoms whatsoever are a freebie, whereas colonoscopies done when patients have symptoms of colon cancer are subject to severe financial penalties.

read more at this link

This link at FamilyDoctor.org helps explain how medial insurance coverage works.

Does disease screening make a difference?

Screening tests don’t prevent disease although they may be helpful for health maintenance or improvement. They may prevent progression or complications of a disease, but don’t prevent it’s onset. They may not even prevent death from the disease, although we like to believe they do. Screening may diagnose the disease before symptoms develop, so the patient lives longer with the disease, but not affect the eventual outcome.

So when should we offer screening tests?

If there is a clear benefit to patients from an effective treatment available to make a difference in the disease course or

If knowledge of the condition helps the patient and family make choices about managing the condition’s likely course or the need for family members to be screened

If the test is reliable enough to identify most people with the disease without falsely identifying people who don’t have it. The scientific terms for this are sensitivity and specificity.

When the benefits clearly outweigh the risks and costs.

How to decide for yourself

These are just some of the factors involved in deciding when to undergo screening tests. To make an intelligent decision about your own screening, you need a physician who reviews your past and current medical history, your family history, and your health goals. Then the doctor can make recommendations based on your needs and desires with the help of expert guidelines published by medical organizations who carefully review the medical literature.

Review the graphics in this post for recent guidelines from professional organizations and discuss with your physician. Help your doctor help you by scheduling a health maintenance visit rather than bringing it up when you are there sick or for chronic care. These discussions deserve your physician’s full attention.

further information from the National Institutes of Health.

To Screen or Not to Screen

¿Hacer o no hacer pruebas de detección?

exploring the HEART of health maintenance

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

These are affiliate links you may find helpful and which help fund this blog with a commission when a purchase is made using them.

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Go to this link to try RoboForm Free; if you like it you can upgrade to RoboForm Everywhere version with all the features I mentioned above. With Roboform, you will have one less thing to feel stressed about.

7 health habits that will make your life more satisfying

Sometimes what we need to simplify is our life, our daily habits. Do you ever feel you’ve been busy all day, and didn’t accomplish anything you really wanted to do? Maybe decluttering, simplifying, and changing our priorities will create a more satisfying -and healthier- life

Do you ever feel you have too much stuff ? Do you spend more time than you want dealing with clutter? Do you organize only to find you still don’t have enough room for your belongings?

If so, maybe you need to discard stuff, not organize it better. This process goes by different names- decluttering, simplifying, minimalism- with a goal of less stress, more peace, and more time to enjoy activities that truly give us pleasure and satisfaction.

Sometimes what we need to simplify is our life, our daily habits. Do you ever feel you’ve been busy all day, and didn’t accomplish anything you really wanted to do? Maybe decluttering, simplifying, and changing our priorities will create a more satisfying -and healthier- life.

Here are some habits that we often neglect and fail to prioritize, but medical science now recognize as vital to optimal health and well being. I’ve illustrated each with a link to an affiliate service or product that you might find helpful (and through which you can help support this blog), but feel free to develop your own ideas on how you can make these a consisent part of your life.

sleep

SLEEP– Too many of us treat sleep like a luxury or a waste of time rather than as the necessity that it is. Some of us need more quality sleep; many people are chronically tired due to undiagnosed sleep disorders  such as obstructive sleep apnea which aren’t recognized without medical evaluation.

Natural Bedding

eating

FOOD– We need  to eat more nutritious food- a whole food, plant based diet with fresh vegetables and fruits, beans, legumes, whole grains, lean meats, dairy- anything that isn’t processed or full of unnecessary sugar or excessive fat.

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connection

CONNECTION– We need to spend more time with our family and friends, keeping in touch physically and emotionally. Parents and children connect when they read together. Family vacations create connection through shared activities and memories.

Free Baby Board Books!

giving

GIVING– We need to cultivate generosity and give more, whether it’s of our money, time, talent or possessions. Every community offers ample opportunities to volunteer and serve others.

physical activity

PHYSICAL ACTIVITY– We need to move more often , including sports, exercise, chores, walking, even just standing up more than we sit. Here are guidelines recommended by the U.S. Department of Health and Human Services

mental activity

MENTAL ACTIVITY– We can read, learn new skills or improve established ones,  start or resume a hobby like photography, learn another language, maybe start a blog.

Digital Photography School Resources

conversation

CONVERSATION– We need communication with other people often and authentically. Social media, phone calls, text and email messages substitute when necessary, but they shouldn’t replace face to face time with others. Book clubs, hobby groups, classes, church groups provide safe places to share ideas and learn from others.

2 women talking over coffee with open bibles
Conversation over coffee can be therapeutic. graphic from the Lightstock collection of stock photos, graphics, and other media, an affiliate link

I am indebted to another physician blogger Vania Manipod, D.O. a psychiatrist who believes “it’s stylish to talk about mental health.” A post she wrote in 2015 addressed these ideas and prompted me to explore them in a previous post here.

Please take time to read Dr. Manipod’s post and others on her blog-

“New Year’s Resolution Ideas to Enhance Your Mental Health”

exploring the HEART of healthy habits

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

 

                              Dr. Aletha 

This website is owned and operated by Aletha Oglesby, an Arbonne Independent Consultant, and is not endorsed by Arbonne. Any opinions expressed on this website are made by and the responsibility of the Independent Consultant and should not be construed as a representation of the opinions of Arbonne.
Arbonne makes no promises or guarantees that any Independent Consultant will be financially successful, as each Independent Consultant’s results are dependent on their own skill and effort.
You should not rely on the results of other Arbonne Independent Consultants as an indication of what you should expect to earn. The annual typical earning statement is contained in the Arbonne Independent Consultant Compensation Summary (ICCS) available iccs.arbonne.com.

August Timely Topics- back to school

August is a strange month. It’s the only month without a major holiday. Although it still feels like the height of summer, by the end of the month kids are back in school. I remember the struggle to get my sons into bed early when it’s still daylight at 9 PM.

August is a strange month. It’s the only month without a major holiday. Although it still feels like the height of summer, by the end of the month kids are back in school. I remember the struggle to get my sons into bed early when it’s still daylight at 9 PM.

Photo by Pixabay on Pexels.com

August Timely Topics

Most schools encourage and even require vaccination to protect all children from disease. This has become a controversial and contentious topic so we’re going to visit the medical reason vaccinations make sense.

Measles-not gone, not forgotten

Recommended Child and Adolescent Immunization Schedule
from the Centers for Disease Control and Prevention

The start of school in August reminds me of my college days- especially since I met my husband in college, the University of Oklahoma. I was studying pre-med; he was in graduate school, using his veterans’ educational benefit after discharge from the Army. Here are a couple of posts about his military service and our courtship.

Bullets to Blessings

Two Words and Two Left Feet

Of course, the main goal of school is education- lectures, textbooks, assignments, studying, projects, experiments, and tests. Reading is vital to all of these-books are the basic building blocks. That’s why Dolly Parton gives books away- read why here.

Overcoming the Dream Killers

Overcoming the dream killers-Watercress Words.com

Can medical knowledge make you a better patient?

And speaking of tests, here’s one for you. Find out how much you know about medicine by taking this quiz that I wrote especially for blog readers.

CAN MEDICAL KNOWLEDGE MAKE YOU A BETTER PATIENT?

sharing the HEART of health

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

                              Dr. Aletha 

These are affiliate links you may find helpful and which help fund this blog with a commission when a purchase is made using them.

myReader Rewards club- photo of woman on a bench reading a book

My Reader Rewards Club is a great way to earn free books and Bibles for yourself, friends, and family! Your journey to earning free faith-based products starts HERE.
(When you sign up through these links, I can earn free books too.)

As a member, you’ll have access to inspiring literature, Bibles, special promotional offers, and much more. Earning points is easy—you’ll receive 25 points just for signing up!

Get active

Summer is the perfect time to start or increase physical activity. I’ve been using a fitness app on my phone, Aaptiv. Consider trying it. I’d appreciate you using this affiliate link through which you can help fund this blog. Thanks and enjoy.

Surprising health benefits of plant based eating

Like you, I want to know more about healthy eating, but find published nutrition information conflicting, confusing, and complicated. But almost all of it seems to agree on one thing-eating more whole plant based unprocessed foods is the best choice, with proven health benefits and little if any harm.

Like you, I want to know more about healthy eating, but find published nutrition information conflicting, confusing, and complicated. But almost all of it seems to agree on one thing-eating more whole plant based unprocessed foods is the best choice, with proven health benefits and little if any harm.

In this post I’m introducing you to two books and associated websites that present the evidence for the benefit of plant based eating and explain in easy to understand terms how to do it.

SURPRISING BENEFITS OF PLANT BASED EATING

Over 30 years ago, a father-son team showed the world the results of “the most comprehensive study of nutrition ever conducted” , so I wonder why it seems we’re just now believing that what we eat influences our health and lifespan for better or worse.

(several affiliate links are in this post. )

The China Study: The Most Comprehensive Study of Nutrition Ever Conducted

by  T. Colin Campbell, Ph.D and Thomas M. Campbell, M.D.

They looked at more than 350 variables of health and nutrition with surveys from 6,500 adults in more than 2,500 counties across China and Taiwan, and conclusively demonstrated the link between nutrition and heart disease, diabetes, and cancer.

“What they found when combined with findings in Colin’s laboratory, opened their eyes to the dangers of a diet high in animal protein and the unparalleled health benefits of a whole foods, plant-based diet. “

Amazon

T. Colin Campbell Center for Nutrition Studies

At the Center for Nutrition Studies website, you can meet Dr. Campbell , learn the history of the China study and explore

“Eat whole plant based foods”

It’s a lifestyle, not a diet

Dr. T. Colin campbell

How Not to Die- Discover the Foods Scientifically Proven to Prevent and Reverse Disease 

by Michael Greger, M.D. with Gene Stone

Like the Campbells, Dr Greger has reviewed thousands of studies of nutrition and concluded that major chronic diseases-heart disease, diabetes, cancer-are caused by the foods we eat, and can be prevented, even reversed by changes in our diet. He too advocates whole food, plant based diet. He recommends

  • Avoid refined processed carbs-chips, pastries, jams, condiments
  • Avoid wheat and gluten
  • Avoid grain fed meat and feedlot chicken
  • Avoid concentrated and synthetic sweeteners, and sweet drinks
  • Avoid commercial oils

Instead, we should be eating

  • Olive oil
  • Grass fed, free range meat
  • Vegetables, legumes, nuts
  • Low sugar fruits
  • Tea, coffee
  • Dark chocolate, herbs, seasonings

NutritionFacts.org

At this website, founded by Dr. Greger, you can

In this video about causes of cancer, Dr. Greger refers to one of Dr. Campbell’s nutrition articles.
Dr. Greger’s Daily Dozen – NutritionFacts.org

I have found his Daily Dozen App useful for tracking my intake of whole plant based foods. This free app is available from the App Store.

Both of these websites are 501(c)3 non-profit entities supported by donors.

a basket filled with fruits and vegetables
Will you commit to buying, preparing, and eating more fruits and vegetable?
photo from the collection at LIGHTSTOCK.COM, an affiliate link

Thanks for joining me to explore the HEART of nutrition and health.     

I hope you will bookmark both of these sites so you can go back often and explore the information they have to offer. You may not choose to incorporate all the changes they propose, but even a few changes may improve your health, decrease your risk of chronic disease, and help you live longer.

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

Consider this affiliate if you’re looking for an easy way to eat better and lose excess weight. (and help me fund this blog with the commission it generates)

468x60 Healthy Weight Loss Delivery Plan

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

July Timely Topics- Celebrations and Souvenirs

For July topics we’ll look at summer safety and wellness. We often call winter the cold and flu season, so we could call summer the poison ivy, sunburn, and blister season. Unfortunately, it’s also the season for drownings and water sport accidents.

Where I live, we just saw the first day of summer come and go. It was the longest day of the year and so far one of our hottest. Summer activities are in full swing. Many of the patients I see now are either just coming back from a vacation or getting ready to leave. I envy them because I am staying home since my husband is recovering from a broken ankle that dashed our plans for a summer trip.

Join My Reader Rewards Club to earn free books and Bibles
Check out MY READER REWARDS CLUB– it’s free and you can earn free stuff

For July topics we’ll look at summer safety and wellness. We often call winter the cold and flu season, so we could call summer the poison ivy, sunburn, and blister season. Unfortunately, it’s also the season for drownings and water sport accidents.

Here in the United States we have our most important holiday of the year-Independence Day, or commonly called the 4th of July. On this day in 1776, the North American colonies of England declared political independence, and the rest, as they say, is history. Much has happened in the 243 years since, and the United Kingdom is now an ally; an American citizen, Meghan Markle, recently married into the British royal family. Friendship is worth pursuing between people and countries.

Statue of Liberty
Lady Liberty lifting her torch in New York harbor

Here are links to July’s Timely Topics, or just search for what interests you

Life, Liberty, and the Pursuit of Healthcare

Don’t drink the water-how to avoid water related illness

Safe and healthy cruising-keys to an enjoyable vacation

5 insect repellents to keep you safe this summer

Christmas in July

Happy Campers

sharing the HEART of health

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

                              Dr. Aletha 

My Reader Rewards Club is a great way to earn free books and Bibles for yourself, friends, and family! Your journey to earning free faith-based products starts HERE.
(When you sign up through these links, I can earn free books too.)

As a member, you’ll have access to inspiring literature, Bibles, special promotional offers, and much more. Earning points is easy—you’ll receive 25 points just for signing up!

Get active

Summer is the perfect time to start or increase physical activity. I’ve been using a fitness app on my phone, Aaptiv. Consider trying it. I’d appreciate you using this affiliate link through which you can help fund this blog. Thanks and enjoy.

June Timely Topics- Relaxation, Recreation, and Remembering

Where I live, the school year has ended and summer vacation has started, although summer will not officially arrive for a few more weeks, at least on this side of the equator. The swimming pool in my neighborhood is open, and the days are definitely longer and warmer.

two people dangling their legs into a pool.
Don’t let water related illness spoil your summer fun. photo from stock photo site- Lightstock.com- affiliate link

For June topics we’ll look at summer safety and wellness. We often call winter the cold and flu season, so we could call summer the poison ivy, sunburn, and blister season.

Here in the United States we have several important observances in June. One we share with Europe is June 6, known as D-Day. This was the day in 1944 when Allied troops invaded France to free the country of Nazi occupation and ultimately to end World War II. Every year since we honor the bravery of those who gave their lives that day for the cause of freedom.

We also honor freedom by remembering those who suffered in slavery for too long and the day their emancipation was finally achieved-Juneteenth.

We honor our flag on June 14th, calling it appropriately Flag Day. There is a famous story about our flag, and its connection to our national anthem; we’ll look at that story.

And let’s not forget the day we honor dads, Fathers Day, the 3rd Sunday in June. Many men “father” us in multiple ways, whether our biological father, or an uncle, brother, teacher, coach, or friend. We thank them and make them feel special this day.

a man reading to two young girls, sitting in a woman's lap
Thanks Dads for all you do for us.

Here are links to get you started enjoying the “lazy, hazy, crazy days of summer.”

Don’t drink the water-how to avoid water related illness

Safe and healthy cruising-keys to an enjoyable vacation

5 insect repellents to keep you safe this summer

Words for Fathers’ Day

Those Lazy Hazy Crazy Days Of Summer – Nat King Cole (LIVE)

Nat “King” Cole

sharing the HEART of health

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

                              Dr. Aletha 

My Reader Rewards Club is a great way to earn free books and Bibles for yourself, friends, and family! Your journey to earning free faith-based products starts HERE.
(When you sign up through these links, I can earn free books too.)

USE THIS LINK TO SIGN UP

As a member, you’ll have access to inspiring literature, Bibles, special promotional offers, and much more. Earning points is easy—you’ll receive 25 points just for signing up!

Winning on the water-a book review of Boys in the Boat

In Boys in the Boat the United States Olympic Rowing team of 1936 beat incredible odds to win the gold medal. But the meat of the book reviews in detail how each man came to be in that boat, especially Joe Rantz.

Why do we like books and movies about sports? Have you noticed how many sports stories there are? (This post offers multiple affiliate links to sites that offer a commission to this blog for purchases made there.)

Some sport stories are about fictional characters and situations-

  • Rocky
  • Field of Dreams
  • Bleachers
  • Friday Night Lights
  • Million Dollar Baby

But the ones that most catch our attention and our hearts are those about real people.

  • Seabiscuit
  • Chariots of Fire
  • A League of Their Own
  • The Blind Side

Rowing- athletes in a boat

Most of us know something about the big sports, like football, basketball, and baseball. We probably know less about horse racing, boxing, track, and ice skating. But rowing , rarely if ever on the sports pages or television broadcasts, isn’t one most of us know at all.


The Boys in the Boat: Nine Americans and Their Epic Quest for Gold at the 1936 Berlin Olympics by Daniel James Brown.

In Boys in the Boat the United States Olympic Rowing team of 1936 beat incredible odds to win the gold medal. But the meat of the book reviews in detail how each man came to be in that boat, especially Joe Rantz. Based on interviews of him by the author, we learn Joe’s painful early family life, struggle to pay for college, and the grueling physical challenges of preparing for competitive rowing.

At that time the sport of rowing was dominated by the sons of wealthy families and the Ivy League colleges they attended. By contrast, the University of Washington athletes who made up the 1936 Olympic rowing team came from working class families and had to work their way through college. That they did so in the midst of a depression makes their achievement even more remarkable.

You may be surprised to learn how much the sport of rowing physically and mentally challenges the human body. To be competitive, the crew’s eight rowers must work synchronously as the leader, known as the coxswain, calls out commands to set a pace that is fast enough to win but sustainable for the length of the race.

Nazi Germany’s Olympic games

Interspersed in the boys’ stories, Daniel Brown outlines the events unfolding in Germany, as Hitler and the Nazi party rose to power. As part of their plan to dominate Europe and eventually the world, they plan to make the 1936 Olympic games in Berlin a showcase of German wealth, knowledge, power, and athletic ability. Specifically, Hitler hoped the German rowing team would beat England and Italy, the teams historically likely to win. The story of his reaction to an American team that not only challenged but upset the status quo completes a book worth reading.

My reaction to Boys in the Boat

From reading this book, I gained an appreciation for this sport that I previously knew nothing about. My husband and I listened to the audio book while on a 12 hour car trip and it kept us interested and entertained. We were inspired by a story where perseverance, courage, loyalty, and commitment were celebrated and rewarded.


This story proves history lessons aren’t dull, boring, or outdated, but can offer us information and inspiration to help us explore the HEART of health

the BOYS OF ’36 documentary

A PBS video documentary The BOYS OF ’36 is available on Amazon Video, free with Prime or available to rent.

Your comments welcome

If you read the book or watch the video, please contact me with your thoughts. I might use your comments in an update.

Thanks for visiting Watercress Words; I’d love for you to follow-use this form to get email alerts when I post something new. about the HEART of health.

                              Dr. Aletha 

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