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This and the next three healthcasts are about the things you need to know at every age to prevent accidents, disease and death. If you are a parent of a child from birth to age ten, you will find out in this healthcast:
- The most common reasons children get sick
- The kinds of physical examinations that should be done on children
- The most critical lab tests
- The key vaccines and drug treatments to prevent disease
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In this podcast, I provide an overview of diabetes.
- How many people have diabetes?
- What is diabetes?
- Why is it called diabetes mellitus?
- What are the complications of diabetes?
- Can these complications be prevented?
- What are the the characteristics of Type 1 (or juvenile) diabetes?
- How did the isolation of insulin change the lives of Type 1 diabetics?
- What are the the characteristics of Type 2 (or what used to be called “Adult Onset”) diabetes?
- What do you need to do to avoid the complications of diabetes?
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This Healthcast will help you to shed those pounds that are raising your blood sugar, your blood pressure and your health care costs. It tells you all you need to know to become a successful loser.
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In this week’s podcast about the importance of exercise, I answer the following questions:
- What are the benefits of exercise?
- Should you see a doctor before starting a program of vigorous exercise?
- How much exercise should you do?
- Which type of exercise should you do to meet your goals?
- How vigorous should your exercise be?
- How many calories will you burn?
- Should you do resistance training and why?
- What strategies can you use to stick to your program?
- Do you need to stretch before you exercise?
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Alan L. Rubin, MD recording a podcast
In my very first podcast, I discuss what you need to do before the age of 50 to ensure good health later in life.
Length: 12 minutes
Hypothyroidism means your thyroid gland is not making enough thyroid hormone for your body’s needs. Most of the hormone coming out of the thyroid is thyroxine (T4) and a much smaller amount of tri-iodothyronine (T3). The vast majority of patients will do fine given just T4 since the body can convert T4 into T3 to make up for missing T3. You take enough T4 to reduce the thyroid stimulating hormone (TSH) level to normal. Changes in the level of T4 you take are checked with blood tests no more often than every 4 weeks.
Do I have High Blood Pressure?
When you or your doctor takes your blood pressure, two numbers are generated, a larger number, the systolic blood pressure (SBP), and a smaller number, the diastolic blood pressure (DBP), written as SBP/DBP or 120/80, for example. How do you know if yours is too high? The numbers have been clearly defined. These are the various categories that you might fall into. Remember that you should use the higher category to determine your particular level. For example, if you have normal systolic blood pressure but a diastolic blood pressure that puts you at stage 1 high blood pressure (HBP), you are considered to have stage 1 high blood pressure.
In the last few weeks, I have had several new patients who came in complaining of weight gain despite not eating excessively. Over the years I have seen many similar patients. When I take a history, I often find that these patients are consuming excessive amounts of alcohol every night. These patients do not realize the calorie contribution of alcohol.
The idea in treating hyperthyroidism is to reduce the amount of thyroid hormone in the blood to normal. There are three main ways of doing this:
- Antithyroid drugs include tapazole and propylthiouricil. These block the production of thyroid hormone and reduce the autoimmune reaction that is taking place. You usually have to stay on the drug for at least a year. They can cause a reduction in white blood cells, making you more prone to infections.
Follow these recommendations and you will not only avoid complications of diabetes but you will be healthier than your friends without diabetes.
- Major monitoring: Make sure your doctor orders hemoglobin A1c tests, lipid profiles, and urine microalbuminuria tests at appropriate intervals
- Devout dieting: Keep your calories down so your body mass index is between 20 and 25
- Tenacious testing: Test your blood glucose at least four times daily if you have type 1 and twice daily with type 2 diabetes
- Enthusiastic exercising: Do 30 minutes of exercise at least 5 times a week
- Lifelong learning: Go to refresher classes on diabetes or read the latest edition of this book.
- Meticulous medicating: Be sure to take your medication at the right time and in the right amount.
- Appropriate attitude: Stay positive and keep your humor level high.
- Preventive planning: Know what you are getting into when you go out to a restaurant or someone.s home to eat.
- Fastidious footcare: Check your feet regularly for damage and use skin lubricants to keep them soft and moist.
- Essential eye care: See the optometrist or ophthalmologist at least once a year to have your eyes checked.
Do I have Diabetes?
Diabetes is very clearly defined by the level of the blood sugar, which is actually called glucose. These are the criteria for making a diagnosis of diabetes:
- If your plasma (the liquid part of the blood) glucose in the fasting state (you have not eaten since dinner the night before) is 126 milligrams per deciliter (mg/dl) or higher on two different occasions, you have diabetes. Using the International System of measurement, that would be 7 millimoles per liter (mmol/L).
- Alternately, if your casual plasma glucose (you have eaten normally prior to being tested) is greater than 200 mg/dl (11.1 mmol/L) on two separate occasions, you have diabetes.
- Finally, if your plasma glucose is 200 mg/dl (11.1 mmol/L) 2 hours after eating 75 grams of glucose, you have diabetes.
A podcast on this topic is also available.
What are the things that should be in place by age 50 that predict that you will be alive and well at age 80 and beyond?
A major study from Harvard Medical School attempted to answer this question by following three groups of people beginning in the year 1910 and continuing through the 20th century. The results are discussed in the book, “Aging Well: Surprising Guideposts to a Happier Life from the Landmark Harvard Study of Adult Development” by George Valliant.
When it comes to cholesterol, except for the form called High Density Cholesterol or HDL (also known as “good cholesterol”), the lower the better. This is especially true of Low Density Cholesterol or LDL (also known as “bad cholesterol”). It was thought that an LDL of less than 100 milligrams per deciliter (mg/dl) was the goal but recent studies show that people who achieve an LDL of 70 mg/dl after a heart attack are at much lower risk of a second heart attack than those at an LDL of 100. The good news is that these goals can be achieved by anyone using modern treatments.
If five people with diabetes read this article, chances are good that four of them will not be taking low dose aspirin to prevent heart attacks, even though it has been shown, conclusively, to do this. Aspirin makes the blood less apt to clot and cause a blockage of the arteries of the heart.
You can do a lot to prevent high blood pressure. These are just some of the more important steps you can take to avoid getting it and its complications.
- Make sure you have it in the first place. There are many ways by which a mistaken diagnosis can be made. See Chapter 2 in my book.
- Find out if you have secondary high blood pressure. This is high blood pressure caused by another disease such as kidney disease and can often be cured by correcting the other disease.
- Give up tobacco and excessive alcohol. One cigarette is too many and more than 10 drinks a week for a man or 5 for a woman is too many.
- Reduce salt in your diet. Most of the salt in food is put there by the food manufacturers so read food labels.
- Adopt the DASH diet. This is a diet that emphasizes fruits and vegetables. See chapter 9 in my book.
- Lose weight if your body mass index is greater than 25.
- Start an exercise program. You can walk for a half hour each day and lower your blood pressure. It will raise your self-esteem, improve your balance and enhance your memory at the same time.
- Try a mind-body technique. Some people respond well to yoga, meditation or biofeedback.
- Avoid drugs that raise blood pressure. Diet drugs and several of the drugs used to treat the common cold will raise blood pressure as will steroids.
- If all else fails, get the right treatment with medications. There is no case of high blood pressure that can’t be controlled with the right drugs. See chapter 13 in my book.