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A person’s family medical history is basically any disease or medical problem that a relative of a person has had, such as high blood pressure or cancer.

When discussing your family medical history with your doctor, it’s important to not only let your doctor know, what first degree relatives had in terms of diseases, but also more distant relatives and this is especially important with cancers that may not affect every generation but may still be in the family history.

The best way to find out if you need to be screened for cancer is to ask your doctor. Your doctor will be able to tell you if you’re at risk for a certain kind of cancer and at what age group you need to be screened for very common cancers.

The prostate is an organ in the male reproductive tract that functions to release an alkaline fluid which basically makes the environment for the sperm a lot more hospitable in the vaginal tract which is a very acidic environment. So it helps the sperm to live longer.

Health literacy is an individual's ability to understand and utilize various health services and information. This typically relates to a patient’s ability to take medications properly, to understand and use the information their provider is giving them and to choose between two different insurance plans, and basically, to make the best or soundest decisions they can when it comes to their medical care. We found that patients who don't have the health literacy they need, under-utilize medical care, don't search out the appropriate amount of preventative services that they need, have more hospitalizations and overall their health is poorer. Oftentimes, patients have no experience navigating the healthcare system and they kind of get lost in the shuffle. Maybe they're too embarrassed to ask their doctor for help and that's a lot of times, where us, as care providers, need to offer a hand, and, and make sure that, that the individual or patient is able to navigate through things.

If a patient is having a hard time understanding their doctor, it can be one of two things: Either it's a physical barrier, such as they can't understand their doctor's accent, or their doctor speaks too quickly. In that case, the patient or individual just needs to simply ask their doctor to slow down or perhaps enunciate better. This should not offend the doctor because they want to be able to have open communication so that everybody is on the same page. Another situation where there might be some communication difficulties is that if the doctor is using too much jargon or medical terminology. We, as doctors, sometimes forget that not everybody speaks our lingo, so we will spurt out a lot of words or terminology that the patient may not understand. It's always totally appropriate to ask your doctor to slow down or say, "Hey, I don't know what that word means. Can you explain it in layman's terms?" And just being honest with your doctor and not, not feeling embarrassed to ask them for clarification, um, is important so that everybody can be on the same page so that there aren't any errors.

It's very important for a patient to know how to read their prescription label. A lot of medication errors occur because patients may get into a habit of taking their medicines without reading everything that's on the label, so it's always a good practice to get into looking at your prescription label every time you're about to take one of your medicines to make sure that that medicine is for you, that your name is on it, that you're supposed to be taking it rather than a family member. That the correct doctor's name is on it. That all of your personal information and your doctor's office information is correct on it. Perhaps most important is that the directions for the medication are read every time you take it. If you're supposed to take that medicine one tablet daily, you want to make sure that that medication label says that on it and that you follow the instructions. You also want to make sure that the medication isn't expired. Over time, medications can break down and become less effective, so if you're taking a medication that's expired, it may not be as effective, so you want to make sure that you're always up-to-date on your refills. And, speaking of refills, it's really important to look at that refill with the number next to it. Once you get down to zero, that's your hint to give your doctor's office a call and make sure you schedule an appointment to make sure that you don't run out of that medicine – especially for somebody with chronic diseases, who has to take a medicine every day, such as diabetes, hypertension, or high blood pressure, you want to make sure that you have enough of that medication so you don't run out and then you're kind of scrambling to play catch up.

There are many important components of a first aid kit. The typical first aid kit will include things like bandages, tweezers, alcohol wipes. But from my perspective, I feel that some even more potentially useful items are medications, such as Diphenhydramine which can treat rashes and allergy symptoms. Acetaminophen, which can treat pain and inflammation at times. Also, a less used medication called petroleum jelly, is very useful. It can slow bleeding, it can treat some rashes, and its a really handy thing to have on hand. Its something to include in a first aid kit that usually is not included to begin with.

There are many situations where a first aid kit can be used. Cuts, scrapes, burns, falls, aches and pains, fevers. Basically the first aid kit is your first line of defense against common medical problems that occur at home or out and about and if the first aid kit is unable to completely resolve or deal with the problem, you always have a primary care provider or emergency room to carry on the treatment from there.

Its difficult to say in concrete terms how often a first aid kit should be replaced. Definitely, the components should be monitored every few months to make sure that there are no expiration dates that are passing. But, as long as your checking the first aid kit every few months to make sure there aren't any expiration dates that are passing, and also to make sure that you're restocking the medications or items in a first aid kit, you'll be in good shape.

Gastroenteritis, it's referring to an infection of your G.I. tract. So gastro, usually referring to stomach, enteritis, more referring to inflammation of the intestines. So whether it's a bacterial or viral infection, it's an infection that causes irritation, a lot of G.I. symptoms such as nausea, vomiting, and diarrhea.

Sometimes when people get simple food poisoning, a couple hours later they may feel really bad abdominal pain but may not actually have any vomiting or diarrhea. It depends on how severe the infection gets, the strength of your immune system in conquering whatever the infectious agent is, but sometimes you may not have any of those symptoms.

There really is no such thing as the stomach flu. That's referring more to a viral cause of gastroenteritis. Flu refers to influenza, and when we have flu season, we're referring to catching a a virus that causes an illness of the upper respiratory tract, the nose, the sinuses, the throat, and the lungs. So it's really a misnomer. It's not really a flu of the stomach.

Gastroenteritis is an illness that, once you get, you really are counting on your immune system to fight the way through you. A lot of the things that we help with from a physician's side are symptomatic care. We're going to remind you, really push your fluids. If you're unable to keep fluids down for even 24 hours, we definitely want you to come see us. Oftentimes, we'll help you with medicines to help get the nausea under control. Also, if you're finding that you're having significant amounts of watery diarrhea for an extended period of time, you run the risk of dehydration. We like to use drinks like Pedialyte or maybe some watered down Gatorade to help get some electrolytes and some sugar back in the system.

One of the things I remind my patients about Gatorade, though, is it's really high in sugar. If you're consuming a lot of sugar, oftentimes that will re-aggravate the diarrhea and make it even worse. So it's really important to make sure not taking in too much.

When someone has infectious diarrhea that's complemented with nausea and vomiting and can't actually hydrate themselves appropriately, it's definitely time to go get some help and see your doctor. If you're noticing that you have a fever as an adult above 104, or if you have a little child or infant with a fever above 102, it's probably a good idea to get them in to see the doctor. If you're noticing any severe abdominal cramps that are so unbearable we can't get them under control, it's time to seek some medical attention to get it evaluated.

Weather patterns definitely can trigger headaches, whether it's changes in barometric pressure that can change your sinuses. Or if it's a very dusty day, activating somebody's allergies, they can certainly bring on different types of headaches.

What we think happens is there's a genetic trait that we get from our mothers and fathers that increase the sensitivity to certain changes in the environment and the weather. When you're exposed to those changes, they can trigger all the events that cause the neurons to depolarize and cause these migraine headaches or other headaches if it's a sinus-related allergy.

Weather changes can actually exacerbate headaches in terms of allergies when we see fluctuations in temperatures, different weather patterns with much higher winds. Oftentimes it'll stir up a lot of the different allergens in the environment. 

We definitely see people struggle when we have major changes of season. So when we go from winter to spring, a lot of the flowers and the trees start to bud and create a lot of pollen. And then we certainly see a lot of headaches that are derived from that. 

Any change of season, whether it's almost from a couple weeks at a time, the different cycles of all the different plants produce different types of pollen. So people may have headaches at the beginning of spring. And other people may not have them until we're in the middle of summer. But certainly, the changes in that weather pattern over a longer period of time can definitely exacerbate headaches that are triggered by allergies.

In order to reduce the amount of headaches that you get from the weather, the first thing you have to know is understanding your triggers. When people come and see me in the office and want to talk about their headaches, the first thing I have them do is what we call a headache diary. 

That's actually creating a calendar where every time you have a headache, writing down what kind of headache, where it was located in your head, and then thinking about everything that was going on that day. Did you have something to eat that was out of the ordinary? Was the weather pattern changing? Did the temperature fluctuate? Or was the pressure changing as well? 

Even if you were exposed to someone else that was sick and then all of a sudden you started getting a headache, those are all clues that will help us figure out how to diagnose what type of headache you have and therefore how we can help you avoid them.

We do have medications that we can use to help prevent headaches, if you suffer from them often. Usually if we see more than 15 or 16 migraine headaches in a month, we're usually going to recommend that you look at a medication to prevent them from happening, or at least reduce them.

We found that three out of four people who take those medications oftentimes have at least a 50% reduction in the amount of headaches they have. So they are effective. But sometimes we have to worry about the side effects, so it's definitely a joint decision we have to make.

One of the medications that we can use is actually a beta blocker, or a blood pressure medication, that sometimes helps reduce some of the vasospasm that we think used to happen in the brain. But it does help for migraines.

We also have a class of antidepressants and a class of anticonvulsants, which are seizure medications, that sometimes help quiet down some of the nerve activity in the brain.

Regarding prevention of headaches, specifically from allergies, the idea is identifying the allergy and then treating it, or trying to prevent the response to the allergies. If you find that you have really bad sinus problems and sinus allergies, we may talk about starting a nasal spray to help prevent the inflammation of the nasal turbinates in the sinuses in order to avoid those.

If you have specific allergies to weather or pollen, we may also talk about some allergy medications to take on a long-term basis in order to reduce the amount of hypersensitivity you have. But again, if it's related to the weather and the environment, we usually have to identify those specific triggers for us to successfully block some of those headaches for you.

What is Fatigue?

Fatigue is a symptom. Not a disease state. So, when someone is coming to talk about feeling tired or sleepy, we really have to get to the bottom of what's causing the fatigue, because something is causing that symptom.

We look at fatigue as something where you're not having enough energy throughout the day to get through normally, or mental exhaustion where you're not having the fortitude to continue doing an activity.

And fatigue is really important to discuss between that lack of energy and actual sleepiness. Sleepiness is a normal function. We only are built to have so much in our personal battery, whether it's our mind or our bodies, to get things done. And we need sleep to recharge. But fatigue means, even though we're sleeping, we're still just really, really low energy and easy to peter out.

Lifestyle-based Fatigue

When we look at the causes of fatigue, I like to look at things that are short-term and more long-term. So, short-term, think of, I caught the flu and I was really worn down and just had really, little energy all day long to get things done, if you've been cramming for a test and you've used a lot of mental energy, and afterwards, you're just feeling really worn out, needing to recharge, like stressors, too. So, if you lost someone that you loved and are really struggling with that emotion, sometimes that uses up a lot of energy.

When fatigue is a main concern and we're trying to get to the root of it, I always want patients to start with the basics. And the basics can be done without having to go to the doctor, too. I want you to take a look at lifestyle, things that go in and out of the body, and things that affect you directly in day-to-day life.

First is diet. In the American diet, oftentimes we're lacking the good nutrition we need. We eat a lot of processed foods and we're missing our fruits and vegetables. So, first things first. Take a look from the beginning. Are you eating a lot of processed foods, or eating a lot of junk? It's not really good fuel. It's like putting ethanol 85 in your Ferrari. It's not going to run very well. So, go back to the basics. Go back to more fresh fruits and vegetables, lean meats, good proteins, and cut out the candy bars and the soda. And that also includes cutting down the alcohol, too. Because alcohol certainly can lead a lot to the changes in energy.

Next step is exercise. Exercise is incredibly important for the body to regenerate itself, and it actually helps a lot with energy. People put a lot of energy into exercise, but exercise actually gives back and helps people feel more energetic, too. If you're not getting enough, the body doesn't get enough of the stimulation, enough of the endorphins, and enough of the training for muscles and heart to really help you feel better.

The third thing that I would have people take a look at would be sleep. So, even if you're getting your hours of sleep, the question is, do you have good-quality sleep? If you're waking up every hour to go to the restroom or you're tossing and turning, oftentimes it's a sign that something is not resting in the body. If you don't get adequate rest, our body doesn't have the ability to process all of your thoughts throughout the day, doesn't have time to regenerate a lot of it's cells that need special time when you sleep. So, if sleeping is disrupted over and over, it's going to lead to fatigue and symptoms of tiredness.

Another important thing to look into when people are complaining about fatigue is their stress management. So, if you have a stressful job and you're working long hours and you've got deadlines ... you know, bosses that put a lot of pressure on you, after a long period of time, that will really start to wear you down. And that's kind of where a lot of this emotional fatigue comes in. Because that's just as important as how much energy your body has.

If you've also had stressors, losing someone very important to you and the amount of impact that that places on you, that's really going to increase your stress level. And that uses up a lot of energy. So really, trying to go back to, what are your main stressors, and what can you do to relieve it? Sometimes going back to the basics with cleaning up your diet, making sure you're getting good exercise, or sleeping well may have a lot to do with how you can handle your stress.

Substance use is also very important when we're trying to figure out fatigue. So, smoking, drinking alcohol, marijuana use, or any of the illicit drugs are not the best substances to be used. They are often used to give us a good sensation. People like a buzz from the nicotine in cigarettes that they use for stress management, but in the end, it ends up being very harmful to the system in many ways. The nicotine sometimes overloads the neuro circuits and all the other by-products of smoking tobacco really cause just about every bad cancer that we know about in the body.

Alcohol use as well. While some people may use that to help with stress or feeling anxious, oftentimes it depresses the mind. Energy levels really suffer as a result from that. So really, I would also try to eliminate as many of those from your diet as possible, and almost let the body heal itself to see if it helps with your energy levels.

Next Steps to Treat Fatigue

After you've really worked through the basics and tried to modify everything you can on your own, it's fair to go to the doctor or your health care provider and ask for health about fatigue. In fact, I get quite a bit of that in my office at all times of year. Sometimes, it's a little bit worse in the wintertime, because the lack of sunlight, the colder temperatures, and the darker days, overall, sometimes make people feel tired, fatigued, et cetera.

So, since fatigue is a multi-component problem, I think most doctors will spend some time doing a really good history and physical. They're going to ask you a lot of questions about your fatigue, what your typical energy level should be like, and asking a lot of things about your lifestyle at home. Once that's gone through, I think a good physical exam is also really important. Sometimes if there are physical problems with any of the glands in the body, or dysfunction of any of our organs, that will sometimes be found on physical exam.

We usually start with basic labs if we want to look at some blood work for other causes of fatigue. Oftentimes, we'll look at blood count to try to rule out anemia or any abnormal cells. We'll look at a metabolic panel to check your electrolytes, check your kidney or your liver function, because both of those organs, kidney and liver, if they have disease states and they're not working normally can lead to fatigue.

We also like to check some basic vitamin levels. Vitamin D has been found to impact fatigue. And where we live up in Ohio, we don't have as much sunlight as if you're living in Florida all year long. So, people who live in the north tend to have lower levels of vitamin D. B-12, and folate, which are vitamins that have a lot to do with metabolism are also often checked. One thing that is nice about the American diet is that a lot of our foods, like our cereals and grains, are well fortified with B vitamins. So, having low B-12 or folate tend to be a little less common. We see it often in alcoholics and people who don't eat very well in general.

Sometimes if we suspect a heart issue, we can also do an EKG and check the electrical signature of the heart. If the heart is not beating normally, or it's not pumping blood efficiently, it also can lead to easy tiredness and fatigue.