FAQs (Frequently Asked Questions

Following are questions that we often receive and general information answers we hope you will find helpful. The information on this page is provided as basic information and is not, in any way, to diagnose your particular situation. Please contact your family physician for a specific diagnosis.

Q: I am a 50-year old woman and have been told that I have multiple risk factors for heart disease. Are there different types of heart disease? Are there things that I can do to reduce my risk? How do I know if I am making any progress toward reducing my risk of heart disease?

A: Heart disease is the Number One cause of death among American women. Coronary heart disease is the main form of heart disease. It is a disorder of the blood vessels of the heart that can lead to heart attack. When an artery becomes blocked, preventing oxygen and nutrients from getting to the heart, a heart attack occurs. This is one of several cardiovascular diseases; diseases of the heart and blood vessel system. Others include stroke, high blood pressure, angina (chest pain), and rheumatic heart disease.

A crucial step in determining your risk is to see your doctor for a thorough checkup. Your family physician can be an important partner in helping you set and reach goals for heart health. Don't wait for your physician to mention heart disease or its risk factors. Be proactive and establish good, clear communication with your doctor.

Ask questions about your chances of developing heart disease and lowering your risk. Ask your doctor and request tests that will determine your personal risk factors. It is important to answer all of your doctor’s questions thoroughly and honestly. When you ask a question and don’t understand something that your doctor says, request a further explanation in simple language.

Your doctor may suggest dietary changes, mild exercise or advise you to quit smoking. Once you make the changes that your doctor recommends, be sure to track your progress through checkups and repeat tests. When listening to your physician’s advice, take notes, so you’ll remember some of that important information when you leave the office. Reviewing and addressing your risk factors and working with your family physician to set and reach goals for your heart health, will help ensure that you prevent and control heart disease.

Q: One of the weight-loss tips that I have heard is to chew gum. Does chewing gum really help you lose weight?

A: The answer to this one is yes and no. The actual act of chewing gum does not cause you to lose weight. However, some research has suggested that chewing sugar-free gum might help with appetite control and satisfying the urge for something sweet. Studies have shown that chewing a piece of gum before snacks appears to reduce the desire for, and intake of, sweet snacks throughout the day. Just the act of chewing gum can help distract you from snacking when you are bored or tired – times you are most susceptible to snacking. Chewing a piece of gum while cooking can help keep you from sampling the meal.

There are also dental benefits of chewing sugarless gum. It helps to cleanse your mouth of bacteria by increasing saliva and thus helping to cleanse the mouth of bacteria that can cause decay. Saliva production is important for oral health because saliva contains buffers, minerals, and antibacterial agents. Increased saliva flow helps to neutralize acids in the mouth and enhances the re-mineralization of the tooth enamel. Chewing sugarless gum also helps clear the mouth of any food debris that may get caught between teeth.

When trying to lose weight, chewing gum is just one tool in the list of common-sense approaches to weight loss. Other effective things to do when trying to lose weight include:

Dieting is not losing weight. A commitment to a lifestyle of healthier eating habits and physical activity is the only way to take weight off and keep it off. Chewing sugarless gum can help, but it is only one tool in an arsenal of healthy lifestyle commitments.

Q: I am a relatively healthy 40-year old smoker. Will my risk of a stroke really decrease if I quit smoking?

A: In a word, absolutely!

A stroke is an injury to the brain caused by a lack of blood that can lead to permanent damage. Without the necessary nutrients and oxygen delivered by blood to your brain, full paralysis, partial paralysis, as well as loss of speech or sight are among the damages that can result from a stroke. Strokes can also cause problems with thinking, learning, remembering and with perception such as the recognition of familiar objects and how to use them. There are three types of stroke: transient ischemic attack (TIA), hemorrhagic and ischemic, with ischemic causing the most permanent damage to brain cells.

The risk of a stroke is 50 percent higher in smokers than in non-smokers and smokers who consume more than 25 cigarettes per day are at greatest risk. One study has demonstrated that the combination of number of years smoked and how many cigarettes a day smoked, expressed as “pack-years,” impacted the thickness of the walls of the carotid arteries (the blood vessels that supply oxygenated blood to your brain). The study compared former smokers to “never” smokers through magnetic resonance imaging (MRI) of the carotid arteries. The results showed that carotid wall thickness increased progressively, depending on how many pack-years a person smoked.

It is estimated that stopping smoking can reduce the risk of stroke by as much as 50 percent within one year. And, regardless of how long or how much you smoked, you will enjoy benefits from stopping that include a lower risk of stroke, as well as a lower risk of cancer, as well as reducing the health risks of second-hand smoke to those around you.

While it certainly isn’t easy to quit smoking, the result of the effort is more than worth it.

Q: I am a healthy 50-year old man; why should I have a yearly physical?

A: A yearly physical is a critical aspect in promoting and maintaining your wellness. It is a snapshot in the continuing portrait of you and your health. Taken in the context of just one visit, it might not mean much. However, taken within the context of the ongoing relationship with your family physician, changes in your physical, mental and emotional health can be noted, addressed and treated.

Heart disease, cancer and stroke are the most common causes of death in the United States. Virtually all of these diseases are preventable, manageable and/or curable when caught early through regular checkups with your family physician. The underlying health problems that cause heart attacks and strokes such as high blood pressure, diabetes, and high cholesterol, can be present without symptoms for several years. With regular check ups your family physician can detect these earlier and possibly prevent the complications.

As a healthy 50-year old man, you will find that your yearly physical can help you maintain that good health. Currrently in the United States, 27% of the population over age 20 has high blood pressure. The onset typically starts in the late 40’s but usually doesn’t have any associated symptoms early on. It is important to have your blood pressure checked once per year. This should be performed by qualified healthcare personnel who can best interpret the results and monitor subtle changes over time. It is also important to have your cholesterol checked. A prostate exam is also a yearly evaluation for enlargement or masses on the prostate.

Because colorectal cancer is more common in older people, doctors usually begin colorectal cancer screening beginning at age 50. A digital rectal exam, in which your doctor puts his or her gloved finger into your rectum to find any growths, should be conducted during each physical. This exam is simple to do and is not painful. However, because this exam can find less than 10% of colorectal cancers, it must be used along with another screening test.

There are multiple acceptable screening tests for colon cancer such as fecal occult blood testing, sigmoidoscopy, and colonoscopy. Your family physician will help you choose the best screening tool based on our history and risk factors for developing colon cancer.

Your annual physical is the best way to maintain your good health and to make sure that you and your family physician are always aware of the health issues affecting your quality of life.

Q: I am in my early 60s. My cholesterol, blood sugar and weight are on the high side of normal. Can the foods that I eat really have that much of an effect on blood pressure, cholesterol and my longevity?

A: Making dietary changes is one of the simplest and most effective things that you can do to improve your overall health. Instead of focusing on what you shouldn’t eat; focus on those foods that you should eat that will make a positive difference. It is important that you look at these changes as improvements and enhancements to your daily diet and not “suffering” over what you can’t eat.

You may want to start slow and incorporate one or two positive changes at a time. Try starting by incorporating some lean and non-animal sources of protein such as oatmeal, soy milk, beans, lentils and peanut butter. Because there is no cholesterol in plant-based foods, this change should have a very positive impact on your cholesterol level. In addition, many of these lean and plant-based proteins are high in fiber and much lower in fat content than animal protein and help contribute to the maintenance of a healthy weight level.

Fruits and vegetables are also great additions to your food palette. Add as many green vegetables as you like because they are particularly rich in antioxidants and contain varying amounts of Vitamin C, flavonoids and carotenoids (another antioxidant). Green vegetables also contribute significant amounts of other nutrients such as fiber, B group Vitamins, Vitamin K and minerals such as iron, potassium and calcium. Mix it up and enjoy a wide variety of green vegetables including asparagus, leeks, beans, peas, broccoli, cucumbers, celery, cabbage, Brussels sprouts, and leafy greens (spinach, collard greens, kale, escarole, bok choy, arugula, watercress).

Eat more often. Small, frequent (healthy) snacks and meals appear to promote weight loss and weight maintenance. They help you to maintain your metabolism level, blood sugar, and provide a nutrient source throughout the day. Just be sure to control your portions during these meals and snacks. The size of your fist is a good rule of thumb to use when looking at serving sizes.

Making these small, positive additions to your daily diet will contribute to lowering cholesterol levels, maintaining good blood-sugar levels and achieving and maintaining an optimum weight level. Over time you will find that your really aren’t depriving yourself of anything but are adding improved health and longevity!

Q: At what age should I begin checking my breasts and how should I check my breasts?

A: You should begin doing monthly checks of your breasts at about age 20. Any small lumps that you feel at this age are most likely just normal breast glands and ducts. With regular self checks you will become used to how your breasts normally feel and be able to tell if a new lump appears. The best time to check your breasts is a few days after your period, when your breasts aren’t so sore. If your periods come at varying times, or you don’t have periods, check your breasts at the same time every month.

To check your breasts you should begin by standing in front of a mirror and look at your breasts with your arms at your side, with your arms raised behind your head, and with your hands on your hips with your chest muscles flexed. Next, lie down with a pillow under your left shoulder. Put your left hand behind your head and feel your left breast with the pads of the 3 middle fingers on your right hand. Start at the outer edge and work around your breast in circles, getting closer to your nipple with each circle. After you've finished checking your breast, squeeze your nipple gently and look for discharge (fluid coming out of the nipple). Now place the pillow under your left shoulder and do the same thing to your right breast using your left hand.

Because cancer can spread to lymph node tissue, be sure to include the area up to your collarbone and out to your armpit. You have lymph nodes in this area.

There are six basic things to look for when examining your breasts:

Q: What are considered risk factors for breast cancer?

A: A risk factor is something that appears in a patient's medical history or a physical exam finding that increases the likelihood that a patient would eventually develop breast cancer. Many of the risk factors relate to a woman’s lifestyle events, such as the age at which the woman began her menstrual period. The onset of menstrual periods before the age of 12 appears to increase risk. Having a first child after the age of 30 also appears to be a risk factor.

Family history, particular among immediate family (mother, sister, daughter) can increase risk. You can inherit a breast cancer gene from your mother or your father. If one parent has a gene abnormality, you have a 50% risk of inheriting the gene from him or her. Genetic counseling can help you better understand the significance of your family’s health history.

Benign breast conditions that are found on biopsies of the breast that are not cancer can lead to an increased risk of developing breast cancer later in life. Your biggest risk for breast cancer is in growing older. The longer you live, the higher your risk. From birth to age 39 there is a less than .5% risk; from ages 40 – 59, a 4% risk; from ages 60 – 79, a 7% risk. At age 90, the overall lifetime risk is 14.3%. Risk increases with age because the wear and tear of living increases the risk that a genetic abnormality, or "mistake," will develop that your body doesn't find and fix.

Smoking, diet and stress can also play a role. Smoking is associated with a small increase in breast cancer risk. The role that diet plays is unclear. Several large medical studies have been to demonstrate the clear connection between eating high-fat foods and a higher risk of breast cancer. Being overweight is a known factor for an increased risk. While not good for your overall health and well being, stress has not been clearly associated with an increased breast cancer risk.

Q: What exactly is a mammogram, how often should I have a mammogram and do they hurt?

A: Once a woman reaches the age of 40 she should get a mammogram every 1 to 2 years. Planning mammograms after your period generally makes it less uncomfortable because your breasts may be less tender at this time. If you are at high risk for breast cancer, with a strong family history of breast or ovarian cancer, or have had radiation treatment to the chest in the past, it's recommended that you start having annual mammograms at a younger age (often beginning around age 30). This, however, is something that you should discuss with your healthcare provider.

Early detection and treatment of breast cancer makes treatment much easier and more effective. More than 90 out of 100 women whose breast cancer is found early will be cured. Self examination, doctor exams and regular mammograms are the best way to ensure early detection.

Mammograms may be the most important tool that doctors have for diagnosis and evaluation. Highly safe and accurate, a mammogram is a photo X-ray of the breast. The procedure is safe. There is a very tiny amount of radiation exposure from a mammogram.

Mammograms have been used for approximately 30 years and, while they do not prevent breast cancer, they can save lives by finding breast cancer as early as possible. Mammograms have shown to lower the risk of dying from cancer by 35% in women over the age of 50.

Finding breast cancers with mammography has also allowed more women being treated for breast cancer to keep their breasts. When caught early, localized cancers can be removed without resorting to breast removal (mastectomy).

Mammograms can be uncomfortable, but they do not take very long. Because your breasts are generally less tender following your period, you may find that planning your mammogram shortly after your period makes it less uncomfortable.

A mammogram is performed by resting your breast on a shelf and the x-ray machine will be slowly pressed against your breast until you feel pressure. This pressure is needed to spread your breast out so that a better x-ray can be taken. The x-ray takes just 1 or 2 minutes, and the entire process usually takes no more than about 20 minutes.

Mammograms are our most powerful breast cancer detection tool. They are worth a brief time of discomfort.

Be sure to have your mammogram at a facility accredited by the American College of Radiology (ACR). The ACR guidelines set standards for the doctors who read the films, technicians, reports, mammography equipment and film-developing materials. Mobile units, freestanding centers and hospitals are among the options available to you.

Q: My 8-year-old daughter has come home from school a few times recently with an itchy rash and has also been nauseous and has vomited. I’m beginning to think that she might be allergic to something she has eaten at school. Is that possible? How do I find out if she has a food allergy and what to do about it?

A: You should definitely have your daughter seen by her family physician to determine if she has a food allergy. While allergic reactions vary by severity of symptoms, it is important to take the possibility seriously. Your daughter’s symptoms are common in those with food allergies. Symptoms of food allergies typically occur within just a few minutes to two hours after the person has eaten the food and include, but are not limited to:

There are over 160 foods that can cause allergic reactions in people with food allergies and it is important to have your family doctor examine your daughter to determine if her reactions are a food allergy and to determine which food or foods are causing the reaction. The FDA (Federal Drug Administration) has identified the eight most common allergenic foods and has enacted labeling laws for them, as well as products derived from them. These foods account for 90 percent of food allergic reactions, and are the food sources from which many other ingredients are derived. These eight foods are:

If it is determined that your daughter does, in fact, have food allergies, you will need to carefully read food labels to avoid the offending foods. It will also be important for you to work closely with your daughter’s school to ensure that they are aware of your daughter’s allergies. You will also need to make the families of your daughter’s friends aware to ensure that they do not inadvertently give her an offending food. You will also need to learn, in case of accidental ingestion, to recognize the early symptoms of an allergic reaction, and be properly educated on — and armed with — appropriate treatment measures provided by your physician.

Don’t delay. Please have your family physician see your daughter soon. If it is not a food allergy, you will have the peace of mind of knowing that it is not. If it is a food allergy, you can begin taking the steps to protect her from the offending food(s) in the future.

Q: There is a child in my daughter’s play group who is extremely shy and seems to have bruises from accidents fairly often. I am afraid that she may be abused. On one hand, I want to do something if she is being abused, but don’t want to be wrong and cause a problem if she isn’t being abused. What should I do?

A: Child abuse is reported on an average of every 10 seconds and three children die every day as a result of such abuse. Many people are afraid of reporting child abuse. They think, "I don't want the person I reported to know," or, "I'm afraid it will come back to haunt me," or, "it's not my business." Without aware adults, some children might never receive help.

According to the Child Welfare Information Gateway, the first step in helping an abused or neglected child is to learn the signs of abuse or neglect. A single sign does not signal a problem, however if the signs appear repeatedly or in combination, you should take a closer look at the situation and consider the possibility of child abuse.

There are signs to look for in the child, the parent and the child and parent together that may signal the presence of child abuse or neglect.

Signs in the child:

Signs in the parent:

Signs in the parent and child:

Be an advocate for children by knowing the signs of abuse and reporting child abuse. Remember, you are reporting suspicion of child abuse, which may protect the child and get help for the family. Even if you aren't sure, it's better to let authorities check it out. You might save a child's life!

To report abuse, contact your local child protective services agency or police department. For more information about where and how to file a report, call the Childhelp® National Child Abuse Hotline (1.800.4.A.CHILD).

Q: I spend a considerable amount of time as a volunteer working with children of all ages, as a Room Mother, soccer coach, and as the “chauffeur” for my children and their friends. Since I am involved with so many children, so often, I thought it would be helpful to learn more about the types of abuse that children suffer and some of the signs that indicate abuse and neglect. Can you help?

A: You are to be commended not only for the volunteer time that you spend with children, but also for your concern and awareness about the abuse and neglect that some children suffer. There are several different types of abuse and the signs vary. The following are some signs often associated with particular types of child abuse and neglect: physical abuse, neglect, sexual abuse, and emotional abuse. It is important to note, however, these types of abuse are more typically found in combination than alone. A physically abused child, for example, is often emotionally abused as well, and a sexually abused child also may be neglected.

Signs of physical abuse include when the child:

Signs of neglect include when the child:

Sexual abuse is a possibility when the child:

Emotional mistreatment is another form of abuse with signs that include when the child:

You can find additional information on abuse and neglect at the following websites: