February 2008: Health Briefs from Baylor Health Care System

Forget the Apple a Day: See Your Doctor Even if You Suspect Your Health is Fine

When was the last time you saw your primary care physician (PCP)? If you're not taking steps to stay healthy, you could find yourself in the emergency room facing a serious condition. And when health problems continue undiagnosed, treatment might take longer and not be as effective.

With a visit to your PCP you can easily check for hidden, but potentially serious conditions.

Invisible symptoms. "With issues like hypertension, high cholesterol and diabetes, people don't really have symptoms. It's nice to catch these things before people end up in the ER," says Penny West, M.D., an internal medicine specialist on the medical staff at Baylor Medical Center at Irving. "A PCP can pick up these conditions with vital signs and lab work. We often find them in younger patients who think they are healthy."

Screening for signs. Your PCP also can make sure your routine screenings are up to date, based on your age and risk factors. "Screenings pick things up earlier, compared to waiting until you have symptoms," explains Dr. West. Screenings for skin, breast, colon, prostate and other cancers can help catch these diseases when they are most treatable.

Wellness work-ups. With a thorough, regular physical and a few tests, such as blood work, EKGs, X-rays, and gastrointestinal and pulmonary tests (depending on what you need), your PCP will have a good idea of your overall health. Then, he or she can let you know what you need to do to stay healthy.

Knowing you. "A PCP knows your history and your family history. They have some baseline so they can ask the right questions," says Dr. West. "They really know the whole person. Having a doctor who has seen you more than a couple of times and seen you when you're not sick can make a difference." And even if someone else is covering for your regular doctor, he or she will have easy access to your chart and your doctor's notes.

Dr. West says that anytime you suspect a health problem you should let your PCP know.

"It's usually easier to take care of a problem the earlier you catch it," she says. If you do need to visit an emergency department on a night or weekend, follow up with your doctor afterward so he or she knows what happened and can help monitor your condition.

Is Your Medicine Making You Fat?

The key to your weight gain may be lurking in your medicine cabinet. It's true. Some medications actually cause weight gain as a side effect. But what are some of the most common drugs that cause weight gain and why? According to Matthew Moreland, D.O., family medicine physician on the medical staff at Baylor Medical Center at Waxahachie, drugs prescribed for chronic conditions such as diabetes, arthritis or certain mood disorders are some of the most common.

"Although some medications do cause weight gain, it's never a good idea to stop taking them because you want to lose weight. In some cases, stopping your medication can have serious side effects-most worse than gaining a few pounds," says Dr. Moreland. "Instead, consult with your physician first. There may be alternative medications available."

Here is a list of common medications that can contribute to weight gain:

• Antihistamines: Some allergy drugs contain diphenhydramine causing drowsiness or sedation which can lead to inactivity meaning that you are not burning as many calories. However, not all antihistamines cause these side effects.
• Antidepressants: Some antidepressants may affect appetite and mood which can contribute to eating more sometimes resulting in weight gain. But again, not all antidepressants have this side effect so consult with your physician or psychiatrist to see if there is an alternative drug available.
• Birth control pills: Many women can attest to the weight gain often caused by birth control pills. They are full of estrogen, a hormone that can cause you to retain water. But there are many types of birth control pills on the market that contain low-dose estrogen as well as other birth control methods not in pill form.
• Sleep aids: Also found in many over-the-counter sleep aids is diphenhydramine which again can cause drowsiness making you feel more tired thus burning fewer calories-especially if you take them regularly. Some prescription sleep aids don't contain diphenhydramine so check with your physician.
• Migraine medication: Some medications used to prevent migraines can cause an increase in appetite.
• Steroids: Steroids are often used to treat rheumatoid arthritis and other chronic inflammations, but they can also contribute to extreme hunger. Sometimes your physician may be able to prescribe you another type of medication besides steroids, but if not, watch your calories and develop a regular exercise regimen.

"Again, you should never stop taking a medication out of fear that it's causing weight gain," adds Dr. Moreland. "If you are gaining more than five pounds in a month, your medicine may be to blame. However, examine your lifestyle carefully to make sure it isn't something else such as exercising less or excess caloric intake."

Dr. Moreland also advises working with your physician to determine your best course of treatment.

Second-Time Weight Loss Surgeries Becoming More Prevalent

The number of Americans getting surgery in the hopes of solving their weight problems is up nine times what it was just ten years ago. But experts say that's due in part to those patients who are now wanting second procedures.

"Any weight loss surgery requires some maintenance both from the physician and from the patient and at any given point if either one of those two parties drops the ball, we start seeing some weight regain," says Nick Nicholson, bariatric surgeon on the medical staff at Baylor Regional Medical Center at Plano.

Dr. Nicholson says he's seeing one to two patients a week who have had a weight loss surgery and now want another.

"Weight loss surgery is not a magic bullet. You're going to get out of it what you put into it," ads Dr. Nicholson.

Experts say the need for a rigid diet and exercise program after weight loss surgery is becoming more and more apparent. It's why weight loss surgery programs like the one at Baylor Regional Medical Center at Plano now strongly recommend that any patient who undergoes a procedure start a lifestyle change program with a trainer immediately after their surgery.

What Women Need to Know About Their Hearts

The American Heart Association calls the presence of heart disease in women "the silent epidemic." Although it still surprises many people to hear this statistic, it's true: Women are six to eight times more likely to die of heart disease than breast cancer.

"Many women still feel that heart disease is primarily a man's disease, but more women than men will die of heart disease this year," says Karla Lee, M.D., a cardiologist on the medical staff at Baylor Regional Medical Center at Grapevine. Dr. Lee also points out that two-thirds of the women who die suddenly from a heart attack will have no previously recognized symptoms.

Why is this happening? Unfortunately, heart disease in women may be undiagnosed or misdiagnosed, and women are often less likely to seek prompt medical attention when faced with symptoms. That may be because women often experience nontraditional warning signs-not always the classic radiating chest pain. So women should watch out for the following warning signs:

• chest discomfort or pressure sensation, which feels as though someone is sitting on you, or as if a band is around your chest
• shortness of breath or difficulty breathing that is not relieved by taking one deep breath
• arm pain, which can be either right or left and usually is described as if a blood pressure cuff is inflated
• back, neck or jaw pain, especially if related to exertion
• unexplained indigestion or nausea, particularly if it's not relieved by antacids
• unexplained tiredness or weakness that results in limited ability to do your usual activities
• dizziness or lightheadedness not associated with standing up too fast

What should you do if these symptoms are present? Don't discount them. Schedule a visit with your family physician. If the symptoms are severe or represent a significant change, seek urgent medical care. Call 911.

Dr. Lee also encourages women to take steps to reduce their risk of developing heart disease.

"As a woman, I know there are a lot of demands on our time," she says. "Taking care of ourselves seems to get pushed down on the 'to do' list. Many women feel that it's an all-or-nothing approach. They don't think they can lose weight, so exercise doesn't seem important. But it is. Not only do you get the benefit of the exercise, but you can know sooner when to get help for a decrease in endurance. Every step in the right direction helps."

Why So Many Children Are On the Road To Heart Disease

We teach our children how to walk, talk and go to the bathroom, but do we teach them how to eat right? National statistics show that many of us do not. According to the American Obesity Association, an alarming 15.5 percent of children between the ages of six and 11 are considered obese, putting them on a collision course with the nation's biggest killer: heart disease.

The power of preventing such a tragedy lies in the hands of parents, according to pediatric health experts.

"Parents are the gatekeepers and the role models for their children's eating and exercise habits," says Marjorie Milici, M.D., pediatrician on the medical staff at Baylor University Medical Center at Dallas.

"Chronic diseases, such as obesity, heart disease and cancer, which take decades to develop, have their roots in childhood, when exercise and eating behaviors are being learned," adds Dr. Milici.

Starting at a very young age, children should begin learning about proper nutrition and exercise. The American Heart Association (AHA) says that children age 2 and older should eat at least five servings of fruits and vegetables daily, as well as a variety of other foods low in saturated fat and cholesterol, in order to promote cardiovascular health.

"It's up to parents to help their children control the factors that they can, such as diet and exercise," says Dr. Milici. "Children should get at least 30 minutes of exercise five days a week. Lack of exercise prevents the breakdown of bad cholesterol in our bodies. Combined with a high-fat diet, it can lead to health problems such as elevated cholesterol levels, heart disease and diabetes when children are older."

A Guide for Parents
Kids are getting too much of the bad stuff and not enough of the good:

Too Much/Too Many

• sedentary time
• busy time
• calories found in lower-nutrient foods
• sugary beverages

Not Enough

• physical activity
• rest or downtime (To increase their energy, children usually eat more when they're tired.)
• fiber, vitamin C, calcium, iron
• low-fat dairy products