Ask the Doctor

A. With each Holiday Season comes an opportunity to make some significant changes in our physical and mental health. Here are 10 resolutions worth contemplating and, if appropriate, acting on for the New Year:

1. Stop smoking cigarettes or cigars.

Smoking cessation decreases the risk for lung cancer and heart disease, as well as other lung diseases including chronic obstructive pulmonary disease (COPD) and stroke. The dependence on nicotine is one of the strongest known substance addictions. There are a number of aides, including nicotine gum or patches and Chantix®, a new oral agent. These aides help manage the withdrawal symptoms but clearly do not provide the most important factor,  self-motivation.

2. Weight control:

Affecting both children and adults, obesity is an epidemic in the United States, with one-third of adults meeting the criteria.  Obesity is associated with a significantly increased risk and incidence of diabetes, heart disease, stoke, hypertension and other medical complications. Together, obesity and smoking account for the two largest health burdens in the United States. 

The solution is always the same: a calorie-appropriate diet low in saturated fats and high in fruits and vegetables, and a regular vigorous exercise regimen.  Avoid prepackaged food or "fast" foods: these typically have a high amount of salt, saturated fats - and calories. A healthy diet must be complemented with exercise five to six days per week, for 30 - 40 minutes per day. Exercise can take the form of fast walking, jogging, swimming, biking or other aerobic exercise.  If you have not exercised in a while it is best to start slow, chart a plan and see your physician before starting a program.

3. Make sure you are up to date with your vaccinations.

Adult vaccines that require boosters include Tetanus, diphtheria, pertussis (Tdap), pneumoccoccal vaccine (every 5-7 years) and the annual influenza vaccine. In addition you may want to check with your physician about the Human Papillomavirus vaccine (females age 9-23 years old), Meningococcal vaccine (college students in dormitories or other group housing situations), Hepatitis A and B vaccines and Zoster vaccine (over 60 years old to prevent "shingles").

4. Women's health:

            a. Yearly mammograms for women 40 or older.

            b. Yearly PAP smears and pelvic examinations

            c. Calcium and Vitamin D supplementation daily in milk products and/or tablets

5. Men's health:

Men should have an annual prostate examination beginning at age 40 and an annual Prostate Specific Antigen blood test (PSA) at age 50. Men with a family history of prostate cancer may require earlier screening. If you experience urinary symptoms at any age, you should see your physician for further evaluation.

6. Prevention for men and women includes:

• a. Colonoscopy at 50 and every few years thereafter, depending on family history and the examination results. Colonoscopy before 50 years old for individuals with higher risk for polyps or colon cancer.
• b. Yearly eye examinations after age 40 to check vision, cataracts, glaucoma, macular degeneration and other potential eye problems.
• c. Yearly skin examination by your primary care physician or a dermatologist, and the daily use of lotions with at least a sun protection factor (SPF) of 30. In addition, limit your sun exposure.
• d. Abstain from heavy alcohol use.

7. Screening laboratory tests:

Check your lipid profile (cholesterol, HDL cholesterol, triglyceride and LDL cholesterol) periodically and consult with your physician on the appropriate level. If diet and exercise do not control the level, you may need medication. Also have a fasting blood sugar check to screen for early diabetes mellitus.

8. Develop and maintain a strong social network.

Studies show that people who socialize regularly, participate in the community and are intellectually challenged, live longer and healthier lives. This is especially true in the elderly. So make new friends and get involved in new activities or hobbies this year.

9. Play it safe on the roads

Always wear a seat belt when driving or traveling by car; always wear a bike helmet when bicycling.

10.  Schedule an annual exam

Be sure to get an annual general physical examinations, keep your follow-up visits, and be complaint with any medications.

Happy New Year!

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N. S. Damle, M.D., FACP, is a primary care physician in Wakefield, RI, and a member of the South County Hospital Medical Staff.  He is Board Certified in Internal Medicine and a Fellow of the American College of Physicians.  Dr. Damle is past President of the Medical Staff of South County Hospital and a consultant to URI Health Services in Internal Medicine.

Send your questions for Dr. Damle to:

Ask the Doctor

C/O South County Independent

203Main Street

Wakefield, RI  02879