Category Archives: Patient education

Tips For Choosing The Right Hospital

All hospitals are definitely not created equal. Specialty and “boutique-type” hospitals are popping up in every good sized town and the ones that used to be of the “general” variety, have also restructured, added or deleted services and found their niche in the new world of hospital services. To make it even more confusing, many free-standing surgery centers, 24 hour emergency centers and other ancillary service centers are proliferating at a phenomenal rate. As a retired health care business development specialist, I can only imagine how hospital systems are scrambling to keep up and position themselves as the leaders with the newest and best equipment and services.
But, as a consumer, how do you know that the hospital you choose is really the right one for you?

There is an enormous amount of very clinical (and sometimes confusing) information about any hospital that is licensed to operate in the United States. You can find it all over the internet or just by calling the hospital association for your state and requesting information such as mortality and morbidity statistics (cheery reading) or how the hospital scored on its most recent Joint Commission survey. The Joint Commission is an independent group of experts in all areas of hospital operation, from safety, to bedside care, to the food served in hospitals. Most hospitals voluntarily submit to these often grueling (and surprisingly subjective, not to mention inconsistent) surveys because their ability to accept most of the larger insurance carriers requires a certain minimum score to participate.

But, most health care consumers want to take a “snapshot” of a hospital, make a quick decision….and hope for the best. The following hospital tips have been compiled by the people who know the hospitals best: hospital professionals, themselves. They are often indicators of how the hospital operates, overall, and can be a quick and easy way to determine what kind of care you are likely to get.

1. The hospital’s appearance is an important and surprisingly often overlooked indicator of how the hospital functions. Look at the flooring. Are the carpets worn and dirty? Are the elevators polished and bright or do they look old, dingy and downright grimy? What do the public restrooms look (and smell) like? Are the hospital personnel well-dressed in proper uniforms? Is the signage appropriate and easy to read? Can you find your way around without assistance? Are the common areas bright and clean, with healthy plants and comfortable chairs? You can be pretty certain that if the hospital looks bad, the care probably will be, too. (The exception to this rule can be the downtown trauma hospitals in big cities. These often grungy places can be the best places to go if you have suffered some horrendous trauma, such as a gunshot, dismemberment, etc. In that case, you will hardly be noticing your surroundings. But, don’t go there to have your baby and expect a lovely environment!).

2. Find out what the hospital is well-known for. This can be difficult as hospitals tend to advertise, just like any other business and they sometimes have quite inflated ideas of what they are (or should be). An example of this is the hospital that advertises itself as “for children” and directs a lot of their advertising budget towards convincing the public that it is. True Children’s Hospitals are just that: for children ONLY. They don’t treat adults. They are the only hospitals who can accurately claim that children are their specialty.

3. How hospitals staff their nursing units says a lot about the level of care you will receive should you wind up in one of them. However, this is not information that most hospitals will share with you. What you want to know is the nurse to patient ratio. A hospital that tends to staff down will have too many patients being cared for by exhausted and overworked individuals. Before you choose a hospital, take advantage of a visit to a friend or acquaintance who might be a patient there and use your powers of observation. Or, just hang out by the nurse’s station for awhile. If it looks and sounds like chaos and there are a lot of call buttons going off and no one answering, this is a red flag.

4. All hospitals do not charge the same for same or similar services. Surprise! So, how can you comparison shop between hospitals? One way would be to contact the hospital association for your state and request that information. But, you can also call a few hospitals ahead of time to get an estimate on the cost of your surgery or procedure. You will need to give them all the information you can including what kind of insurance you have, the exact condition you have and what the surgery or procedure will be that you are contemplating. You might find that you could save several thousand dollars by choosing one hospital over another (assuming your physician/surgeon is licensed, and willing, to perform your surgery there).

5. Have lunch or a snack in the hospital’s cafeteria. The same food is served to the patients, so pay attention. Is it fresh and acceptable? If not, you might want to cross this hospital off your list. (You would be surprised by the number of times people have been made sick by eating the food in some hospitals). You should also know that most hospitals, nowadays, farm out their food services to outside companies such as the ones who provide food services to large venues, like ballparks and convention centers.

This checklist can provide you with a very revealing snapshot of the hospital you are considering without wading through mountains of data. And when it comes down to it, the place you choose should be one that you feel safe and relatively comfortable in. If you do just a little bit of homework in advance of your choosing a hospital, you might find that it pays off in the end with a better hospital stay.

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Diabetes – The Secret to Blood Sugar Control

It’s not the food. It’s not the medication. Nor is it lack of exercise or merely aging. If your blood sugar is poorly-controlled, the problem is something else entirely.

In decades of treating diabetes, I’ve become convinced the problem is one of relationship.

Now why would I say that? Doesn’t medication matter? Yes. Isn’t diet important? Also yes. But the most important factor in the whole equation is your relationship with your doctor, and even more so, with yourself.

People don’t lose weight for the same reason they don’t control their blood sugar. We nibble, we cheat, we avoid exercise – basically, we lie to ourselves, all the time. Tomorrow will be different, we say. A little won’t hurt. We’ll go for a walk when it cools off.

Believe me, doctors know when their patients aren’t taking their insulin, or watching their carbs, or getting any exercise. It doesn’t take a rocket scientist to know, either. Just ask your kids. They know why your blood sugar is high.

But just like Dr. House says, patients lie. Patients lie to their doctors all the time. Why? Good question. Why would a patient lie when it’s in his or her best interest to be honest?

In many ways, the doctor-patient relationship is much like any other. We want to look good in our parents’ eyes. We want our children to think highly of us. We can’t bear for people to know who we really are.

Wouldn’t it be wonderful to have a doctor with whom you could be 100% honest? Someone you could tell anything to without fear of reprisal?

But then, what would a doctor expect from us? Would a physician pat us on the head and say, “That’s OK”?

People aren’t merely afraid of disappointing their parents, or their kids, or their doctors. It’s not just that we’re seeking approval. The problem is, patients know that if they’re really honest and confess their failings, their inadequacies, their doctor will ask them to do something more. It’s like asking my own teenagers to help with the dishes. They know, next it’ll be empty the trash, do your homework, sweep the floor. Better to hide from mom, from the doctor, from ourselves.

If you want your sugar to be better controlled, get honest with yourself and get honest with your doctor – a tough prescription, but truly the only answer.

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How Doctors Accurately Diagnose Asthma

The diagnosis of an asthma patient can depend on the symptoms presented, a detailed medical history, the physical examination done by the doctor and the laboratory tests done to confirm the diagnosis. For the most part the diagnosis of asthma can be fairly easy once the results come through; however, the diagnosis has an involved process before the eventual results are determined.

For asthmatic patients symptoms can include problems related to breathing such as difficulty taking a breathe, wheezy respiration, labored breathing during activities that require exertion, chest tightness and any obstruction of airflow. A true indicator for asthma can be seen when the person gasps for breath with a wheezy sound, which is a characteristic picture of asthma. In addition, having a detailed medical history that includes any history of allergy, family history of asthma, persistent coughs, cold and seasonal allergies can be contributing factors for asthmatic patient.

After the diagnosis process has begun laboratory tests are usually ordered to confirm that the patient has asthma and can include blood tests for ESR and eosinophil counts that could give indication of any allergic reaction or chest infection, as these are also contributory factors. The chest x-ray confirms the expansion of the lungs as well as any infections or other abnormalities in the lungs that can contribute to asthma. The groups of tests performed to diagnose asthma are Pulmonary Function Tests, otherwise known as Spirometry. In this test the degree and access of airflow obstruction is measured along with the confirmation of its severity. These are otherwise termed FEV1, FVC, and FEV1/FVC. The assessment of the reversibility of asthma can also be done through these tests. Carrying out tests of allergen detection through skin sensitivity tests is also a form of testing. These tests are of prolonged duration by which time the person has a fully established asthma. Still, if the allergens detection is accurate and the person needs to stay away from certain allergic substances, then asthmatic attack is preventable.

One of the most experienced symptoms of asthma is a wheezing sound as air enters the respiratory system. Many other chest diseases can present the same types of breathing problems as asthma; hence an accurate diagnosis is very essential. Spirometry is the confirmatory lung test for asthma. Once the diagnosis is made, the options open to the patient vary in range from no prescription, for very mild cases of asthma, to a full course of asthmatic preventatives to help those patients who have a severe asthmatic problem.

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How to Increase Lung Capacity

While many have not really considered this there are many ways that you can increase the capacity of your lungs to draw in oxygen. You cannot actually increase the size of your lungs themselves but you can do some things that will increase the amount of oxygen you can bring in. This will help to improve the efficiency of your lungs, making you healthier, and it has a host of other benefits, like helping you to hold notes longer when singing, having more efficient breathing for sports, and holding your breath longer under water. That is just the tip of the iceberg.
Before we spend too much time diving into the benefits, it is best to learn the how part of inhaling more air, i.e., improving lung capacity. It is actually a fairly simple process to get started.
Your lungs are like any other organ or muscle in your body. The more you exercise them the healthier and more efficient they will be. Now, all of us breathe in and out all day, so clearly they are working, but what I am talking about is akin to going to the gym to do squats to improve the strength and efficiency of your legs. Your legs work and you can always walk on them, but if you spend time properly exercising them, you can add a lot of tone and strength to them, making you able to do more lifting and exercise.
This is true of your lungs as well. The more you do with your lungs to improve efficiency, the greater your lungs will operate. The more efficient that air flow will be for you and you will feel much better.
So let’s start learning some exercises and techniques that can improve your lung capacity.

Pushing Out

This is a technique that was created by two doctors, Paul and lungsPatricia Bragg, as part of their Super-Power Breathing techniques. The exercise is actually quite simple. What you want to do is to stand or sit (preferably stand) in an upright position, and have your feet flat on the floor. Make sure that you do not lock your knees however; they should be loose so as to not cause undue stress or tension on your body.
Now, bend over from the waist as you expel the air from your lungs. Make sure you push all the air out as you do. Once you have done that, return to the upright position very slowly, drawing in air as you do. As you inhale take in as much air as you can and once you are upright, hold the air for about 20 seconds, then repeat. Adjust the time frames if need be. As you are counting to 20, extend both arms fully overhead and as you exhale lower your arms slowly. Complete four cycles of this exercise a few times a day.

The Pursed-Pinched Lip Technique

This is one of the most popular and simplest exercises a person can do to start improving lung capacity. To perform this exercise all you do is inhale as much air in as you can through your nose, which will force your abdominal muscles to push out. You then want to slowly exhale with your lips pursed so that you allow out as small amount of oxygen as possible at one time. Your lips should be opened a very small amount. As you exhale it should take about twice as long as it took to inhale and you should hear a small kind of hissing sound from the air being pushed out through the small opening in your lips.
This exercise puts a great deal of pressure on your chest and increases the elasticity of your abdominal muscles. This will make more room for your lungs to expand.

Deep Breathing

You don’t need to do all kinds of fancy techniques to expand your lung capacity. You can increase the capacity by simply doing a deep breathing exercise. All you need to do is take in air slowly, then hold it for 20 seconds. Then slowly let it out, and hold for 20 seconds before inhaling again. Do this over and over about 15-20 times, three times a day and you will see some immediate results within weeks.

The Prop

You can do a lot to increase your lung capacity by using a prop that requires you to blow into it. One of the best is a simple balloon. What you want to do is find an average size balloon, not a small water balloon style, and practice reducing the amount of breaths you need to fill the balloon. Now, I understand that “filled” is a subjective term, so you have to be honest with yourself in the standard that you set.
Practice four or five times to blow up a balloon in a single breath. As you are able to do this practice on balloons that require more air, like the ones that would be used for balloon animals. These can be blown up to some rather incredible lengths, so if you can get really good you can definitely add some serious capacity to your lungs.

The Instrument

Want to improve your lung capacity? Learn to play a wind or brass instrument like a trombone or oboe. You simply cannot play any of these instruments well if you cannot improve your lung capacity. The instrument, by its very nature, will help you to improve the capacity.
You will see that the longer you play the more your lungs will expand to help you play notes longer. Much like a singer can hit notes for longer periods of time by having an increased lung capacity, the same is true for a musician. If you don’t play a musical instrument and have always wanted to learn, and you want to improve your lung capacity, then it’s a no-brainer.

Abdominal Breathing

We have looked at one exercise to improve the capacity of the abdomen to allow more air in by increasing the elasticity of the diaphragm. Here is another exercise you can use that will help you to expand your abdominal breathing.
What you want to do is to lay your back in a comfortable position. Put one hand directly on your abdomen and the other on your chest. Breathe in very deeply and slowly from your mid-section. What you are attempting to do is to raise the hand on your belly higher than the one on your chest. You are successfully accomplishing this when you are able to accomplish this task.
Some will put a mirror to the side of them so they can actually watch to see if the one hand raises above that of the other. This may take some time to gain success, but if you stick with it you will begin to see results and this will help to make you feel better.

For Athletes and Runners

For those of you who are looking to improve your lung capacity to make it easier for you to run or exercise, there are a list of exercises you can do that will help you to accomplish this. While these are good for anyone to do, they are especially beneficial for those wishing to improve their performance on the court, field or road.


The reality is that there is no better way to increase the capacity of your lungs than to do exercises that require an increased lung capacity to be able to perform the activity. Running, aerobics, and playing sports all do these things. They help to build up the lung capacity because you are exerting yourself in such a way that increases the amount of oxygen that is needed and your body will adjust to allow this to happen.
There is an important note related to this however. One mistake that many make is that they reach a plateau quickly because the exercise they are performing they learn to maintain a constant rate. For example a person may cycle at about the same speed all the time. As you improve your stamina you will find that your body will adjust as well, and soon your lung capacity will begin to decrease because there is not a need to reach the same level anymore. Your improved physical stamina will actually decrease your lung capacity.
To counteract this, you want to make sure you do a routine a few times a week that alters your normal routine and gets you out of your comfort zone. This can be accomplished by doing a hill workout, adding in intervals, and altering your course frequently to include differing terrain and slopes.
It is for this reason that aerobics are so good for you. They force you to add huge amounts of oxygen into your body at infrequent times, increasing lung capacity.

Train at Higher Altitudes

It doesn’t matter who you ask, if you are looking for a way to increase your lung capacity, there is no better option than to train at a higher altitude. The reason for doing so is simple. At higher altitudes the amount of oxygen in the air is decreased. This makes you winded much easier, gasping for air.
To counteract this you would need to take in a larger amount of air to be able to obtain the amount your body is used to getting. This can be accomplished in one of two ways: you can breathe faster or you can breathe more fully. If you practice on breathing in more fully you will see an instant improvement on your lung capacity.


If you are a swimmer or at least if you can swim, this will really help you to improve your lung capacity. To help improve there are two things you need to work on: your endurance and your capacity. Let me explain those.
The first thing to practice is how long you can go without having to turn your head to breathe. The more you practice the better you will get at this, especially when you first begin each day. You will probably find that you can go 10-12 strokes without having to take in air, and soon may be able to reach as high as 20-25 times.
That brings in the next part: endurance. When you first get into the pool you will probably find that you can go 10-12 strokes without taking your first breath, and that is great. But what happens when you have swam for 10-15 minutes? Do you need to breathe after every other stroke? If so, then the next big step to improve your lung capacity it is to improve your endurance. You want to be hitting a point where you can go at least 6-8 strokes without turning your head to breathe, even if you have been swimming for 15 minutes.
You can also improve that endurance by varying the kinds of strokes you are doing. Don’t always do the freestyle daily, but add to the challenge by practicing the butterfly. That is a very demanding exercise and will help to improve your endurance as well.


This is not all the things you can do to improve your lung capacity, but it is quite a comprehensive list that will give you a lot of things to do to help you to improve your lung capacity. Begin with some of the breathing exercises and practice them daily and you will see some real results right away.
The key to this is determination and repetition. Don’t think because for two days you practiced some deep breathing exercises that you are going to increase your lung capacity drastically. This takes time, like any exercise, however, if you work at it you will see some significant results and will see improvement in your performance in whatever activity you want to do. You will also feel a lot healthier and happier.


Common Medical Abbreviations and Terms

Wondering why you can’t read what the doctor wrote on your prescription? Ever see the doctor’s notes in your medical record and found peculiar abbreviations and jargon? Doctors commonly use a variety of abbreviations in order to rapidly and succinctly record information about, and give instructions to, their patients. Below is a listing of many common terms and abbreviations defined so that you can decipher those charts Continue reading


6 medical Symptoms You Shouldn’t Ignore

Most aches and pains aren’t a sign of something serious, but certain symptoms should be checked out. See a doctor if you feel any of these things:

1. Weakness in Your Arms and Legs

If you get weak or numb in your arm, leg, or face, it can be a sign of a stroke, especially if it’s on one side of your body.

You could also be having a stroke if you can’t keep your balance, feel dizzy, or have trouble walking.

Get help quickly if you suddenly can’t see well, get a bad headache, feel confused, or have problems speaking or understanding.

“Caught early, it is often reversible,” says internist Jacob Teitelbaum, MD.

Don’t wait to see a doctor. Call 911. If you get a clot-buster drug within 4.5  hours of your first symptom, you can lower your risk of long-term disability from stroke.

2. Chest Pain

When it comes to chest pain, it’s better to be safe than sorry.

“Any chest pain, especially accompanied by sweating, pressure, shortness of breath, ornausea, should be evaluated by a medical professional right away,” says Shilpi Agarwal, MD, with One Medical Group in Washington, DC.

Chest pain or pressure can be a sign of heart disease or a heart attack, particularly if you feel it after being active. It may also mean that you have a blood clot moving into yourlung, Teitelbaum says.

If your chest feels tight or heavy, and it lasts more than a few minutes or goes away and comes back again, get help. Don’t try to tough it out.

3. Tenderness and Pain in the Back of Your Lower Leg

This can be a symptom of a blood clot in your leg. It’s called deep vein thrombosis, orDVT. It can happen after you’ve been sitting for a long time, like on a long plane ride, or if you’re sick and have been in bed a long time.

If it’s a blood clot, you may feel the pain mostly when you stand or walk. You may also notice swelling.

It’s normal to feel tenderness after exercise. But if you also see redness and feel heat where it’s swollen or painful, call your doctor.

Teitelbaum says you can also check for what’s called the Homans sign. “If you flex your toes upward and it hurts, that’s also suggestive of a blood clot,” he says. “But don’t rely on that. If it’s hot, red, and swollen on one side, go to the ER.”

It’s important to catch a blood clot before it can break off and block your blood flow, which can lead to complications.

4. Blood in Your Urine

Several things can cause you to see blood when you pee.

If you have blood in your urine and you also feel a lot of pain in your side or in your back, you may have kidney stones. A kidney stone is a small crystal made of minerals and salts that forms in your kidney and moves through the tube that carries your urine.

Your doctor may take X-rays or do an ultrasound to see the stones. An X-ray uses radiation in low doses to make images of structures inside your body. An ultrasound makes images with sound waves.

Many kidney stones eventually pass through your body when you pee. Sometimes your doctor may need to remove the kidney stone.

If you see blood in your urine and you also have an increase in feeling that you urgently need to pee, make frequent trips to the bathroom, or feel burning when you urinate, you may have a severe bladder or kidney infection, Teitelbaum says. Don’t wait to see your doctor, especially if you have a fever.

If you see blood but don’t feel any pain, it may be a sign of kidney or bladder cancer, so visit your doctor.

5. Wheezing

Breathing problems should be treated right away. If you’re wheezing, or hear a whistling sound when you breathe, see your doctor.

“Without urgent evaluation, breathing can quickly become labored, and it can be catastrophic if not evaluated and treated quickly,” Agarwal says.

It may be from asthma, a lung disease, a severe allergy, or exposure to chemicals. Your doctor can figure out what’s causing it and how to treat it. If you have asthma, an allergist will create a plan to manage it and reduce flare-ups.

Wheezing can also be caused by pneumonia or bronchitis. Are you coughing up yellow or green mucus? Do you also have a fever or shortness of breath? If so, you may havebronchitis that’s turning into pneumonia. “Time to see your doctor,” Teitelbaum says.

6. Suicidal Thoughts

If you feel hopeless or trapped, or think you have no reason to live, get help. Talking to a professional can help you make it through a crisis.

Go to a hospital emergency room or a walk-in clinic at a psychiatric hospital. A doctor ormental health professional will talk to you, keep you safe, and help you get through this tough time.

You can also call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). It’s free and available 24 hours a day, 7 days a week. It’s confidential, so you can feel safe about sharing your thoughts.