Between hearing the dreaded prep stories and the thought of having a device inserted into your bottom, it’s no wonder you’re probably questioning … is colonoscopy screening really necessary?
Yes, it is! According to Johns Hopkins Medicine, colorectal cancer is the second leading cause of cancer deaths in the United States and the third most common cancer in men and women. Yet, it’s one of the most curable types of gastrointestinal cancer, if detected early.
It all starts with a small polyp that grows in the colon’s lining. If untreated, the polyp grows larger and larger, to the point of becoming cancerous. When it’s at that point, the cancer starts to spread.
Now knowing why it’s necessary, let’s get to the truth behind the myths.
The prep drink tastes awful and you have to drink a lot of it.
While it might not taste like your favorite beverage, the good news is bowel prep has become easier. Products have greatly improved, as recently as within the last few years, and many physicians are prescribing a split dose – half the night before and half the morning of the procedure.
Expect to live in the bathroom.
To say you will live in the bathroom during your prep is an exaggeration, but you will visit it often, so it’s best that you spend your time in a comfortable setting with a bathroom close by.
No food the day before your procedure.
Not exactly, though you can expect to be on a limited diet. Physicians will typically instruct you to only eat a light breakfast and lunch before noon. After noon, you can expect to be on a clear liquids diet, but don’t worry, it’s not just water. You can drink your favorite juices, tea, coffee (without cream), soda and indulge your sweet tooth with jello, popsicles and Italian ices, so long as they don’t include pieces of fruit.
The goal is to have a clean colon so the physician can easily detect any polyps.
Having a device inserted in your bottom must hurt.
The device is a colonoscope. It’s a flexible camera that can easily move through the colon, allowing the physician to examine your colon and detect and remove any polyps.
While this may sound uncomfortable, you’ll be given a sedative before the procedure, so that you’re in a comfortable, drowsy, twilight sleep while this is happening. You probably won’t even remember the procedure when you wake up or feel any discomfort – most don’t.
No symptoms, no family history means no need for screening.
Colon cancer typically starts as precancerous growths. Precancerous growths don’t usually display symptoms, so feeling fine doesn’t exempt you from getting screened. And, if you think you can escape colon cancer because it doesn’t run in your family, think again. Everyone is at risk.
Screening should start at age 50 and younger if you do have a family history of colon cancer or if you are African-American or Eastern European Jewish decent.
Don’t let myths or fears stop you from getting screened. If you have additional question and concerns, speak with your physician. But if you’re ready to get screened, make an appointment with our physicians.
Heart disease is the leading cause of death in men and women in the United States, according to the Centers for Disease and Prevention (CDC). Unfortunately, you may not realize that you are at risk of having a heart attack until it’s too late.
While there is very little you can do to change your family medical history, you can make lifestyle changes to lower your risk. First, learn about the behaviors that increase the risk of heart disease, and then start taking preventive steps.
Behaviors that Increase Heart Disease Risk
Eat a heart-healthy diet
Add these following foods to your diet. They are considered to be the main ingredients of a heart-healthy diet.
Vegetables – greens (spinach, collard greens and kale), broccoli, cabbage and carrots
Fruits – apples, bananas, oranges, pears, grapes and prunes
Whole grains – plain oatmeal, brown rice and whole-grain bread or tortillas
Fat-free or low-fat dairy foods – milk, cheese or yogurt
Protein-rich foods – fish high in omega-3 fatty acids, lean meats, poultry, eggs, nuts, seeds, soy products and legumes (lentils and some bean types)
Oils, butters, nuts and seeds – canola, corn, olive, safflower, sesame, sunflower and soybean oils; nut and seed butters; walnuts, almonds and pine nuts; and sesame, sunflower, pumpkin and flax seeds
Aim for a healthy weight
Body mass index (BMI), a measure of weight relative to height, is commonly used for determining weight category (underweight, healthy weight, overweight and obese). Adults are typically considered to be at a healthy weight when their BMI ranges from 18.5 to 24.9.
Use Johns Hopkins Medicine’s BMI calculator to help determine your BMI.
Improve your emotional and physical health by learning to manage stress and practice stress-reducing activities, including:
Seeing a mental health care provider
Joining a stress management program
Being physically active
Practicing relaxation therapy
Speaking with friends, family and community or religious support systems
Increase physical activity
Routine physical activity can lower bad (LDL) cholesterol and increase good (HDL) cholesterol levels, control high blood pressure and help with losing excess weight.
The National Heart, Lung and Blood Institute recommends the following:
Moderate-intensity aerobic exercise – at least 2 hours and 30 minutes per week
Vigorous aerobic exercise – 1 hour and 15 minutes per week
Before starting a new exercise program, you should first ask your doctor how much and what physical activities are safe for you.
Speak with your doctor about programs and products that can help you quit smoking, and try to avoid secondhand smoke. If you are having trouble with quitting on your own, consider joining a support group.
Visit your doctor
According to David Jackson, M.D., a cardiologist on staff at HCGH, one of the critical steps to keeping your heart healthy is seeing your doctor for a routine physical exam. Your doctor checks your blood pressure, cholesterol and blood sugar – the big three indicators for heart attack and stroke.
“If your numbers start to become abnormal, you may not feel different or experience symptoms, so it’s important to have them checked periodically and more frequently as you age,” says Dr. Jackson. “Having a primary care physician monitoring your care to identify trends in your numbers is important.”
Last April, something strange and unexpected happened to me. I noticed that my left ear felt clogged up, as if water was trapped in my ear canal, which was entirely possible from bathing or swimming. I went around for a week or two shaking my head wildly left and right, tugging on my ear lobe and repeatedly Googling terms such as “my ear feels clogged up” and “how to remove water trapped in your ear.” All to no avail. After a few more weeks of waiting for this mysterious symptom to resolve, I made an appointment with an Ear, Nose and Throat specialist (AKA an otolaryngologist, but try saying that three times with your mouth full!), who, after a thorough examination, referred me for a hearing test with an audiologist.
At this point I was a little confused but not at all concerned. It did seem weird that even after having impacted ear wax removed at the ENT’s office, the strange muffled sensation in my ear persisted. The hearing test, my first as an adult, revealed that I have a moderately-severe high frequency loss in my left ear, as well as mild loss in the right ear. Further testing revealed my hearing loss was permanent, unexplained, and that I would need hearing aids for both ears! Trust me when I tell you, I was in complete shock.
I was diagnosed with sensorineural hearing loss (SNHL). What does this mean? Well, there are three main types of hearing loss: SNHL, conductive, or mixed. SNHL is the most common type of hearing loss. It’s caused by damage to the inner ear or to the nerve pathway from the inner ear to the brain. When SSNL occurs over the course of just a day or two, it is known as sudden sensorineural hearing loss. Some possible causes of SNHL include genetics, aging, head trauma, exposure to loud music, or even certain ototoxic medications that have a deleterious effect on hearing. The truth is, though, like in my case, often a cause can not be determined.
Conductive hearing loss involves the middle or outer ear, and can be caused by things such as colds, allergies, ear infections, Eustachian tube dysfunction, impacted ear wax, or the presence of a foreign body, to name a few. In contrast to SNHL, conductive loss is more frequently treatable and reversible. A mixed hearing loss involves having both sensorineural and conductive loss at the same time.
As soon as I found out that I had partial but irreversible hearing loss that is likely to only get worse over time, I wanted to make sure that I was doing everything in my power to mitigate the communication difficulties that accompany hearing loss. I wasted no time in getting fitted for high quality hearing aids. Hearing aids have come a long way from the “ear trumpets” of days gone by. The latest hearing aids are state of the art, programmable, and designed to be comfortable and unobtrusive. An audiologist works with the patient over time to tweak the settings for optimal effectiveness.
In addition to wearing hearing aids, I am planning on taking a speech/lip reading class, as this skill can be important to help fill in the blanks when in noisy environments such as restaurants. I have only just started to explore assistive listening technologies such as hearing loops and captioning in public venues, as well as personal listening devices. Finally, I have found many organizations online that offer advocacy, education, and support for those affected by hearing loss and related conditions. Having hearing loss is a highly individual experience, but it can be isolating, so it is wonderful to connect with others who understand what it is like and who can offer advice and support.
Sadly, a stigma still surrounds hearing loss in our society. This is part of the reason I wanted to share my personal experience. Stigma makes people feel ashamed and so they keep information to themselves that may actually benefit others also experiencing the same problem. Silence perpetuates stigma, stereotypes, and misinformation. I have decided that even though I may sometimes feel embarrassed or uncomfortable, it is in my best interest to advocate for myself and to be honest about my hearing loss.
My personal advice to anyone experiencing a change in your hearing is to see your doctor ASAP. Even if you think you just have a cold or a clogged up ear, do not delay seeking treatment because some types of sudden hearing loss may be reversible if treated immediately. However, even if you have been avoiding getting treatment for a long-standing problem, please stop burying your head in the sand – there is help! I recently read a statistic that the average hard of hearing person waits seven years before seeking treatment for their hearing loss. People will suffer in silence because of fear or shame rather than admit to a problem that can be effectively treated and managed, leading to an enhanced quality of life.
Depending upon severity and individual circumstances, the effects of hearing loss upon an individual can range from mildly inconvenient to completely life altering, but by addressing your particular situation head on, you can minimize further negative consequences and take control of your life.
There is life after hearing loss!
Andrea L. Dowling has been with HCLS since 2006, and is currently an Assistant Customer Service Supervisor at the HCLS East Columbia Branch. Andrea’s interests include genealogy, travel, reading banned books, and collecting vintage cook books.
Jeniah Simpson wearing a red hat from the American Heart Association’s Little Hats, Big Hearts. Supporters knit and crochet red hats to give to thousands of babies at participating hospitals during American Heart Month.
Congenital heart defects are the most common type of birth defect. But despite great advances in screening and diagnosis, congenital heart disease can go unnoticed for a long period of time until heart damage has progressed enough to cause detectable symptoms.
While we celebrate Valentine’s Day this week, it also marks Congenital Heart Disease Awareness Week. The pediatric cardiologists at Johns Hopkins Children’s Center and elsewhere remind both parents and their pediatricians to watch for any subtle signs that could signal the presence of congenital heart disease.
What Is a Congenital Heart Defect?
When the heart or blood vessels around it do not develop properly or develop abnormally before birth, a condition called congenital heart defect occurs (congenital means “existing at birth”). Congenital heart defects occur in close to one percent of all babies born, affecting some 40 thousand infants annually in the U.S. That’s about eight babies for every one thousand children born in the U.S. Most young people with congenital heart defects live into adulthood now, but may require more than one intervention or surgery to treat their condition.
Types of Congenital Heart Defects
A hole between two chambers of the heart (common defect)
The right or left side of the heart is not formed completely (hypoplastic)
Only one ventricle is present
Both the pulmonary artery and the aorta arise from the same ventricle
The pulmonary artery and the aorta arise from the “wrong” ventricles
Signs and Diagnosis of Congenital Heart Disease
In infants, the classic signs include the following:
Sweating around the baby’s head during feeding
Breathing fast while at rest and/or asleep
Bluish or pale skin, a sign of abnormally low oxygen levels
In older children, typical signs of congenital heart defects include:
Complaints of heart palpitations
Feelings of dizziness
Getting tired very easily with physical exertion
Inability to keep up with other kids
Cause of Congenital Heart Defects
In most cases, the cause is unknown. Sometimes a viral infection in the mother causes the condition. The condition can be genetic (hereditary). Most heart defects either cause an abnormal blood flow through the heart, or obstruct blood flow in the heart or vessels.
Treatment for Congenital Heart Problems
As children grow, some minor heart defects such as small holes may repair themselves. But when a defect requires correction, there are both non-surgical and surgical treatments available today which are less invasive and involve cardiac catheterization, medical device insertion, and minimally invasive heart surgery. In rare cases, a heart transplant may be needed.
Primary care physicians (PCPs) hold the key to better health for you and your family. These physicians are on the front lines of health care and they get to know you, your family and medical history. It’s important to have a PCP that you like and have a good relationship with to get the best care possible.
Your PCP is like the quarterback on a football team calling the plays, or in this case, making the plans to address your health concerns and guiding your plan of care. Primary care can handle 85 percent of the problems that patients have, and can coordinate care needed for other problems as well.
It’s so important to get good primary care that many health care systems, including Johns Hopkins Medicine, are creating a new approach to primary care called “medical homes.”
Vice President of Population Health and Advancement at Howard County General Hospital, Elizabeth Edsall Kromm, Ph.D., offers some important insights on the benefits of primary care.
Broad Knowledge and Skills
While PCPs are not specialists, they have a special skill set, which allows them to be adept at spotting a broad, underlying condition responsible for a range of symptoms. Depression or a chronic inflammatory disorder, for example, can manifest in any number of ways: stomach discomfort, joint pain or problems with multiple organs.
There is a growing emphasis today on preventive medicine and maintaining overall wellness to ward off problems before they occur, if possible. Helping preserve and protect your health helps you save money on health care costs and also reduces costs for the health system overall.
For example, cardiovascular disease, diabetes and other chronic conditions are preventable. The effect of healthy habits on a person’s life can be enormous. Recent preliminary evidence shows a 5 percent reduction in weight in an overweight person can reduce their risk of diabetes by 65 percent.
Your Primary Care Team
To help ensure care is delivered most effectively and efficiently, health care systems are creating the “patient-centered medical home.” In short, the medical home transforms a primary care clinic or other facility into a home base, where most of what a person needs for better health is located and available.
Though the primary care physician remains at the center of providing care, emphasis on a team is paramount. These teams typically include nurse practitioners, physician assistants, health coaches, community health workers and more.
Technology Makes It More Personal
Electronic medical records are another component of the medical home that seamlessly weave together detailed notes from every care provider who sees the person, lab and imaging results, and the like. This way the primary care team can get reports on which patients are facing gaps in their care.
Measure your health scale. [Credit: Iqoncept] / [Dreamstime]
A healthy weight is an important contributing factor in your overall health. It can help you prevent and control many diseases and conditions, including heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems and certain cancers.
Determining a Healthy Weight
How much you should weigh is not as simple as looking at a height-weight chart. You need to consider the amount of bone, muscle and fat in your body’s composition.
The amount of fat your body carries is a critical measurement, and can be measured using the Body Mass Index (BMI). Our Adult BMI Calculator helps you determine if you are at a healthy weight, overweight or obese.
If your results indicate you are overweight, having extra body weight from muscle, bone, fat and/or water; or obese, having a high amount of extra body fat; you should consider speaking to your health care provider. While BMI provides a fairly accurate assessment, it’s not a perfect measure.
Achieving a Healthy Weight
Many factors can contribute to your weight, and while you may not be able to control factors like family history, the environment, genetics and metabolism, you can change your behaviors and habits.
The service providers of our Journey to Better Health program, a program that provides health monitoring and support services to Howard County residents and faith community members, recommend the following when trying to lose weight to achieve a healthy weight:
Set a goal
Your weight loss goal should be a realistic goal that you can accomplish. You should start slow and change only one habit at a time.
Conduct a needs assessment
Identify what you need to accomplish your goal. Make a checklist of supplies/tools and resources you need to support your goal. For example, identify the amount of healthy food options in your pantry. If you have little to none, you will need to stock up on your healthy food supply.
In the words of Benjamin Franklin, “do not put off until tomorrow what you can do today.” Empower yourself to make small efforts that can be repeated to make your goal come to fruition. For example, take the stairs instead of the elevator or include a fruit or salad with your meal.
Track your progress
Whether it be on paper or a mobile app, recording your activity informs you of how you are progressing towards completing your goal. You may find you are on target or need to make improvements. It may seem mundane, but tracking your progress is critical towards achieving success.
Celebrate your success
Find healthy ways to reward your accomplishments. For example, schedule a massage or go line dancing with friends.
Maintaining a Healthy Weight
Continuing the healthy lifestyle changes you adopt, including eating a healthy diet and engaging in 60 to 90 minutes of physical activity most days of the week, are key to maintaining a healthy weight.
Successful weight maintenance is considered to be regaining less than six to seven pounds in two years and sustaining a reduced waist circumference of at least two inches.
For long-term motivation, ask your friends, family and health care provider(s) for encouragement, consider joining a support group and attend health screenings that assess your weight. Our Journey to Better Health program offers such screenings in the community for free. For a schedule of dates and locations, call 410-720-8788 or send an email to firstname.lastname@example.org.
The longer you can maintain a healthy weight, the more likely you will achieve long-term success.