Staying Young

5 Medical Tests That May Keep You Well

Like a scene out of Star Trek, someday our doctors may simply wave a handheld device over our bodies and instantly diagnose any malady. In the meantime, however, it's important to keep abreast of the latest tests that can help us stay healthy - especially those that uncover risks before symptoms actually occur.

The following five tests are not yet considered as routine as cholesterol or blood-sugar tests, but chances are your doctor already is familiar with them. Not every test is necessary at every visit, and your insurance company may not pay unless it considers a particular test "medically necessary." Still, ask about them. Here's why they may be important to you.

CRP, or C-reactive Protein

This is a simple blood test that measures the amount of inflammation in your body. In many ways, CRP is the best "crystal ball" of health ever devised in a single blood test. Elevated CRP levels have been shown to precede and predict heart attack, stroke, colon cancer, diabetes, high blood pressure, Alzheimer's disease, aneurysms, sudden cardiac death, abnormal heart rhythms like atrial fibrillation and even macular degeneration, a leading cause of blindness.

CRP is a protein made by our immune system that fuels the fire of inflammation in our bodies. The higher your CRP level, the more at risk you are to develop problems. Optimal levels - less than 0.7 milligrams per liter - predict good health.

It's important to understand that CRP doesn't diagnose any particular conditions - it's not specific. It just identifies whether you're at risk for illness. It's best to check your CRP during your routine annual physical, when you feel fine. If you're sick with something, your CRP probably will be elevated.

The good news is that CRP levels can be lowered by exercise, modest weight loss, taking a multivitamin, eating a diet rich in fruits and vegetables, and certain medications such as aspirin and statins (cholesterol-lowering drugs).

Vitamin D Level

Vitamin D is essential for healthy bones because it's needed for calcium absorption. But new research also is identifying an important role for vitamin D in the immune system and in the prevention of cancer, including breast and prostate.

Studies show that more than half of American women don't get enough vitamin D. It's known as the "sunshine vitamin," because your skin makes it when you're out in the sun. That's why people who lack daily sun exposure or who use sunblock when outdoors may be deficient in the vitamin. It's almost impossible to get adequate amounts from foods, despite fortification of dairy and some soy foods. All multivitamins contain vitamin D, but for most people even that is not sufficient. You may need to take a vitamin D supplement. Most people should get between 1000 and 1500 IU of vitamin D3 daily. (D3 is the natural form of vitamin D. It's more easily absorbed and stays in the body longer.) The best way to know if you're getting enough vitamin D is to get a blood test.

H. pylori Test

About 20% of Americans may unknowingly be infected with the bacteria responsible for stomach cancer, heartburn, ulcers and even eye disorders. The discovery of H. pylori (Helicobacter pylori) infection as the primary cause of stomach ulcers worldwide earned Australian researchers Robin Warren and Barry Marshall the Nobel Prize in medicine for 2005. The bacteria also have been found to cause stomach cancer.

H. pylori is a chronic, potentially lifelong infection of the stomach. It can cause stomach pain, heartburn or indigestion, but it's often silent, causing no symptoms. Infection typically occurs when a person eats contaminated food and ingests the bacteria. The infection can be cured with a combination of antibiotics and antacids.

A blood-antibody test can show if you've ever been infected, and a stool test or breath test can identify if you currently have an active infection. Fortunately, successful treatment of H. pylori eliminates the increased risk of stomach cancer, ulcers and related disorders.

Aspirin Check

Aspirin has been shown to be a powerful preventive measure for people at risk for heart attack and stroke as well as for colon cancer, and it's estimated that as many as 50 million Americans take aspirin daily to prevent a heart attack. What's not clear is the optimal dose of aspirin for prevention. Most people are taking a baby aspirin (81 milligrams), but research has shown that 10% to 20% of people are resistant to aspirin and require higher dosages in order to benefit from its protective effects.

An aspirin check is a test that determines the effectiveness of the daily aspirin for an individual. This is important for people who are taking aspirin therapeutically for cardiovascular disease as well as those at increased risk for heart disease who are taking aspirin for prevention. The test can be ordered by your doctor but also is available directly from an online lab.

Insulin Level

Type 2 diabetes is characterized by an excess of insulin production in response to eating. The glucose tolerance test has long been the standard way to identify someone with diabetes. Until recently, glucose tolerance tests measured only blood sugar, or glucose levels, which are raised when a person has diabetes. But measuring your body's insulin-production levels improves the test by being able to identify your risk of diabetes long before symptoms emerge.

Typically, to do the test, your blood is drawn twice - first after fasting, then again two hours later after a glucose drink. Your insulin levels are recorded. If the results indicate that you're at a higher risk for diabetes, the good news is that you also have time to take action. Type 2 diabetes can be prevented by adopting a lifestyle that includes daily exercise, weight control and a low-glycemic diet that reduces the intake of sugar, refined grains and starches.

Technorati : Aspirin, H. pylori, Insulin, Protein, Vitamin D, Young

Extend Your Life

1/Monitors don't stop patients from waking
Patients say it feels like being trapped in a corpse: They wake up during surgery, unable to move or scream. Some remember hearing their surgeons talk, and a few recall feeling intense pain.

Some experts have said special brain-wave monitors were the best way to prevent anesthesia awareness. Now, in a big setback for efforts to prevent it, the first large, independent test of the monitors shows they are no better than older technology.

Researchers at Washington University School of Medicine in St. Louis compared two groups of about 1,000 patients each, all deemed at high risk of waking up during surgery because of health conditions, medication or other factors.

One group used the leading brain-monitoring system, which uses electrodes on the forehead to measure brain waves and software to calculate likelihood of consciousness. The other used an older device that analyzes exhaled anesthetic gas.

Anesthesiologists watched for movement and changes in vital signs and followed protocols to maintain patients' depth of sleep, adjusting anesthesia levels as needed. Patients were interviewed after their surgeries about what they remembered.

Two people in each group had experienced awareness - and the two monitored with the newer system reported having felt pain as well.

Lead researcher Dr. Michael Avidan said that in two of those cases - one with each system - the monitors indicated no problems with the anesthesia. In the other two cases, the monitors signaled problems.

The study analyzed groups of people who had surgery at the university's partner hospital, Barnes-Jewish in St. Louis, in 2005 and 2006. It was published in Thursday's issue of the New England Journal of Medicine.

Anesthesia awareness occurs in 1 or 2 of every 1,000 surgical patients - possibly more often in children - and is thought to happen to roughly 30,000 Americans each year.

Some just have fleeting memories of things they heard, but others describe "white-hot pain" and terror, triggering long-term emotional problems.

Carol Weihrer of Reston, Va., said that 11 years after awakening during surgery to remove a diseased eye that caused severe pain, she still has post-traumatic stress disorder, can sleep for just short periods and suffers mood swings and panic attacks.

Weihrer, who founded the group Anesthesia Awareness Campaign Inc., said she heard the doctor give instructions: "Cut deeper, pull harder." "I actually saw them cut the optic nerve when everything went black," she said.

"While you're laying there on the table," she recalled, "you are thinking, praying, cursing, plotting, pleading, trying to crawl off the gurney, trying to kick, scream, move any part of your body to let them know you're awake. In effect, you are entombed in a corpse."

Kathy LaBrie of Nashua, N.H., also suffered awareness during surgery for a deviated septum. She said she heard "the sound of pushing and grinding and the surgeon talking to the nurses about the kind of car he had. ... I tried moving my arms and legs - I couldn't do anything. I thought I was dying."

Dr. Jeffrey Apfelbaum, president of the American Society of Anesthesiologists, who was not involved in the study, said there is "tremendous pressure" from industry and patient advocates to use the brain-wave technology, despite the lack of solid evidence that it works better.

The position of the anesthesiologists group has been that brain-wave monitoring should not be done routinely, but may be helpful for certain patients at high risk of awareness. But widespread use would be very costly.

The dominant maker of brain-wave systems, Aspect Medical Systems, says its monitor, called a bispectral index or BIS, is used in about 17 percent of the roughly 20 million U.S. surgeries each year in which anesthesia gas is used.

The device can cost as little as $5,000. But the researchers estimated that if it were used on all U.S. patients getting general anesthesia, the disposable electrodes alone would cost more than $360 million a year.

The device, on sale since 1998, "can prevent both too little anesthesia, which could cause awareness, and too much anesthesia, which could cause prolonged recovery and anesthetic side effects" such as grogginess and nausea, said Aspect's medical director, Boston anesthesiologist Dr. Scott Kelley.

He said the new results show the system can help anesthesiologists "achieve a very low incidence of awareness in high-risk patients."

But Avidan's fellow researcher, anesthesiology professor Dr. Alex Evers, said he thinks having doctors closely follow a protocol to maintain the patients' depth of sleep was the key to reducing anesthesia awareness in both groups.

The Food and Drug Administration has stated only that the BIS device "may be associated" with reducing awareness during surgery.

About 10 percent of U.S. surgical patients receive intravenous anesthesia, without any gas. The study findings do not apply to them.

Dr. Douglas Jackson, assistant anesthesiology professor at University of Medicine and Dentistry of New Jersey in Newark, said the study shows the BIS system "is not a magic bullet."

"We still don't have a monitor that can tell us about depth of anesthesia (and) awareness," he said, adding that controlling that is still an art.

2/Health Tip: Early-Stage Alzheimer's
People with early-stage Alzheimer's disease may fear losing their independence and being reliant on someone else.Here are suggestions on how to maintain independence longer, courtesy of the Alzheimer's Association:

Hire a service or ask a friend to help with activities, such as paying bills, cooking meals, cleaning the house or going to the grocery.
Write instructions on how to work appliances, place labels on items you frequently forget, and compose notes to help you remember to perform certain tasks.
Help keep your home safe by reducing the risk of slips and falls. For example, install grab bars in the bathroom. Also, make sure appliances have automatic shutoffs.
Enroll in a safety alert program, so you can immediately get help if you need it.
If you can't drive, get a bus schedule, have a cab company's phone number handy, or ask friends and family to drive you.
Try to stay as physically and socially active as you can, and don't be afraid to ask for help.

Health Tip: When You're Diabetic and Sick
common cold, flu or infection that is an inconvenience to many people can cause much more serious health problems in diabetics.When you're sick, your body is under stress and releases hormones that can affect your blood sugar. So it's important to know how to take care of yourself.Here are suggestions for diabetics on dealing with an illness, courtesy of the American Diabetes Association:

Closely monitor and regulate your blood sugar, which can fluctuate more than usual while you're sick.
Keep a notebook where you record your blood sugar and urine ketone levels.
Talk to your doctor to see if your medications need to be adjusted when you're sick. Have a plan ready ahead of time.
In advance of illness, prepare a list of contact names and phone numbers of your doctor, dietitian, and diabetes educator.
Know when you should call your doctor. For instance, if you've been sick for an extended period or can't get your blood sugar under control.

Technorati : Extend Life, fitness, health, lifestyle