After Hours Emergency

If you are experiencing a life-threatening emergency call 911 immediately for emergency medical services.

For urgent health care needs after our office is closed, please contact your nearest, contracted Urgent Care Facility or Emergency Room, then follow up in our office with your Family Physician.  Contact your health plan for any additional information you may need to obtain emergency health services.

Hospitals
St. Joseph’s St. John’s  Woodwinds United Regions St. Paul Children’s	651-232-3000 (We are on staff here) 651-232-7000 651-232-0228 651-241-8000 651-254-3456 651-220-6000
Nearby Urgent Care Facility
Fairview University Urgent Care 2155 Ford Parkway, St. Paul 651-696-5000 Mon-Fri 6AM–10PM Sat 8AM–10PM Sun 10AM–6PM

After Hours Phone Calls

When the clinic is closed, the on-call physician will return phone calls.  Please call for medically related issues only.  Please do not call regarding billing or scheduling questions or regarding issues that could more easily be dealt with the next business day.  Your discretion is much appreciated.

Scheduling An Appointment

Please call us at 651-690-1311 during business hours to schedule an appointment.  We pride ourselves in trying to accommodate your schedule, including same-day appointments.

What Should I Bring On My First Visit?

Please bring your insurance cards, a list of medications, a picture ID and any medical information you feel will be helpful. As a new patient you will need complete the following forms:

• Patient Information
• Patient Health History
• Patient Disclosure
• Patient Authorization
• Notice Of Privacy Practices Acknowledgement

For your convenience you can print these forms and complete them prior to you appointment.

Prescription Refills

Prescription refills are a particularly complex issue in today’s world of insurance formularies and constant change. Each refill or substitution requires medical evaluation and a medical decision. Every effort will be made to refill prescriptions at your visit.  It is our goal that your prescription will last until your next visit.

If you require an emergency refill, contact your pharmacy and have them send us a fax.
We will authorize enough medication to last until you can follow up in our office.  If
possible, allow 72 hours, although we will answer most requests within one day.

All other refills, including new pharmacy refills, rewriting prescriptions for mail order
pharmacies, medication change required by insurers, lost prescriptions and medication
change requests for financial reasons will be handled by appointment.  These all require
communication, good medical judgment and proper documentation and cannot be
properly handled over the phone.  We strongly prefer not to refill antibiotics or
narcotics by telephone. ADD medications require a monthly prescription picked up at
the office.

We will continue to do our best to comply with published formulary guidelines, but we
will treat you as we feel is medically appropriate.  If you require a prior authorization for payment of your prescription please contact your health plan for information about covered medications and what information is required from your physician.  We will schedule an appointment as soon as possible so that you may bring this information to your physician, who will assist you in working to obtain the proper medications, with the most cost effective options.

Referrals

We have worked within this medical environment for over thirty years and have
relationships with some of the best specialists in the health care industry, to
help coordinate your medical needs outside our office.

We always attempt to provide referrals to excellent consulting specialists who are on
your health plan.  If they are not contracted with your health plan, call your health plan
for alternatives and we can discuss your options to arrive at a choice in your best
interest. You may use our referrals with any provider you choose.

Some insurance companies allow their clients to see their own choice of specialist
without a referral.  In that case we would appreciate it if you notify the consulting
specialist that we would like to have copies of their notes and tests, so that we can
properly coordinate your care.

Your insurance policy may have specific guidelines for obtaining a referral for outside
tests, consultants or treatment of any kind. It is very important that you check FIRST
with our office about referrals to avoid any misunderstanding or unnecessary bills.
Please contact Jan at 651-690-1311 for any referral questions you may have.

Always notify our referral specialist (Jan Easterday, C.N.F.P. at 651-690-1311) about your
appointment dates so that we can obtain the proper paperwork and send the
appropriate clinical information.

What Is Family Medicine?

Family Medicine combines the art and the science of medicine. It is a medical specialty that provides continuing and comprehensive health care for individuals and the families.

At the center of this process is the patient-physician relationship with the patient viewed in the context of the family. It is the extent to which this relationship is valued, developed, nurtured and maintained that distinguishes family practice from all other specialties. Family doctors are the only specialists in the medical system that have see the big picture of the entirety of our lives and how we interact with our health care system and one another. Other specialists only see their small area . . . while we see the entire playing field and this is our advantage.

The family physician is the physician of first contact in most situations and, as the initial provider, is in a unique position to form a bond with the patient. The family physician evaluates the patient's total health needs and provides personal care within one or more fields of medicine. The family physician's care is comprehensive and not limited by age, sex, or type of problem, be it biological, behavioral or social. The family physician refers the patient when indicated to other sources of care while preserving continuity of care.

What Are The Independent Physician Advantages?

Independent physicians are focused on personalized care. At Parkway Family Physicians we believe that patients thrive when they can choose their own physicians and collaborate with them fully.


When you choose one of our independent physicians, your care will be driven by your specific health care needs. Your physician will have the time to listen carefully to your thoughts and concerns. Finally, your physician will have access to the highest-quality medical facilities in the Twin Cities area to assure that your plan of care is well implemented and the very best, tailored to your individual needs.

How Is Parkway Family Physicians Different From The Big Health Care Systems?

Your health depends on good communication between you and your doctor. At Parkway Family Physicians we are not influenced by big corporate protocol, guidelines, strictly controlled schedules and timelines so we can spend more time and attention to our patients. Talking openly with your Parkway physician builds trust and leads to better results, quality and your satisfaction.

At the big health care systems, time with your medical professional is limited, because the primary focus is on profits and this affects decisions on patient care. Without a doubt these doctors know a lot about a lot of things, but they don’t know everything about you or what is best for you.

At Parkway Family Physicians we’re different.  We see quality health care as being developed by a special relationship and you play a very important role. That is why we encourage you to ask questions . . . a lot of questions . . . we want to hear your most important health care concerns. By spending more time with each patient we get a very clear understanding of each patient’s needs and concerns as an individual and we’ll never make you feel rushed or that our time is more important than yours.

In today’s maze of modern medicine, people want a personal physician, a doctor who knows them and is not only aware of their medical history, but their family and work situation as well. This type of patient-physician relationship allows for continuity of care and for individualized selection of consultants when more specialized care is required.

Parkway Family Physicians have the freedom to cater to our patients as individuals. You get to see the same doctor every time, and we call our patients if something is important. It’s about building a personal relationship and then making sure you get the care and treatment you need . . . because we work for you.

What Is The Recommended Schedule For Immunizations & Routine Visits?

At Parkway Family Physicians we strongly encourage immunizing your child on time. Not immunizing your child puts him or her at risk and it also puts his or her friends and our community at risk. Individual patient’s schedule may vary and we would be happy to discuss any concerns and answer all questions you may have.

Please be aware that the schedules frequently change. Use the links below to see the continuously updated recommendations:

Vaccine Recommendations for Infants and Children

Recommended Adult Immunization Schedule — United States

Infants & Children

Newborn     PKU (if not done in the hospital) preventive examination

2 Months    Pediarix, Hib, PCV-13, and preventive examination

4 Months    Pediarix, Hib, PCV-13, and developmental screening and preventive examination

6 Months    Pediarix, Hib, PCV-13, and developmental screening and preventive examination

9-10 Months    Hemoglobin, lead screening, developmental screening and preventive examination

1 Year    MMR, Varivax, PCV-13, developmental screening and preventive examination

15 Months    DtaP, Hib, Hepatitis A, developmental screening and preventive examination

18 Months    Autism screening, developmental screening and preventive examination

2 Years    Hepatitis A autism screening, lead screening, developing screening and preventive examination

3 Years    Vision and hearing screening, lead screening, developmental screening and preventive examination

4 Years    Vision and hearing screening, developmental screening and preventive examination

5 Years    DTaP-IPV, MMR, Varivax, vision and hearing screening, developmental screening and preventive examination

6-10 Years    Yearly preventive examination, vision and hearing screening

11-12 Years    Tdap, Menactra, Gardasil, yearly preventive examination, vision and hearing screening

13-15 Years    Yearly preventive exam, vision and hearing screening, lab screening

16-21 Years    Yearly preventive examination, vision and hearing screening, Menactra booster and lab screening

Influenza    Yearly for all children and adults beginning at 6 months of age

Adult Immunizations-Ages 19 & Up

Influenza    You need a dose every fall for your protection and other around you.

Pmeumococcal    You need 1-2 doses if you smoke or have certain chronic medical conditions.

Polysaccharide (PPSV)   You need 1 dose at age 65 (or older) if you’ve never been vaccinated.

Tetanus, Get a 1-time dose of  “Tdap” vaccine if you are younger than 65,

Diphtheria, are 65+ and have contact with infants, are a healthcare workers,

Pertussiss, are pregnant, or simply want to be protected from whooping

(Td, Tdap) cough. After that, you’ll need a Td booster every 10 years. Consult your Parkway physician if you haven’t had at least 3 tetanus and diphtheria containing shots sometime in your life or have a deep or dirty wound.

Hepatitis B You need this if you have a specific risk factor for hepatitis B virus (HepB) infection or you simply wish to be protected from this disease. This vaccine is usually given in 3 doses, usually over 6 months. Consult your Parkway physician to determine your level of risk and if you need this vaccine.

Hepatitis A You need this if you have a specific risk factor for hepatitis A virus
(HepA) infection or you simply wish to be protected from this disease. This vaccine is usually given in 2 doses, 6-18 months apart. Consult your Parkway physician to determine your level of risk and if you need this vaccine.

Human You need this vaccine if you are a woman age 26 years of younger
Papollomavirus or a man 21 years or younger. Men age 22 – 26 with a risk
(HPV)    condition also need vaccination, consult with your Parkway physician to determine your level of risk. The vaccine is given in 3 doses over 6 months.

Measles, mumps,    You need at least 1 dose of MMR if you were born in 1957 or
Rubella later. Consult your parkway physician to determine your level
(MMR)    of risk and your need for this vaccine.

Varicella    If you’ve never had chickenpox or you were vaccinated but received only one dose, talk with your Parkway physician to determine if you need this vaccine.

Meningococcal    If you are between 19-21 years and a first year college student
(Chickenpox)    living in a residence hall, or have one of several medical conditions, you need to get vaccinated against meningococcal disease. You may also need additional booster doses, please consult with your Parkway physician about your risks and need for this vaccine.

Zoster    If you are age 60 years or older, you should get this vaccine now.
(shingles)

When Should I See a Doctor For A Cold Or Flu?

Difficultly Breathing or Chest Pain

Aside from the stuffy nose and some general muscle aches, a cold or the flu should not make you short of breath or cause pain your chest. Chest pain and shortness of breath could be symptoms of a more serious problem such as heart disease, asthma, pneumonia, or others. Contact Parkway Family Physicians right away or if your condition is serious go to the emergency room immediately.

Persistent Fever

A fever that won't go away may be a sign of a secondary infection in your body and should be treated right away.

Vomiting or Inability to Keep Fluids Down

To stay hydrated your body needs fluids. If you can't keep down fluids, you should schedule an appointment with us and in some cases you may need to go to the hospital to receive fluids intravenously.

Painful Swallowing

Painful swallowing is not normal. Minor discomfort when you swallow can come from a sore throat, but severe pain can be a sign of an infection or injury that needs to be treated by a doctor.

Persistent Coughing

A cough that won't go away is usually just postnasal drip that may be treated with antihistamines. However, it could also be related to asthma or GERD, both of which can be treated by your physician. Over the past several years, doctors have noticed an increase in a former childhood infection called pertussis (whooping cough). If you or your children have an unexplained cough for more than two to three weeks, you should schedule an appointment to treat this type of infection.

Persistent Congestion and Headaches

Colds and allergies that cause congestion and blockage of the sinus passages can lead to a sinus infection. If you have symptoms that don't go away with usual medication, you may need to be treated with antibiotics. Please see us if these symptoms persist.

Is It A Cold Or The Flu?

Knowing whether you have a cold or the flu is important because the flu can have serious complications such as pneumonia or even death. Treating flu within 48 hours of symptoms is best. Prescription antiviral drugs may reduce the time you're sick.

It’s The Flu

Feel like a truck has hit you? It's most likely the flu. Flu symptoms like sore throat, fever, headache, muscle aches, congestion and cough tend to come on suddenly and are more intense than cold symptoms. Colds on the other hand, usually include a runny or stuffy nose. Flu symptoms usually improve over two to five days, but you might feel run-down for a week or longer. Colds come on gradually and last about a week.

Flu Swab Tests Can Identify The Flu Fast

The quickest and most effective way to know if you have flu or a cold is to get a test at our clinic.  By taking a nasal or throat swab, your doctor can tell if you have the flu virus, usually within 30 minutes or less. If you test positive for flu and your symptoms started within the last 48 hours, your doctor may suggest antiviral treatment to help you recover more quickly.

Flu Prevention - Vaccines

At Parkway Family Physicians we recommend that you get a flu vaccine. The vaccine is made of harmless versions of flu virus to help your body recognize and fight it if exposed to the real thing. Despite what you may hear, they don't give you the flu.

Flu shots are especially important for children older than 6 months, pregnant women, adults older than 50 and people with chronic illness or suppressed immune systems.

Ear Infections

Ear infections are very common, especially in kids. The latest research indicates that when a child get colds, he or she will end up with an ear infection 61% of the time.

Diagnosing an Ear Infection

At Parkway Family Physicians our doctors usually diagnose an ear infection by examining the ear and the eardrum with a device called an otoscope. A healthy eardrum appears translucent and pinkish-gray. An infected eardrum looks red and swollen.

Ear Infection Symptoms

The hallmark symptom of an ear infection is piercing pain in the ear. The pain may be worse when lying down, making it difficult to sleep. Other symptoms may include:

• Trouble hearing
• Fever
• Fluid drainage from ears
• Dizziness
• Congestion

Ear Infection Symptoms- Babies

It can be tricky to identify an ear infection in babies or children who are too young to tell you where it hurts. Signs to watch for are tugging or pulling on an ear, crankiness, trouble sleeping and loss of appetite. Many babies may push their bottles away because pressure in the middle ear makes it painful to swallow.

Home Care For Ear Infections

The immune system will put up its fight and you can take steps to ease the pain of an ear infection. Applying a warm washcloth can be soothing. Eardrops provide rapid pain relief, but check with your doctor before using them. Over-the-counter painkillers and fever reducers, such as ibuprofen and acetaminophen, are also an option. DO NOT give aspirin to children.

Antibiotics For Ear Infections

Antibiotics can help a bacterial ear infection, however in most cases the child’s immune system can fight off the infection. In a recent study, parents were asked not to give their child antibiotics (just treat the pain) unless the infection was "not better, or worse" after 48 hours. The delay resulted in far fewer kids taking antibiotics.

Complications Of Ear infections

Chronic or recurring middle ear infections can have long-term complications. These include scarring of the eardrum with hearing loss, speech and language developmental problems and meningitis. A hearing test may be needed if you child suffers from chronic or frequent ear infections and Parkway Family Physicians can perform thorough hearing tests right in our clinic.

Preventing Ear Infections

The biggest cause of ear infections is the common cold, so one strategy for prevention is to keep cold viruses at bay. The most effective way to do this is frequent and meticulous hand washing. Other lines of defense include avoiding secondhand smoke, vaccinating your children and breastfeeding your baby for at least six months.

What Is Swimmer’s Ear?

Swimmer's ear is an infection in the ear canal. It occurs when water or debris gets trapped in the ear canal. Bacteria breed in the water and cause pain, swelling and itching of the outer ear. Although it's often associated with swimming, anyone can get swimmer's ear. Breaks in the skin of the ear canal, such as from scratching or using cotton swabs, can also increase risk for infection. The condition is usually treated with medicated ear drops and keeping the ear dry.

Frequently Asked Questions About the Common Cold

What Is The Difference Between A Cold And The Flu?

Although the flu and the common cold are both respiratory illnesses, different viruses cause them. They do have similar symptoms, which make it difficult to tell them apart.  But generally cold symptoms are much milder than the flu. Common cold symptoms include:

• Sore throat
• Stuffy nose
• Runny nose
• Cough
• Mild fever

The flu, on the other hand, often causes higher fever, chills, body ache and fatigue.

Could My Cold Symptoms Actually Be Allergies?

If you’re sniffling, but not achy or feverish, you may very well have allergies. If your symptoms last longer than two weeks and you have red, itchy eyes, the evidence points to allergies. However, it's often hard to tell because people with allergies and asthma are more likely to get colds. They may already have inflamed and irritated lungs - so they are less able to fight off a cold virus.

What's The Best Treatment For A Cold?

Unfortunately, there is no cure for the common cold. The most important thing you can do is drink a lot of fluids to keep your body hydrated. This will help prevent another infection from setting in. Avoid drinks like coffee, tea and sodas with caffeine. They may rob your system of fluids. As for eating, follow your appetite. If you're not really hungry, try eating simple foods like white rice or broth. Chicken soup is comforting, plus the steam helps break up nasal congestion.

Over-the-counter cold medicines can offer relief from aches and fever. However, doctors no longer believe in suppressing low-grade fever except in very young and very old people, or people with certain medical conditions such as heart or lung disease. Low-grade fever helps the body fight off infection by suppressing the growth of viruses or bacteria and by activating the immune system.

You're contagious for the first few days of your cold, so it's best to stay home during that period of time. You need to be careful about coughing and sneezing around other people. Also, you will recover quicker if you get some rest.

How Can I Prevent Getting A Cold?

Hand washing! Both flu and cold viruses are transmitted the same way - through microscopic droplets from an infected person's respiratory system. Someone sneezes or coughs and droplets are sprayed onto any nearby surface - including you! If people cough or sneeze into their hands (without a tissue), they can contaminate every surface they touch. If you touch that same surface, you pick up the virus. If you rub your eyes or nose, you've just infected yourself. To protect yourself and prevent spread of cold and flu viruses:

• Wash your hands frequently with soap and water. Use an alcohol-based gel if you don't have access to water
• Cough and sneeze into a tissue or into your hands. Wash your hands afterward with soap and water. Use an alcohol-based gel if you don't have access to water
• No tissue? When you cough, turn your head away from others
• If you have a sudden sneeze, bend your arm and sneeze into it
• Don't touch your eyes, nose, or mouth
• Wash any shared surfaces (like phones and keyboards) frequently. Viruses can live on surfaces for several hours
• Stay away from crowds during cold and flu season

Can You Catch A Cold From Getting Chilled?

This is one of the biggest myths about colds. The only way to catch a cold is by being exposed to a cold virus. Cold air may irritate an existing condition, such as asthma, which would weaken your immunity. This could make your body more receptive to a cold virus, but only if you come in contact with it.

Why Does My Child Always Seem To Have A Cold?

School children are incredibly good at passing a virus along. Children naturally exhale more highly concentrated virus droplets than adults do. They also exhale them for longer periods of time. Plus, children are very active, always in each other's faces. And there is a general lack of hygiene - children don't their wash hands. They don't cover noses or mouths when they sneeze or cough. Even more importantly, they don't get very sick - which means they continue to spread the virus while they are very contagious.

What Are The Most Important Things A Woman Can Do On Her Own To Protect Her Health?

Keeping a keen eye out for early signs of health problems is important, but there are also things you can do to protect yourself now and in the future. These include:

• Eating a sensible diet that includes all the major food groups, and watching portion size.
• Try for 30 minutes of exercise or more daily.
• Protect your bones by eating three servings of low-fat dairy every day and performing weight-bearing exercises - like walking, running, aerobics or dancing - at least three times a week.
• Get regular health screenings.
• Take time out for yourself. Experts say 30 minutes a day is ideal if you can swing it. Make it a time when you do something just for you - reading, taking a bath, working in the garden, chatting online with friends - whatever relieves your stress will add years to your life and life to your years.

What Are The Most Important Medical Screening Tests For Women And At What Age Should They Have Them?

While not all medical organizations agree on what you need and when, here’s what the National

Women’s Health Information Center suggests:

• Thyroid test - every five years beginning at age 35
• Blood pressure test - Every two years beginning at age 18
• Cholesterol test- Start at age 20 and let your doctor suggest frequency.
• Bone mineral density test - Have baseline test around age 40 and let your doctor decide on frequency.
• Blood sugar test (diabetes) - Every three years beginning at age 45
• Mammogram - Beginning at age 40, every one to two years
• Pap test/Pelvic exam - Every one to three years if you are sexually active, up to age 65. After age 65 let your doctor decide on frequency.
• Colorectal health testing - Yearly fecal occult blood test beginning at age 50.
• Flexible sigmoidoscopy every five years if not having a colonoscopy.
• Colonoscopy - Every 10 years beginning at age 50.
• Talk to your doctor about a screening plan that is best for you.

What Are The Most Important Medical Symptoms Women Should Not Ignore?

While any symptom that causes you distress should be reported to your doctor, there are some specific signs no woman should ever ignore. They include:

Heart Attack

Pain or discomfort in the center of the chest sometimes accompanied by pain in the upper body including arms, back, neck, jaw, or stomach; shortness of breath; a cold sweat; nausea and lightheadedness.

Stroke

Sudden or developing problems with speech, sight, balance, and coordination, as well as numbness or weakness in the face, arms, or legs.

Reproductive Health Problems

Bleeding or spotting between periods; itching, burning, bumps, blisters or sores on the vagina or genital area; pain during sex; severe menstrual pain; severe pelvic pain, unusual vaginal discharge particularly with a strong odor; lower back pain with bloating and/or feelings of fullness.

Breast Problems

Nipple discharge, breast tenderness or pain, changes in the skin covering the breast or nipples (ridges, dimpling, pitting, swelling, redness, or scaling), a lump or thickening in the tissue of the breast or underarm area or tenderness in these areas.

Digestive Or Stomach Problems

Bleeding from the rectum; blood or mucus in the stool or black stools; change in bowel habits; constipation, diarrhea, or both; constant heartburn, pain or feeling of fullness in stomach; bloating; vomiting blood.

Skin Problems

Changes in the color, shape, or size of a mole; small lump on skin that is smooth, shiny, and waxy and often reddish brown in color; painful, crusty, scaling, or oozing skin lesions that don’t heal within 14 days.

What Are The Most Important Medical Screening Tests For Men And At What Age Should They Have Them?

Cholesterol Screening/Lipoprotein Profile

Cholesterol is a type of fatty protein in your blood that can build up in your arteries, so knowing how much cholesterol is present is a good predictor of your risk for heart disease. 200 is the magic number that you want to stay beneath

When to start: Age 20

How often: Every five years. If testing reveals your levels are high, your doctor will recommend retesting every six months to one year. If you have risk factors for heart disease in your family, the regular cholesterol test may not be specific enough and we may recommend a test called the lipoprotein subfraction test. It's more sensitive and checks the size of the cholesterol particles as well as the amount.

Blood Pressure Check

Checking your blood pressure regularly is one of the most important things you can do to protect your present and future health. Many experts believe 120/80 is a healthy target to shoot for.
When to start: Any age; best to begin during childhood

How often: Once a year if readings are normal, we will recommend every six months if readings are high or if you're taking medication to control hypertension.

Diabetes Screening

To check your risk for diabetes, we check your tolerance for glucose absorption, which means how readily your body digests sugar.

When to start: At age 45 if you have no risk factors or symptoms. If you're significantly overweight, have high blood pressure, or have other risk factors for diabetes, such as family history of the disease, it's a good idea to get tested younger.

How often: Every three years

Colonoscopy Or Sigmoidoscopy

Colorectal cancer, which is cancer of the lower part of the intestines, is curable in 90 percent of all cases—as long as it's caught early. And screening tests that look inside the colon, called colonoscopy and flexible sigmoidoscopy, are the secret to catching it early.

When to start: Age 50 for those with no risk factors. If, however, you have a first-degree family member who's had colon cancer before the age of 50, begin colonoscopy screening when you're 10 years younger than the age at which your family member was diagnosed.

How often: Flexible sigmoidoscopies should be repeated every five years, and a colonoscopy should be repeated every 10 years.

Fecal Occult Blood Test (FOBT)

Although it sounds otherworldly, the word occult simply refers to the fact that this test checks for blood in the stool that's not visible to the eye. This is the least invasive screening tool available. A chemical solution is used to test a stool sample for the presence of blood, which can indicate intestinal conditions such as Crohn's disease and ulcerative colitis or colorectal cancer. Colorectal cancer still strikes more men than women—more than 50,000 men are diagnosed with the disease every year.

When to start: At age 50. We may suggest it earlier if there's cause for concern about intestinal conditions.

How often: Yearly after age 50

Skin Cancer Screening

Skin cancer, while less deadly than some, is the No. 1 cancer diagnosed among Americans. And men are at higher risk for skin cancer than women, something most men don't know. While most types of skin cancer are easily treated, one type, melanoma, can be deadly. Skin cancer is relatively easy to detect as long as you bring any suspicious areas to our attention.

When to start: Any age

How often: Experts recommend conducting a personal "mole check" once a month in the shower to look for unusual growths or changes to existing moles

Hearing Test

Fourteen percent of adults between ages 45 and 64 have hearing loss and by the age of 60 one in three adults is losing hearing. Men are at highest risk for all types of noise-induced hearing loss, the most common type. Yet many men go years before getting tested, primarily because hearing tests are voluntary. You and your doctor have to decide that you need a hearing test and request one.

How often: The American Speech-Language-Hearing Association recommends hearing tests every 10 years for adults up to the age of 50. After that, experts say, you should have a hearing test every three years.

Thyroid Test

The thyroid, a small gland in your neck, regulates your body's metabolic rate. If your thyroid is overactive, a condition known as hypothyroidism, your metabolic rate is too high. Symptoms include insomnia, weight loss, and overactive pulse. If you're hypothyroid, it means your thyroid is under active and your metabolism will be slow and sluggish. This usually leads to fatigue, constipation, and weight gain. While more women than men are hypothyroid, that doesn't mean men can't be—and in men, hypothyroidism can cause some upsetting side effects, such as erectile dysfunction, low sex drive, and ejaculation problems.

When to start: Age 35

How often: Once a year, says the American Thyroid Association. Other doctors don't recommend a thyroid test for midlife adults unless you have symptoms of hypothyroidism or hyperthyroidism. After the age of 60, thyroid testing is usually conducted annually.

Screening For Metabolic Syndrome

Metabolic syndrome is a group of symptoms that put you at increased risk for both diabetes and heart disease. The screening involves checking for a list of issues and, if they're present, recommending additional tests. Doctors consider men to have metabolic syndrome if three of the following five risk factors are present:

• Waist circumference greater than 40 inches
• Low "good" cholesterol (below 40 mg/dL)
• Elevated triglycerides (greater than 150 mg/dL)
• Blood pressure higher than 130/85
• Fasting glucose above 100 mg/dL

If three or more of these apply, we will discuss an additional screening test called the C-reactive protein (CRP), which many experts think is the best way to monitor heart health risks.

When to start: Age 50

How often: Every three to five years, along with cholesterol and diabetes screening

Testicular Cancer Screening

With early detection, a man's chances of survival go up by a whopping 90 percent, so it pays to be vigilant. While testicular cancer is rare, it's the most common type of cancer in younger men, ages 15 to 34.

What it is: A self-exam or doctor's exam for tumors in the testicle. The doctor (or you) rolls each testicle slowly between thumb and forefinger, looking for any hardened areas or lumps and checking to make sure there haven't been changes in size.

When to start: All ages

How often: The Livestrong Foundation recommends that all men do a self-exam every month. At the first sign of concern, call Parkway Family Physicians and schedule and appointment.

Prostate Cancer Screening

Not the favorite of most men, the digital rectal exam is a lifesaver because prostate cancer is one of the most common types of cancer, affecting one in six men. A second test, called the PSA test, is used to look for elevated levels of prostate-specific antigen.

When to start: Age 50, according to the American Cancer Society, unless you have symptoms such as difficulty with urination. In that case, you should have a prostate cancer exam at age 45.
How often: Every year

What Exactly Is Preventive Care And What Do You Need After Age 50?

Preventive care is a term we use for making sure that you are doing everything you can to protect your health. At Parkway Family Physician we see good communication between you and your doctor as the first and key step. It is very important to make sure you’re getting all the care you need and invite you to talk with your Parkway physician about the following screening exams:

• Men over 50: Colorectal cancer; prostate cancer, skin and other types of cancer; diabetes, high blood pressure, high cholesterol, vision and hearing.
• For women over 50: Cancer screenings for breast, colon, ovarian, cervical, and skin cancer, diabetes, high blood pressure, high cholesterol, osteoporosis, vision and hearing.
• In addition, if you are over age 50 you should consider a yearly flu shot. You should consider asking your doctor about a shingles vaccine if you are at least 60 years old. If you are over 65 we should discuss a pneumonia vaccine.

What Is Chronic Obstructive Pulmonary Disease (COPD)?

COPD is a lung disease that makes it hard to breathe. It is caused by damage to the lungs over many years, usually from smoking.  COPD is often a mix of two diseases:
Chronic Bronchitis, the airways that carry air to the lungs get inflamed and create a lot of mucus. This can narrow or block the airways, making it hard for you to breathe.

Emphysema, in a healthy person, the tiny air sacs in the lungs are like balloons. As you breathe in and out, they get bigger and smaller to move air through your lungs. But with emphysema, these air sacs are damaged and lose their stretch. Less air gets in and out of the lungs, which makes you feel short of breath.

COPD gets worse over time. You can't undo the damage to your lungs. But you can take steps to prevent more damage and to feel better.

What Causes COPD?

Smoking almost always causes COPD. Over time, breathing tobacco smoke irritates the airways and destroys the stretchy fibers in the lungs. Other things that may put you at risk include breathing chemical fumes, dust, or air pollution over a long period of time. Secondhand smoke is also bad.
It usually takes many years for the lung damage to start causing symptoms, so COPD is most common in people who are older than 60.

You may be more likely to get COPD if you had a lot of serious lung infections when you were a child. People who get emphysema in their 30s or 40s may have a disorder that runs in families, called alpha-1 antitrypsin deficiency. But this is rare.

What Are The Symptoms?
The main symptoms are:

• A long-lasting (chronic) cough
• Mucus that comes up when you cough
• Shortness of breath that gets worse when you exercise
• As COPD gets worse, you may be short of breath even when you do simple things like get dressed or fix a meal. It gets harder to eat or exercise and breathing takes much more energy. People often lose weight and get weaker
• Symptoms may suddenly flare up and get much worse. This is called a COPD exacerbation, which can range from mild to life threatening. The longer you have COPD, the more severe these flare-ups will be

How Is COPD Diagnosed?

To find out if you have COPD, there are many things your Parkway Family Physician will perform. We will do a complete physical exam and listen to you lungs, ask questions about your past health history and whether you are a smoker or have been exposed to other lung irritants.

We may also have you do breathing tests, including spirometry, to find out how well your lungs work and take chest X-rays and other tests to help rule out other problems that could be causing your symptoms. If there is a chance you could have COPD, it is very important to find out as soon as you can. This gives you time to take steps to slow the damage to your lungs.

How Is It Treated?

The best way to slow COPD is to quit smoking. This is the most important thing you can do. It is never too late to quit. No matter how long you have smoked or how serious your COPD, quitting smoking can help stop the damage to your lungs.

We know it’s hard to quit smoking and we are always happy to talk with you about treatments that can help. There are medicines that can help you breathe easier. Most of them are inhaled so they go straight to your lungs. If you get an inhaler, it is very important to use it just the way your Parkway physician shows you and be sure to ask as many questions as you like, we’re here to help you.

Is Your Blood Pressure In Check?

While the cause of high blood pressure in most people remains unclear, a variety of conditions -- such as getting little or no exercise, poor diet, obesity, older age and genetics can lead to hypertension.

What Is Systolic And Diastolic Blood Pressure?

The blood pressure reading is measured in millimeters of mercury (mm Hg) and is written as systolic pressure, the force of the blood against the artery walls as your heart beats, over diastolic pressure, the blood pressure between heartbeats. For example, a blood pressure reading is written as 120/80 mm Hg, or "120 over 80". The systolic pressure is 120 and the diastolic pressure is 80.

What Is a Normal Blood Pressure

The Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure has classified blood pressure measurements into several categories:

• Normal blood pressure is systolic pressure less than 120 and diastolic pressure less than 80
• Prehypertension is systolic pressure of 120-139 or diastolic pressure of 80-89
• Stage 1 Hypertension is blood pressure greater than systolic pressure of 140-159 or diastolic pressure of 90-99 or greater.
• Stage 2 Hypertension is systolic pressure of 160 or greater or diastolic pressure of 100 or greater.

What Health Problems Are Associated With High Blood Pressure?

Several potentially serious health conditions are linked to high blood pressure, including:
Atherosclerosis a disease of the arteries caused by a buildup of plaque, or fatty material, on the inside walls of the blood vessels. Hypertension contributes to this buildup by putting added stress and force on the artery walls.

Heart Disease heart failure (the heart can't adequately pump blood), ischemic heart disease (the heart tissue doesn't get enough blood), and hypertensive hypertrophic cardiomyopathy (enlarged heart) are all associated with high blood pressure.

Kidney Disease Hypertension can damage the blood vessels and filters in the kidneys, so that the kidneys cannot excrete waste properly.

Stroke Hypertension can lead to stroke, either by contributing to the process of atherosclerosis (which can lead to blockages and/or clots), or by weakening the blood vessel wall and causing it to rupture.

Eye Disease Hypertension can damage the very small blood vessels in the retina.

How Do I Know If I Have High Blood Pressure?

High blood pressure often doesn't have any symptoms, so you usually don't feel it. For that reason, hypertension is usually diagnosed by a health care professional on a routine visit. This is especially important if you have a close relative that has hypertension or embody risk factors for it.

If your blood pressure is extremely high, you may have unusually strong headaches, chest pain and heart failure (especially difficulty breathing and poor exercise tolerance). If you have any of these symptoms, seek treatment immediately or call 911.

What Is The Treatment For High Blood Pressure?

High blood pressure treatment usually involves making lifestyle changes and, if necessary, drug therapy.

Lifestyle changes for high blood pressure include:

• Losing weight
• Quitting smoking
• Eating a healthy diet
• Reducing the amount of salt in your diet
• Regular aerobic exercise (such as brisk walking)
• Limiting alcohol drinking
• High blood pressure drugs include angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, diuretics, beta-blockers and calcium channel blockers.

What Type Of Diet Should I Follow If I Have High Blood Pressure?

A healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, is very effective at lowering high blood pressure. The DASH diet calls for a certain number of daily servings from various food groups, including fruits, vegetables and whole grains.
The following steps can also help:

• Eating more fruits, vegetables and low-fat dairy foods
• Eating less of foods that are high in saturated fat and cholesterol, such as fried foods
• Eating more whole grain products, fish, poultry, and nuts
• Eating less red meat and sweets
• Eating foods that are high in magnesium, potassium and calcium