Living Wills

 Do you have one? I suggest you do. Too often people confuse living wills with their personal wills, which describe how they want their assets distributed when they die. They’re completely different documents. A living will describes what type of medical and life-sustaining treatment you expect if you’re terminally ill or have been injured and your prognosis is poor AND you are unable to speak.

What efforts do you want the medical team to take to prolong your life? That’s the main question this document answers. In most cases, you don’t need a lawyer to prepare a living will.  Some hospitals and physicians provide information on how to prepare a living will. Or you can download a form off the web. Most states require someone to witness your signature. This document does not appoint someone to act on your behalf. That’s where the medical power of attorney steps in. Watch for DocHandal’s next blog.

As always Doc welcomes your comments!


Having Chest Pain-Is It Your Heart?

A few words on getting info across to Docs. Just watching the news can give you ‘agita’ (Italian slang for indigestion, so can your Aunt Sophie’s spicy casserole but intermittent chest pain (termed angina) can be caused by heart disease. Many use the term ‘pain’ others ‘discomfort’. It is important to decide if chest pain is caused by your esophagus in spasm, your stomach or your heart.

Most describe ‘angina’ (heart pain) as tightness, taking breath away, squeezing around chest. Many say they have a sense of ‘impending doom’. Others especially woman may describe a band around chest, indigestion or feeling faint. Elderly may just say they feel weak.

Not to miss/ignore Angina, describe to your Doc the pain/discomfort.

Pain is perceived differently. We are all unique hence our body talks to us in a different manner. By relating pain level to a past condition that was diagnosed (ex. broken bone, tooth abscess), your tolerance or lack of – to pain can be gauged.

Communication in a succinct, preferably written form, will help guarantee that your descriptions – the ‘what when where’ are heard. Be sure to mention if something relieved your pain.

It is up to you to try to get the best possible care.

Vitamin D

MH900409552The 1997 Dietary Reference Intake (DRI) values for vitamin D is too low, as are many of the recommendation from that year. Remember a vitamin is something your body needs but can not make. Emerging research supports the possible role of vitamin D in protecting against cancer, heart disease, fractures and falls, autoimmune diseases, influenza, type 2 diabetes, and depression.

Ultraviolet B rays from sun can allow our body to make Vitamin D from cholesterol! Need to get at least 15 minutes a day of direct sunlight, those of us that are dark skinned, obese or living north of the line from San Francisco to Philadelphia (latitude) need more sun exposure and/or Vit. D3 supplements. Most important function of this Vitamin is to maintain a balance in Calcium and Phosphorous -guessed it for bone health! Adults ages 50-70 were told to take 400 IU daily, but today a dose of over 1,000 IU is recommended.Doctors for a long time have been telling patients to take much more than the DRI. Number watchers believe over 1 billion people worldwide, (all ethnicities/ages), have a vitamin D deficiency. Very much a routine blood test, find out if you are deficient.

CPR & You

 Would you stop if someone collapsed near you?  Would you know what to do? Yes call or shout for help. What next?
Please use common sense, find out if person is responsive -breathing.

 A nationwide Japanese study just published (Circulation) showed bystanders starting “Hands Only CPR” allowed 40.7% of out of hospital cases to survive at least a month functioning on their own! Very impressive numbers.  A system was in place that started with bystanders performing “Hand – Only CPR” & public access to a defibrillator (paddles placed on chest –machine prompts you). These are in many public spaces through out the world

What I am getting at –   YOUR doing the recommended “Hands Only CPR” can save lives! It is straightforward –

Not breathing/responding

Find the middle of person’s chest (between nipple) & middle breastbone (sternum)

-Place flat of your hand over each other lean over lock elbows and push fast and hard (about 100/min.). It is said The Bee Gees disco song “Stayin’ Alive” is in sync with pace needed to make a difference. Please go online and spend 60 seconds watching this AHA video.

End of Year To Do List -Health Check

You feel fine so you did not take time for wellness check-ups. Yes you were told they were a good idea but…

Whither you have health insurance or not there are certain wellness checkups you need annually. So read this wellness to do list and get the screening you need:

Bone density Scan (for osteoporosis)- for women over 65/men over 70, unless other health issues factor in. Yes men get osteoporosis!  According to results you may need to be tested again in 1, 2 or 10 years.  Painless and non invasive. ‘Porous’ bones affects over 10 million Americans.

Diabetes – over 45  & overweight you need to be checked for prediabetes. Just a quick blood test. If under 45 with one or more risk factors (high blood pressure, high cholesterol or Diabetes during pregnancy), you need the blood test.

Eye Exam – ‘Visual’ exam (what your eye sees) vs. ‘Eye’ exam (inside health of your eye) are recommended once every year or two dependent on age, medical history and findings of last exam. The eye provides tremendous information about overall health – if a trained eye looks in!

Heart Health – every one over 20 should have a ‘lipid profile’ (total cholesterol, components (HDL, LDL) and  triglycerides). If you have normal values – recheck every 5 years. After age 18 blood pressure checks every 2 years if normal.

Skin Test – cancer of skin most common form of cancer in US (listen to DocHandal’s podcast). Only a dermatologist can totally check every inch of your skin start at age 21 and repeat as frequently as the Doc tells you.

Older Driver Awareness Week-Dec 3 – 7

 Why Not? Realize that before 2020, 1 in 4 drivers will be over 65! 

You know age affects driving skills. Think about response times (reflexes), vision along with possibility of side effects from medication(s) taken for medical conditions. Remember certain medical conditions can affect ability to drive safely.

Many state motor vehicle agencies have tests for older drivers. You can also purchase a CD or take such a test free online.  This test measures 8 functional abilities that are linked to crash risk in older drivers. Check out for free tests and information.

Do not just think about the driver’s ability –  the car has to be right – hence the birth of “CarFit” ( an education program to evaluate if the vehicle (seat height, restraints, access to pedals mirrors) is right for the senior driver.

This week, give some attention to the older driver in your life!

Call IN/OUT Sick?

No matter the  phrase  you use ‘call out sick’ or ‘call in sick’ can be a tough decision.

Sick days cost 25 billion in looses (17.5 b. in decrease productivity).

How do we approach this, initially we tend to think,

-How many sick days remain

-OR  I don’t get paid unless I  work

Not that the above is unnatural but more important is– how do you feel, consider:

-Will my symptoms allow me to do my job? Ex: repeated vomiting and diarrhea would make an job difficult.

-Do I have a fever?

Greater than 102 F (38.9 C degrees is an automatic stay home, and do not return to work till no fever for 24 hours (learn normal for you – most folks greater than 99.5F (37.5 C) is a fever). Higher than normal body temperature – ‘Fever’ is a body defense- working to ‘fight’ something raises your temperature. Low-grade fever that accompanies the common cold (running nose, slight cough) when treated (ex. aspirin, ibuprofen) may allow you to go to work.

If you go to work take sanitary precautions on computers/appliances so you do not spread your illness often one of the many cold virus.

Remember: If you have underlying medical conditions ex. Diabetes, Asthma, err on the side of staying home!

Please consider the above when making a decision and ALWAYS – if more guidance is needed – – call your medical provider.