A basic plan can help you make the most of your appointment whether you are starting with a new doctor or continuing with the doctor you’ve seen for years. The following tips will make it easier for you and your doctor to cover everything you need to talk about.
List and Prioritize Your Concerns
Make a list of what you want to discuss. For example, do you have a new symptom you want to ask the doctor about? Do you want to get a flu shot? Are you concerned about how a treatment is affecting your daily life? If you have more than a few items to discuss, put them in order and ask about the most important ones first. Don’t put off the things that are really on your mind until the end of your appointment—bring them up right away! Discussing Your Concerns with the Doctor: Worksheet can help.
Take Information with You
Some doctors suggest you put all your prescription drugs, over-the-counter medicines, vitamins, and herbal remedies or supplements in a bag and bring them with you. Others recommend you bring a list of everything you take and the dose. You should also take your insurance cards, names and phone numbers of other doctors you see, and your medical records if the doctor doesn’t already have them.
Consider Bringing a Family Member or Friend
Sometimes it is helpful to bring a family member or close friend with you. Let your family member or friend know in advance what you want from your visit. Your companion can remind you what you planned to discuss with the doctor if you forget. She or he can take notes for you and can help you remember what the doctor said.
Be Sure You Can See and Hear As Well As Possible
Many older people use glasses or need aids for hearing. Remember to take your eyeglasses to the doctor’s visit. If you have a hearing aid, make sure that it is working well and wear it. Let the doctor and staff know if you have a hard time seeing or hearing. For example, you may want to say: “My hearing makes it hard to understand everything you’re saying. It helps a lot when you speak slowly.”
Plan to Update the Doctor
Let your doctor know what has happened in your life since your last visit. If you have been treated in the emergency room or by a specialist, tell the doctor right away. Mention any changes you have noticed in your appetite, weight, sleep, or energy level. Also tell the doctor about any recent changes in any medications you take or the effects they have had on you. Discussing Changes in Your Health: Worksheet and Tracking Your Medications: Worksheet can help you get organized.
Request an Interpreter if You Know You’ll Need One
If the doctor you selected or were referred to doesn’t speak your language, ask the doctor’s office to provide an interpreter. Even though some English-speaking doctors know basic medical terms in Spanish or other languages, you may feel more comfortable speaking in your own language, especially when it comes to sensitive subjects, such as sexuality or depression. Call the doctor’s office ahead of time, as they may need to plan for an interpreter to be available.
Always let the doctor, your interpreter, or the staff know if you do not understand your diagnosis or the instructions the doctor gives you. Don’t let language barriers stop you from asking questions or voicing your concerns.
Mary I. O’Connor, M.D., chair of the Department of Orthopedic Surgery at the Mayo Clinic campus in Florida, discusses the follow-up, recovery and rehabilitation associated with knee replacement surgery. She addresses how soon patients may resume activities, such as exercise, walking and driving.
Knee Surgery (3-Part-Series)
Part 1: http://www.youtube.com/watch?v=LNPy5-6qWrU
Part 2: http://www.youtube.com/watch?v=sNkaiDo3za8
Part 3: http://www.youtube.com/watch?v=JAQW073ZUx8 (This video)
The causes of rosacea are complex and not well understood. Both genetic and environmental factors appear to influence the disorder, although many of these factors have not been identified.
Studies suggest that rosacea is associated with abnormalities of blood vessels (the vascular system) and the immune system. In people with this condition, blood vessels expand (dilate) too easily, which can cause redness and flushing of the skin. Rosacea is also associated with abnormal inflammation. Inflammation is a normal immune system response to injury and foreign invaders, such as bacteria. Abnormal inflammation impairs the skin’s ability to act as a protective barrier for the body. Researchers believe that a combination of blood vessel abnormalities, abnormal inflammation, and a disruption of the skin barrier underlie the signs and symptoms of rosacea.
Among the genes thought to play roles in rosacea are several genes in a family called the . The HLA complex helps the immune system distinguish the body’s own proteins from proteins made by foreign invaders. Each HLA gene has many different variations, allowing each person’s immune system to react to a wide range of foreign proteins. Certain variations in HLA genes likely contribute to the abnormal inflammation that is characteristic of rosacea.
Another group of genes that appear to be involved in the development of rosacea are glutathione S-transferases (GSTs). The proteins produced from these genes help protect cells from oxidative stress. Oxidative stress occurs when unstable molecules called reactive oxygen species (ROS) accumulate to levels that can damage or kill cells. Variants in several GST genes have been associated with an increased risk of developing rosacea. Researchers suspect that these variants reduce the ability of GSTs to protect skin cells from oxidative stress, leading to cell damage and inflammation.
Environmental (nongenetic) factors can also increase the risk of developing rosacea and trigger its symptoms. Among the best-studied risk factors for rosacea is exposure to ultraviolet (UV) radiation from the sun. UV radiation causes oxidative stress that can damage skin cells. Studies suggest that having an overgrowth of certain microorganisms that live on facial skin, particularly mites called Demodex folliculorum, may also contribute to the development of rosacea. These mites stimulate an abnormal immune response and disrupt the normal skin barrier. Other factors that can trigger the signs and symptoms of rosacea or make them worse include heat exposure, spicy food, cigarette smoking, and alcohol, all of which cause blood vessels in the skin to dilate.
Could blocking an androgen ( testosterone) receptor lead to a new way to treat an aggressive form of breast cancer?
That’s a question researchers at the Mayo Clinic in Arizona and the Translational Genomics Research Institute (TGen) in Phoenix, Ariz are exploring. Preliminary results of a Mayo Clinic — TGen collaborative study show the androgen receptor may be a potential target to attack in treating triple negative breast cancer (TNBC).
Barbara Pockaj, M.D., a surgical oncologist at the Mayo Clinic in Arizona, discusses the study findings and the next steps in research.
49,XXXXY syndrome is a chromosomal condition in boys and men that causes intellectual disability, developmental delays, physical differences, and an inability to father biological children (infertility). Its signs and symptoms vary among affected individuals.
Boys and men with 49,XXXXY syndrome have mild or moderate intellectual disability with learning difficulties. Speech and language development is particularly affected. Most affected boys and men can understand what other people say more easily than they themselves can speak. People with 49,XXXXY syndrome tend to be shy and friendly, but problems with speech and communication can contribute to behavioral issues, including irritability, difficulty tolerating frustration, defiant behavior, and outbursts or temper tantrums.
49,XXXXY syndrome is also associated with weak muscle tone (hypotonia) and problems with coordination that delay the development of motor skills, such as sitting, standing, and walking. Affected infants and young boys are often shorter than their peers, but some catch up in height later in childhood or adolescence.
Other physical differences associated with 49,XXXXY syndrome include abnormal fusion of certain bones in the forearm (radioulnar synostosis), an unusually large range of joint movement (), elbow abnormalities, curved pinky fingers (fifth finger ), and flat feet (). Affected individuals have distinctive facial features that can include widely spaced eyes (), outside corners of the eyes that point upward (), skin folds covering the inner corner of the eyes (epicanthal folds), and a flat bridge of the nose. Dental abnormalities are also common in this disorder.
49,XXXXY syndrome disrupts male sexual development. The penis is often short and underdeveloped, and the testes may be undescended, which means they are abnormally located inside the pelvis or abdomen. The testes are small and do not produce enough testosterone, which is the hormone that directs male sexual development. The shortage of testosterone often leads to incomplete puberty. Starting in adolescence, affected boys and men may have sparse body hair, and some experience breast enlargement (gynecomastia). Their testes do not produce sperm, so all men with 49,XXXXY syndrome are infertile.
Dr. W. Edward Deming traveled the world teaching the principles of Quality Improvement. The Red Bead Experiment is one of his more famous examples. This Experiment depicts one of the main tenets of Quality Improvement: a flawed System is the culprit for poor quality outcomes, not willing employees.
Jonathan Finnoff, D.O., Medical Director for Mayo Clinic Square, Sports Medicine Center, Minneapolis, Minnesota discusses the services they provide in their program. Sports performance training, psychology, trainers for individuals and teams. Rehabilitation services with physical therapists who are specialized in sports medicine. Orthopedic surgeons and physiatrists with sports medicine training are also available. The center includes on-site musculoskeletal ultrasound, the Exos sports performance program and a regenerative medicine program. Mayo Clinic Square is ready to help athletes of all ages and levels of ability.