Preventive Care

Aspirin

Are you at risk for heart attack and stroke? Over 40? High blood pressure? Diabetes? A small dose of aspirin may help you. Talk to your doctor.

Dental Care

Part of caring for your body is caring for your teeth and oral health. Everyone needs regular dental cleanings—at least one per year—so visit your dentist regularly.

Depression

Depression is a serious medical condition that can cause disability and even death. Symptoms of depression include:

• Excessive sadness
• Diminished interest or pleasure in daily activities
• Weight gain or loss
• Increased or decreased sleep
• Poor concentration
• Fatigue
• Recurring thoughts of death or suicide

If you are experiencing one or more of these symptoms, please contact your healthcare provider.

For more information, go to www.nimh.nih.gov/health/publications/depression

Drinking Problems

Do you or a loved one have a drinking problem?

• Have you ever felt that you should cut down on your drinking?
• Have people annoyed you by criticizing your drinking?
• Have you ever felt bad or guilty about drinking?
• Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

If you answered yes to any of these questions, it may be time to get help. Contact your healthcare provider or Alcoholics Anonymous.

Drug and Alcohol Use

• Use prescription drugs only as directed by a healthcare provider.
• Use non-prescription drugs only as instructed on the label.
• Tell your healthcare provider all of the medications you are currently taking, including vitamins and other supplements.
• If you drink alcoholic beverages, do so in moderation. Moderation is no more than one drink daily for women and no more than two drinks daily for men.
• Do not drink alcohol before or while driving a motor vehicle.
• Don’t use illegal (street) drugs.
• If you have concerns about your alcohol or drug use, talk to your healthcare provider.

Durable Power of Attorney and Living Will

You can make decisions about your healthcare through legal documents known as a Durable Power of Attorney for Healthcare Decisions and a Living Will (a directive to physicians by the patient). Please ask for these forms during a clinic visit. It is also important to talk to your family and healthcare provider about your preferences for treatment, particularly regarding end-of-life issues. If you do not want CPR or other resuscitative efforts, talk to your provider.

Folic Acid

Folic acid (or folate) is a B vitamin that is in some enriched foods and vitamin pills. Adequate dietary folic acid before and during pregnancy can decrease the risk of birth defects of the baby’s brain and spinal cord. An easy way to get enough folic acid is to take a vitamin with folic acid in it—400 micrograms (or 0.4 milligrams) every day. Folic acid is added to some foods, such as enriched breads, pastas and rice.

Folic acid is found in the following foods:

• Fortified breakfast cereals
• Lentils
• Asparagus
• Spinach
• Black beans
• Peanuts (but do not eat if you have a peanut allergy)
• Orange juice (from concentrate is best)
• Enriched breads and pasta
• Romaine lettuce
• Broccoli

Hearing

Untreated hearing loss might lead to feelings of isolation, sadness or anger. If you are experiencing any of the symptoms below, or have other problems with your ears, talk to your provider about getting a hearing test.

• Feeling that people mumble more than they used to
• Missing the clarity of conversations, especially when in a group or a crowd
• Turning the volume of the TV or the radio louder than what is comfortable for others
• Being accused by others of being inattentive, preoccupied or “spacey”
• Hearing noises such as ringing or buzzing in your ears

Nutrition

Knowing what to eat can be confusing, but if you follow these simple guidelines, you can’t go wrong!

• Eat less, move more.
• Eat lots of different fruits and vegetables.
• Choose whole grains such as whole wheat bread or brown rice as your main starch.
• Use liquid vegetable oils such as canola or olive oil rather than margarine or butter.
• Choose poultry, fish and low-fat dairy products instead of beef, pork and lamb.
• Limit sweets.

Eating the right foods will help you live a longer, healthier life. Many illnesses such as diabetes, heart disease and high blood pressure can be prevented or controlled through a healthy diet. It is never too late to start eating right. For guidance on how to balance your diet for your individual needs, talk to your
provider. Also visit http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid/ for details on the newest “food pyramid” and information about nutrition and diet.

Osteoporosis Prevention

The National Osteoporosis Foundation recommends screening for osteoporosis in all women over the age of 65, plus some younger women at high risk. The most reliable test to determine if a person has osteoporosis is the Dual Energy X-ray Absorptiometry (DXA) scan. Ask your provider to schedule you for a DXA scan at Pacific Medical Centers to help identify potential risk for future osteoporosis. The DXA exam takes approximately 20 minutes, does not require you to change from your street clothes and involves lying on a very comfortable platform while your bones are being scanned. The process is so comfortable, some patients actually fall asleep during the exam. To prepare for a scan, you should not take a calcium tablet the day before.

To prevent osteoporosis:

• Participate regularly in weight-bearing exercise.
• Avoid smoking and excessive alcohol use.
• Take at least 1200 mg of calcium daily through food or supplements.
• Women over 50 years old should get 1200 – 1500 mg.
• In addition, adequate vitamin D is needed for calcium to be absorbed. Try to get 400 – 800 IU daily. You can get this through the diet or through 15 minutes of sun exposure daily.

Calcium Sources in Food Per Serving

Photo Aging and Skin Cancer

One in five Americans is affected by skin cancer. More than 90 percent of these cancers are caused by sunburns and blistering that occurred before age 20.

To prevent skin damage from sun, use full-spectrum sunscreen or protective clothing when outdoors. Look for “broad-spectrum” sunscreens that protect against UVA and UVB rays; aim for SPF 30 or higher. Look for ingredients such as Parsol 1789 and octyl methoxycinnamate (a “chemical” block) or titanium or zinc oxide (“physical” blocks) on the label. Avoid any sun exposure between 10 a.m. and 3 p.m. if possible. If you have a personal or family history of skin cancer, mention this to your healthcare provider. You may need a special skin exam periodically.

Physical Exercise

Physical activity can help prevent at least six diseases: heart disease, high blood pressure, obesity, diabetes, osteoporosis and depression. Physical activity also will help you feel better and stay at a healthy weight. Brisk walking can be just as good for you as an activity such as jogging. Try to do a total of 30 minutes of constant physical activity most days of the week. Before you start being physically active: Talk with your provider about ways to get started. Choose something that fits into your daily life, such as brisk walking. Choose an activity you like, such as dancing or swimming. Try a new activity, like biking. Ask a friend to start with you or join a group. Make time for physical activity, start slowly and keep at it. Try to build up your physical stamina.

Safety

Many serious injuries can be prevented by following basic safety rules:

If you choose to keep a gun in your home, make sure that the gun and ammunition are locked up separately and are out of children’s reach.

Firearms pose a particular risk in homes where children, adolescents, domestic violence and alcohol or drug use are present. Firearms should be removed from the house or stored, unloaded, in a locked compartment. Firearm injuries account for about 1,800 unintentional deaths and about five times that many non-fatal injuries each year. Visit lok-it-up.org for information on safe storage of firearms.

Sleep Apnea

Sleep apnea means that you may stop breathing during sleep. This serious medical condition can be associated with many symptoms, including daytime sleepiness, nonrestorative sleep, heavy snoring, restless sleep, night sweats, morning headaches, morning dry mouth, sore throat or hypertension. If you are experiencing one or more of these symptoms, please talk to your healthcare provider.

STDs

Sexually transmitted diseases, or STDs, are infections you can get by having sex with someone who has one of these diseases. Anyone can get an STD. Common STDs are syphilis, gonorrhea, chlamydia, genital herpes, genital warts, hepatitis B & C and HIV.

Sadly, many people consider sexually transmitted infections a moral issue. Discomfort can get in the way of common sense. Keep yourself healthy by speaking frankly and openly with your provider about your sex life and your sexual health concerns. Safer sex is anything we do to lower our risk of sexually transmitted infection.

Safer-sex practice allows couples to reduce their sexual health risks. The basic rule for safer sex is to prevent contact with genital sores and prevent the exchange of body fluids, such as semen, blood and vaginal secretions. If you have sex just once with someone who has an STD, you can catch it, whether the sex is genital, oral or anal. If you find out you have an STD, tell the person or persons with whom you’ve had sex. Anyone who has had sex with a person with
an STD needs to get treatment.

How to Reduce Your Risk of Getting an STD If you have sex:

• Have sex with only one, mutually faithful, uninfected partner.
• Use a latex condom correctly every time you have sex.
• If you use drugs, do not share needles or syringes.

Consider not having sex.

Contact your healthcare provider or your county’s Department of Public Health if you think you may have been exposed to HIV or any sexually transmitted disease.

Tobacco Use

Don’t start smoking or using smokeless tobacco. If you do smoke, quit. It is the best thing you can do to stay healthy. Smoking is the single most preventable cause of death in the U.S. and causes one in every six deaths annually. Ask your healthcare provider to help you pick a date to quit and for
advice on how to keep from starting again.

• Before trying to quit, stop smoking in places where you spend a lot of time (like at home or in the car).
• Once you quit, avoid smoking even one puff and try to keep yourself away from all cigarettes. Talk with your provider about things to do when you want a cigarette.
• If you fail the first time, don’t give up. Keep trying and learn from your experience. Ask yourself what helped or did not help you in trying to quit. You can succeed and live a healthier and longer life.
• If you have young children, your smoking may harm their health; if you quit, you will be helping them stay healthy, too.

Risks:

• Stroke
• Heart attack
• Cancer of the lung, pancreas, bladder, cervix, mouth and throat
• Respiratory infections and ulcers
• Loss of calcium in the bones

Resources:

• WA State Dept. of Health toll-free quit line: 1-877-270-STOP.
• American Cancer Society toll-free quit line: 1-800-ACS-2345.
• Internet resources: www.quitnet.com and www.cdc.gov/tobacco.

Vision

Are you having trouble seeing street signs? Reading your bank statements? All prescription lens wearers (glasses or contacts) should have their eyes rechecked every two years. Ask your healthcare provider for a referral to a doctor who provides preventive eye exams and refractions for glasses and fits contact lenses.

If you are 65 or older or have a family history of glaucoma, talk to your provider about getting tested.

Weight

Weighing too much or too little can lead to health problems. You should have your weight checked regularly by your healthcare provider. You can control/maintain your weight by eating a healthy diet and getting regular physical activity. Talk with your provider about determining your healthy
weight and ways you can control your weight.

• Find your Body Mass Index (BMI) on the chart below.
• If you are overweight or obese, losing just 10 percent of your body weight can improve your health.
• If you need to lose weight, do gradually—1/2 pound to 2 pounds per week.

Determining BMI

BMI is a measure of weight in relation to height.

As an alternative to calculating BMI, an automatic computerized form to determine BMI is available at NIH.

Are you at a healthy weight? What is your Body Mass Index?