I have noticed, particularly among younger patients, that people are not carrying around their health insurance cards.  Sure, you could look up your policy number if you get into a medical emergency, but is that what you want to be doing when you’re in severe pain or just got into an accident?  At this moment, if you walk through any emergency room without that card or insurance ID number, you will get a ton of paperwork and perhaps a bill.  You may be insured, but not having that information upfront means you will be on the phone with the insurance company for many hours and many repetitions of “Press 1 for English, Press 2 for Spanish, etc.”

Save yourself the trouble!  Make sure you have your insurance card with you at ALL times.  You can also take a photo of the card (front and back) and store it on your smartphone.  I hope you will never need it, but medical accidents can happen at any time.  Another card you should keep in your wallet is your HSA/FSA card.  Did you know that you can purchase sunscreen with it?  Here are some other commonly eligible items:  band-aids, contact lens solution, first aid kits, condoms, reading glasses, blood pressure monitors, and insoles for your shoes. Don’t forget that you should always pay your medical and dental office co-pays with it.

If you have any medical issues, I highly recommend putting them on a card in your wallet and also on your phone.  You may even want to buy a medical alert bracelet for conditions such as diabetes, atrial fibrillation (abnormal beating of the heart), or seizure disorder.  You can never be over-prepared when it comes to your health!

Most of us see a primary care physician once or twice a year for a complete physical exam. However, many conditions can develop during the time in between exams.  I strongly advise my patients to make sure they know how to do self-exams for certain conditions and to get into the habit to examine ALL your body parts at least once a month.  Get to know your body and be familiar with your unique features.  The best time to do this would be just before you get in the shower where we all usually have a large mirror.

Here are some recommendations:

• Skin.  Skin cancer is the most common cancer in the US.  You want to examine every inch of skin.  Don’t forget your lips, and fingernails.  Melanomas can develop in these places, especially if you are African American or Latino.  Examine your moles.  Do they look different?  Are they growing larger in diameter (>5 mm) or growing outward from the skin?  Do they have different colors?  Are the borders looking irregular?  Do they bleed or itch?  If your answer is “yes” to any of these, you should get the mole checked out.  I have some patients who take pictures of their moles with their cell phones and save the images on their computer so they have a record of what each mole looks like year after year.
• Breasts.  Breast cancers can develop over a few months.  Detecting cancers early generally lead to improved survival.  If you don’t know how to examine your breasts, you can refer to this link from the American Cancer Society.  You can also ask your primary care physician or gynecologist at your next visit.
• Testicles.  The United States Preventative Services Task Force (USPSTF) recently recommended against routine testicular exams by medical providers.  They changed their standing because testicular cancers are relatively rare and they were concerned guys weren’t going for their annual exams because they were afraid or embarassed at this particular exam.  However, this does not mean you should not examine your own testicles.  Here is a link to the American Cancer Society website to learn how to do it.
• Genitals.  If you are sexually active, you need to check the skin in the genital area at least once a week, or more frequently if you have a new partner or have multiple partners.  Genital warts caused by HPV (human papilloma virus), herpes, syphilis, and chlamydia can start with skin irritation but can rapidly progress to the entire body if untreated.
• Mouth.  Oral cancers are more common in alcohol and tobacco users, particularly people who chew tobacco or smoke cigars or cigarettes. There are some virus such as Epstein Barr virus that can increase your risk for mouth cancers.  Typically, mouth cancers look like discolored ulcers that don’t seem to go away in the mouth and can sometimes bleed.  If you find one, you should see a dentist or primary care doctor immediately.  Bad breath or foul odors in the mouth could indicate cavities or gum infections.
• Feet.  You should examine your feet at least once a month.  Diabetics should check once every week because they are at high risk for foot infections that won’t heal.  You want to look to see if there are callouses, fungal infections, splinters, or infections around the toenails.  Do your feet smell?  That odor could be caused by foot fungus.  You may need to buy an anti fungal powder and change to breathable socks.  If you see callouses, that could indicate that your shoes are not fitting properly.  Warts are common, especially in people who shower at the gym or use a local pool.  By finding a wart early, you can prevent spread to other parts of the foot and your family.  These can easily be cured with over-the-counter treatments or by visiting your primary care provider.
• Eyes.  How is your vision in both eyes?  How is your peripheral vision?  Many diseases of the eye develop very gradually and can be difficult to notice until it’s too late.  The situation is also complicated by the fact that we have two eyes and that we often unconsciously compensate with the better eye.  I recommend covering one eye and holding a newspaper in front of you about 14 inches away (if you wear glasses or contacts, you are allowed to wear them for this test).  If you start noticing a large difference, you may need to see your eye doctor.

When I grew up, seatbelt laws were just starting to be enforced for the driver and companion seat.  But I would argue that there is just as much danger in the backseat without a seatbelt.  Having practiced medicine in New York City for over 10 years, I have seen many accidents involving taxicabs where the people in the back seat are thrown into the partition or TV monitor behind the front seats, usually when the driver brakes suddenly.  Frequently, these result in lacerations (cuts) to the face that often are quite bloody, require many stitches, and can be disfiguring.  I have also seen cars hit from the side where the rear seat passengers sustain head injuries from hitting the side window.  If all passengers wore seatbelts there would be much lower risk of serious injury.

I’m always amazed when I see everyone on an airplane buckle up, yet the percentage of people who use seatbelts in the back seat of cars is much less.  In fact, your risk of being injured in a car accident on the way to the airport is much higher than during the flight!  While there are not uniform laws enforcing seatbelt use for back seat passengers in the US, you should still take the necessary extra precautions to protect yourself and your family.  Make it a habit for yourself and teach your kids that safety is always important.  As Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.”

This past winter has been a particularly brutal in most parts of the US.  It’s been bitterly cold until this past week in New York.  There has also been record snowfall and rainfall.  Typically, heavy rainfall encourages flowers and trees to produce more pollen.  Also, we are going to have a shorter period between the start of warm weather to start of summer.  This means that plants that normally release pollen in the spring, will bloom later and overlap with the plants that pollinate in the summer.  If you suffer from allergies in spring and summer, your allergies may be particularly bad this year.  You can track the pollen count daily.  Here is a link to my blog post on allergies with helpful tips to minimize your symptoms.

Our feet take a beating every day!  They are designed to support the weight of our bodies for over 12 hours a day!  We really don’t know how important our feet are until we develop pain in them from wearing improper shoes or infections.  For people with diabetes, foot care is essential to prevent serious infections.  Be kind to your feet!  Here are some tips on how to care for your feet properly.

• Wear comfortable shoes.  Shoes that are too tight can result in bunions or skin breakdown at the heel that can be very painful.  I know that for some people, fashion is a higher priority than comfort.  There are fashionable and comfortable shoes.  It’s worth looking for the shoe that will make you look good and your feet feeling good!
• Wear appropriate shoes.  If you know you are going to be walking around for many hours either shopping, walking in a museum, or hiking, be sure to wear a good pair of sneakers that will properly support your feet.  “Flip-flop” sandals are a common reason for foot pain, twisted ankles, and cuts to the feet.  They do not support the foot at all and you are vulnerable to getting stepped on or stepping on broken glass shards in the street.
• Clip your toenails, but not too short!  Toenails that are clipped too short especially at the corners can result in ingrown toenails (where the nail grows into the fleshy part of the toes) and infections that can be very painful.
• Inspect your feet at least once a week.  Foot fungus, commonly called “Athlete’s Foot” can start off between the toes and spread quickly.  You definitely want to start treatment as soon as possible.  Also, look for callouses, thickened skin at the base of the foot usually caused by excess pressure.  They could be signs that your shoes are not providing enough support in those areas and you may need to buy insoles or new shoes.
• Dry off your feet thoroughly.  Wet feet from walking in the shower floor at the gym are breeding grounds for foot fungus.  By keeping your feet dry, you can protect yourself.
• Let your shoes breathe.  Putting your shoes in a cabinet with little air circulation can promote growth of fungi and bacteria.  Store your shoes in an open space for at least 12 hours before putting them away.  Another good tip is to rotate your shoes every 2 days.  This way, your shoes will have at least 24 hours before you wear them again, which is about enough time for them to dry out completely.  If your shoes smell like yeast, you may want to spray anti-fungal powder into the shoes before and after you wear them to kill the mold spores.
• Know when your sneakers “expire”.  If you exercise regularly, I recommend writing the date of purchase with permanent marker somewhere on the inside of the shoe to remind you when to buy new sneakers.  Generally, for people who run at least 5 days a week should change their sneakers at least every 6 months.
• Thoroughly clean your feet at least once a week.  I recommend using a Epsom salts to soak your feet and to scrub off dead skin. Soaking them in warm water and a baking soda also “freshens” them up.  I find this is a great way to end a day of walking around.