Medical emergencies can happen at any time.  You need to make sure you are protected and prepared.  Here is a list of items to have handy and accessible.

• Health insurance card/information.  If you go to an ER without one, you will have a lot of paperwork to fill out over the next few months trying to reverse the huge bills you will get.
• Emergency contact information.  Make sure you have updated phone numbers of local family and friends who will be able to help you.  Do not have their info just on your phone.  What if your phone runs out of batteries?  Create a card with this information and put it in your wallet.  You should also have your neighbor’s information handy.  In cases such as a snowstorm or hurricane, your relatives may not be able to get to your home to feed your pets or gather information that you may have left behind.  If you don’t know your neighbors, get friendly with them.
• Medical test results.  If you have a chronic condition such as heart disease, include your most recent lab work or EKG result.  You should not be afraid to ask your physicians for copies of your medical tests.  You have every right to get them.  It’s just like your tax returns.  You must keep your own records.  Your doctor’s office may be closed when you have an emergency on a weekend, and most ER doctors don’t have time to hunt down your information.
• Living will or health care proxy paperwork. It is never too early to think about having this ready.  Not sure what these are?  Here is a link from the CDC describing Advance Care Planning.
• List of updated medications with dosages and allergies.  Imagine you are having a heart attack and someone is asking you about what medications you are taking and you are trying to remember all 15!  That could be a frustrating and time-wasting endeavor.  Now imagine if you had taken the time to make a list.  You could just hand the list over and be done with it.  Sidenote:  It is often not helpful to just remember the size and shape of the medications.  Many pills are “round, white, with a line down the middle”!  Most providers are not trained to recognize the hundreds of thousands of pill shapes, markings, and colors.
• Local pharmacy telephone number.  Most medical offices do not use paper prescriptions.  Instead we use “E-prescriptions” where the information is sent to the pharmacy directly.  This saves you the time of having to drop off, wait, and pick up the prescription.  It also improves accuracy, as many pharmacists will tell you it is often hard to decipher the writing on some paper prescriptions.  The medication is ready right after you leave the doctor’s office or emergency room.  You must know the phone number, name, and address of the pharmacy so that your doctor can transmit the prescription to the correct location.

Everyone should get an annual physical exam from a primary care provider.  Here are ten questions and issues you should be prepared to ask.

• What are the vaccines I need?  Immunizations are not just for children.  Many adults do not realize that they need to get vaccines as an adult.  The Flu vaccine is just one of many.
• What cancer screening is appropriate for my age and risk factors?
• My family medical history has recently changed, and I recently found out a relative has been diagnosed with a disease, how does this change my cancer screening?  Your doctor should ask you about any updates to your family medical history.  For example, if a parent has developed colon cancer you may need to be screened earlier (usually 10 years before the age your relative developed the tumor) than the general population.
• What is my BMI (body mass index)?  The BMI is a number that determines whether you are underweight, normal weight, overweight, or obese.  You may think you look “normal” compared to your friends, but you may actually be overweight.
• What are my total cholesterol, low density cholesterol (LDL or “bad” cholesterol), and high density cholesterol (HDL or “good” cholesterol), what are the cut-offs for these and what can I do to improve the numbers?
• What is my fasting blood sugar?  This is a test that can detect diabetes and early diabetes.
• Is my blood pressure in the pre-hypertension range?  Pre-hypertension readings mean you may develop true hypertension (high blood pressure requiring medications) in a few years.  This would require lifestyle modifications.
• I am taking herbal medications, do you think they will benefit me?  Do they have any side effects?  Do they interact with any of the medications I’m taking?
• If there are abnormalities on the physical exam or labs, when should I follow up to repeat the tests?  Be sure to make a note of this in your calendar or smartphone so that you will not forget.  Many busy medical offices will not routinely send reminders to patients.  It is important to keep track of your own health.
• Is there a cheaper, generic version of the medications I am taking?  Many generic medications work just as well as the brand name counterparts.  You could save hundreds of dollars per year by switching to one of these.  You may also want to do research yourself by looking at your insurance plan’s formulary.  This is a list of medications that your insurance company “prefers” and these generally cost much less or have lower co-pays than other medications.

As most people know, the skin is the largest organ in the body. It provides protection for the body.  Be sure to treat your skin right and you will minimize the signs of aging.  A recent study conducted in Australia showed that sunscreen use can reduce wrinkles even after 4 years.  The study randomized two groups.  One group was advised to use sunscreen with SPF 15+.  Both groups had pictures taken of their skin at baseline and regular intervals.  At the end of the study period, dermatologists were presented photos of the skin, without knowledge of whether the person was in the suncreen or non-sunscreen group.  In scientific study design, we call this “blinding”.  After 4 years, the group who used sunscreen had markedly fewer wrinkles.

Though the study used SPF (Sun Protection Factor) with a minimum of  15, I would highly recommend 30 or greater.  If you are fair skinned, or have a history of skin cancer, use SPF 60.  Sun avoidance is also recommended.  Avoid staying outdoors between the hours of 12-3 when the sun’s rays are most direct.  Even though it is cold during the winter, the sun can still be intense.  In fact, many snowboarders and skiiers get severely sunburn because the snow reflects sunlight like a mirror.  They may not even realize they are getting sunburned because they still feel cold.   I advise using a facial moisturizer containing SPF 30 all year round.   

Don’t forget the lips!  Lips can get extremely painful if they are sunburned.  Always carry lip balm with SPF 15+ and apply liberally and reapply after meals. 

The skin faces different challenges in the wintertime.  We lose water through our pores.  Skin can easily dry out with the colder weather during winter.  Skin conditions such as eczema and psoriasis often worsen when skin becomes dry.  It is extremely important to drink extra water, especially if you are going to be outdoors for prolonged periods of time.  Apply moisturizer liberally.  When people ask me which moisturizer is the best, I advise them that the key is not quality, it is quantity and consistency of application.  Buy a few bottles and keep them in different rooms, so that you remember to apply it.  The best time to do this would be immediately after your shower as you can lock the moisture in that is in the pores.  Remember to moisturize around the nail and cuticle areas.  When these areas are very dry, they can turn into painful “hang nails”.  Again, don’t forget to apply lip balm to the lips!  Keep your bedroom humidified.  This can be accomplished by keeping a bowl of water next to your radiator/heat vent, or if you have a green thumb having houseplants.  I usually advise people to avoid buying humdifiers with a tank, as these require very frequent cleaning or else they will develop mold and algae, which can become aerosolized and worsen indoor allergy symptoms.

Eating a balanced diet rich in vitamin A, C, and Zinc is also essential for good skin and healing after wounds/surgery.  You can accomplish this by eating a diet full of fruits and vegetables and plenty of fresh seafood.  Be sure to pick fruits and vegetables with different colors, such as red bell peppers, carrots, beets, as the color is created by different vitamins. 

Exercise regularly.  Did you ever wonder why people who exercise regularly have that “glow”?  When you exercise, the circulation in your body increases blood flow to all organs including the skin and sweat glands.  This provides extra moisture for the skin.  Sweating also helps remove toxins on the surface of the skin. 

While there is no magic pill to look younger, we do know that the key to looking younger is living a healthy lifestyle.  Start taking care of your largest organ with these suggestions and you will be look and feel younger!

Stress caused by work, family situations, financial problems, and relationship issues can take a toll on your health.  Your immune system can become weakened by stress itself and also from the lack of sleep, unhealthy eating habits and lack of exercise which often come with stressful moments in our lives.  We should all try to eliminate sources of stress as much as possible.  However, sometimes this is out of our control.  In this situation, we should find ways to recharge our minds and bodies.

Here are some tips to follow to help you cope with stress:

• Meditation:  This does not have to be a spiritual or long process.  Even something as simple as closing your eyes and thinking about your last vacation- imagining the sights, sounds, and smells and “taking your mind to a different place” can be helpful
• Healthy Eating:  While it is important to eat healthy, it is even more important to eat healthy when you are under stress.  Reaching for “fast food” during stressful times may make you feel worse.  Avoid caffeine and alcohol as these can cause you to feel more stressed or anxious.  Eat foods rich in antioxidants.  Think about fruits and vegetables with bright colors such as carrots, bell peppers, tomatoes, and eggplant.
• Talk with a Friend:  When you talk about your problems with someone, you get another perspective on your problems.  Sometimes, you will find your own solution just by talking it through.
• Exercise:  Exercise increases blood flow to all parts of the body including the brain.  You may notice that you can come up with solutions to your problems while going for a brisk run.
• Take a Hike:  Nature is very calming and relaxing.  Take a walk along the beach or walk through the woods or a nearby park.
• See your Healthcare Provider:  Certain medical conditions can cause feelings of anxiety.  You may need blood tests and a physical exam to make sure your problems are not due to thyroid, liver, heart or hormonal problems.

The summer is a great time to go outdoors, get some fresh air, and some much needed vitamin D.  It is also a time for potential injuries.  Here are my top 10 items to throw into your beach bag or hiking bag and why they are must-haves for the summer.

• Sunscreen with SPF 30+: Studies have shown that sunscreen can prevent premature aging of the skin.  Long term exposure to harmful UV rays also increase your risk of skin cancer.
• Lip balm with SPF 30+:  Don’t forget that your lips are very sensitive and vulnerable to sunburn.
• Sunglasses with thick sides:  Pollen floating in the air can stick onto your eyeballs, causing itching and irritation if you suffer from seasonal allergies.  Sun can also reach your eyes from the sides.
• Coconut water:  When the weather gets hot, sweating can leave you with low levels of potassium.  Make sure that you hydrate with a fluid containing potassium.  Coconut water has plenty of this electrolyte without excess sugar and calories.
• Insect repellent with Deet:  Mosquitoes and ticks can transmit diseases such as West Nile Virus and Lyme disease.  Protect yourself by making sure you spray exposed areas before hiking or walking through tall grasses.
• Wide brimmed hat:  The sun can be very intense especially if you are out for the whole day.  Your hair may cover some of your scalp, but sunburns and skin cancers are very common on the top of the head.  We often are not able to apply sunscreen on those areas because of the hair.  A wide brim is important to make cover your forehead and neck.
• Fruits:  They provide potassium and are rich sources of vitamin C and antioxidants.  You need these to protect against the harmful radiation from the sun.  Summer is a great time to enjoy locally grown produce.
• Antibacterial ointment:  During the summer, we all get scrapes and injuries.  Make sure you keep them clean by washing them immediately with gentle soap and water.  Then apply antibacterial ointment to keep them from getting infected.
• Hydrocortisone cream:  Bug bites can cause tremendous amount of itching.  Hydrocortisone cream can alleviate those symptoms.
• Beach ball, frisbee, running shoes, or yoga mat:  Summer is a great time to exercise, burn calories, and get in shape.  Reach your fitness goals this summer!  You’ll look and feel great!