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HEALTH SCREENINGS IN OUR OFFICE
 ABI SCREENING IS USED TO DETECT poor circulation in the lower legs caused by clogged arteries. “Peripheral Arterial Disease,” or PAD, reduces the flow of blood to the lowest part of the body and creates a risk of heart disease, aortic aneurysms and stroke. It is a condition similar to coronary artery disease, which restricts the flow of blood to the heart,and carotid artery disease, which restricts the flow of blood to the brain.
People with PAD are at increased risk for heart disease and strokes. PAD can also be an indicator of diabetes, hypertension and other conditions.
The ABI test is simple. It uses uses a standard blood pressure cuff and a special ultrasound stethoscope called a Doppler. The pressure in the ankle is compared to the pressure in your arm to determine how well the blood is flowing and whether additional testing is needed.
Early detection of peripheral arterial disease can help prevent amputation, heart attack and stroke.
Peripheral Arterial Disease of the arteries that affects 10 million Americans. It can affect anyone regardless of age but is most common in men and women over the age of 50. Over the age of 65 it affects as much as 20 percent of the population.
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BREATH AND LUNG TESTING USING SPIROMETRY is a simple  and short examination to test your lung capacity and your ability to inhale and exhale. This testing is helpful to diagnose conditions such as asthma, bronchitis, emphysema and other respiratory diseases, and to take effective remedial action immediately, if needed.
A Spirometry test takes about 15 minutes. The patient breathesthrough a mouthpiece while the test device (the spirometer) measures the results. It evaluates the speed at which an individual can exhale; and the amount of air the lungs can hold at a time (lung capacity).
 Your doctor can use the information from this test to evaluate your ability to breathe and to diagnose potential health risks. In addition, these tests can be used with existing patients to gauge the progression of respiratory diseases identified above, and help determine effective forms of treatment.
Spirometry is a useful diagnostic tool for patients of all ages, and as young as five.
Spirometry comes the Greek word “spiro” which means, breath. Spirometry is defined as the measurement of breathing.
Who should consider a Spirometry health screen?
Anyone who experiences breathing difficulties in waking hours or during sleep may be a candidate for a Spirometry test. People at greater risk for respiratory illnesses include:
• Smokers
• Workers who have been exposed to respiratory irritants, sensitizers and nuisance dusts
• People who experience sleep disorders or difficulty during sleep
• Diabetes patients for using Exubera, an insulin inhalant.
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24-HOUR BLOOD PRESSURE MONITORING -- By monitoring your blood pressure over a full night-and-day cycle, you provide your doctor with valuable information on variations in your blood pressure that are not detected by a single reading during your appointment.
 Your blood pressure is different when you sleep, when you exercise, when you feel stressed and when you go about your normal activities. By monitoring how your blood pressure reacts to these activities over a 24-hour period, your doctor will receive a more accurate picture of your heart health. This understanding will assist in the ability to diagnose whether there may be a problem, or whether a change in treatment may be needed. If you take medication for blood pressure or hypertension, this test will also measure the medicine’s effectiveness over the period being monitored.
Here’s how it works:
The cuff is worn on the arm. It will inflate and deflate at intervals over the course of the day and night. A diary comes with the 24-Hour Blood Pressure Monitor for you to write down the date and time and your activity at each interval. For example, you would make a note after you walk up stairs, sleep, smoke or engage in other types of activities. In addition, you record the times that you feel specific symptoms, such as headaches, stress, dizziness, etc. If you take medication, the medicine and doses are also recorded.
Your doctor will receive these results from the monitor after you return to the office. The results will provide a more complete picture of your heart’s condition, whether a treatment program is needed, or whether an existing program needs to be modified.
Who should consider using a 24-Hour Blood Pressure Monitor?
• Patients who suffer from hypertension
• Anyone who experiences episodic heart palpitations, or other irregularities in their blood pressure at different intervals over the course of a day
• Anyone who suffers from nervousness when having their blood pressure taken by a medical professional. This may give an abnormal result that is not indicative of the person’s typical blood pressure.
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24-HOUR HEART MONITORING -- The Holter Monitor is a portable device worn on the patient and which measures the electrical activity of the heart over a 24-hour period. 
Named for its inventor, Dr. Norman Holter, the monitor is helpful for people who suffer from palpitations. It determines is used to measure irregular heartbeats (arrhythmias) and other electrical disturbances.
A Holter monitor provides your physician with more information than a standard electrocardiogram (EKG). This is because palpitations and irregular heartbeats may not be detected during a physical exam or during an EKG. This is especially true if symptoms are episodic. The 24-hour monitor offers a more comprehensive evaluation.
Over the 24 hours, each and every heartbeat is recorded. Sticky patches (electrodes) on the chest are connected to wires from the monitor. The monitor is worn by the patient for the recording period. The information that comes from the test includes heart rates during the day and night, ab normal heart beats, and recording of rhythm during any symptoms during the recording. A diary comes with the Holter for the patient to write down the time and type of symptoms they feel so that they can be reviewed by the physician.
Who should consider using a Holter Moniter?
• Anyone who experiences episodic heart palpitations or irregularities in their heart beating may be a candidate for using the Holter Monitor.
• Included are diabetics because diabetes often causes cardiac complications such as heart attacks, strokes and the need for heart bypass operations. Once prevention is no longer an option, the challenge becomes an early and accurate diagnosis with timely treatment.
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ECHOCARDIOGRAPHY is used to diagnose cardiovascular diseases. It shows the size and shape of the heart, its pumping capacity and the location and extent of any damage to its tissues. 
An Echocardiogram is alsohelpful in evaluating the condition of the heart valves. In addition, it helps doctors determine if there are abnormalities in the pattern of blood flow, such as the backward flow of blood through partly closed heart valves. By assessing the motion of the heart wall, echocardiography can help detect the presence and assess the severity of coronary artery disease, as well as help determine whether any chest pain is related to heart disease.
There are other uses as well but one of the advantages of echocardiography is that it is non-invasive, meaning that information about the heart can be obtained easily in the doctor’s office without penetrating the patient’s skin, and without known risks or side effects.
No special preparations are needed for most types of echocardiography. The test is painless and usually takes less than an hour. Generally you recline on an exam table and EKG electrodes are attached to your chest. The doctor or technician applies a gel to your chest and then passes a wand-like device around on your chest.
The wand, called a “transducer,” sends ultrasound waves into your chest, then echoes from the sound waves are converted into images of your heart that appear on a computer screen. The technician records the images, for review by the doctor or cardiologist.
Who should consider an Echocardiogram?
Anyone who suffers from heart disease symptoms. These include shortness of breath, chest pains or other heart problems and even swelling in the legs.
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HEALTH SCREENINGS AT HOME
DEPRESSION
Almost one in every six adults is affected by depression at some time during their lives but only 25 percent of them are adequately treated. Many people are embarrassed to ask for help when they feel they may be depressed. Even so, it is important to talk with your doctor. Why? In addition to making you feel sad, depression can strain your immune system and is associated with various illnesses. Depression can also be made worse by chronic illness, such as diabetes.
If you feel you may be suffering from depression, try taking this simple quiz. You can even print it out and bring it with you on your next doctor’s appointment. Type or copy this Web link (Is It Really Depression), paste it into your internet browser and press “go.”
www.IsItReallyDepression.com
Once on the Web site you can take a simple “Mood Questionnaire,” and read more about the symptoms of depression and what they might mean.
Don’t ignore your feelings. There is help available.
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RISK OF HEART ATTACK OVER 10 YEARS
Complete the questions at the following link to evaluate your risk of heart attack within the next 10 years. Then, bring your form with you on your next visit. Framingham Risk Assessment
RISK OF BONE FRACTURE
See whether you are at risk for bone fracture. The following risk assessment tool could help you avoid the pain and inconvenience of a broken bone. Go to the site, click the tab for "Calculation Tool," then select from the drop-down menu your ethnic category ... there are four shown, e.g., U.S. Caucasian; U.S. Black; U.S. Hispanic; and U.S. Asian. FRAX Assessment Tool
ADDITIONAL SCREENINGS OFFERED THROUGH REPUTABLE SOURCES
These additional, short risk assessmens ask you about various symptoms on the following topics. If you think you might be a candidate for any of these, take a few minutes to complete the questionnaire in the privacy of your home. If it indicates that you are at risk, bring it in and discuss with your doctor for treatment.
Diabetes
Heart Health Check
Prostate Check
Peripheral Arterial Disease (PAD)
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