Friday, May 17, 2019

A Test to Predict Longevity?

According to a recent study, there is a simple test to predict your risk of premature death, including death from heart disease, cancer, and other causes as well.  See if you can climb four flights of stairs in under a minute, without having to stop. 

This study measured the exercise capacity of over 12,000 participants.  The study then followed these people for about 5 years.  People with poor functional capacity, had a death rate from heart disease almost 3 times higher, and cancer deaths were almost double, compared to study participants who had good exercise capacity.

If you want to try this test yourself, please use good judgement.  If you have heart disease, or if you have trouble walking up a single flight of stairs, you should talk with your doctor before trying this.  If you try the test and have chest pain, stop and contact your doctor.
If you can complete the stair test, then you have a good functional capacity.  Good functional capacity comes from being physically active on a regular basis.

How does exercise help your heart?
Your heart is a muscle, just like other muscles in the body.  The more it is used, the stronger it gets.  When you are physically active, your heart has to pump blood faster in order to supply your muscles with the oxygen they need.  So not only are your leg or arm muscles getting a work out, your heart muscle is getting a work out at the same time.

If you are physically active on a regular basis, your heart becomes strong enough that it can pump more blood with each contraction, which allows your heart to beat slower.  A slower heart rate, due to a strong heart, is associated with a longer life.

Regular exercise also improves your blood pressure.  Lower blood pressure means lower risk of cardiovascular disease.  Exercise also improves your cholesterol levels, increasing the good cholesterol and decreasing the bad.

You may be thinking "I understand why exercise helps my heart, but how does it decrease my chances of getting cancer?" 
You might be surprised to hear that your immune system kills cancer cells that develop in your body all the time.  Mutations can occur in cells for a number of reasons, and if left to continue to multiply, that mutated cell would become a cancer.  If your immune system is functioning well, it recognizes those tiny cancers and attacks them; that's just part of the job of the immune system.   If you are exercising regularly, your immune system functions well.  It is "tuned up" and ready to fight for you.

What should you do if you cannot meet the stair test challenge?
 If you cannot do it, that is a sign that you need more exercise on a regular basis.  If you are young and healthy, you should gradually increase the amount that you exercise on a daily or weekly basis.  If you are older, or have underlying health problems, you should talk with your doctor before increasing your exercise regimen, just to be sure that you are healthy enough for the level of exercise that you are planning.  Your doctor may want to do a stress test, in order to get a more accurate measure of how many METs of activity you can perform, and to make sure that your heart is healthy.

If you have any questions about longevity, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Monday, May 13, 2019

Autism Spectrum Disorder - Part II

Last week we talked about the symptoms of autism spectrum disorder (ASD). This week I thought we could focus on screening and diagnosis.

Unfortunately, there is no specific medical test to diagnose ASD, so the diagnosis can sometimes be difficult. Doctors must look at many features of a child's behavior and development in order to make the diagnosis. It is important to make the diagnosis as early as possible, in order to provide the child with as much help as we can. Early intervention can make all the difference in the world to these kids. The first step in screening is developmental screening.

Developmental Screening
Your pediatrician or family doctor will ask questions about what your child can or cannot do, and compare this to a chart of usual developmental milestones and when they usually happen. Normal development varies among all children. My daughter talked much earlier than my son, but they both fell within the normal range.

Your pediatrician or family doctor will also talk and play with your child during an exam to see how they move, behave, speak, etc. Sometimes they are watching your child's actions without you even realizing it. Sometimes they may seem to be just playing (and don't we all love to play with a baby!), but they are gathering important information during this interaction.

Developmental screening is routinely done at all well child exams, especially at 9 mo
nths, 18 months, and 24 months. If your child has a developmental delay, or is at risk due to prematurity or other reasons, your doctor may do additional screenings.

Autism-Specific Screening
The American Academy of Pediatrics currently recommends that all children be screened with an ASD-specific screening test during well-child visits at 18 months and 24 months, in conjunction with the routine developmental screening. The Modified Checklist for Autism in Toddlers (M-CHAT) is the currently recommended test for the age group 18-24 months. It is a 20 question quiz that a parent fills out about their child's behavior, which is then scored and interpreted by the pediatrician.

Comprehensive Diagnostic Evaluation
If your child's doctor suspects ASD, based on the screening tests, the next step in the process of diagnosis is a comprehensive evaluation. This is a thorough review which may include:
  • More extensive behavioral and developmental testing and parental interviews
  • Hearing and vision testing
  • Genetic testing
  • Neurologic testing
  • Other medical testing may be required
Many times, your child's doctor may choose to refer you and your child to a specialist for the comprehensive diagnostic evaluation, such as a pediatrician who specializes in developmental disorders or a pediatric neurologist.

The Latest Research
There is a new research study that just came out in the last couple of months, which indicates that ASD may be diagnosed as early as 14 months with specific standardized testing starting at 14 months. In this study, by doing standardized testing, they were able to diagnose ASD with 84% accuracy. Only 2% of the children who these researchers thought had ASD went on to develop normally, and 14% ultimately were diagnosed with another developmental disorder. This is very promising.

With earlier diagnosis of ASD, we can provide earlier intervention. Earlier intervention could lead to improvement in overall function of kids with ASD by improving the connections in the brain that develop at a young age. If you suspect that your child may have symptoms of ASD, it is important to bring these concerns to your child's doctor as early as you can.

If you have any questions about autism spectrum disorder, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Autism Spectrum Disorder - Part II

Last week we talked about the symptoms of autism spectrum disorder (ASD). This week I thought we could focus on screening and diagnosis.

Unfortunately, there is no specific medical test to diagnose ASD, so the diagnosis can sometimes be difficult. Doctors must look at many features of a child's behavior and development in order to make the diagnosis. It is important to make the diagnosis as early as possible, in order to provide the child with as much help as we can. Early intervention can make all the difference in the world to these kids. The first step in screening is developmental screening.

Developmental Screening
Your pediatrician or family doctor will ask questions about what your child can or cannot do, and compare this to a chart of usual developmental milestones and when they usually happen. Normal development varies among all children. My daughter talked much earlier than my son, but they both fell within the normal range.

Your pediatrician or family doctor will also talk and play with your child during an exam to see how they move, behave, speak, etc. Sometimes they are watching your child's actions without you even realizing it. Sometimes they may seem to be just playing (and don't we all love to play with a baby!), but they are gathering important information during this interaction.

Developmental screening is routinely done at all well child exams, especially at 9 mo
nths, 18 months, and 24 months. If your child has a developmental delay, or is at risk due to prematurity or other reasons, your doctor may do additional screenings.

Autism-Specific Screening
The American Academy of Pediatrics currently recommends that all children be screened with an ASD-specific screening test during well-child visits at 18 months and 24 months, in conjunction with the routine developmental screening. The Modified Checklist for Autism in Toddlers (M-CHAT) is the currently recommended test for the age group 18-24 months. It is a 20 question quiz that a parent fills out about their child's behavior, which is then scored and interpreted by the pediatrician.

Comprehensive Diagnostic Evaluation
If your child's doctor suspects ASD, based on the screening tests, the next step in the process of diagnosis is a comprehensive evaluation. This is a thorough review which may include:
  • More extensive behavioral and developmental testing and parental interviews
  • Hearing and vision testing
  • Genetic testing
  • Neurologic testing
  • Other medical testing may be required
Many times, your child's doctor may choose to refer you and your child to a specialist for the comprehensive diagnostic evaluation, such as a pediatrician who specializes in developmental disorders or a pediatric neurologist.

The Latest Research
There is a new research study that just came out in the last couple of months, which indicates that ASD may be diagnosed as early as 14 months with specific standardized testing starting at 14 months. In this study, by doing standardized testing, they were able to diagnose ASD with 84% accuracy. Only 2% of the children who these researchers thought had ASD went on to develop normally, and 14% ultimately were diagnosed with another developmental disorder. This is very promising.

With earlier diagnosis of ASD, we can provide earlier intervention. Earlier intervention could lead to improvement in overall function of kids with ASD by improving the connections in the brain that develop at a young age. If you suspect that your child may have symptoms of ASD, it is important to bring these concerns to your child's doctor as early as you can.

If you have any questions about autism spectrum disorder, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor