Prevention

Exercise

Regular exercise has many benefits that may help individuals live longer, healthier lives. Individuals who engage in regular moderately intense physical activity may reduce their risks of developing heart disease and other serious illnesses.

Benefits of an Exercise Routine

Regular physical activity can improve health and lengthen life expectancy by helping a patient to achieve and maintain an appropriate weight, become energetic and fit, strengthen the immune system, and preserve emotional balance.

Cardiovascular Health

Engaging in exercise, particularly aerobic exercise, carries with it several cardiovascular benefits. Among these, research has shown that exercise:

  • Reduces the risk of stroke
  • Reduces the risk of heart attack
  • Lowers LDL, or "bad," cholesterol level
  • Raises HDL, or "good," cholesterol level
  • Improves circulation
  • Improves oxygen level
  • Lowers blood pressure
Other Health Benefits

Among the other far-reaching advantages of maintaining a program of regular exercise, are greater physical strength and fitness, a stronger immune system, and a more positive frame of mind. There is increasing evidence that proper exercise:

  • Lowers the chance of developing type 2 diabetes
  • Improves symptoms of type 2 diabetes, asthma or arthritis
  • Helps to build and maintain bone, muscle and joint health
  • Elevates self-esteem, reduces depression, anxiety and stress
  • Improves patterns and quality of sleep
Types of Exercise

Every person is different, so the type of exercise that works well for one person may not work well for another. Engaging in a variety of different activities has a dual purpose. It keeps the individual from becoming bored by the routine and is productive in achieving fitness goals.

An efficient exercise routine should also help the individual to improve balance and coordination as well as strengthening the body's core, or trunk, and improving the body's immune response. Ideally, an exercise program should be designed to improve: aerobic fitness, muscular strength, bone density, balance and flexibility.

Cardiovascular or Aerobic Exercise

Sometimes referred to as cardio, this type of exercise involves steady physical activity using large muscle groups. Aerobic exercise, evidenced by increased respiration and heart rate, strengthens the heart and lungs, improving the body's ability to use oxygen.

Strengthening Exercise

This type of exercise involves repeated muscle contractions until the muscle becomes tired. Strengthening exercises include weight lifting, crunches and lunges. This kind of exercise strengthens bones and muscles.

Stretching Exercise

Stretching before and after you exercise can help prepare your muscles for activity and may help prevent injury and muscle strain. Regular stretching also increases range of motion and flexibility.

In general, in order to achieve a healthy body, the individual should gradually work up to an aerobic session lasting 20 to 30 minutes, most days of the week, with time for both a warm-up and cool-down.

Woman’s Health

Women’s health examinations are focused on general wellness and disease prevention as well as certain female-specific conditions. Two of the most frequently occurring problems among women include urinary incontinence issues and sexual health and function.

Female Urinary Incontinence

Urinary incontinence is loss of bladder control. Symptoms can range from minor leaking to severe loss of control. While not a serious condition, it can be embarrassing and affect daily life. Incontinence may occur while laughing, coughing, sneezing, jogging or lifting a heavy object. This is known as stress incontinence. Another type of incontinence occurs as a strong urge to urinate without enough time to reach a bathroom. This is known as urge incontinence.

Urinary incontinence can affect people of all ages, but women are especially susceptible during and after pregnancy. The incontinence is often caused by a urinary tract infection or weak muscles in the urinary tract. Weak muscles may prevent you from closing off the urethra while doing certain activities. Urinary incontinence can usually be diagnosed through a medical examination and simple tests. Treatment may include lifestyle changes or medication.

Sexual Dysfunction

Many women experience problems with sexual function at some point in their lives. However, when sexual problems continue to occur over a long period of time, a woman may be suffering from sexual dysfunction. Sexual dysfunction is defined as any problems that prevent an individual from enjoying or receiving satisfaction from sexual activity.

The most common concerns or symptoms of sexual dysfunction in women may include:

  • Reduced sex drive
  • Inability to maintain sexual arousal during sexual activity
  • Inability to achieve orgasm
  • Pain during sexual activity

Women may experience symptoms of sexual dysfunction at any age. Both physical conditions and psychological factors may contribute to the problem. To diagnose this condition, the doctor will discuss past sexual, medical and psychological histories to evaluate what may be contributing to the problem. A physical examination may be performed to rule out any physical causes for the problem.

Men’s Health

Men’s health examinations are focused on general wellness and disease prevention as well as certain male-specific conditions. Two of the most frequently occurring problems among men include prostate issues and sexual health & function.

Enlarged Prostate

The prostate is a golf ball-sized gland located under the bladder and in front of the rectum in men. While all of its functions are not known, the prostate adds fluid and nutrients to sperm to produce semen and allow the sperm to move more effectively. An enlarged prostate, known as benign prostatic hyperplasia or BPH, is a common condition that occurs as men age. BPH causes the prostate to press against the urethra which results in urinary problems. It is believed that an enlarged prostate may be due to an excess of certain hormones in the body.

An enlarged prostate can be diagnosed after a thorough physical examination by a doctor, which may also include some additional tests. There are a wide range of treatment options available for an enlarged prostrate and if treated promptly and effectively, patients can live relatively normal lives.

Sexual Dysfunction

Many men experience problems with sexual function at some point in their lives. Common concerns are significantly reduced sex drive, an inability to maintain sexual arousal during sexual activity and ejaculation issues. Exhibiting any of these signs, and having feelings of distress as a result, is known as sexual dysfunction.

Your doctor will perform a physical examination and discuss your past sexual, medical and psychological histories to evaluate what may be contributing to your problem. With this information, your doctor may be able to treat any underlying medical conditions, adjust any current medications that may be affecting you or administer hormone therapy if necessary.

In men, two common problems are erectile dysfunction (ED) and premature ejaculation. ED refers to the consistent inability to achieve or maintain an erection for sexual intercourse. There may be physical or medical conditions that contribute to ED, including a variety of diseases, physical injury or side effects from prescription medications. Psychological factors and certain life choices such as smoking, obesity, stress, anxiety, guilt and fear of poor sexual performance can all contribute to ED.

Premature ejaculation takes place when a man reaches orgasm too quickly. The man does not have voluntary control of the timing of his ejaculation and it may occur with very little stimulation. For some patients, there are biological reasons for the premature ejaculation. Some physical influences that may cause this condition are an infection within the prostate or urethra, a thyroid disorder, problems with hormone levels or abnormalities of the ejaculatory system.

Nutrition

Proper diet is essential to maintaining good health. Keeping the body well-nourished and at a healthy weight has been proven to improve mood, quality of life and longevity. It may also go a long way in preventing or controlling many serious illnesses. Obesity, which has now reached epidemic proportions in the United States, can be kept at bay through proper nutrition along with a program of healthy exercise.

Benefits of Good Nutrition

Not only do people feel more energetic and happier when they eat well, they also keep their bodies in the best possible condition. The benefits of good nutrition include developing and maintaining physical strength as well as preventing or controlling disease processes. Research has shown that the following disorders may be avoided, controlled or mitigated by life styles that include well-balanced nutrition:

  • Apnea
  • Arthritis
  • Asthma
  • Certain cancers
  • Gout
  • Heart disease
  • Hypertension
  • Liver and gall bladder disease
  • Osteoporosis
  • Type 2 diabetes

While there are complex causes for diseases to occur, some hereditary or unknown, proper nutrition can make a noticeable difference in keeping individuals healthy.

A Healthy Diet

Generally speaking, a healthy diet is a varied one, containing the balanced nutrition needed for cell growth, cell regeneration and the maintenance of healthy organs and tissues. It includes an appropriate balance of protein, fiber, carbohydrates and unsaturated fats in reasonable portions. A good diet is one that:

  • Is rich in fruits, vegetables, whole grains and fat-free or low-fat milk products
  • Includes protein sources such as lean meats, poultry, fish, beans, eggs and nuts
  • Is low in saturated fats, cholesterol, sodium and added sugars
  • Contains a balance of appropriate vitamins and minerals

Calorie intake should be determined by age, activity level and weight goal. While our culture tends to focus on avoiding obesity, being underweight or malnourished is also a serious, often life-threatening problem. In some cases, depending on age and physical condition, certain individuals may require vitamin or mineral supplements in order to maintain proper nutrition and an appropriate weight.

Avoiding Obesity

Obesity, which affects approximately a third of all adults and a fifth of all children in the United States, is avoidable with proper diet and nutrition and a program of regular exercise. Through refraining from overeating and from ingesting foods high in calories and low in nutritional values, individuals can improve their health immeasurably. A regimen of physical exercise is also a very important part of a program designed to avoid obesity.

Nutritional Counseling

Since avoiding obesity requires making wise food choices, the more informed individuals are about what they eat, the better. Reading labels, eating fresh foods whenever possible and keeping informed about nutritional research may all contribute to leading a healthier, and often a longer, life. Nutritional counseling is invaluable in pursuing this goal.

Nutritional counseling services include taking a medical, and sometimes a psychological, history and establishing a customized dietary plan for each individual patient. Such a specific diet takes into account each patient's weight goals, personal food preferences, overall health and particular medical conditions. Anyone can benefit from nutritional counseling, especially patients with food allergies or eating disorders. Ongoing nutritional counseling allows for evolving dietary guidelines.

STD Screening

A sexually transmitted disease, or STD, is a disease or infection that is spread from one person to another through sexual contact. Most STDs are caused by bacteria, parasites or viruses that are transmitted through contact with the genitals, skin, mouth, rectum or bodily fluids. STDs can cause problems ranging from mild irritation to severe pain. Left untreated, some STDs can cause illness, cancer, infertility or harm to a fetus during pregnancy.

Risk Factors for STDS

STDs may be caused by a bacterial or viral infection that is spread through sexual contact. Individuals who may be more at risk for contacting an STD may include those who:

  • Engage in unprotected sex
  • Have multiple sexual partners
  • Are already infected with an STD
  • Abuse drugs or alcohol
  • Share needles for drug use or tattoos

In many cases, sexually transmitted diseases have no symptoms, especially in women, so a person may not even know if they have been infected. Periodic testing is recommended for anyone who may be at risk for an STD, including those who have multiple sexual partners, even if they are having protected sex.

Types of STD Testing

STD testing is not part of a standard physical exam or gynecological checkup, so unless an STD infection is suspected by a physician, testing must be specifically requested. The method of testing may vary depending upon the type of STD and it may include the following methods:

  • Blood test
  • Urine test
  • Swab sample from the genitals
  • Tissue sample

If an individual tests positive for an STD, a treatment plan should be discussed with and developed by a doctor. Fortunately, there are many effective treatments available for most STDS and although many STDs cannot be cured, there is medication available to treat and manage symptoms. Patients infected with a sexually transmitted disease should inform any sex partners of the infection to make sure they are tested and treated. This reduces the risk of re-infection and spreading the disease to a partner.

STDs are serious infections that can cause lifelong or recurring symptoms and side effects. It is important for individuals to practice safe sex and get tested often.

Travel Medicine

International travel is an exciting prospect, especially if you are visiting a place you have never been before. However, there are health issues that may be present in some foreign destinations that we do not commonly face in the United States. For that reason, it is essential to seek pre-travel health advice from a physician who is an infectious disease specialist in order to ensure that you take all necessary medical preparations before your trip.

Detailed Itinerary

The more information you can provide your doctor with about the specifics of your destinations, the better your chances are of remaining healthy during the trip.

Specifics about your travel should include:

  • all of the cities or villages you will be visiting in a particular country
  • any planned excursions taking place within the trip
  • the length of the visit
  • the type of accommodations or lodging
  • means of travel
  • activities in which you expect to participate
  • time of year, since certain diseases are more prevalent during rainy season or hot weather

Armed with knowledge, your physician can tailor a prophylactic medical plan designed to protect you from known health-related concerns in your region of travel.

Advance Planning

Some foreign destinations require more precautions than others. It is ideal to have an initial consultation with your doctor four to six weeks before your travel is scheduled to occur. This will provide enough time to receive any necessary immunizations or medications as well as documentation of these if necessary to the travel. Your doctor can also offer instructions for the prevention and treatment of illnesses common to travelers to the location you are visiting, such as diarrhea and conditions spread by insect bites.

By checking your medical history, your doctor can determine whether you are up-to-date on all routine vaccinations, such as polio and measles/mumps/rubella, which should be current before traveling to a country in which these diseases may be communicable. Depending upon the destination you are visiting, other immunizations might be recommended as well. For certain countries where malaria is present, pre-treatment with anti-malarial medications can be very helpful in preventing infection.

Traveler's Diarrhea

The most frequently occurring malady among visitors to other nations is traveler's diarrhea. Caused by exposure to bacteria, viruses or parasites, this illness is especially common for visitors to less developed countries. Loose stools are often accompanied by fever, nausea, cramps and/or vomiting. Many patients with traveler's diarrhea are forced to spend several days in during the trip because they are too sick to participate in normal activities.

Your doctor can give you specific information for avoiding traveler's diarrhea based on the destination you will be visiting. In general, though, safety precautions include eating only fruits and vegetables you can peel yourself, opting for dry food items and consuming only cooked foods that are served thoroughly cooked and very hot. Stay away from tap water, juices, ice cubes, salads, unpasteurized dairy products and any reheated food.

You cannot be vaccinated against traveler's diarrhea and prophylactic prescription drugs are rarely necessary. Hydration is important if you do acquire this illness and your doctor can recommend which over-the-counter medications are most effective so you can bring them with you as a precaution.

Insect-Carried Illnesses

There are numerous diseases that can be transmitted by an insect bite during a foreign trip. They are often serious illnesses, including malaria, dengue fever, yellow fever and tick-borne encephalitis. Insect repellent is typically the most effective method of prevention for the majority of these conditions. Use a repellent containing Diethyltoluamide (deet) in a 30 percent concentration for adults and a 10 percent concentration for children to receive the maximum protection safely. Apply it directly to exposed skin, but wash it off as soon as your risk of exposure to insects has decreased. In addition, clothing and bed-netting treated with permethrin can help you avoid getting bitten by an insect.

After the Trip

Prior to the journey, your physician will provide you with information on symptoms of many travel-related illnesses to help make you aware of whether to seek medical assistance during or after the trip. If you return home and you are not feeling well, it is essential to schedule an appointment with your doctor. Some of the diseases prevalent in foreign countries have longer incubation periods with no signs showing up until days, weeks or even months after the travel has ended.

Travelers' Wellness Center
  • The Emporiatric Medicine and Travelers' Wellness Center provides complete care for the international traveler. Established over a decade ago as one of the first full service international travel health centers in New York City, the center is an official Yellow Fever Vaccination site and is certified to endorse the World Health Organization International Certificate of Vaccination. Learn More »

Weight Management

People who are overweight or obese face an increased risk of weight-related health problems. Diabetes, high blood pressure and heart disease are just a few of the conditions that have been linked to excessive weight. The management of one's weight is becoming more and more medically relevant to help people improve their level of fitness and prevent these health issues from occurring or worsening.

Body mass index, or BMI, is a calculation of total body fat based on height and weight. It is used to determine whether a patient is underweight, at a healthy weight or overweight. A high BMI can alert both doctor and patient to potential health risks associated with obesity. Another indicator of weight risk factors is waist circumference, which indicates how much abdominal fat a patient has and can help in patient weight and health risk assessment. The following guidelines are used to determine categories of body mass index:

  • Underweight: less than 18.5 BMI
  • Normal weight: 18.5-24.9 BMI
  • Overweight: 25-29.9 BMI
  • Obese: 30 or greater BMI

Patients whose BMIs are 30 or higher face an increased risk of weight-related health problems. The risk is even higher for men with a waist circumference of more than 40 inches, or 102 cm, and women with a waist circumference of more than 35 inches, or 88 cm. Categories of risk are designated as follows:

  • BMI of 30-34.9 - High Risk
  • BMI of 35-39.9 - Very High Risk
  • BMI of 40 or more - Extremely High Risk

Decreasing BMI by a relatively small amount by weight loss can significantly decrease risk to patients. Losing 15 to 20 percent of body weight results in measurable health gains, particularly when combined with an increase in physical activity, giving up smoking or getting cholesterol within normal limits.

Wellness

A routine wellness examination is recommended at least once each year for patients of all ages. This complete medical evaluation allows your doctor to assess your health and discover problems before they start. Early detection of a disease could result in easier and more effective treatment.

How to Prepare for Your Wellness Appointment

In anticipation of your wellness visit and physical exam, the following is a list of what you should do prior to your appointment:

  • Write down a list of problems or questions you may have
  • Review and revise your family's health history
  • Make sure that you have had your recommended screenings
  • Review any lifestyle changes that you feel need to be made
The Physical Examination

Your doctor will examine you and determine what preventive services you will need depending on your age, medical history and family's medical history. The procedures that may be performed include:

  • Measurement of height, weight and blood pressure
  • Screening of body parts
  • Blood tests
  • Pap test, if needed
  • Osteoporosis screening
  • Breast exam
  • Rectal exam
  • Immunization update
Tips for Better Health

Your doctor may provide you with methods to stay in optimum health. Some of these tips may include:

  • Stop or avoid tobacco use
  • Establish a heart-healthy diet
  • Exercise on a regular basis
  • Avoid alcohol or limit its use
  • Avoid illegal drug use
  • Practice safe sex
  • Use seat belts when driving or as a passenger in an automobile

With the services, screenings and treatments available, you will be able to establish a pattern of good health.

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