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Multiple Myeloma

Questions to Discuss with Your Doctor:

• Have you had any recent infections?
• Do you know when to call your doctor with symptoms of infection?
• Do you have pain in any of your bones? If so, is it constant, or does it occur only when you move?
• Have you had any recent fractures?
• Do you have pain in your spine? Does it radiate to another part of your body?
• Have you noticed a decrease in sensation or strength in your hands or feet?
• Have you had loss of bladder or bowel control?
• Do you know when to seek medical attention for back pain?
• Have you been fatigued?
• Have you been lightheaded?
• Have you been short of breath with minimal exertion?
• Do your gums bleed when you brush your teeth?
• Do you bruise easily, or get nosebleeds?
• Have you been weak, nauseated, constipated, or confused?
• Have you had a headache or a change in your vision?
• Can you feel any lumps or masses under your skin?
• Are you aware of the possible complications that can develop from multiple myeloma?
• Do you know which symptoms should cause you to call your doctor?

Your Doctor Might Examine the Following Body Structures or Functions:

• Skin
• Heart
• Lungs
• Arms and legs
• Spine
• Neurology examination (to check for strength and sensation in your hands and feet)
• Lymph nodes (neck, axilla, and groin)

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests for complete blood count, electrolytes, kidney function, uric acid, calcium, and beta-2 microglobulin
• Serum protein electrophoresis or SPEP
• Urine protein electrophoresis or UPEP
• Quantitative immunoglobulin levels in the urine and blood
• Immunoelectrophoresis
• 24-hour urine collection for protein
• Bone marrow biopsy
• Skeletal radiographs
• CT scan
• MRI scan

Mitral Valve Prolapse

Questions to Discuss with Your Doctor:

• Have you had an echocardiogram?
• What did it show?
• Does your mitral valve leak?
• Do you get chest pain?
• What brings it on?
• How long does it last?
• What relieves it?
• Do you ever get a rapid or pounding heartbeat (palpitations) for no reason?
• How long does it last?
• Do you feel faint or develop chest pain or shortness of breath?
• Have you ever fainted?
• Do you get short of breath when you lie down or exert yourself?
• Have you ever taken any medications for your heart?
• Did you develop any side effects from these medications?

Your Doctor Might Examine the Following Body Structures or Functions:

• Heart rate, blood pressure, and weight
• Heart (sometimes while you are standing, squatting, or performing other maneuvers)
• Lungs

Your Doctor Might Order the Following Lab Tests or Studies:

• Electrocardiogram
• Echocardiogram
• Holter monitor or event monitor

We know how helpful it is to have "when you visit your doctor" questions handy at your medical appointments. Here at Ì첩ÌåÓý Publications, we have prepared these additional sets of questions you can print out and take with you so you'll know what to discuss with your doctor. Here are some of the topics available to help you partner with your doctor to get the best medical care: Parkinson'Â’s disease, cataracts, gallstones, pregnancy, and many more.

Insomnia

Questions to Discuss with Your Doctor:

• Are you particularly stressed at work or at home?
• Are you depressed or anxious?
• Do you have any underlying medical problems such as hyperthyroidism or sleep apnea?
• Do you snore?
• Do you have chronic pain or difficulty breathing at night?
• Do you have restlessness or twitching of your legs at night?
• Do you drink caffeine-containing beverages after noon (such as coffee or sodas)?
• Do you use stimulants? Drink alcohol? Take sedatives? Smoke cigarettes?
• Do you take any medications?
• What time do you usually go to bed?
• What time do you get up in the morning?
• Do you eat or work before going to bed?
• Have you noticed changes in your sleep patterns?
• Do you wake frequently at night?
• Do you feel tired during the day?
• How long do you stay in bed before you fall asleep?
• Do you have worries about not sleeping?

Your Doctor Might Examine the Following Body Structures or Functions:

• Blood pressure, heart rate, weight
• General physical exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Complete blood cell count
• Thyroid function
• Sleep study with monitoring of heart rate, respiratory rate, oxygen level, eye movements, and brain waves

Inguinal Hernia

Questions to Discuss with Your Doctor:

• Do you have pain in the lower abdomen or groin area?
• Have you noticed a bulge in your lower abdomen or groin area?
• Does lifting heavy objects, coughing, sneezing, or straining increase the size of the bulge?
• Can you push the bulge back in?
• Do you suffer from constipation?
• Have you had bloody stools?

Your Doctor Might Examine the Following Body Structures or Functions:

• Careful abdominal exam
• Groin exam (including testicular and scrotal exam in men)

Your Doctor Might Order the Following Lab Tests or Studies:

• Stool sample
• Abdominal/Pelvic ultrasound
• Abdominal/Pelvic CT scan

Irritable Bowel Syndrome (IBS)

Questions to Discuss with Your Doctor:

• Do you have pain or cramping in the lower stomach?
• How often do you get the pain?
• Is the pain related to meals?
• Do you suffer from constipation and small bowel movements?
• Do you have diarrhea that alternates with constipation?
• Do you have frequent bloating and gas?
• Do you have a feeling of fullness in the rectum?
• Is there a family history of inflammatory bowel disease?
• Do you have a history of mental illness or depression?
• Are there any things causing unusual stress in your life?
• Please describe your diet in detail.

Your Doctor Might Examine the Following Body Structures or Functions:

• Careful abdominal exam
• Rectal exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Stool testing for blood and cultures
• Conventional abdominal X-rays
• Endoscopy or sigmoidoscopy
• Barium enema
• Complete blood count and other blood tests

Macular Degeneration

Questions to Discuss with Your Doctor:

• Have you noticed a change in vision in one eye or both?
• Do you have trouble reading, even with reading glasses?
• Do you have difficulty seeing fine details?
• Do you see a gray patch in the middle of the words when you read?
• Do straight vertical lines appear "wiggly" when you look at them?
• Is your side or peripheral vision affected?
• Do you have diabetes?
• Do you smoke?
• Do you have a family history of macular degeneration?

Your Doctor Might Examine the Following Body Structures or Functions:

• The inside of your eye, using an ophthalmoscope (see p. 417)

Your Doctor Might Order the Following Lab Tests or Studies:

• Referral to an ophthalmologist (eye specialist) who will do a complete eye exam with drops to dilate your pupils.

Multiple Sclerosis

Questions to Discuss with Your Doctor:

• Do you have cloudy or double vision?
• Do you ever have eye pain or involuntary jumping of your vision?
• Do you have problems with clumsiness or poor coordination?
• Have you ever had numbness or tingling in your arms or legs? Tremors?
• Do you ever have hearing loss or vertigo?
• Do you have difficulty concentrating or problems with memory loss?
• Do you have any problems with bladder or bowel control?
• Do you have constipation?
• Do you have any family history of multiple sclerosis?
• Are you taking any medications?

Your Doctor Might Examine the Following Body Structures or Functions:

• Complete neurological exam focusing on reflexes, strength, gait, sensation, and vision

Your Doctor Might Order the Following Lab Tests or Studies:

• Lumbar puncture for removal and analysis of cerebrospinal fluid
• Magnetic Resonance Imaging (MRI)

When you think of risk factors for hearing loss, over-the-counter pain relievers probably aren't among them. But a Harvard study published in the American Journal of Epidemiology suggests that frequent use of ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may be an important contributor. In the study, women who took the pain relievers at least twice a week were more likely to experience hearing loss, and more frequent usage increased the risk by up to 24%. The findings are similar to a study of men and hearing loss, although aspirin was also found to contribute to risk in that study.

Researchers speculate that the pain relievers may be damaging the cochlea, the snail-shaped hearing mechanism in your inner ear. "Ibuprofen can reduce blood flow to the cochlea, which could result in cellular damage and cell death. Acetaminophen may deplete the antioxidant glutathione, which protects the cochlea from damage," says study author Dr. Sharon Curhan, instructor in medicine at Harvard Medical School.

Does this mean you should think twice before popping a pill for headache or back pain? These medicines do provide good pain relief for many people. "However, frequent use of these medications and use over long periods of time may increase the risk of hearing loss and may cause other adverse health effects. Therefore, it is important to take these medications mindfully and to limit their use as much as possible," says Dr. Curhan. As always, talk to your doctor before making any changes in your medication use.

To learn more about the things that can threaten your hearing, and what you can to do keep this sense sharp and clear, buy , a Special Health Report from Harvard Medical School.Ìý

Hard to detect and quick to spread, pancreatic cancer is among the deadliest of cancers. Scientists hope that genetic research will make it more like other cancers-a treatable disease. But even if it's caught while confined to the pancreas-and it rarely is-just 16% of patients are alive five years after the initial diagnosis. By comparison, the five-year survival rate for localized breast cancer is 86%. If the cancer has spread beyond the pancreas, the likelihood of living another five years is just 2%. Only the statistics for liver cancer are as grim.

Fortunately, pancreatic cancer is uncommon compared with other major cancers. About 50,000 new cases are diagnosed every year in the United States, in contrast to about 250,000 new cases of breast cancer, and 225,000 new cases of lung cancer. But because it's so untreatable, pancreatic cancer causes about 40,000 deaths each year. It is the 4^th leading cause of cancer death.