Health Screening

Screenings are tests that look for diseases before you have symptoms. Screening tests can find diseases early, when they're easier to treat. You can get some screenings in your doctor's office. Others need special equipment, so you may need to go to a different office or clinic.

Some conditions that doctors commonly screen for include:

• Breast cancer and cervical cancer in women
• Colorectal cancer
• Diabetes
• High blood pressure
• High cholesterol
• Osteoporosis
• Overweight and obesity
• Prostate cancer in men

Which tests you need depends on your age, your sex, your family history, and whether you have risk factors for certain diseases. After a screening test, ask when you will get the results and whom to talk to about them.

Agency for Healthcare Research and Quality

Health Statistics

Health statistics are numbers that summarize information related to health. Researchers and experts from government, private, and non-profit agencies and organizations collect health statistics. They use the statistics to learn about public health and health care. Some of the types of statistics include:

• How many people in the country have a disease or how many people got the disease within a certain period of time
• How many people of a certain group have a disease. The groups could be based on location, race, ethnic group, sex, age, profession, income level, or level of education. This can help identify health disparities.
• Whether a treatment is safe and effective
• How many people were born and died. These are known as vital statistics.
• How many people have access to and use health care
• The quality and efficiency of our health care system
• Health care costs, including how much the government, employers, and individuals pay for health care. It could include how poor health can affect the country economically
• The impact of government programs and policies on health
• Risk factors for different diseases. An example would be how air pollution can raise your risk of lung diseases
• Ways to lower risk for diseases, such as exercise and weight loss to lower the risk of getting type 2 diabetes

Numbers on a graph or in a chart may seem straightforward, but that's not always the case. It's important to be critical and consider the source. If needed, ask questions to help you understand the statistics and what they are showing.

Healthy Sleep

What is sleep?

While you are sleeping, you are unconscious, but your brain and body functions are still active. Sleep is a complex biological process that helps you process new information, stay healthy, and feel rested.

During sleep, your brain cycles through five stages: stage 1, 2, 3, 4, and rapid eye movement (REM) sleep. Different things happen during each stage. For example, you have a different pattern of brain waves during each one. Your breathing, heart, and temperature may be slower or faster in some stages. Certain phases of sleep help you :

• Feel rested and energetic the next day
• Learn information, get insight, and form memories
• Give your heart and vascular system a rest
• Release more growth hormone, which helps children grow. It also boosts muscle mass and the repair of cells and tissues in children and adults.
• Release sex hormones, which contributes to puberty and fertility
• Keep from getting sick or help you get better when you are sick, by creating more cytokines (hormones that help the immune system fight various infections)

You need all of the stages to get a healthy sleep.

The amount of sleep you need depends on several factors, including your age, lifestyle, health, and whether you have been getting enough sleep recently. The general recommendations for sleep are:

• Newborns: 16-18 hours a day
• Preschool-aged children: 11-12 hours a day
• School-aged children: At least 10 hours a day
• Teens: 9-10 hours a day
• Adults (including older adults): 7-8 hours a day

During puberty, teenagers' biological clocks shift, and they are more likely to go to bed later than younger children and adults, and they tend to want to sleep later in the morning. This delayed sleep-wake rhythm conflicts with the early-morning start times of many high schools and helps explain why most teenagers do not get enough sleep.

Some people think that adults need less sleep as they age. But there is no evidence to show that older adults can get by with less sleep than people who are younger. As people age, however, they often get less sleep or they tend to spend less time in the deep, restful stage of sleep. Older adults are also more easily awakened.

And it's not just the number of hours of sleep you get that matters. The quality of the sleep you get is also important. People whose sleep is frequently interrupted or cut short might not get enough of certain stages of sleep.

If you are wondering whether you are getting enough sleep, including quality sleep, ask yourself:

• Do you have trouble getting up in the morning?
• Do you have trouble focusing during the day?
• Do you doze off during the day?

If you answered yes to these three questions, you should work on improving your sleep.

Sleep is important for overall health. When you don't get enough sleep (sleep deprivation), it does more than just make you feel tired. It can affect your performance, including your ability to think clearly, react quickly, and form memories. This may cause you to make bad decisions and take more risks. People with sleep deprivation are more likely to get into accidents.

Sleep deprivation can also affect your mood, leading to:

• Irritability
• Problems with relationships, especially for children and teenagers
• Depression
• Anxiety

It can also affect your physical health. Research shows that not getting enough sleep, or getting poor-quality sleep, increases your risk of:

• High blood pressure
• Heart disease
• Stroke
• Kidney disease
• Obesity
• Type 2 diabetes

Not getting enough sleep can also mean that you don't get enough of the hormones that help children grow and help adults and children build muscle mass, fight infections, and repair cells.

Sleep deprivation magnifies the effect of alcohol. A tired person who drinks too much alcohol will be more impaired than a well-rested person.

You can take steps to improve your sleep habits. First, make sure that you allow yourself enough time to sleep. With enough sleep each night, you may find that you're happier and more productive during the day.

To improve your sleep habits, it also may help to:

• Go to bed and wake up at the same time every day
• Avoid caffeine, especially in the afternoon and evening
• Avoid nicotine
• Exercise regularly, but don't exercise too late in the day
• Avoid alcoholic drinks before bed
• Avoid large meals and beverages late at night
• Don't take a nap after 3 p.m.
• Relax before bed, for example by taking a bath, reading or listening to relaxing music
• Keep the temperature in your bedroom cool
• Get rid of distractions such as noises, bright lights, and a TV or computer in the bedroom. Also, don't be tempted to go on your phone or tablet just before bed.
• Get enough sunlight exposure during the day
• Don't lie in bed awake; if you can't sleep for 20 minutes, get up and do something relaxing
• See a doctor if you have continued trouble sleeping. You may have a sleep disorder, such as insomnia or sleep apnea. In some cases, your doctor may suggest trying over-the-counter or prescription sleep aid. In other cases, your doctor may want you to do a sleep study, to help diagnose the problem.

If you are a shift worker, it can be even harder to get a good sleep. You may also want to:

• Take naps and increase the amount of time available for sleep
• Keep the lights bright at work
• Limit shift changes so your body clock can adjust
• Limit caffeine use to the first part of your shift
• Remove sound and light distractions in your bedroom during daytime sleep (for example, use light-blocking curtains)

Heart Health Tests

Heart diseases are the number one killer in the United States. They are also a major cause of disability. If you do have heart disease, it is important to find it early, when it is easier to treat. Blood tests and heart health tests can help find heart diseases or identify problems that can lead to heart diseases. There are several different types of heart health tests. Your health care provider will decide which test or tests you need, based on your symptoms (if any), risk factors, and medical history.

Cardiac catheterization is a medical procedure used to diagnose and treat some heart conditions. For the procedure, your provider puts a catheter (a long, thin, flexible tube) into a blood vessel in your arm, groin, or neck, and threads it to your heart. The provider can use the catheter to:

• Do a coronary angiography. This involves putting a special type of dye in the catheter, so the dye can flow through your bloodstream to your heart. Then your provider takes x-rays of your heart. The dye allows your provider to see your coronary arteries on the x-ray, and to check for coronary artery disease (CAD). CAD is caused by plaque buildup in the arteries.
• Take samples of your blood and heart muscle.
• Examine your heart valves.
• Do procedures such as angioplasty or minor heart surgeries to repair congenital heart defects or replace heart valves.

A cardiac CT (computed tomography) scan is a painless imaging test that uses x-rays to take detailed pictures of your heart and its blood vessels. Computers can combine these pictures to create a three-dimensional (3D) model of your whole heart. This test can help providers detect or evaluate various heart problems, including:

• Coronary artery disease
• Calcium buildup in the coronary arteries
• Congenital heart defects
• Problems with the aorta (the main artery that carries blood away from the heart)
• Problems with heart function and valves
• Pericardial diseases

Before you have the test, you get an injection of contrast dye. The dye highlights your heart and blood vessels in the pictures. The CT scanner is a large, tunnel-like machine. You lie still on a table that slides you into the scanner, and the scanner takes the pictures.

Cardiac MRI (magnetic resonance imaging) is a painless imaging test that uses radio waves, magnets, and a computer to create detailed pictures of your heart. It can help your provider figure out whether you have heart disease, and if so, how severe it is. A cardiac MRI can also help your provider decide the best way to treat heart problems such as:

• Congenital heart defects
• Coronary artery disease
• Heart valve problems
• Pericarditis
• Cardiac tumors
• Damage from a heart attack

The MRI is a large, tunnel-like machine. You lie still on a table that slides you into the MRI machine. The machine makes loud noises as it takes pictures of your heart. Sometimes before the test, you might get an injection of contrast dye. The dye highlights your heart and blood vessels in the pictures.

A chest x-ray creates pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. It can reveal signs of heart failure, as well as lung disorders and other causes of symptoms not related to heart disease.

Coronary angiography (angiogram) is a procedure that uses contrast dye and x-ray pictures to look at the insides of your arteries. It can show whether plaque is blocking your arteries and how severe the blockage is. Providers use this procedure to diagnose heart diseases after chest pain, sudden cardiac arrest (SCA), or abnormal results from other heart tests such as an EKG or a stress test.

You usually have a cardiac catheterization to inject the dye into your coronary arteries. Then the provider will take special x-rays while the dye is flowing through your coronary arteries. The dye lets your provider study the flow of blood through your heart and blood vessels.

Echocardiography, or echo, is a painless test that uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart. They also show how well your heart's chambers and valves are working. Providers use an echo to diagnose many different heart problems, and to check how severe they are.

There are several different types of echocardiography. For transthoracic echocardiography (the most common type), a technician applies gel to your chest. The gel helps sound waves reach your heart. The technician moves a transducer (wand-like device) across your chest. The transducer connects to a computer. It transmits ultrasound waves into your chest, and the waves bounce (echo) back. The computer converts the echoes into pictures of your heart.

An electrocardiogram, also called an ECG or EKG, is a painless test that detects and records your heart's electrical activity. It shows how fast your heart is beating and whether its rhythm is steady or irregular.

An EKG may be part of a routine exam to screen for heart disease. Or you may get it to detect and study heart problems such as heart attacks, arrhythmia, and heart failure.

For the test, you lie still on a table and a nurse or technician attaches electrodes (patches that have sensors) to the skin on your chest, arms, and legs. Wires connect the electrodes to a machine that records your heart's electrical activity.

Stress testing looks at how your heart works during physical stress. It can help to diagnose coronary artery disease, and to check how severe it is. It can also check for other problems, including heart valve disease and heart failure.

For the test, you exercise (or are given medicine if you are unable to exercise) to make your heart work hard and beat fast. While this is happening, you get an EKG and blood pressure monitoring. Before or after the test, you might also have an echocardiogram, or other imaging tests such as a nuclear scan. For the nuclear scan, you get an injection of a tracer (a radioactive substance), which travels to your heart. Special cameras detect the energy from the tracer to craeate pictures of your heart. You have pictures taken after you exercise, and then after you rest.

NIH: National Heart, Lung, and Blood Institute

Heart Surgery

What is heart surgery?

Heart surgery can correct certain heart problems when other treatments haven't worked or can't be used.

In some cases, heart surgery may be a medical emergency. For example, surgery for a severe heart attack may need to be done right away. In other cases, you can plan heart surgery ahead of time. Some heart surgeries are major operations, such as heart bypass surgery for blocked arteries in the heart. Other surgeries are more minor heart procedures, such as putting in a pacemaker.

There are different types of heart surgery that can help treat many heart conditions:

• An implantable cardioverter defibrillator (ICD) to help prevent sudden cardiac arrest.
• A biventricular pacemaker to coordinate the heart's pumping action so it's more powerful.
• A ventricular assist device to help the heart pump blood.
• A total artificial heart to pump blood for the heart.

The approach a surgeon uses to do heart surgery depends on your heart problem, your general health, and other factors. Approaches to heart surgery include:

• Open-heart surgery (also called traditional heart surgery) is when the surgeon cuts the chest open to reach the heart. Because it's difficult to operate on a beating heart, medicines are used to stop the heart. A heart-lung bypass machine keeps oxygen-rich blood pumping through the body during the surgery.
• Off-pump heart surgery is open-heart surgery on a beating heart without using a heart-lung bypass machine. The surgeon holds the heart steady with a device. Surgeons may use off-pump heart surgery to do coronary artery bypass grafts (CABG), but only in certain cases.
• Minimally invasive heart surgery uses small cuts between the ribs. The cuts may be as small as 2 to 3 inches. The surgeon inserts tools into the chest through the cuts. This type of heart surgery may or may not use a heart-lung bypass machine.
• Robotic-assisted surgery is a type of minimally invasive surgery. The surgeon uses a computer to control tools on the arms of a robot. This allows the surgeon to be very accurate when doing difficult operations.

Like all surgery, heart surgery has risks even though the results are often excellent. The risks include:

• Bleeding
• Infection, fever, and swelling
• A problem from anesthesia (medicine that makes you sleep during surgery)
• Arrhythmia
• Damage to the heart, kidneys, liver, and lungs
• Stroke

The risks of heart surgery tend to be higher if:

• The surgery is an emergency.
• You have other medical conditions, including:
  • Diabetes
  • Kidney diseases
  • Lung diseases
  • Peripheral artery disease (PAD)

NIH: National Heart, Lung, and Blood Institute