In a limited UK survey, only 21 percent of the doctors surveyed got a minimum of 30 minutes of exercise five days a week. Doctors cite a lack of time, motivation and resources as excuses for not following the advice they dispense to patients. That's Fit asked readers what they thought -- does the physical fitness of a doctor matter?

• 52.2 percent of you feel that doctors should practice what they preach.
• 23.9 percent of you feel that a doctor's lifestyle doesn't change what they know, and their knowledge is more important when practicing medicine. One reader commented that doctors who have struggled with weight themselves tend to be more helpful and empathic with patients.
  
• 23.9 percent feel that it depends on what kind of doctors they are and what type of advice they're dispensing.

Several years ago, I felt a numbness in my arm and ended up in the emergency room. Though every test came back crystal clear, I was admitted to the cardiac unit as a precaution. The next morning, it was determined that I was in fine health and could go home. (The numbness was attributed to a pinched nerve.) Before leaving, the cardiologist spoke to me about exercising and eating right. Unfortunately, he must have weighed well over 300 pounds and was sweating profusely as his gave me his healthy lifestyle recommendations. Though I knew everything he said was spot on, I couldn't help but wonder why he didn't take his own advice.

A limited UK survey (only 61 physicians were surveyed) found that many doctors don't practice what they preach. Only 21 percent of those surveyed get at least 30 minutes of exercise five days a week. In surveys of the general population, 44 percent claim to meet the minimum activity recommendations. The doctors claimed a lack of time, motivation, and workout facilities for their lack of physical activity.

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What kinds of foods are good sources for vitamin D? Let's see:

• salmon
• mackerel
• tuna
• sardines
• fortified milk
  

Except for milk, nothing on that list is typical kid-friendly fare, making it difficult for parents to help kids get enough vitamin D in their diet.

That job just got a little tougher. The American Academy of Pediatrics is recommending that kids get 400 units of vitamin D daily, twice the past recommendation of 200 units. The most efficient way to get vitamin D is by exposing skin to the sun, but with winter on its way, that's just not practical for parents in northern climates.

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A sedentary lifestyle and poor eating habits can lead to a host of health problems. This comes as no surprise to anyone, particularly doctors and other medical professionals. But knowing that patients should lead a healthy lifestyle and knowing exactly what entails a healthy lifestyle are two different things.

A friend of mine is an OB/GYN and she recently attended the Healthy Kitchens, Healthy Lives conference at The Culinary Institute of America at Greystone. The conference is interactive -- the medical professionals who attend have a hands-on experience of tasting and preparing nutritious meals. The conference had a great impact on my friend. She learned so much about nutrition, eating healthfully, and preparing healthful and delicious meals. Not only are the things she learned going to benefit her own family, her new knowledge is going to benefit her patients as well.

My friend is already health-conscious. She's a runner and she pays attention to what she eats. But this conference fired something new in her ... passion for healthful cooking. When she talks to expectant mothers and other patients about eating healthfully, that new-found passion will come out. And while a dry recommendation to a patient to live a healthier lifestyle may not have much effect, a passionate sharing of information and knowledge will.

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Having a good relationship with your doctor is so important. During the years following college, I bounced around from place to place. I don't know why, but after a year or so in one apartment, I always felt the need to move. Moving from city to city like I did, I never kept a consistent relationship with a doctor. Now that I'm older and -- dare I say -- settled in one place, I've been seeing the same doctor for seven years. I've learned to appreciate having a physician that knows me, my son, and both of our health histories.

If you're going to a new doctor, there are some questions that are good to ask. AOL Health has a slideshow with 10 questions you should ask your doctor. Some of the questions are:

• "Do I really need that test?" Sometimes doctors prescribe a test to be cautious, but it's not truly necessary. Talk tests over with your doctor and learn the reasons he/she is recommending them.
  
• "How many surgeries do you perform each year?" It's not insulting to ask your doctor how skilled they are in the surgery you need.
  
• "If I get sick, will you see me in the hospital?" It used to be a matter of routine for physicians to make rounds at the hospital. But the number of physicians who specialize in inpatient care has risen, and many primary-care physicians no longer do rounds. Ask your doctor if he has hospital rounds.

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When your time on this planet is almost up, do you want a doctor to tell you your days are numbered? Or do you prefer to be in the dark, living your days with hope that there will be a bunch of tomorrows? Me? I think I'd want to know. I'd want to prepare, take care of any final matters, say goodbye to my loved ones.

Many people do not get straight talk from their doctors, who think they are doing patients a favor by giving them hope. New research says these docs are wrong and they aren't doing anyone any favors by keeping their lips sealed.

Being in the know can be healthy. Research shows patients were no more likely to become depressed when told they were dying than those who were not told. They were also less likely to spend their final days in a hospital -- they avoided costly care and lived out their last days perhaps at home and in the care of hospice.

It's a tough issue, whether or not to discuss grim prognoses with patients. From an ethics point of view, "it's easy -- patients ought to know," says Dr. Anthony Lee Back of the Fred Hutchinson Cancer Center in Seattle. "Talking about prognosis is where the rubber meets the road. It's a make-or-break moment -- you earn that trust or you blow it." But people react differently. Some want to know; some do not.

If it were you, how much would you want to know?

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Anybody remember the episode of Seinfeld where Kramer is observing a surgery and drops a Junior Mint into the guy's body cavity? It was funny because it was so obviously outlandish -- of course doctors would notice if something was left in the body that shouldn't be there. Of course they would remove it before sewing the body shut, right?

Perhaps not.

Medical litter has become a major problem, with 72 deaths and 4675 injuries occurring due to "unretrieved device fragments" known as UDFs. Most often the problem has to do with wire guides for catheters used for heart operations -- they can break or fracture and the device (or fragments) are left behind. Bone screws are a problem as well, but there are other, less common issues, such as needles and scalpel blades being left behind. And often, even if the doctor is aware of the problem, the patient is not informed.

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For many people, visiting a doctor can be intimidating. There's the whole authority issue, plus the anxiety that comes with having to deal with a physical exam or possible bad news about a health condition. But according to CNN, women especially can be at risk for a less-than-helpful doctor's visit if they aren't careful.

Some helpful tips:

• Ask questions, or bring someone with you who will.
• Go ahead and research your condition, but don't become overwhelmed by it.
• Recognize gender bias when it happens, and choose a different physician.
• Just the facts, ma'am! Don't interpret your symptoms for you doc, just describe them factually.
• Always trust your intuition.

I've found that if I have specific issues I want to discuss, I must write them down. Otherwise, I nearly always forget to bring them up during the five to 10 minutes I'm actually with the doctor. How do you get the most out of your doctor's appointments?

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I have a few friends who have email contact with their kids' teachers, and I'm envious. Emailing my kids' teachers would be nice, but I can't even imagine emailing their doctor. I've been a part of the "call and make an appointment" system so long, it's hard to imagine it any other way.

But patients are pushing for doctors to move into the 21st century and use email on a more regular basis. Doctors, however, are reluctant. A recent survey found that only 31% use email to communicate with patients. Doctors cite workload concerns, as well as compensation for time spent and privacy issues as reasons for not using email.

I only see one doctor with any regularity, my allergist. He's such a busy guy, I'd be afraid to communicate with him through email. With my flexible schedule, however, it's easy for me to pop in and see him. If I was working a 40+ hour work week, I might feel differently.

What about you? Does your doctor use email? Do you wish that he or she would?

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Join me as I search my soul for direction regarding my latest pursuit: A tummy tuck. Will I go through with it? Will I "Tuck It In?" Keep reading. Keep coming back. And you'll find out.

March 20, 2008

I have a lot of doctors. I have a family doctor, an OB/GYN, a dermatologist, an opthamologist, a dentist, a breast surgeon, a medical oncologist, a radiation oncologist, a physical therapist, and now a plastic surgeon -- well, almost. If I decide to make good on my tummy tuck plans, I'll have a plastic surgeon. Which means I'll have one more list of questions to carry around.

I ask a lot of questions of my lot of doctors. When an appointment with any one of them approaches, I start jotting down everything I need to know. When I'm in front of my medical guru, then, I fire away. This method works well for me as I aim to keep myself medically informed.

I'm five weeks from my potential tuck-in date and I've already started the list of questions I plan to ask during my April 1 pre-op visit. My list -- which is already pretty long -- may grow over the next two weeks. For now, though, here's what's on my mind.

• What pre-op tests will I need? Insurance won't cover cosmetic procedures like this one so I'm concerned about how much this venture will ultimately cost me.
  
  

• Should my heart be tested prior to surgery due to two chemotherapy drugs I've received that can compromise heart function?
  
  

• If complications arise and I need hospitalization -- this procedure is outpatient -- will insurance kick in?
  
  

• What are my chances of developing infections or blood clots? These are two of the major risks with tummy tuck surgery.
  
  

• What are my chances of waking during surgery?
  
  

• What is the chance that this surgery will need a re-do? I'm reading on the Make Me Heal message boards about women who go back into surgery for tummy tuck fixes.
  
  

• What type of numbness or nerve issues might I experience?
  
  

• Should I use the inflammation supplement Bromelain for swelling?
  
  

• What kind of compression garment will I need for recovery?
  
  

NOTE: Abdominoplasty is recommended for those whose skin and muscle cannot recover on their own as a result of significant weight loss, pregnancy, aging, heredity, or prior surgery. It is not a substitute for weight loss or an appropriate exercise program. For more information about this surgery, click here.

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Every so often, we hear news reports about accidental deaths or overdoses due to over-prescribed, often unnecessary drugs or surgery. But these seems to be rare, right? We'd like to think so, anyway. I recently read some alarming statistics on deaths in the US:

• 12,000 were caused by unnecessary surgery
• 7,000 were caused by medication errors in hospitals
• 20,000 were caused by other errors in hospitals
• 80,000 were caused by infections in hospitals
• 106,000 were caused by non-error, negative effects of drugs.

That's right -- in one of the most medically-advanced countries in the world, hundreds of thousands of people are dying at the hands of medical professionals by errors, unnecessary measures and other preventable causes. Does this seem odd to anyone else? I think its time we began questioning the motivations behind the 'remedies' we're being offered.

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In a move that is sure to make hospital administrators feel slightly uneasy, medicare is implementing a no-pay policy for hospital errors that could have been prevented. These eight medical mistakes are not going to be reimbursed to facilities which mess up and do things like leave objects inside people after surgery.

Other insurers are starting to catch on as well. This could lead to better patient care because hospitals will want to mitigate any chance of extraneous costs -- especially if they aren't getting paid back for it. Another item on the do-not-pay list is urinary tract infections from catheters.

Twenty-five percent of patients get one of these, yet only ten percent or less of hospitals check every day to see if they're even necessary. So someone could end up with a catheter for days on end without even needing it -- which leads to urinary tract infections. Tacked on costs for these types of mistakes can run up your hospital bill by $10,000 or more! It will be interesting to see if (and how much) this improves medical care to those people in such facilities.

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When you think of the sanitary conditions of an operating room, you pretty much figure that everything is either used once and discarded or used and then immediately sterilized. This seems to be the case with just about every instrument, tool, tube, etc. However, British researchers discovered that something has been seriously overlooked ... and overused.

According to a small article appearing in this month's edition of Men's Health, surgery markers (the actual felt-tip markers that are used to draw incision marks and such on the body) are commonly reused, which may lead to the spread of methicillin-resistant Staphylococcus aureus (MRSA).

Researchers from the U.K. tested this very theory, in fact. They intentionally contaminated 26 markers with the bacteria, finding that older, more dried-out markers kept the MRSA for over thirty minutes.

I'm guessing this report will lead to a change in policy when it comes to reusing surgery markers.

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Apart from how crowded it has made my gym over the past few years, I'm excited to see that the exercise revolution reach such a fever pitch. Best of all, doctors are now looking at exercise as a viable solution to some of their patients' ills.

Such is the case with a recent report from the BBC; doctors have discovered that regular exercise may help people to better deal with their depression. In a survey of 200 English general practitioners, the Mental Health Foundation found that twenty-two percent suggest exercise to help people with milder forms of the condition. This is a marked increase from the five percent that was reported in a similar survey three years ago.

Doctors are looking to exercise more and more these days, rather than reporting to prescription drugs for their patients. This is all good news, even if it does mean I may have to wait a few minutes for a treadmill to finally become available!!

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If you believe relaxation contributes to good health and you believe cruises lead to relaxation, then sailing the oceans blue might be just what you need. But if you believe there will be dependable medical care on board should your health take a detour, then you'd possibly be wrong and therefore, a cruise may not be just what you need.

Nearly 10 million Americans will set sail this year. What these 10 million may not know is that cruise lines claim no responsibility for doctors' actions. Cruise lines hire doctors, and they assign them as part of the crew -- but the buck stops there. The doctor merely has to claim to be competent. If he or she is not, cruise lines disavow any responsibility whatsoever.

This fact can be found in the fine print on tickets, Web sites, and brochures. But most of us don't read every detail and for some, discovering this hidden wording occurs too late.

If cruise lines are not responsible, then the doctors must be, right? In theory, perhaps. But many doctors are foreigners who and are tough to track down in legal scenarios.

In the book Unsafe on the High Seas, Miami attorney Charles Lipcon offers advice for protecting yourself : Get travel insurance if yours doesn't have an evacuation provision, he says. And bring copies of your medical records, and tell the cruise line about pre-existing conditions. And most important: If you have a serious medical problem, maybe a cruise is not right for you.

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