OSTEOPOROSIS SCAN

Osteoporosis is a leading cause of mortality and morbidity in both men and women. Osteoporosis means thinning of the bones over time. Bone mass (thickness, strength) is partly genetic but also is affected by smoking, body size, exercise, medicines, alcohol etc. We offer thorough evaluation for both women and men via a DEXA Osteoporosis scanner. We scan the two most important parts of the body directly; the hip and the lower spine. These are the parts of the body that if fractured, have the biggest effect on your life in terms of pain and suffering.

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PULMONARY FUNCTION TEST

Pulmonary Function Testing allows your provider to assess the function of your lungs. Many factors affect lung function. Advancing age, smoking, heredity, and environmental factors all affect how well your lungs work. Shortness of breath, Difficulty with breathing during exercises and activities, Asthma, Chronic Lung Disease, Emphysema all can be assessed by basic breathing tests done in our office.

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MAMMOGRAM

Mammograms are front line defense against breast cancer. We can arrange for prompt thorough mammograms done by several imaging centers nearby. We will make the appointment with you, check with your insurance regarding coverage etc. We are promptly notified of any abnormality and provide for immediate follow up.

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Chest X rays remain very useful in the evaluation of chest pain, cough, pneumonia, bronchitis, shortness of breath, etc. Although cat scans are superior for tumor or mass evaluation, CXR's are still the main diagnostic test for initial evaluation of many complaints, symptoms, signs, conditions, etc. We can arrange for prompt thorough CXR's done by several imaging centers nearby. We are promptly notified of any abnormality and provide for immediate follow up.

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Heart Disease remains the Number One cause of death in both men and women. Exercise Stress Testing remains a front line test in the evaluation of chest pain, palpitations, fluttering in the chest, exertional shortness of breath, etc. We also offer routine stress testing for patients who want to begin an exercise program or who need evaluation of cardiac risk, as smokers, patients with hypertension, elevated cholesterol, family history, etc.

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Although colonoscopy (long flexible camera) is the gold standard for colon cancer evaluation and surveillance, the sigmoidoscopy (shorter flexible camera) as well as barium enema (using x rays to visualize the farther part of the colon), remains a reasonable choice. We have a long experience with this cheaper, safer, but still very thorough alternative. Dr. Barry and Dr. Knudsen are very experienced with this equipment. Any significant abnormalities are referred on for further workup.

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These paper cards are used by patients to provide tiny samples (of stool) to the staff to check for blood in the bowel movement. Occult (hidden) blood in the stool is an important sign of trouble in the gastrointestinal track including ulcers, cancer etc. Full instructions are provided with the cards. This is an unbelievably quick way to screen for colon and stomach problems. This is a basic and initial test only and we strongly suggest using these cards in conjunction with a thorough cancer-screening program.

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End of life issues are very important but also very often overlooked by patients and their families. We can help you with free forms for both living will and health care proxy's to cover these very basic and important documents.

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High Blood Pressure is a common killer and crippler. People with hypertension have greatly increased risk for stroke, blindness, kidney failure, and heart disease. We strongly urge all patients with high blood pressure to check their pressures periodically. This is best done via home monitoring. We have a number of blood pressure machines which we will lend to patients as time permits. Just as monitoring your sugar is important if you are diabetic, so is monitoring your blood pressure if you have hypertension. The more careful you are controlling your blood pressure the better the benefits. We cannot recommend monitoring of your home blood pressure strongly enough. This is true whether you are taking medication or not.

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Accidents are the fifth leading cause of death in this country. Staying off of your roof, being careful with ladders and wearing a seatbelt are three very easy ways to ensure better safety at home. Data strongly suggests that seatbelts save lives. Between the winter weather, along rainy seasons and our roads wearing a seatbelt makes a lot of sense.

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As discussed elsewhere osteoporosis is an important health concern. All women should take sufficient calcium in their diet to keep from losing bone. We have a lot of information on supplements calcium intake and your bone Health. The recommendations for using calcium span many lifestyles, nationalities, and age groups.

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We think it's crucial to your health care to know exactly what medicines you are taking and why. Also knowing to allergies could be very important to you. In today's world many patients see multiple doctors. You can't count on your doctors having seamless communication between them. You're responsible for your pills, and it makes a lot of sense having all your medicines written down on one piece of paper. We strongly urge all patients to have all the medicines written down on a piece of paper and to carry it with them. Of course we would like to know every pill you're taking. Any time you visit another physician you should make sure that any changes in medicines are noted by you and reported to us. Literally thousands of lives are lost every year because of medication errors. Don't be one of them. We have preprinted sheets to list your medicines for you to use.

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Just as its very important for hypertensive patients to check their blood pressure at home, it's also very important for diabetics to monitor their own sugar. Diabetes is a very common cause of blindnes, heart disease, premature stroke, and kidney failure. Close monitoring of your diabetes at home is essential to lower your risks for these complications. We are very happy and very well equipped to teach you how to measure your sugar at home very easily. Our nurse practitioners have years of experience with diabetes. We can work with your endocrinologist as well to keep your diabetes under control. Diabetic testing equipment is increasingly available and covered by insurance.

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Infection is the fifth leading cause of death in America. Every year more people died from flu and pneumonia that died during the Vietnam War. The flu shot, it is universally available from drugstores to your local church to the senior citizen center and yes we have it in our office. The Pneumovax vaccine is a special vaccine designed to protect the patient from pneumococcal pneumonia. This is a common cause of pneumonia but the vaccine cannot protect the patient from all causes of pneumonia. Currently the pneumonia shot is offered to children and the elderly, but we believe that all adults should strongly consider this vaccination.

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Several of our physicians have extensive experience in minor surgery both in lesion removal/biopsy and same day repair of minor lacerations that occur at home or work. No Emergency Room wait, no uncertainty regarding your tetanus/immunization status. Nationally certified pathology lab used for tissue diagnosis. We know what we can handle in the office and when to refer to the surgeons.

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Colon cancer is one of the top three killers for adult men and women. It is the only cancer we know that can be cured completely without any chemo / major surgery. The very best time to check for colon cancer is before any symptoms. If you believe in mammograms you should also believe in a bowel check for cancer. They share the same principle. Checking a part of the body for cancer, just to be safe, even without symptoms. We offer office based sigmoidoscopy (to check the most important areas for cancer) matched with barium enemas but are very happy to refer patients to colonscopy if symptoms warrant or patients request.

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Heart Disease is the number one cause of death in both men and women. We deal with the evaluation, diagnosis and treatment of the full spectrum of heart disease. Of course, we work with cardiologist but we can offer a full array of diagnostic heart evaluations including cardiac ultrasound to evaluate valvular heart disease and general heart function. We offer in office stress tests to evaluate for both symptomatic and a symptomatic patients. We have an emphasis in evaluating your overall health risks and advising accordingly.

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Our office has been involved at infancy of the evaluation and treatment of osteoporosis. Hip and spine fractures kill thousands and thousands of adults each year. Finally we have agents that can possibly make a difference and decrease fracture risk. Bone mass and density can easily be checked and the patient counseled in office regarding available treatments and dietary guidelines. Our DEXA scanner was just inspected 2/04 and passed in all quality assurance and safety issues. In fact we passed without any deficiencies period.

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Diabetes is a killer. It's also the most common cause of blindness and kidney failure in America. We offer comprehensive diabetic screening and management. We believe diabetic control means patient direct diary involvement in their care. We deal with the hypoglycemic patient, the prediabetic, syndrome X , and the insulin dependent diabetic on dialysis. We work with the "recognized regional centers of excellence".

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We strongly suggest you let us be the central resource for your immunizations. We keep track of your shots and what you need and what you might want. Having one place that has accurate records of your shots could prove invaluable in case of accident, emergency or in school or employment requirements.

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Having a certified, monitored, accredited on-site lab allows for a very rapid turn around of important lab results that can affect the decisions regarding whether or not to hospitalize someone, frequency of next follow up or need for additional urgent testing. The lab answers to the physicians who answer to you the patient ...not your insurance company.

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We offer school, employment, and athletic physicals. We handle all the appropriate paperwork, review the immunizations, perform and document the exam etc. Usually we can offer very quick appointment times. Physicians do DOT physicals and Independent Medical Examinations.

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The EKG remains a first line tool in the office diagnosis of chest pain and palpitations, as well as preoperative evaluation for surgery. The EKG can provide a wealth of information regarding the heart and its health, and we have collectively reviewed thousands and thousands of these tracings.

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