Daily Preparedness

“Bless you!” “Gesundheit!” “Need a tissue?” Are you hearing these comments to often this Spring? It could be that you are one of the countless victims of a record-setting Spring allergy season. Nearly every state is reporting significant increases in the number of people suffering from seasonal allergies, including many who have never been previously afflicted.

Though you cannot lower the pollen count outside, there are some simple steps you can take to reduce the impact you feel. Also remember that the typical symptoms of allergies, runny nose, sneezing, itching, eyes watering, may seem to be no more than a nuisance, inflamed nasal passages and congested sinus’ can lead to more serious issues such as sinus infections, respiratory involvement and even life-threatening anaphylaxis. Consult your physician if your symptoms are not under control or suddenly worsen.

In the meantime, try these simple methods of gaining some relief from the down side of Spring’s splendor:

1. Make your bed every morning. I know, I know this sounds like your Mom speaking. Simply throwing the bedspread up over your pillows keeps a certain amount of dust and pollen from your pillow.

2. Frequently launder your bedding, including the mattress pad.

3. Shower before you go to bed and wash your hair. Your body & hair collect pollen all through the day. Don’t go to bed with it.

4. Keep your windows shut in the car & house, especially in the early morning and evening. Use your a/c and frequently change the filters.

5. Use nasal cleaning devices such as a Neti pot or saline spray. Spritzing out your nasal passages removes dust and pollen as it first enters the body. Be sure to ask your doctor first if you have chronic sinus problems and discontinue if you experience pain. Some people have very narrow sinus passages or other physiological issues that make using a Neti pot inadvisable.

6. Launder your clothing frequently. Don’t rehang clothing in your closet that you have worn in high pollen areas.

7. Frequently wash your dog. If you family has serious allergies, consider getting rid of hairy pets. Even if you are not allergic to the pet, the animal’s fur carries pollen, et al into your house and deposits it everywhere.

8. Invest in appropriate pillow and mattress covers that prevent the build up of allergens.

9. In the case of serious allergies, consider removing as many fibers as possible from sleeping areas. This includes carpet, drapery, bed drapings, etc.

10. Dust frequently with a damp or electrostatically charged micro-fiber cloth that traps dust instead of spreading it about.

11. Invest in a vacuum with a good HEPA filter. Vacuum frequently.

12. Remove dead leaves and other lingering vegetation from around your house. Last fall’s leaves are growing mold! If you are the allergy sufferer, have someone else do this job or wear a respirator.

13. Sanitize your shower curtains and bathrooms frequently to remove mold and mildew spores. Adding salt to the rinse cycle can cut down on mold & mildew.

14. Remove as many dyes, phospates and fragrances from your home that you can possibly manage. This includes laundry detergents, dryer sheets, fabric softeners, air fresheners, ‘plug-ins’, deodorants, shampoos, soaps, etc. Consider using ‘old fashioned’ cleaning solutions such as baking soda, salt, vinegar, borax and plain old elbow grease!

15. Reduce the clutter so that you can dust and vacuum with less hassle.

Remember, there are a wide range of allergy products available by prescription and over-the-counter. Be certain to speak with your healthcare provider about what options may be open to you!

And try to enjoy the Spring foliage!

Ah, finally Spring has arrived. The birds are chirping, the sun is shining and you can’t wait to get outside without being bundled in layers of clothing. WAIT! Before you leap into the beauty of the season, take a few hours to inspect your home. Winter, especially ones with severe weather, can cause a multitude of problems inside and outside your home. A few minutes (okay hours) now could save you thousands of dollars and untold heartache later. If you are renting your home, you would be wise to follow this checklist. Though you are not usually responsible for repairs, the resulting damage will impact your life and wallet. Report any discrepancies to your landlord/property manager.

To speed up your inspection, here is a handy dandy checklist of items you should check!

1. Kitchen

• Turn on all of the light switches. Wait an hour and see if any are warm. If they are, have an electrician check them for shorts.
• Change the filters in your refrigerator and sink (if you have one).
• Check appliance cords for signs of wear and tear.
• Clean the inside of your dishwasher. Set the washer for a short cycle. Once it is filled with water, carefully open the dishwasher and add one gallon of white vinegar. Continue with the cycle. When completed, wipe down the interior. Check the gaskets for signs of damage.
• Be certain your drains are running easily. A simple way to refresh the drains and garbage disposal is to pour a cup of baking soda down the drain. Add up to a quart of vinegar and stand back. Leave mixture alone for an hour and then flush with hot water.
• Check window trims for signs of leaking or loose caulk.
• Remove and clean the filter on your range hood. Clean the hood thoroughly.
• Check the microwave. Clean it thoroughly. Food particles adhering to the interior may be growing bacteria. When you microwave something new, these particles may fall on your food.
• Run the oven through a self-cleaning phase or clean with an oven cleaner. (Be sure to wear gloves and open a window)
• Check under the sink for signs of leaks. Consider installing inexpensive water leak detectors. (These battery operated devices are available for less than $20 at any home improvement store. They should be placed near any area where you think a leak may occur–under sinks, near hot water heaters, sump pumps, basement doors, etc. They emit a loud, piercing alarm as soon as they detect water.)
• Pull out the stove and clean under it. Grease trapped under a stove can become a fire hazard. Food stuff can attract vermin you don’t want.
• Check the cabinets for signs of insects or other unwanted guests.
• Have a fire extinguisher handy and check the expiration date.

2. Bathrooms

• Check cabinets, tub, shower & toilets for signs of leak & install inexpensive water leak detectors.
• Place a few drops of food coloring in the tank of toilet. Check back in an hour or two. If the water in the bowl is colored, you need to replace the flap valve unit in the tank.
• Test any ground fault circuit breakers that you have.
• Check shower curtain liners for signs of mold or mildew. Replace if needed.
• Check caulk around all surfaces. There should be no breaks, cracks or spots that are showing signs of mold.
• Clean out medicine cabinets and dispose of expired prescription or OTC meds.
• Clean drains as above in kitchen section. Make sure toilet is running well & filling appropriately.

3. Entire House

• Replace batteries in all smoke/fire/carbon monoxide detectors. Test and clean units.
• Replace furnace/air filters. Check duct work for signs of dirt or corrosion. Clean vents.
• Replace light bulbs as needed. Be certain all light bulbs are the appropriate wattage for the fixture.
• Clean dryer lint trap under running water. Check outside exhaust for lint build up. Clean lint trap. Clean under and around dryer. (Lint is highly flammable!)
• Have furnace and a/c unit inspected and serviced. You can do a preliminary inspection by looking for signs of corrosion, scale, funny noises or odd smells. If you suspect a gas leak LEAVE and call for professional help. If there is a serious gas leak, LEAVE and call 911.
• Have chimney cleaned if you used it over the winter. Chimney fires can smolder for hours before erupting.
• Clean out the fireplace. Remove all ash and clean all surfaces.
• Clean your clothes washer as you did your dishwasher. Install water detector alarm.
• Check area around your sump pump for signs of wear or corrosion. Consider installing a back-up battery operated unit. Install water detector alarm.
• Check all light switches as described in kitchen section.
• Check all water supply lines (don’t forget the line to the refrigerator) for signs of wear, corrosion, cracks or leaks. Test the shut off valves to make sure they work (and you know where they are!)
• Check all power cords.
• Check ceilings for signs of water leaks. If you see any, have your roof inspected (See below).
• Check all windows and doors for air leaks. Inspect caulking and weather stripping.
• Protect your valuable appliances, computers, TVs, etc with surge protectors. Consider installing a whole house surge protector.
• Inspect and test your security alarm system.
• Consult your owner’s manual and check your hot water heater. Install water detection alarm!
• Test the batteries in your water detection alarms.
• Check the attic for signs of leaks, birds, rodents, insects or missing/damaged installation.
• Vacuum upholstery and mattresses. Wash mattress and pillow covers as recommended.
• Inspect stair railings. Be certain they are snug and do not flex inappropriately.
• Inspect beds and cribs used by children. Be certain they are safe & secure.
• Inspect any child safety gates that you have installed.
• If you use child safety devices such as outlet plugs, cabinet locks, etc. inspect them.
• As you put away your child’s toys, sleds, winter gear, etc. inspect for loose parts, damage, etc.

4. Outside Grab some binoculars and head out into the fresh air!

• Stand away from the house and using binoculars, inspect your roof for signs of damage. Look for shingles that are missing, curling or bending at odd angles. Look at the roof ridge vent and check for loose portions or signs of wear. Look at the flashing around chimneys, checking for signs of corrosion, cracks, separation or lifting from the roof. Look at the siding under the roof eaves. If you see damage, this may indicate that an ice dam caused damage to the roof and the siding.
• If you see damage to your roof, get estimates from at least three different roofers. Be certain repair estimates are in writing and that the company offers a solid guarantee. Be extremely cautious in attempting any repairs to your own roof.
• Inspect your gutters. Again, use your binoculars and look for separation from the roof line, cracks, clogs, corrosion or bending of the gutter line. If you see damage, get several estimates.
• Use those binoculars again to scan any power lines above or around your house. Report any concerns to the appropriate utility. Be certain that trees are not encroaching on lines. NEVER attempt to work near a power line.
• Clean or have your gutters cleaned. Be certain that run-off positions are causing the water to run away from the foundation of your home. Install extenders if necessary.
• Clear debris, leaves and foliage from your foundation. Plants should encourage water to flow away from your home. Having plants up against the foundation encourages water retention, rodents & insects.
• With your binoculars, inspect all trees around your home. Look for limbs that show signs of breaking, strain or hanging at odd angles. Look for branches or limbs that have broken off but are stuck on lower branches of the tree. Consider hiring a professional to remove any damaged limbs. Again, get multiple estimates.
• If you are storing large amounts of water, this is a good time to drain the barrels, clean them and refill them. Look for signs of corrosion, damage, etc.
• Check your deck! Look for water stains where the deck attaches to the house. Ongoing water damage can weaken the deck and your home. Consult a professional (remember estimates) if you suspect damage of this sort. Look for signs of rot, loose boards, shaky handrails, nails pulling loose and splinters.
• Clean your deck to rid it of moss and mold. Reseal if needed.
• Check your foundation for cracks. If you see any, mark with tape and check again in a few months. If they remain stable, simply fill with an epoxy or foam product. If the cracks increase, consult a structural engineer.
• Check the foundation area for pellet-shaped droppings or shed wings from termites.
• Be certain that the ground around the foundation slopes away at about 1″ per foot. If needed, add compacted soil to increase slope.
• Fill in any low spots where water pools. Near the house, these can lead to foundation leaks. Away from the house, they are breeding grounds for mosquitoes.
• Remove branches and other debris from your yard.
• Move firewood well away from house.
• Fill in gaps in siding or foundation with expanding foam product.
• Inspect your siding for signs of damage. Repaint as needed.
• Inspect all wood surfaces. Gently probe with a screwdriver. If you feel the wood give way, you may need to replace it. Repaint and caulk as needed.
• Inspect brick work for signs of cracking or chipping away of the brick. If a brick surface is damaged, reseal it with an appropriate product.
• Inspect your driveway and walkways for cracks, fissures or chipped areas. Repair to prevent falls.
• Check outside hose faucets for damage. Be certain they shut off completely and that there are no interior leaks when they are used. Check hoses for rot, cracks, wear, etc.
• Have a qualified technician inspect and service your a/c unit now before it gets hot! There are still tax credits available for upgrading units.

5. Garage and Cars

• Check your garage for oil stains and clean.
• Inspect the ceiling/under side of the roof for signs of leaking.
• Sweep up any spills. Be especially careful to sweep up spills of ice melting chemicals.
• Dispose of old chemicals, cleaning agents, paints, etc per local regulations.
• Thoroughly test your garage door:  Place a 2×4 or other 4″ structure on the floor where the garage door closes. Close the garage door. When the door hits the 4″ structure, it should immediately reverse direction. Next, cover an electric eye as the door is closing. The door should stop immediately and reverse. (You may be able to easily adjust the eye. If you cannot, see below) Next, disengage the electric garage door opener and open the door manually. It should rise and lower easily and evenly. If the door fails any of these tests, have a professional inspect and repair it.
• Inspect the exterior of your garage door for signs of flaking paint, leaks, water damage, etc.
• Wash the inside and outside of your cars. Chemicals and sand used to treat snowy/icy streets are hard on your car’s interior and exterior. Vacuum the carpets thoroughly.
• Check tire pressure, oil, washer fluid, antifreeze, etc.
• Look at the car’s engine. Inspect belts and hoses for signs of cracks, wear or weakness.
• Check the a/c coolant level.

A few hours in these early days of Spring may very well save you hours, dollars and heartache later on. These inspections can be done quickly, easily and spread out over time. Enjoy the beautiful weather and stay safe!

One of the most common medical errors that can lead to serious illness or even death is one that you can help prevent. Approximately 1.3 million Americans are injured annually due to errors in the administration of medications. Though many of these errors occur in hospital settings, many occur in our own homes. The vast majority of these errors can be prevented by YOU and those you love. What can you do to protect yourself?

1. Know that the elderly and chronically ill are the most likely to be victims of medication errors. Both groups are most likely to have a larger than average number of prescription medications prescribed for them.

2. Children may be at a higher risk because their smaller body size makes it more likely that a dosing or drug interaction error will cause serious harm or death.

3. FULLY UNDERSTAND that medication errors can be fatal.

4. When prescribed a medication, be certain that the doctor explains why you are being prescribed this medication, what the medication should do for you, what the side effects are and how you should take the medication. For instance, should it be taken with meals, before a meal, at bedtime, etc.

5. Always provide every health care professional (including the pharmacist) with a complete list of ALL prescription medications, over-the-counter medications, supplements, herbal products, homeopathic remedies and vitamins that you take. Include the name of the medication, the dosage, how long you have been taking it and the medication’s use.

6. Understand that there is limited, peer-reviewed science based research into the interaction of herbal products, supplements and homepathic remedies. Most of these substances are NOT tested by independent peer-reviewed research nor their quality and potency regulated. Be certain that you fully research any ‘natural’ product that is recommended to you. Many of these products are the ‘natural’ version of powerful prescription medications. For instance, foxglove is merely natural digitalis, which can alter heart rhythms. Echinacea can lead to permanent liver damage, especially if used in combination with other medications/supplements. Prescription medications can interact with a wide range of products and there is, again, limited knowledge as to the interaction of prescription (or over-the-counter medications) and ‘alternative therapies’. Even simple vitamins can lead to overdoses and drug interactions.

7. Before taking a new medication, know how the drug is supposed to help you and all possible side effects.

8. Know what your medications look like. If you receive a new prescription and the medication looks different, do not take it until you speak with a pharmacist. Preferably, the pharmacy will have alerted you to a change in the appearance of your medication.

9. If hospitalized, ask what each medication you are being given is and what it is for. Competent staff will tell you the name of the medication before giving it to you. If they do not, be extra cautious. Again, if the medication looks different than what you normally see, ask!! Know what the dosage prescribed is. If something seems ‘off’, stop and ask to speak to a supervisor. My daughter was nearly killed in a hospital when a nurse attempted to administer 100 times the prescribed dose of a pain killer. The nurse had ‘misread’ where the decimal point was.

10. If the dosage and frequency of taking a medication is different than your physician told you, ASK questions!

11. Be certain that you are taking your medications exactly as prescribed. Regularly review the instructions on your prescription bottles!

12. If you take multiple medications, or care for someone who does, consider using a medication minder container. Many types are available at a variety of price points. These specially designed containers can be a great help in being certain that you are taking your medications as prescribed. This is vitally important for the elderly or anyone who may have memory issues.

13. Periodically review with your physician the medications you are taking. Each office visit should include a review of your medication, including when you need a new prescription written. Again, the elderly are most likely to have too many medications prescribed for them, often creating secondary problems. If a new symptom appears, ask the pharmacist if this could be a reaction to a medication.

14. When prescribed a medication, ask if there is a generic alternative which may save you money. Often, prescribers will merely write for the newest medication when an older, proven medication may work just as well. Also ask if there is an alternative to medication. Could you achieve the same results through lifestyle or diet changes?

15. Choose carefully and use one pharmacy for all of your prescriptions. Some points to consider when choosing a pharmacy:

• Is there a pharmacist available to answer all of your questions?
• Know the role of pharmacy technicians. Though they may perform many tasks within a pharmacy, including accepting prescriptions from you, they should not be answering questions about your medication’s interactions, uses and side effects.
• Does the pharmacist have time to talk to you in person or on the phone? If not, they may be over-worked which leads to more errors. Some pharmacies evaluate pharmacists on the number or prescriptions they fill per hour, not the number of customers they serve.
• Does the pharmacist answer your questions about drug interactions? If you are on medications for serious pain, heart problems, liver disease or kidney disease (or other serious long-term illnesses), be certain that you ask the pharmacist before taking over-the-counter, herbal or supplement preparations. Pharmacists should be able to answer your questions, with the exception of some herbal & ‘natural’ remedies that have not been well researched.
• Is the pharmacy efficient? Are prescriptions filled when they say they will be? An efficient pharmacy should be able to estimate when your prescription will be ready and alert you to possible delays. If they are chronically misrepresenting the time it will take to fill a prescription, they may be over-worked, under-staffed and more prone to errors.
• Can you understand the pharmacist? You should be able to freely communicate with this important member of your health care team!
• Be certain that the pharmacy has up-to-date software that warns of drug interactions, low/high dose alerts, LASA error checking (Look alike/sound alike) and patient allergies. Be certain that the pharmacist is aware of your drug and food allergies. Some food allergies can significantly impact the medications you can be prescribed.
• Is the pharmacy concerned with your privacy? Pharmacy staff should never announce the medication they are filling for you in a way that others might over hear.
• Does the pharmacy alert you when the appearance of your medication has changed?
• Does the pharmacy provide you with an information sheet that describes the appearance of your medication, possible side effects and uses of the medication?
• Does your pharmacy communicate efficiently with your physician’s office? Some communication errors are due to delays in the doctor’s office, but pharmacy staff should be able to up date you on their progress.
• Does your pharmacist relay information to you effectively? If they say they will get back to you, do they? Do they call you if there is a problem with a refill?
• Will your pharmacist attempt to answer your questions with research? We have had multiple times where a great pharmacist will go to extraordinary lengths to be certain that a medication is safe. This has included the pharmacist calling the pharmaceutical company for further information. This type of dedication can, literally, safe your life and you SHOULD EXPECT IT!
• Remember that the pharmacist is your safe guard when it comes to medications! They should have the most up-to-date and effective means by which you can be protected from possible allergic reactions or drug interactions. They are the trained professional when it comes to medication management!

16. Keep your medication information confidential and safe. Remove prescription labels from empty bottles before discarding. Likewise, shred information sheets or other paperwork that details what medications are in your home. Do not discuss publicly or post online medications you take. Theft of prescription drugs is on the rise.

17. Teach your children to never take medication (again, including ‘natural’ products) from someone other than you or a licensed health care professional.

18. Discard of out dated medications safely. Be especially vigilant about medications you may not take regularly, such as epi-pens or inhalers. Check their expiration date and get refills when needed.

19. Store your medicaitons safely. Know if the medication needs to be refrigerated. In general, most medications need to be protected from moisture, light and extremes in temperature.

20. Don’t run out! Be certain to carry vital medications with you and refill your prescriptions BEFORE you run out. Most insurers will allow you to refill a prescription seven days prior to the day you will run out.

21. KEEP YOUR MEDICATIONS OUT OF THE HANDS OF CHILDREN! Keep all medications, including vitamins, away from children. Be certain that visitors to your home safe guard any medication they have. Many children suffer overdoses while exploring Grandma’s luggage or purse.

Though there are many medical errors we cannot prevent, medication errors can often be prevented through our own vigilance, common sense and just a bit of time. Be wise, be cautious and be healthy!

Lyme Disease, a tick-borne infectious disease endemic in most areas of the United States is often called the ‘great imitator’ as the symptoms can mimic everything from the flu to multiple sclerosis. Transmitted from ticks that feed on infected rodents, Lyme Disease can lead to a serious acute illness as well as a life time of chronic illness. Unfortunately, it is one of the smallest cycles of life, the nymph cycle, that ticks can be most likely to transmit infection. Treated early and aggressively, Lyme Disease patients have a good chance of making a complete recovery. Even patients with mild symptoms should be treated with antibiotics to prevent long term illness.

Of course, any disease is better prevented than treated. Ticks do not magically fly onto humans and animals. They cling to low vegetation and attach to hosts (such as mice, deer, dogs and people) as they walk by. Once attached, they imbed themselves in their host. Once they have fed, they drop off and go on to the next host.

You can avoid picking up a tick by keeping away from areas with tall grass and dense vegetation. When in these areas, walk in the center of mosed trails. Tuck your pant legs into socks and boots. When hiking, wear long-sleeved buttonless shirts tucked into your pants. Wearing light colored clothing will make it easier to see and remove ticks before they become attached. Wear tick repellent containing at least 30% DEET to the body. Clothing can be treated with up to 0.5% permethrin. Permethrin should NOT be applied to skin.

Around your home, you can reduce the likelihood of tick exposure by carefully treating your animals for ticks. Inspect them regularly for tick infestation. Likewise, check their bedding, furniture and any area of the house that could harbor a tick. Keep your grass cut, underbrush thinned in yards and maintain a clearly defined manicured border with wood chips, mulch or gravel. Keep hedges near pathways and proches well trimmed so that those walking on sidewalks do not have to brush against the greenery. Check periodically for signs of rodent infestation on your property and treat any suspected areas. Minimize deer on your property with deer repellent, fencing and replacing deer-enticing plantings with growth deer do not like such as dogwood, ferns, sage and thyme. You can also apply pesticides yourself or have it done professionally. Spring and summer months are the highest months of infection, due to the life cycle of the tick.

Anytime that you or your children are outside in an area where there may be ticks, check carefully for evidence of ticks. Should you find a tick, grasp with a blunt pair of tweezers as close to the skin as possible. Gently, but firmly, pull the tick straight out. Clean the area with soap and water, followed by an application of antiseptic. DO NOT use petroleum jelly or a match to remove the tick.

Should you find a tick on yourself, in your clothes or your bedding, it is now possible to have the tick itself tested for Lyme Disease and the most common co-infections prevalent among ticks. If the tick is loose, use tweezers to place in an a container with a lid. Contact your doctor’s office for a lab that can test the tick. Most health authorities recommend treatment with antibiotics if a tick from a human being tests positive for Lyme’s, regardless of whether the patient develops symptoms or not.

One of the most common first symptoms of Lyme Disease is a characteristic ‘bull’s eye’ rash around the site of the bite. However, remember that a rash may NOT develop. If you remember a tick bite and begin to develop symptoms, do NOT delay in being treated. Early treatment is the first and foremost way to prevent some of the most debilitating effects of Lyme Disease.

Untreated, Lyme Disease can spread to other parts of your body within a few days or weeks. It can cause damage to the nervous system, including chronic severe headaches, memory loss, encephalitis, personality disorders, depression, pain, sleep disturbances, palsy, tremors, pain, numbness, muscle weakness and fatique. Joints can become inflamed, causing pain and eventually arthritis. Lyme Disease can cause the heart to become inflamed, develop palpitations or changes in heartbeat.

Many physicians in areas where Lyme Disease is prevalent now watch for and aggressively test for Lyme Disease in patients who exhibit the early symptoms of the disease. In addition to the rash (which again may or may not occur), patients may complain of a flu like aches, pains, fevers, headache, swollen lymph nodes, chills and fatique. The symptoms do not go away in a few days as flu does and may or may not resolve on their own. Many patients become unbelievable weak, dizzy and may appear mentally altered. Blood tests can, in at least most people, detect the presence of the disease. Some physicians choose to begin antibiotic treatment based on clinical symptoms. The routine treatment includes at least 30 days of oral antibiotics, often extended if symptoms do not improve. Occasionally, in severe cases, IV antibiotics are given.

Like many ‘up and coming diseases’, the treatment of Lyme Disease is the source of some controversy. There are those who believe that long-term oral and IV antibiotics (sometimes into months and years) should be given. Four scientific studies have not backed up these assertions, but individual patients report an improvement in their symptoms. Unfortunately, there are some physicians and other ‘medical’ personnel who have been shown to take advantage of those with mysterious symptoms.

Should you suspect that you or a family member is developing the symptoms of Lyme Disease or have received a tick bite, be certain to contact your family physician. If in doubt, also consult a board-certified infectious disease specialist for evaluation and treatment.

Ben Franklin is quoted as having said, “An ounce of prevention is worth a pound of cure.” This old adage is as true today as it was back when Mr. Franklin was alive! And it certainly applies to a key area of preparedness—maintaining our physical bodies.

“Currently, about 95% of health care dollars in the United States are spent on treating diseases, with relatively little attention paid to preventing diseases, which should be a national priority,” states former U.S. Surgeon General David Satcher, MD, PhD. Dr. Satcher chaired a panel of 24 experts that ranked health screening and counseling suggestions. The screenings and counseling suggestions were scored on two factors:

• Disease, injury, and premature death that would be prevented if the service was delivered at recommended intervals over a lifetime.
• Cost effectiveness.

“Basically, these are the preventive health services that offer the biggest bang for the buck,” says Satcher.

The list starts with the most highly rated services, but many services had tied scores. For instance, three services earned the top score of 10; six earned the second-place score of eight. To compare rankings, check the services’ scores.

• Discussing daily aspirin use in men aged 40 and older, women aged 50 and older, and others at increased risk for heart disease to help prevent cardiovascular events such as heart attack and stroke: 10
• Childhood immunizations: 10
• Screening adults for tobacco use and providing brief counseling to help them quit using tobacco: 10
• Colorectal cancer screening among adults aged 50 and older: 8
• Measuring blood pressure in all adults and using high blood pressure medicines to prevent cardiovascular disease: 8
• Influenza immunization for adults aged 50 and older: 8
• Pneumococcal immunization for people aged 65 and older: 8
• Screening adults about alcohol use and providing brief counseling with follow-up: 8
• Vision screening for adults aged 65 and older: 8
• Cervical cancer screening (Pap smears) among women who have been sexually active: 7
• Cholesterol screening and lipid-lowering drugs, if needed, for men aged 35 and older, women aged 45 and older with other risk factors for coronary heart disease: 7
• Breast cancer screening for women aged 50 and older; discussions and options to start screening at aged 40-49: 6
• Screening sexually active women under age 25 for chlamydia, the most common sexually transmitted bacterial disease in the U.S.: 6
• Counseling adolescent and adult women to use calcium supplements to prevent fractures: 6
• Vision screening in children less than 5 years old: 6
• Folic acid supplementation to help prevent birth defects: 5
• Obesity screening: 5
• Depression screening: 4
• Hearing screening: 4
• Injury prevention counseling: 4
• Osteoporosis screening: 4
• Cholesterol screening for high-risk adults: 2
• Diabetes screening: 2
• Diet counseling: 2
• Tetanus-diphtheria booster vaccination: 2

Though the list was aimed at healthcare providers, encouraging them to take on a preventative role, there are many of these items that we can adapt into our lifestyle immediately. It is interesting to note that those fully living the gospel need not worry about some of the items, such as alcohol, tobacco and STD’s.

Take charge of your health today. Ask your doctor which of these screening tests apply to you.