What is a lipid profile? 

A lipid profile, or lipid panel, is a blood test to check your lipid levels. Lipids are fats that cannot dissolve in blood. High lipid levels increase your risk for heart disease and a heart attack or stroke. A lipid profile includes the following:

•   Total cholesterol is the main number used for cholesterol values

  o  Goal: Less than 200 mg/dL

  o  Borderline high: 200 to 239 mg/dL

  o  High: 240 mg/dL or higher

 •   LDL (bad) cholesterol carries cholesterol and deposits it in the arteries. This can cause a blockage

  o  Goal: 100 mg/dL or lower

  o  Near goal: 100 to 129 mg/dL 

  o  Borderline high: 130 to 159 mg/dL

  o  High: 160 to 189 mg/dL

  o  Very high: 190 mg/dL or higher

 •   HDL (good) cholesterol removes cholesterol from your body

  o  Goal: 60 mg/dL or higher

  o  Borderline risk: 40 to 59 mg/dL

  o  High risk: 40 mg/dL or lower

 •   Triglycerides are a different kind of fat than cholesterol

  o  Goal: 150 mg/dL or lower

  o  Borderline high: 150 to 199 mg/dL

  o  High: 200 to 499 mg/dL

  o  Very high: 500 mg/dL or higher

How do I prepare for the test? 

Do not eat or drink anything, except water, for 12 to 14 hours before the test. Ask your doctor if you should take your medicines on the day of your test. 

What do I need to know about my test results? 

Your doctor will discuss your test results with you. If your test results are abnormal, you may need treatment to decrease your risk for heart disease. 

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your lab tests. You can then discuss the results with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment. 

© 2017 Truven Health Analytics LLC All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics. 

What are non-pharmacological therapies for pain? 

Non-pharmacological therapies are ways to decrease pain in addition to medicine. Your doctor will help you choose therapies that are right for you. Your provider will explain the advantages for each treatment and which may work best for the cause of your pain. Each person may respond to these therapies differently.

Why is pain control important? 

If pain is not treated, it can decrease your appetite and make it difficult for you to sleep. You may feel that you lack energy or the ability to do things. Pain can also affect your mood and relationships with others. Non-pharmacological therapies may help decrease your pain or give you more control over your pain. This can improve your quality of life.

What therapies are used with medicine to help control pain?

What are non-pharmacological therapies for pain?

 A number of therapies in addition to medicine can help decrease your child's pain. Your child's doctor will help you choose therapies that are right for your child. Each therapy has advantages and may work best for certain age groups. You may need training when the therapy involves your help in guiding your child through exercises. 

What therapies are normally used with medicine to help control pain? 

What is a wound infection?

A wound infection is an infection that occurs after surgery in the part of the body where the surgery took place. Most patients who have surgery do not develop an infection. Some of the symptoms of a wound infection are:

•      Redness and pain around the area where you had surgery

•      Drainage of cloudy fluid coming from the wound

•      Fever

Can wound infections be treated?

Yes, most wound infections can be treated with antibiotics. Some patients may need additional surgery to treat the infection.

What is Jiahui Health doing to prevent this type of infection?

•     Clean our hands and arms with an antimicrobial hand wash (one that kills germs) just before the surgery

•     Clean our hands before and after caring for each patient

•     May remove hair in the area of the procedure just before your surgery using electric clippers

•     Follow sterile procedures during surgery to keep the area clean

•     When recommended, give you antibiotics just before your surgery starts; and then stop antibiotics 24 hours after surgery

•     Clean the skin in the area of the procedure with an antimicrobial handwash just before the surgery

How can I help prevent a wound infection?

Before your surgery:

·     Tell your doctor about other medical problems you may have, such as allergies or diabetes

What is type 1 diabetes? 

Type 1 diabetes is a disease that affects how your child's body makes insulin and uses glucose (sugar). Normally, when the blood sugar level increases, the pancreas makes more insulin. Insulin helps move sugar out of the blood so it can be used for energy. Type 1 diabetes develops because the immune system destroys cells in the pancreas that make insulin. The pancreas cannot make enough insulin, so the blood sugar level continues to rise. A family history of type 1 diabetes may increase your child's risk for diabetes.

What are the signs and symptoms of type 1 diabetes? 

•  More thirst than usual 

•  Frequent urination or unexplained bedwetting

•  Feeling hungry most of the time

•  Weight loss without trying 

How is type 1 diabetes diagnosed? 

•  An A1c test shows the average amount of sugar in your child's blood over the past 2 to 3 months. Your child's doctor will tell you the level that is right for your child. The goal is usually below 7.5%. Your provider can help you make changes if your child's A1c is too high

•  A fasting plasma glucose test is when your child's blood sugar level is tested after he or she has fasted for 8 hours. Fasted means he or she has not eaten anything or had anything to drink except water

•  A 2-hour plasma glucose test starts with a blood sugar level check after your child has not eaten for 8 hours. Your child is then given a glucose drink. Your child's blood sugar level is checked after 2 hours

•  A random glucose test may be done any time of day, no matter how long it has been since your child ate

•  An antibody test may show that your child's immune system is attacking his or her pancreas

How is type 1 diabetes treated? 

Type 1 diabetes cannot be cured, but it can be controlled. The goal is to keep your child's blood sugar at a normal level. 

•  Your child will need insulin each day. Insulin can be injected or given through an insulin pump. Ask your child's doctor which method is best for your child. You and your child will be trained in the best method for him or her. Give your child insulin as directed. Too much insulin may cause his or her blood sugar level to go too low

•  You will also be taught how to adjust each insulin dose your child takes with meals. Always check his or her blood sugar level before the meal. The dose will be based on his or her blood sugar level, carbohydrates in the meal, and activity after the meal

How do I check my child's blood sugar level?

 You will be taught how to check a small drop of blood with a glucose monitor. You will need to check your child's blood sugar level at least 3 times each day. Ask your child's doctor when and how often to check during the day. Before meals, your child's blood sugar should be between 90 and 130 mg/dL. At bedtime, it should be between 90 and 150 mg/dL. You may need to check for ketones in your child's urine or blood if his or her level is higher than directed. Write down the results and show them to your child's doctor. The provider may use the results to make changes to your child's medicine, food, or exercise schedules. 

What should I do if my child's blood sugar level is too low?

Your child's blood sugar level is too low if it goes below 70 mg/dL. If the level is too low, have your child eat or drink 15 grams of fast-acting carbohydrate. These are found naturally in fruits and dairy products. Fast-acting carbohydrates will raise your child's blood sugar level quickly. Examples of 15 grams of fast-acting carbohydrate are 4 ounces (½ cup) of fruit juice or 4 ounces of regular soda. Other examples are 2 tablespoons of raisins or 3 to 4 glucose tablets. Check your child's blood sugar level 15 minutes later. If the level is still low (less than 100 mg/dL), give another 15 grams of carbohydrate. When the level returns to 100 mg/dL, have your child eat a snack or meal that contains carbohydrate and protein. This will help prevent another drop in blood sugar. Always carefully follow your doctor's instructions on how to treat low blood sugar levels. 

What do I need to know about nutrition for my child? 

A dietitian will help you create a meal plan to keep your child's blood sugar level steady. Do not let your child skip meals. His or her blood sugar level may drop too low if he or she takes insulin and does not eat.

•  Keep track of carbohydrates (sugar and starchy foods). Your child's blood sugar level can get too high if he or she eats too many carbohydrates. His or her dietitian will help you plan meals and snacks that have the right amount of carbohydrates

•  Give your child low-fat and low-sodium foods. Examples of low-fat foods are lean meat, fish, skinless chicken or turkey, and low-fat milk. Limit high-sodium foods, such as potato chips and soup. Do not add salt to food you cook. Limit your child's use of table salt

•  Give your child high-fiber foods. Foods that are a good source of fiber include vegetables, whole-grain bread, and beans

What else can I do to manage my child's type 1 diabetes? 

•  Go to all follow-up appointments. Your child may need to return to have his or her A1c checked at least 2 times each year. Your child may also need tests to check his or her blood pressure, cholesterol, eyes, and feet

•  Have your child exercise as directed. Exercise can help keep your child's blood sugar level steady. Encourage your child to exercise for at least 60 minutes on most days of the week. Help your child include activities 3 days each week that strengthen his or her muscles and bones. Work with your child's doctor to create an exercise plan:

·   Check your child's blood sugar level before and after exercise. Doctors may tell you to change the amount of insulin your child takes or food he or she eats. If the blood sugar level is high, check your child's blood or urine for ketones before you exercise. Do not let your child exercise if the blood sugar level is high and he or she has ketones

·   If your child's blood sugar level is less than 100 mg/dL, have him or her eat a carbohydrate snack before exercise. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of milk, or 4 ounces (½ cup) of juice. Have your child drink water or liquids that do not contain sugar before, during, and after exercise. Ask your dietitian or doctor which liquids your child should drink when he or she exercises

•  Help your child maintain a healthy weight. Ask your child's doctor how much your child should weigh. A healthy weight can help control your child's diabetes. Ask your child's doctor to help you create a weight loss plan for your child if he or she is overweight. The provider can help your child set reasonable weight loss goals

•  Check your child's feet each day for sores. Have your child's feet checked at least 1 time each year for problems that may develop if his or her diabetes is not controlled. Make sure his or her shoes and socks fit correctly. Ask your child's doctor for more details about foot care

What other care will my child need for type 1 diabetes? 

•  Make sure your child always wears medical alert jewelry or carries a card that says he or she has diabetes. Ask your child's doctor where to get these items

•  Give instructions to your child's school. Make sure your child's teachers know he or she has diabetes. Provide written instructions about what to do if your child has symptoms of high or low blood sugar levels at school

•  Do not smoke around your child. Do not let others smoke around him or her. Do not let your older child smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Cigarette smoke can worsen the problems that occur with diabetes. Ask your doctor for information if you or child currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your doctor before you or your child use these products

What is an upper respiratory infection? 

An upper respiratory infection is also called a common cold. It can affect your nose, throat, ears, and sinuses. 

What causes a cold? 

The common cold is caused by a virus. There are many different cold viruses, and each is contagious. This means the virus can be easily spread to another person when the sick person coughs or sneezes. The virus can also be spread if you touch something that a person with a cold has touched. You are more likely to get a cold in the winter. Your risk of getting a cold may be increased if you smoke cigarettes or have allergies, such as hay fever.

What are the signs and symptoms of a cold? 

Cold symptoms are usually worst for the first 3 to 5 days. You may have any of the following:

•      Runny or stuffy nose

•      Sneezing and coughing

•      Sore throat or hoarseness

•      Red, watery, and sore eyes

•      Fatigue 

•      Chills and fever

•      Headache, body aches, or sore muscles

How is a cold treated?

There is no cure for the common cold. Colds are caused by viruses and do not get better with antibiotics. Most people get better in 7 to 14 days. You may continue to cough for 2 to 3 weeks. The following may help decrease your symptoms:

•      Decongestants help reduce nasal congestion and help you breathe more easily. If you take decongestant pills, they may make you feel restless or cause problems with your sleep. Do not use decongestant sprays for more than a few days

•      Cough suppressants help reduce coughing. Ask your doctor which type of cough medicine is best for you

•      NSAIDs, such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your doctor if NSAIDs are safe for you. Always read the medicine label and follow directions

•      Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day

How can I manage my cold? 

•      Rest as much as possible. Slowly start to do more each day

•      Drink more liquids as directed. Liquids will help thin and loosen mucus so you can cough it up. Liquids will also help prevent dehydration. Liquids that help prevent dehydration include water, fruit juice, and broth. Do not drink liquids that contain caffeine. Caffeine can increase your risk for dehydration. Ask your doctor how much liquid to drink each day

•      Soothe a sore throat. Gargle with warm salt water. This helps your sore throat feel better. Make salt water by dissolving ¼ teaspoon salt in 1 cup warm water. You may also suck on hard candy or throat lozenges. You may use a sore throat spray

•      Use a humidifier or vaporizer. Use a cool mist humidifier or a vaporizer to increase air moisture in your home. This may make it easier for you to breathe and help decrease your cough

•      Use saline nasal drops as directed. These help relieve congestion

•      Apply petroleum-based jelly around the outside of your nostrils. This can decrease irritation from blowing your nose

What is earwax?

Earwax, also called cerumen, is soft yellow wax. It is produced by glands inside your ear canals. Earwax works with tiny hairs inside the ear to keep out dirt, water and other foreign matter that could cause damage to your inner ear.

Should you clean the wax out of your ears?

In most cases, earwax takes care of itself. A small amount of earwax regularly makes its way to the outer ear where it dries up and flakes off or is washed away when you take a shower.

Can earwax cause a problem?

Usually earwax does its job without causing any problems, but sometimes too much earwax builds up and can block the ear canal. This can cause pain, interfere with your hearing, and cause ringing in the ear or dizziness.

What causes earwax buildup?

Some people are just born with narrow or winding ear canals that make it hard for earwax to wend its way out. People with very dry skin may produce hard, dry earwax that moves less smoothly from the inner to the outer ear.

A bad cold or an ear infection can cause tissue to swell up, narrowing the ear canal and keeping earwax stuck inside. People who wear hearing aids, earplugs or use cotton swabs (Q-tips) to clean their ears can push earwax back into the ear canal, causing build-up. And, finally, as we get older, the glands in theears weaken, producing less-oily, drier earwax that is more likely to get stuck inside the ear.

How can I tell if I have earwax buildup?

Earaches, hearing problems, ringing in the ears and sometimes dizziness may be signs of earwax buildup - and a variety of other medical conditions. These symptoms do not necessarily mean that you have earwax buildup. The only way to know for sure is to ask your doctor to look into your ear canal.

What can I do at home to remove excess earwax?

As long as you do not have tubes in your ears or a perforated eardrum, you may try to gently remove excess earwax on your own. Do not use cotton swabs to clean your ears. Never use anything else - like a paper clip or a bobby pin - to clean your ears. Doing so may push the earwax back into the ear canal, making your problems worse.

Instead, try one of these safer methods:

1.      Use an eyedropper to place a few drops of baby oil, mineral oil, glycerin or hydrogen peroxide in your ear canal twice a day for no more than four or five days. This will soften the wax

2.      Use a bulb syringe to gently squirt lukewarm water into your ear canal. Don’t squeeze the bulb too hard, and don’t force the syringe deep into the canal. Tip your head to allow the water to drain out. When finished, dry yourouter ear with a towel or a hand-held hair dryer

 You may need to repeat these wax-softening and irrigation procedures several times before the excess earwax falls out. If your symptoms do not improve after a few treatments, see your doctor.

Can the doctor remove excess earwax for me?

Your doctor can scoop out excess wax with a small, curved curette or ‘spoon,’ or rinse out excess wax with a gentle spray of warm water from a water pick or rubber syringe. If the wax is very hard, your doctor may prescribe eardrops to soften the wax for a few days before you return to the office to have it removed. Sometimes the eardrops alone are enough to loosen up earwax so it comes out on its own.

If earwax buildup is a recurring problem, your doctor may recommend putting a drop or two of mineral oil in the affected ear once a week to help keep the wax from hardening and building up.

This document is intended to provide health related information so that you may be better informed. It is not a substitute for your care team's medical advice and should not be relied upon for treatment for specific medical conditions.

© 2017 The General HospitalCorporation.

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What is benign paroxysmal positional vertigo?

Vertigo is the sudden sensation that you are unsteady or that your surroundings are moving. Benign paroxysmal positional vertigo (also called BPPV) is the most common kind of vertigo.

BPPV is an inner ear problem that causes you to suddenly feel dizzy when you move your head in a certain direction, lie down from an upright position, turn over in bed, or sit up in the morning.Moving your head to look up can also make you feel dizzy.

Although BPPV can be bothersome, it is rarely a serious problem. Episodes of BPPV are usually short, lasting less than a minute, and the problem tends to come and go. In some cases, BPPV goes away by itself with little or no treatment.

What causes BPPV?

Your inner ear contains tiny calcium particles that help you keep your balance. Normally, these particles are distributed evenly in the inner ear's three canals. When you move your head, the calcium particles stimulate nerve cells inside the canals. These cells send your brain a signal telling it what direction your head is moving.

However, these calcium particles can break loose and clump together in one of the ear's canals. When this happens, the nerve cells tell your brain that your head has moved more than it actually has. This incorrect signal results in vertigo. In most cases, BPPV is something that happens as part of aging. It can also occur after a blow to your head or, less often, as a result of a virus that infects your ear.

How does my clinician know I have BPPV?

Your clinician may suspect BPPV if you feel dizzy when you move your head certain ways. Your clinician will do a physical exam, ask you some questions, and review your medical history. If there is doubt about what is causing your dizziness, your clinician may order one or more tests to rule out more serious problems.

What can I do to cope with BPPV symptoms?

•      Get out of bed slowly. Sit on the edge of the bed for a minute before standing up

•      Be careful when you bend to pick something up or when you raise your head back to get something from an upper cabinet. Make these movements slowly

•      Sit or lie down right away whenever you feel dizzy

•      Be careful when getting up from lying back at the dentist's office, beauty parlor or barbershop, or during activities such as yoga or massage

How is BPPV treated?

Your clinician may recommend some simple head movements that you can do at home. These movements, called the Brandt-Daroff exercise, can help move the calcium particles in the canals in your inner ear. This easy exercise can stop the symptoms and may keep the dizziness from coming back.

How to Do the Brandt-Daroff Exercise

1.   Sit on the edge of a bed or sofa with your legs hanging over the side. Sit near the middle so that you can lie down in either direction

2.    Quickly lie down onto your right side, resting your right ear on the bed or sofa, looking straight ahead. Hold this position for 30 seconds (or until any dizziness passes, whichever is longer)

3.   Return to the up right position and look straight ahead. Hold this position for 30 seconds

4.    Quickly lie down onto your left side, resting your left ear on the bed or sofa, looking straight ahead. Hold the position for 30 seconds or until any dizziness passes

5.   Return to the upright position and look straight ahead for 30 seconds

These steps make up one 'set' of the Brandt-Daroff exercise. Do 5 repetitions of this set.It should take about 10 minutes.

 Try to do 2 or 3 exercise sessions a day for 10 days to 2 weeks. You can do one exercise session in the morning, another at lunchtime, and/or one before you go to bed. If your symptoms go away after one week of doing these exercises, you can cut back to 2 repetitions 3 or 4 times a week for the next week.

This document is intended to provide health related information so that you may be better informed. It is not a substitute for your care team's medical advice and should not be relied upon for treatment for specific medical conditions.

© 2017 The General HospitalCorporation.

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developed by the MGH Laboratory of Computer Science and Division of General Internal Medicine

Answer the following questions, circling Y for yes and N for no.

Y         N          Do I have a problem hearing on the telephone?

Y         N          Do I have trouble hearing when there is noise in the background?

Y         N          Is it hard for me to follow a conversation when two or more people talk at once?

Y         N          Do I have to strain to understand a conversation?

Y         N          Do many people I talk to seem to mumble (or not speak clearly)?

Y         N          Do I misunderstand what others are saying and respond inappropriately?

Y         N          Do I often ask people to repeat themselves?

Y         N          Do I have trouble understanding the speech of women and children?

Y         N          Do people complain that I turn the TV volume up too high?

Y         N          Do I hear a ringing, roaring, or hissing sound a lot?

Y         N          Do some sounds seem too loud?

If you answer"Yes" to 3 or more of these questions, you may have significant hearing loss. Ask your primary care doctor whether you should see aspecialist.

This document is intended to provide health related information so that you may be better informed. It is not a substitute for your care team's medical advice and should not be relied upon for treatment for specific medical conditions.

© 2017 The General HospitalCorporation.

Primary Care OfficelnSite

developed by the MGH Laboratory of Computer Science and Division of General Internal Medicine