Here’s to Your Good Health

Here’s to Your Good Health

This upcoming year, take time to take care of yourself.

Two days before Thanksgiving, I noticed flashing in my visual field. I was talking to Dr. Ronald Hirsch and wondered whether I was going to develop a migraine. The next day, I started having some floaters. When you have visual issues, you close each eye to determine if you are seeing the problem with both eyes open, which suggests that it could be from your brain, or from one eye while the other eye is closed. Turns out my left eye was having an issue.

Thanksgiving morning, a very pleasant ophthalmology resident was dilating my eyes to discover that I have a posterior vitreous detachment, H43.812. I was unfamiliar with this common consequence of aging. The vitreous gel in the eye liquifies and shrinks, causing it to separate from the retina at the back of the eye. Minuscule amounts of blood cells released into the vitreous cause the floaters. For me, the floaters resemble fine hairs waving in front of my visual field. Apparently, eventually your brain disregards them and your visual field clears. Once it has happened to one eye, it is likely it will occur in the contralateral eye within the next year.

I also had been experiencing pretty weird and intense muscular and joint pains, especially in my shoulder and pelvic girdle, impairing my sleep. It takes a lot for me to seek medical attention, but I went to the rheumatologist. He was able to easily diagnose my new malady from my history. I was the proud owner of another age-related condition, this one likely autoimmune mediated, called polymyalgia rheumatica, M35.3. It is more common in whites and women. The treatment is low-dose steroids, but the treatment duration can be prolonged.

Fortunately, I have only been dealing with irksome but not life-, limb-, or sight- threatening conditions. Poor Kirstie Alley just died after a short illness with colon cancer, reminding me of the shock when Chadwick Boseman died in August 2020 after his courageous battle. I wonder if Kirstie had ignored warning signs.

A new year is coming, and I think it is a good time to make a resolution to take good care of yourself. When I worked in the ED, patients often came in after ignoring signs and symptoms of serious illness to be blindsided by their diagnosis. I am going to review some important recommendations with you.

First, you should know when your baseline medical conditions might leave you more susceptible to other conditions developing and might initiate preventative measures. My extreme near-sightedness leaves me prone to a retinal detachment which can be vision-threatening, which was why I took these floaters and flashers seriously. Being a petite, white woman and now being on steroids predisposes me to osteoporosis, so I take vitamin D, calcium, and do weight-bearing exercise. I am proud that in 2022, I only missed 10 days to take a 2 ½ mile morning walk every day – I just bought myself some really awesome fleece-lined water- and wind-resistant pants. Stepping up my activity caused me to drop 10 pounds this past year.

Being overweight makes one prone to innumerable medical problems including high blood pressure, Type 2 diabetes, certain cancers, sleep apnea, and severe COVID-19.

If there is an acute change in any of your senses, like loss of vision or hearing; if you have the onset of shortness of breath, chest, or abdominal pain; if you see blood anywhere it doesn’t belong, like in urine, stool, or sputum, you should see a professional urgently or emergently. If you or a loved one has trouble moving a limb not due to pain from an injury or experience numbness of the face or one side of the body, if there is trouble talking or thinking, or onset of a severe headache or dizziness without known cause, a stroke should be ruled out. Sudden, unintended weight loss or a growth or mass should raise red flags.

This upcoming year, take time to take care of yourself. Quit smoking, lose weight, be more active, take your blood pressure medication, wear your seatbelt and bicycle helmet. Get your vaccines including against COVID-19, flu, and pneumonia. Do your self breast or testicular exams and get your appropriately scheduled mammogram and colonoscopy. Seek mental health care if you feel depressed or very anxious.

Take care of yourselves, we want you to listen to Talk Ten Tuesdays for a long time! Have happy and safe holidays! See you next year.

Programming note: Listen to Dr. Erica Remer Tuesdays on Talk Ten Tuesday when she cohosts the broadcast with Chuck Buck at 10 Eastern.

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Erica Remer, MD, FACEP, CCDS, ACPA-C

Erica Remer, MD, FACEP, CCDS, ACPA-C has a unique perspective as a practicing emergency physician for 25 years, with extensive coding, CDI, and ICD-10 expertise. As physician advisor for University Hospitals Health System in Cleveland, Ohio for four years, she trained 2,700 providers in ICD-10, closed hundreds of queries, fought numerous DRG clinical determination and medical necessity denials, and educated CDI specialists and healthcare providers with engaging, case-based presentations. She transitioned to independent consulting in July 2016. Dr. Remer is a member of the ICD10monitor editorial board and is the co-host on the popular Talk Ten Tuesdays weekly, live Internet radio broadcasts.

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