Many doctors recommend that women should take hormones only if their menopausal symptoms—especially vaginal soreness, hot flashes, and night sweats—are severe enough to cause extreme discomfort. Other doctors believe that most women should take hormones to protect themselves against the effects of osteoporosis, and other benefits (see chapter 10). The therapy is generally not recommended for women who have a history of breast and/or uterine cancer, stroke, pulmonary embolism, liver disease, or deep-vein thrombosis.

If you are taking hormones, you should follow your doctor’s instructions exactly—have regular medical checkups, including pelvic examinations; Pap smears; blood pressure checkups; and mammograms. In order to eliminate symptoms such as hot flashes, most women need to continue treatment for at least one year. If a woman stops her treatment abruptly, the symptoms can reappear in just a few months. Hormone replacement as a treatment to prevent osteoporosis may need to continue for five to ten years or longer.

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THE MOST OFTEN

There are several factors which can affect a doctor’s ability to diagnose a patient’s symptoms. Sometimes a doctor’s lack of knowledge of a disease can place certain limitations on his or her ability to diagnose a specific problem. At other times the elaborate array of tests doctors now have to help in making their diagnoses aren’t always conclusive, and doctors sometimes have trouble interpreting them.

To further complicate the process, the specialist may not have a complete medical history and physical exam to refer to. There are also many diseases that have similar symptoms, making their diagnosis difficult. As a result, diagnosis is not an “exact” science. Here are several of the most commonly misdiagnosed, or hard to diagnose diseases and illnesses:

1) Osteoporosis— in a study conducted at the University of Kansas in Kansas City, researchers evaluated 180 women who had either had or were suspected of having osteoporosis. The researchers learned that in 46 percent of the women involved in the study, there were other health factors that could cause or worsen the disease but that had gone undetected by their doctors. Among those factors: menopause before age 40, thyroid disease, asthma or other lung diseases, and a loss of calcium through the kidneys. The researchers recommend that women should furnish their doctors with a complete and detailed medical history.

2) Food sensitivity— this involves an abnormal reaction to food or a food additive. It may or may not be caused by a food allergy. The illness can cause vomiting and/or diarrhea; hives; headaches and stomachaches; fatigue; respiratory problems; and severe cases can result in a life-threatening allergic reaction.

The symptoms are vague and may be hard to diagnose because they can suggest any number of illnesses. It is also difficult to track down the precise food causing the problem.

The American Academy of Allergy and Immunology, 611 East Wells Street, Milwaukee, Wl 53202, can furnish you more information on food sensitivity. Write, or call, 414-272-6701.

3) Rheumatoid arthritis— this is an autoimmune affliction that causes inflammation of the joints. Its symptoms may include pain when moving; swollen, tender and painful wrist, knuckle or finger joints; stiffness; and difficulty forming a fist.

The problem can be hard to diagnose because blood tests may produce false-negative results. The symptoms are also similar to many other autoimmune disorders.

To get more information, you can write to: Arthritis Foundation, P.O. Box 19000, Atlanta, GA 30326, or call, 800-283-7800.

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According to a recent study conducted in China, a relatively small drop in blood cholesterol could mean a significant drop in the risk of having a heart attack— even if your cholesterol level is already within the safe range. Results from the study indicate that a 4 percent drop in cholesterol level may mean as much as a 21 percent drop in the risk of having a fatal heart attack.

The key words in the Chinese study appear to be “relatively small”. Research conducted in the United States suggests that those people with extra-low cholesterol levels are more likely to die in later years from a variety of causes, including certain cancers, liver disease and lung disease, than those people with “normal” cholesterol levels.

The latest findings do not question the standard recommendation that people with high cholesterol should go on diets or, in extreme cases, take drugs to reduce their levels. The concern is for people with extremely low cholesterol- -160 units or less. The research appears to indicate that to reduce certain health risks an individual’s cholesterol level should be neither too high nor too low.

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If you are not alone with the victim, have someone call for an ambulance while you apply pressure to the wound. Place a thick, clean compress, such as sterile gauze or a soft, clean cloth directly and firmly over the entire wound. Don’t try to remove any objects that may be embedded in the wound, because that could worsen the bleeding.

Unless doing so causes the victim pain, you should elevate the wounded area. Cover the cloth or gauze with a bandage, tying or taping it in place. If blood soaks through the compress, do not remove it— instead, add another pad over the first compress, and continue to apply pressure.

C) Seal your lips around the victim’s mouth and give two full breaths of 1 to 1 1/2 seconds each. Remove your mouth after each exhalation and take a deep breath.

D) Turn your head toward the victim’s chest, with your ear just above his or her mouth. Listen for air being exhaled and watch the victim’s chest. Continue breathing into the victim’s mouth at a rate of 12 breaths per minute for an adult, 15 per minute for a child.

If you are alone with the victim, call for an ambulance after one minute and then resume resuscitation efforts. Check for a pulse and breathing every minute.

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DON’T WANT TO

Millions of Americans have learned the hard way that collecting on insurance claims can be a nightmare. The procedure features a myriad of confusing forms, numerous phone calls and letters, and an intimidating bureaucracy. What can you do when your insurance company doesn’t seem willing to pay your claim? Insiders say that the key to getting your insurance claim(s) paid is in knowing how to cut through all the confusing red tape.

Here are several insider tips for getting your insurance claims settled to your satisfaction:

1) Try to stay one step ahead of the bureaucracy. One way to do this is to make sure that you fill in every blank properly when filing a claim. Some companies will reject your claim simply because you omitted your date of birth.

2) Do not take “no” for an answer. Insiders say that every medical procedure has a code and that claims are sometimes rejected because of a computer mistake, resulting in the wrong code. It is estimated that as many as 30 percent of insurance claims are rejected because such minor details are incorrect.

3) Know what your policy covers before you undergo any treatment. You need to know how much your insurer has agreed to pay.

4) If all else fails, turn your claim over to a firm that files claims for policy holders who haven’t had any success in getting their claims paid. These firms can usually cut through the red tape and get the insurance company to pay the claim, or call your state’s insurance department for free help or advice.

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