Why Medical Appointments are like Math Tests

By Eileen B. Wyner, NP
Bulfinch Medical Group

Eileen Wyner, NP

A medical appointment is a really big investment.  It takes time from our busy lives that may impact our employment or family commitments.  It costs us financially through transportation costs, parking fees, childcare expenses and copays.  It also can cause anxiety and uncertainty because of worry about the outcomes of tests (on top of all of the other things I mentioned).  Even so, a medical appointment is the single best investment you can make in your healthcare. The best way to gain the most from this investment is studying the night before. That’s right, just like preparing for that all important math test it’s worthwhile to prepare for your upcoming medical appointment.

Remember, you and your health care provider are teammates working for the same goal: the best health you can achieve.  Using the tips below to prepare for your appointment will help you both get the most out of your time together.

  1. Review your prescriptions and see if you need any refills on medications or supplies.  It is also important to have updated pharmacy contact information so your prescriptions are not delayed, and check to see if you need any specialty referrals.
  2. Make sure that you have your updated insurance information and photo ID with you. Medical offices do not automatically receive insurance changes, so it is important to check this information at each appointment to prevent issues with bills and referrals. You can update your address and phone number at this time if they have changed since your last office visit.
  3. Allow plenty of time to get to your appointment and park so you are not late. We try to accommodate people who are late but sometimes it can’t be done.
  4. Please be patient with me if I am running late. I work very hard to keep on time because I value YOUR time, but if I have a very sick patient, I may run behind. I promise that I will still give you the time you need for your care.
  5. Don’t forget to bring any results from home such as blood pressure, weight, and blood sugar checks. The information I get during the office visit is just one snapshot in time; seeing it along with your home results gives me a clearer picture of your health.
  6. Write down any questions and concerns you want to talk about during your appointment.
  7. Take notes during the appointment and use the same notebook for each visit. This will help keep all of your information organized and in one place if you need to review something you’re unsure about.

I know being a patient is a full time job for many people, and it can be daunting to keep track of everything that goes into good self-care and good health.  I think that preparing for your appointment, just like studying the night before the math test, can make this process less overwhelming and as successful as possible.


Winter Safety Tips

By Eileen B. Wyner, NP
Bulfinch Medical Group

Eileen W

The calendar tells us that winter begins December 21st. I’ve lived in New England all my life and am used to winter beginning anytime around Halloween, so this year I feel like I’ve already received the best Christmas gift ever…fall weather in December!  Alas, the reality is starting to set in and winter preparations are needed. Winter safety is very important for all of us, but presents challenges for people living with Diabetes. It’s better to think about these challenges now when the ground is bare and the thermostat above freezing.  I’ve listed below a few common issues that may occur and could become serious problems if not identified and dealt with sooner rather than later.

Foot protection:

Daily foot care is one of the most important principles of good Diabetes management. The first place to start is with your boots.  Make sure your shoes fit well—poorly fitting shoes (too big, too small, and too narrow) can lead to skin breakdown, blister formation, and possible infection. You also need to keep your feet warm and dry.  Leaving wet socks on can cause serious problems such as lacerations and blisters that could develop into dangerous infections.  Even waterproof shoes have their limits, so always throw an extra pair of socks in your bag or your desk drawer.  Here’s a tip:  When shopping for boots, try them on with heavier socks (since we usually wear thicker socks in the winter).

Traveling & Commuting:

Foul weather can really disrupt your daily commute to work— as well as long distance travel for work or pleasure— which can impact your schedule when you’re trying to regulate your blood sugars. If you’re commuting on public transportation, trains may be delayed or you may have to walk unexpected distances. When driving, there may be road closures, detours that take you far from your destination, traffic jams, or totally impassable roads. It’s a good idea to carry some extra snacks, water, and glucose tabs with you to prepare for unexpected situations. Severe weather or unsafe road conditions may make it too dangerous to get out of the car to open the trunk for your provisions, so keep some snacks in the backseat at all times and always have a stash of glucose tablets or gel readily accessible in the glove compartment. Take a survey of the trunk and pack it with a sturdy shovel, ice melt, jumper cables, and blankets. Also, make sure you have a working flashlight, extra batteries, flares, a cell phone charger, and a first aid kit. Take your car in for winter maintenance in the fall and always double check that you have enough wiper fluid and antifreeze (try to keep your gas tank full also). I think a great gift to give or receive is AAA membership, so consider that your tip for last minute Christmas shopping!

Frostbite & Hypothermia:

It’s important to stay as warm and dry as you can during inclement weather to prevent frostbite and hypothermia—two very serious cold weather complications.

Frostbite is an injury to the body caused by freezing. In areas affected by frostbite, loss of feeling and color can occur. The early signs include redness or pain to an area of skin—both of which indicate it’s time to protect that area immediately and get out of the cold if possible. The skin may also turn grayish yellow in color and/or feel waxy or numb. Frostbite most often affects the nose, ears, cheeks, chin, fingers, or toes and can cause permanent damage.  Severe cases can lead to amputation. The risk of frostbite is increased in people with reduced blood circulation, Diabetes, and neuropathy and also may affect people who are not dressed properly for extremely cold temperatures.

Hypothermia is an abnormally low body temperature that may occur when you’re exposed to cold temperatures for a prolonged period of time, especially if you are underdressed or very wet from precipitation. The body begins to lose heat faster than it can be produced. Prolonged exposure to cold will eventually use up your body’s stored energy; if the body temperature gets too low the brain starts to slow down.  Warning signs of hypothermia include shivering, exhaustion, confusion and slurred speech—not unlike some symptoms of hypoglycemia. It’s important to be sure your blood sugar is at a safe value, and then try to get as warm and dry as possible and get medical attention as soon as you can.


There are a couple more things to keep in mind. Any of these situations that I have mentioned could cause you to have hypoglycemia:

  • Winter is also the time for illness. Getting a flu vaccine, washing your hands, and getting plenty of rest are the most important steps you can take to good health.
  • Remember home safety, too.  Make sure your heating system is in good working order and you have household carbon monoxide (CO), monitors. If you have a fireplace or woodstove be sure that they are vented properly to avoid fire or CO poisoning.

The most important thing to remember is to try to be prepared…then go out any enjoy all that winter in New England has to offer…the good and the bad.


Warm Up, Cool Down

Young woman stretchingRegular exercise has a number of benefits for overall health and wellness.  It can help with reducing stress, strengthening the heart and bones, and is a key factor in weight loss and management (to name just a few).  Regular physical activity also plays a role in helping to control blood sugar.  But did you know that what you do immediately before and after exercise, regardless of the activity you choose, is just as important as the exercise itself? 

Before starting your exercise session, it’s best to do a warm up.  It doesn’t have to be anything strenuous—in fact it shouldn’t be.  The purpose of a warm up is to prepare the body for more strenuous exercise by raising the heart rate slightly and increasing the flow of blood and oxygen to the muscles.  A low-impact version of the activity you’ll be doing (i.e. walking and jogging before going for a run) is a perfectly acceptable way to warm up, as is using a foam roller.  How long you warm up varies by individual and activity, but a good guideline is 5-10 minutes before starting more strenuous exercise. 

In addition to getting the body ready to move, warming up properly can help prevent injury and improve performance.  Think about it this way:  an elastic band kept in a desk drawer is easier to stretch and less likely to break than one that’s been in the refrigerator.  Your muscles are just like that elastic band; warming up makes the muscles (as well as ligaments—the connective tissues in joints) more flexible and respond to commands more efficiently. 

A cool down is like a warm up, except in reverse.  Where the purpose of a warm up is to increase blood flow and body temperature, a cool down brings the heart rate and breathing back down to resting.  Gradually slowing down your activity level can also prevent feelings of dizziness or lightheadedness that’s caused by blood pooling in the legs and feet (which sometimes happens when you stop exercising suddenly).  Just like a warm up, the length of time spent doing a cool down varies by individual but the general recommendation is again about 5-10 minutes. 

Granted, sometimes it can be difficult to find the time to exercise period, let alone add extra time at the beginning or end.  Diving right in might seem like a good shortcut, but taking the time to warm up and cool down properly is better for your body and can help get the most out of your workout.  In short, that “extra” time is time well spent. 

 Finally, a few reminders: consult your health care provider before starting an exercise program, monitor your blood sugar and keep a snack or fast acting glucose on hand in case of lows.

(Information reviewed by the Clubs at Charles River Park)