medical tests

Cancer hit Bob Hendrickson like a rogue wave at age 37. The Coast Guard officer turned to an online support group using the screen name SpongeBob—and came away with some life-changing personal connections.

Testing blood glucose levels regularly is one of the keys to managing diabetes. But pricking your finger multiple times a day is a real pain. Learn how to make testing blood sugar less painful.

If you're like me, open enrollment--that time of year when you sign up again for your employer's health insurance plan--is a bit like deciphering hieroglyphics. Every term is cloaked in an abbreviation--and even the decoded terms are confusing.

Here's a list of common benefit abbreviations and what they mean.

SPD--Summary Plan Description
The Summary Plan Description is also known as the Certificate of Coverage. The SPD is provided with your health insurance policy and outlines the policy's rules, limits, bylaws, fees and benefits. It's often thick and difficult to read. But you should at least scan the highlights. That way you'll know what you're in for should you get sick in the coming year.

FSA-- Flexible spending account
FSAs (sometimes called a cafeteria plan) let you divert part of your income pre-tax to pay for anticipated medical expenses. If you spend $50 a month on prescription drugs, for example, you can set aside this amount in your FSA to cover those expenses in the next year. Your employer will deduct money from your check each pay period.

There are some drawbacks to FSAs. There is a limit to the amount of money you can put in an FSA. That limit is set by your employer and federal law. In 2012, employers can allow employees to set aside up to $5,000 in FSAs. In 2013, that drops to $2,500.

You forfeit any money you don't spend by the end of the year. And not every medical expense is eligible. For example, the federal government excluded many over-the-counter medications from reimbursement last year.

Some companies may offer a limited purpose FSAs. These are used for eligible dental and vision expenses only. They are limited to policies with health savings accounts.

FFS--Fee for Service
This is a traditional insurance plan. Under such plans, you typically pay a percentage of your health bill and your insurer picks up the rest. FFS plans focus on treating health problems and not preventing them. As a result, they don't usually cover annual check-ups and other "well" doctor visits that can quickly amass costs, especially for families.

HDHP-High Deductible Health Plan
This is what it sounds like. An HDHP has a high deductible--ranging from hundreds to thousands of dollars and may be favored by low-income individuals or young people who rarely need healthcare. One of the benefits of a high deductible health plan is lower premiums. However, you have to pay for all medical expenses up to your high deductible.

HSA-Health Savings Account
A health savings account is a tax-exempt account that you set up with a qualified trustee to pay or reimburse certain medical expenses you incur. You must meet certain qualifications to have an HSA: You must be covered under a high deductible health plan, have no other health coverage and not be enrolled in Medicare. You also can't be claimed as a dependent on someone else's tax return.

Health reimbursement accounts (HRAs) work similarly to HSAs--only your employer is the only one who can make a contribution.

CDHC--Consumer Driven Health Plan
This is a term for a plan that combines high-deductible health plan with a health savings account. In other words, CDHP=HDHP + HSA.

PPO--Preferred Provider Organization
This kind of health plan offers both in-network and out-of-network benefits. To get the maximum benefit, you have to choose one of the in-network providers.

HMO--Health Maintenance Organization
Plans tied to an HMO typically require you to see only doctors or hospitals that are on a specified list of providers--or network.

ERISA-- Employee Retirement Income Security Act
ERISA is a federal law that protects the health benefits of people in the U.S.

It wasn't long after my wife and I started raising honeybees that a woman whose property adjoins ours asked to buy some of our honey. We were so excited to have a customer--months before we even figured out how to extract honey from the hives--that I nearly missed her next statement.

"I have really bad allergies," she sniffed.

I felt like a killjoy when I explained to her that there were probably better ways to control allergies than eating honey produced locally, especially since honey doesn't help cure or lessen allergies.

In honor of fall allergy season, here are some other facts about allergies you might not know.

Myth: Kids grow out of food allergies
Although it is common for kids to leave some allergies behind as they get older, certain food allergies almost never go away. Unfortunately, they tend to be the more severe kind: Peanuts, tree nuts and shellfish.

Allergists used to think that kids grew out of other allergies within a few years of diagnosis, but recent research suggests that food allergies linger much longer. Two studies from 2007, for example, found that most children will outgrow allergies to milk and eggs, but not until they reach adulthood.

The good news: Doctors are coming up with new methods for desensitizing children to the worst food allergies.

Myth: You can buy a hypoallergenic dog
A few years ago we acquired a Labradoodle puppy as a rescue pet. We hoped our son, who is severely allergic to cats and doesn't handle dog dander very well either, would have a sniffle-free companion.

But even hypoallergenic dogs shed and have dander. They just have less than other breeds. And you pay a price premium for so-called hypoallergenic dog breeds and hybrids like labradoodles, which are often even more expensive, especially compared to pound puppies. You may empty the bank on one of these hounds and still have to invest in tissue.

Myth: Poison ivy is contagious
For people with allergies to poison ivy, oak or sumac, a walk in the woods can quickly turn into itching agony. That's because the plants contain an oil called urushiol. Brushing uncovered up against a plant or even coming into contact with a pet who's brushed up against poison ivy can cause redness, itching, swelling and even blisters.

But once urushiol is cleaned off the skin, you can't spread poison ivy to someone else. Their skin must come into direct contact with the plant's oil to be affected.

Myth: Allergy tests are accurate
Allergy tests are a great tool for allergists to narrow down possible allergies when a patient is experiencing allergic reactions, but they're not that reliable. That's because skin scratch and blood serum tests vary in accuracy and can result in false positives. In fact, the same test given at different times to the same person may result in different findings.

That's not to say these food allergy tests have no value. Doctors can use them along with medical history and follow up tests to diagnose and treat patients. An allergist might use the results of a scratch test for food allergies along with patient history, for example, to recommend a food challenge test, the gold standard of food allergy testing.

The good news: Researchers are getting close to a test that is as accurate as a food challenge test and less expensive.

Myth: Honey can cure your sniffles
Unfortunately this isn't true. Honey bees typically harvest pollen from flowers. But most people aren't allergic to that kind of pollen; they're allergic to wind-spread pollen from tree and grass, which is why research indicates that local honey is no cure for allergies.

Funny thing about bees and allergies: Six months after we installed our bee hives I found out I was violently allergic to honeybee stings. No amount of honey, unfortunately, can cure my allergy.

The phrase "high quality, low cost health care" gets thrown around quite a lot these days. Unfortunately, no one seems to be able to agree on what it means. Are there really ways to cut costs and improve the quality of healthcare at the same time, and how do we find them?

A group of doctors from the National Physicians Alliance (NPA) recently listed several common patient problems for which medical care could be improved and costs lowered. Hear are five of the most frequently mentioned areas where less may truly be more:

Sinus Infections
People with mild to moderate acute sinus infection do not generally require antibiotics unless symptoms have lasted more than a week (or if there is worsening after initial improvement).

This one is near to my heart as an infectious disease specialist. Fellow healthcare workers often seem annoyed or hurt when I fail to give them antibiotics in hospital hallways for this problem. (I suspect they quickly slip off to descend on another unsuspecting colleague.) Most new sinusitis episodes are viral infections, and antibiotics are not helpful, though they are prescribed in a clear majority of cases.

EKGs and Heart Disease
Annual electrocardiographs on low risk patients without any symptoms of heart disease are unnecessary. This is another classic case of more is not always better. Routine EKGs are very unlikely to improve health outcomes in such patients, and they can lead to an "off to the races" series of more invasive tests, often with possible serious complications as well as significant costs.

Pap Tests
Screening Pap tests are not necessary in women younger than 21 or in women after hysterectomy performed for reasons other than cancer. Most abnormal tests in adolescent women return to normal spontaneously over time, and such abnormal tests can lead to unnecessary further testing as well as needless anxiety.

Sore Throats
Patients with sore throat (pharyngitis) do not require antibiotics unless they test positive for Strep. Once again, most upper respiratory tract infections are viral, but physicians prescribe antibiotics in a majority of patients with these complaints.

Furthermore, most people with sore throat and no fever, no tender neck lymph nodes, and no white patches on the tonsils should not even be tested for Strep throat. Strep is very unlikely without any of these present.

Low Back Pain
Finally, people with low back pain of less than six weeks' duration should not have routine x-ray or other imaging performed unless they complain of neurological deficits such as weakness or if serious underlying conditions such as cancer or bone infection are suspected. Early screening increases costs without improving outcomes.

Always remember that general rules don't apply to every individual or situation. Be sure to discuss with your physician any unusual details of your problem that may require additional testing.

Each of the scenarios above, however, does offer an opportunity to improve care and control costs. We all can hope that the NPA and other physician groups will continue to look for opportunities to lead in health care reform, keeping patients' welfare first while improving care in this era of limited resources.

Test your knowledge. Define "idiopathic."

Not only is celiac disease on the rise, but a person can develop it later in life, according to researchers at the University of Maryland School of Medicine Center for Celiac Research. Their study, published in the September issue of Annals of Medicine, debunks the myth that celiac disease begins in childhood.

"You're not necessarily born with celiac disease," says lead author Dr. Carlo Catassi, co-director of the Center for Celiac Research. "Our findings show that some people develop celiac disease quite late in life." Catassi, also of the Universita Politecnica delle Marche in Italy, urges physicians to consider screening their elderly patients.

Celiac disease is an inherited, autoimmune condition that centers in the digestive tract. According to the National Institutes of Health, when someone with celiac disease ingests gluten (a protein found in wheat, barley and rye), his or her immune system responds by damaging or destroying villi —the tiny, fingerlike protrusions lining the small intestine that help the absorption of nutrients. Without working villi, a person becomes malnourished. Classic symptoms of celiac disease include abdominal bloating and pain, chronic diarrhea, vomiting and constipation.

In the study, Italian and American researchers tracked more than 3,500 adults using blood samples and found that the incidence of celiac disease jumped from 1 in 501 in 1974 to 1 in 219 in 1989. A 2003 study conducted by the celiac research center placed the number of people with celiac disease in the U.S. at one in 133.

The finding also contradicts the common wisdom that nothing can be done to prevent autoimmune disease. If individuals can tolerate gluten for many decades before developing celiac disease, some environmental factor or factors other than gluten must be in play, notes study co-author Dr. Alessio Fasano, director of the University of Maryland's Mucosal Biology Research Center and the celiac research center. The key is finding those other triggers.

In a Wall Street Journal Health Blog, Fasano theorizes that changes in gut bacterial ignite the disease late in life. A person might be born with a genetic predisposition to celiac disease, but that for years those genes aren't turned on. Then the gut bacteria changes, perhaps as a result of infection, surgery or antibiotics, and those genes get flipped on.

The diagnosis of celiac disease can be difficult because many patients, especially adults, who test positive for the disease may not have the classic gastrointestinal symptoms. Atypical symptoms include joint pain, chronic fatigue, seizures, depression and even an itchy skin rash called dermatitis herpetiformis. In the study, only 11 percent of the celiac patients had actually been diagnosed with the disease before the study.

According to the Celiac Disease Foundation, the only treatment is the lifelong adherence to the gluten-free diet. It means avoiding everything with wheat, barley and rye. But gluten can lurk in unexpected places: It may appear on food labels as modified food starch, preservatives or stabilizers. Gluten can also be present in everyday products such as medicines, vitamins and lip balms.

Test your knowledge. Define "hematocrit."

If you or a loved one has been recently diagnosed with type 2 diabetes, just managing the information onslaught can be a real challenge. I know it was for me, and I came from a family steeped in diabetes history. In fact, my grandfather was in the first generation of diabetics to take insulin for the disease.

A decade after being diagnosed, I still encounter things about managing the disease that surprise me. Here are five facts about type 2 diabetes that might surprise you:

5. Exercise can actually increase blood sugar.

It doesn't seem to make much sense. Exercise is supposed to burn sugar and bring blood glucose levels down. Intense workouts, however, can have the opposite effect. That's because the body releases stress hormones that tell your body to increase available sugar as fuel for your muscles.

4. Testing gets expensive...

Most blood glucose meters are either very cheap or free. Unfortunately, the test strips needed to operate them aren't. (Companies that make razors use a similar model.) Retail prices for some strips of some meters exceed $1.50 each. If you test five times a day (before meals and bed time, for example), testing supplies can run you more than $225 a month.

3. ... And it's not all that accurate.

The Food and Drug Administration requires that blood sugar monitors be only so accurate. That tolerance--within plus or minus 20 percent of the actual blood glucose level--means that a monitor may read normal when your blood sugar is actually high. Or it may read high when your glucose levels are actually normal. The good news: Most meters are more accurate than the FDA requires, and the agency is considering stricter standards.

2. It's not only about sugar.

I still find it funny that people think diabetes is about sugar. The disease, still called "sugar diabetes" by many older Americans, isn't caused by overeating sugary foods. In fact, we don't know what causes either main type of diabetes, though scientists and physicians have many excellent ideas.

For type 2, being overweight, which can easily come from eating too many sweets or from just eating too much and not exercising enough, plays a big roll. But there are also genetic and environmental contributors. And there's a surprising number of new cases in populations that are considered thin. Misconceptions abound.

1. There's a silver lining to having type 2 diabetes.

Finding out you have type 2 diabetes can be devastating. Managing the disease is expensive and frustrating, and it generally requires major life changes. But the diagnosis can also be a wake up call. In most cases, gaining tight control over diabetes requires frequent exercise and healthy eating habits--things that are good for diabetes and also good for general health. Everything you do that's good for diabetes is good for the rest of you.

Many people go to their doctors with lists of questions, but have you ever stopped to make sure that you're armed with answers to their questions? Providing physicians with all the information they need can make a big difference in getting help for your current problem and warding off future ones.

Here are five tips to make sure your doctor gets the answers required to give you the best possible care:

1. Summarize the reason(s) for your visit into one or two main problems. Helpful facts include how long the problem has been bothering you, how severe it is, and what makes it better or worse.

2. Provide information about your past health. Previous problems can have a big impact on your current difficulty, and it's crucial for your doctor to know about them. Most doctors' offices keep track of these issues in your records, but if you're seeing a new doctor, he or she may not yet have all the necessary information. This includes a list of past hospitalizations and what was done at the time, any prior surgeries or other medical procedures and the reasons, and any specific allergies to medications. Also, don't forget to have a list of all current medications and doses, including non-prescription medicines and dietary supplements.

3. Give details about your habits, including smoking, alcohol intake, exercise and work. Be honest; you'll only hurt yourself by fudging the truth. Be sure to include any unusual exposures such as travel or pets that could put you in contact with less common illnesses.

4. List illnesses in your family members, particularly parents, siblings and children. Conditions such as premature heart disease, diabetes, high blood pressure, and autoimmune diseases (lupus, rheumatoid arthritis) can run in families, Because your family history can help predict your future health, it's important for your doctor to have this information. (Don't know much about your family medical background? Here's an easy Internet-based tool from the U.S. Surgeon General that will help you get started.)

5. Describe any other problems or symptoms that are unrelated to the reason for your visit. Typically, your doctor will ask for this information in a written questionnaire to be filled out while you wait. Sometimes, issues that seem unrelated may in fact be relevant to your problem - or warrant further investigation by your doctor.

Turn your head and worry: The three-day wait after comedian Brian Frazer’s annual physical nearly killed him with hypochondria.

Trying to relieve stress, comedian and hypochondriac Brian Frazer takes knitting for spin.