Measuring Your Health Tips

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11. Take The CEO Approach To Managing Chronic Conditions

Chronic diseases or conditions are those that require ongoing treatment or medication. They rarely get better, but they can be managed and prevented from getting worse. You may also find your “chronic diseases” mirror those of others in your family.
What are the diagnosed illnesses that you are treated for on an ongoing basis (hypertension, high cholesterol, depression, arthritis, back pain, diabetes, cancer, stroke, periodontal [gum] disease…).
CEOs know that, when a production breakdown or slowdown happens, the profits of the organization are dependent upon restoring the production line to normal capacity as soon as possible. You, too, must take this approach to managing flu, colds, minor injuries, and also when managing arthritis, diabetes, asthma, heart disease, the like.

--Do you have and/or are you being treated for high blood pressure, high cholesterol, coronary artery disease, stroke, or other vascular (vein-artery) condition?
--Do you have and/or are you being treated for diabetes/high blood sugar/pre-diabetes?
--Do you have and/or are you being treated for chronic allergies or asthma?
--Do you have and/or are you being treated for arthritis, low back pain, other muscle/joint issues?
--Do you have and/or are you being treated for any cancers?

For any of these answers above that were “yes,” are you filling all prescriptions and taking them appropriately?
For any of these answers above that were “yes,” are you following doctors' orders for care (keeping follow-up appointments, getting tested regularly, seeing other care providers, such as eye doctor for diabetes eye exam, or foot specialist for diabetes foot exams)?
Other? Don't forget herpes, gum disease, etc.


10. Be Honest About The Acute Illnesses

Acute means “of the moment”—this is something that is currently causing you pain, distress, a general feeling of “not feeling well.” Acute means you either have been to the doctor recently or you are considering going within the next 24-48 hours if you don't feel much better. Are you currently under the care of the physician for a new illness or a flare up of symptoms?
Are you currently taking any prescribed medications that are limited in time (such as an antibiotic for bronchitis, NOT an asthma inhaler)
Are you taking any pain medication? For what? Who prescribed it? Is this a recurring flare-up?
Have you fallen or had a recent X-ray for joint or muscle pain?
Are you taking aspirin/other over-the-counter pain medication for a new ache or pain?
Are you in rehab/physical therapy for a new condition, or one that recurred with flare-up?
Have you been treated in the emergency department or after-hours clinic recently? For what? Does this happen often?
Are you experiencing any complications from a condition or disease that may be long-term? For example, if you have diabetes, how is your eyesight? Are your toes/fingers in good condition, or are they causing you worry?


9. Your Emotional Health Is An Important Factor

CEOs recognize that the environment and culture of an organization contribute to the overall morale and the ability to “get things done.” This section asks you about your physical and mental/emotional condition. It may be a surprise to you that there are questions asking about mental health, but there is clear evidence that real physical pain can develop from under-managed or mismanaged depression and anxiety. So, be honest. Mental health is just as important to your health-wealth portfolio as your physical health is.

--What hurts you physically? This could be a joint pain (knee or elbow or back); it could be a dull pain in your abdomen…
--Does this pain keep you from enjoying any activities or get in the way of your work?
--Do you look forward to each new day, or have you felt anxious or depressed more than 5 days of the previous month?
--Do you get frequent headaches? If so, how do you treat them?
--Does your heart ever race?
--Is your vision clear and focused (if you wear glasses/contacts, consider how well you see with them).
--Do you have any unusual lumps, bumps or redness?
--Do you get frequent colds? Sinusitis?


8. Be Honest About Your Risks

The CEO also identifies the risks to the corporation; in this case you are the corporation. How efficiently is the organization running? What are the risks and how are they managed? You'll need to refer back to the family and personal risks that you identified early in this chapter. This section focuses your thinking about the risks you have inherited (genetic risk) and the risks you may be taking. These are not diseases you currently have, but, instead, could develop into conditions if you don't pay attention. Do you wear a seatbelt in the car at all times? Do you bike or motorcycle with a helmet at all times?


7. Be Honest About Your Actions

You ARE the Chief Executive Officer (CEO) of your health assets. You hold the data and the power to improve the investments you make in both the health and wealth portfolios. It's time to consider the actions you do to improve the “healthy/active” section of the healthcare continuum.

This is the first section of the health care continuum. In this section, you look at your current state of health through the lens of “what indicators do I have that I am in good health and what actions am I doing to preserve that health?”
In order to understand exactly how your actions are affecting your health checkbook, think about the questions asked below. RECORD your answers and manage what you measure.
--What actions do you currently do that preserve or improve your health? [example: I record all the food I eat every day…]
--Exercise (how often, how long)
--Sleep (how many hours per night)
--Preventive health check ups (how often) [ideas: breast self-exam, prostate screen, etc.]
--Nutrition (maintain a proper weight, eat low fat foods, …)
--Community (connected to a good support network—family, friends, church, etc.?)
--Maintain scheduled follow-ups and visits with physicians
--Limited alcohol use (how much do you drink each day, each week?)


6. Pause, And Reflect

It's time for some reflection, to reinforce what you've learned. You have done a lot of thinking, measuring, and consideration to this point. Now, it's time to record your thoughts and ideas for action.
It may seem “hokey” to create a written account of your actions and emotions to them. However, by keeping a journal, you begin to see patterns of thoughts and behaviors that either cause you great joy or perhaps great grief. By identifying those positive or negative patterns, the opportunities for change become apparent. If you regret eating the ice cream each time that you buy it, and you record this regret, you will see it pop up and know that, in this case, it's time for you to stop buying so much ice cream. If not taking your medicine is causing you to feel poorly and become distracted at work, then clearly taking the medicine is the better action. If not having energy to be with your family or go for a 2 mile walk is distressing you, then you will find the time to go for the walk…if you have written it down.
Remember, you can't manage what you don't measure. You are measuring the efforts—positive and negative—that you are making towards more health and wealth. Write it down and see if there is a credit balance in either your health your wealth account.


5. Consider Your Current Health In New Ways

When you look at what you are currently doing, and put the actions into a continuum, you can see where you need to improve. It's usually cheaper to improve in the categories that don't involve medical costs, such as health promotion and some risk management steps. Again, get the paper or the computer ready to record your answers
-- Healthy Active: Are you doing what you can to promote your health? Do you get the preventive screenings, eat healthfully and meaningfully, exercise for improvement, practice stress reduction?
-- At Risk: Do you know your risk factors (you should by now!) and are you keeping a watchful eye, managing them with your physician's advice?
-- Symptomatic: Have you recently been diagnosed with symptoms of disease, such as knee pain that could be arthritis, or high blood pressure? Are you taking care of the symptoms before they become acute or long-term?
-- Acute Illness: Are you being treated for an illness that has recently developed, such as bronchitis or low back pain? Is the illness keeping you from your daily functioning? Have you sought medical advice, and, just as important, are you following the advice to get well?
-- Chronic Disease: Have you been diagnosed with an illness that will probably require lifelong care, such as asthma, high blood pressure, or cancer? Are you following the medical advice for managing your condition, including checkups, medication, therapy, stress reduction, and other interventions? If not, why not? Have you discussed this with your physician (medical consultant)?


4. Consider Your Health By The Activities And People You Enjoy

Do you love to be outdoors? Do you adore chocolate? Then it's important that you don't give up your passions, but, instead, use them to your advantage. You need to think hard about short-term and long-term actions that increase or decrease your assets, it's true. But you also want to live a life that's enjoyable, and only you can define that joy.
Start to think about the people and activities you really enjoy, that you look forward to. Do they bring you pleasure over and over? Is there any regret—like the incessant increase on the scale due to the momentary pleasure of ice cream? Is this a “cost” that you are willing to bear? Are you prepared to workout 30 more minutes each time you eat the ice cream? If not, are you prepared to buy increasingly larger clothes? If you buy the clothes, will you have less dollars to put into a savings account? How about your blood pressure from all the excess calories and fat? Are you prepared to be on blood pressure medication the rest of your live?
Now you begin to see that each action has a resultant health AND wealth consequence. Since you are responsible for both your health and wealth, you need a plan to manage consequences. Perhaps eating an ice cream cone once per month, while weekly putting the dollars saved from purchasing new clothes or co-pays for medication, will keep you on track. Perhaps scheduling a 40 minute walk with your oldest child, sharing thoughts and plans, can help you to stop eating so much ice cream….and increase your family time and exercise time.
You want to plan for the right outcomes, including improved health and wealth. Start writing down the “Value” of your family and activities that you want to enjoy….and see how, when you do the “depletion” activities, you are also depleting the enjoyment you get for the long term.


3. Know Your Numbers

It's just as important—if not more so—to know the numbers that indicate your health is in good shape. Here are some numbers that every man and woman should know. We are also including the frequency of checking up on them; are you getting them measured when you should?

1. Blood pressure: Normal is 120/80; you are recommended to have a blood pressure test every 2 years unless you are diagnosed with high blood pressure [in which case your physician will tell you how often to have the test]; after age 40, every year
2. Fasting Cholesterol: Normal Total cholesterol should be under 200. The HDL (high-density, the good component) should be over 50 for women, over 40 for men. The LDL (low –density, non-desirable component) should be 100 or lower. The Triglyceride measure should be less than 150. You should have your cholesterol tested every 5 years, unless you have high cholesterol, high blood pressure, diabetes, or other chronic conditions, in which case the test should be performed yearly.
3. Blood glucose: this test for high blood sugar is normal if the fasting score is less than 110. You should be tested every 1-3 years, based upon risk or chronic conditions, such as high blood pressure or high cholesterol.
4. Waist: the measure around your waist is a good indicator of other chronic risks, and your normal measure should be under 40 at navel (men), and under 35 at navel (women). You should be re-measured every 1-2 years, or if there is a considerable weight gain in the interim.
5. Colon screening: a colonoscopy is recommended folks over 50, and the “normal” result is negative for cancer or polyps. You should have the screen regularly after age 50 (typically every 5-10 years),unless the physician indicates otherwise.
6. Gynecologic exams: women need to have mammograms yearly after age 40; PAP smears every 1-3years if you are sexually active or over age 21,
7. Prostate exam: Men should have a prostate exam every 1-2 years unless under treatment for prostate cancer or benign prostate hypertrophy (BPH) [enlarged prostate].
8. Bone mineral density: women should be screened beginning at age 40, yearly after age 65 or if on certain medications.

These questions help you look at your health management behaviors, including prevention and regular check-ups, showing you what is recommended and providing information for considering your next steps. The more answers that you “match,” the better you are doing. This is not a comprehensive list. In fact, it's important to consider your health across a wide variety of variables, including self-care, prevention/screenings, physician care, lifestyle behaviors, and stress/rejuvenation.


2. Know Your Personal Health...Today

Your age, sex, race and health history all play a part in your current health profile, a picture of your health assets. Take a high-level picture of your health as of today. Remember, the idea here is to begin to show you where you can make some new decisions to impact your personal health.
1. What illnesses or diseases are you currently being treated for? List them all, as well as the treatments (prescriptions, therapies, etc.) that your doctor recommends. Note, too, if you are sticking with the plan recommended by your doctor—we call this adherence. Are you adhering to his or her treatment plan? If so, that's great! If not, why not? Better to get a grip on these answers right now….
2. What positive health steps do you take? Do you exercise regularly, eat balanced meals, curb your alcohol, and avoid tobacco? Do you wear your seatbelt at all times in the car/train/bus? Do you eat 5-8 servings of fruits and vegetables every day? Do you maintain a recommended body weight?
3. What is your waist measurement? If you are a man, is it under 40 inches? If you are a woman, is it under 35? if not, you could be piling on abdominal fat, a risk factor for heart disease, diabetes, some cancers, and other debilitating diseases--diseases with high costs that will deplete your health-wealth portfolio.


1. Benchmarking Your Family Health

In order to make a sound decision on new actions, you must first understand what the current state of your health, including what health risks or poor behaviors can be improved.
You could call this the “beginning balance” in your checkbook. There are many ways to begin this process, through your company health risk assessment, through your insurer's web-based information system, and more. A simplified snapshot can be developed right here:
Know your health history. The best place to start is at the beginning—take a close look at the genetic blueprint that came with you. Your family history has an effect on your overall risk and your potential to develop disease. You can't change your age or race, but you can watch for indicators that your health assets (your body and symptoms) are changing and take direct action to improve.
Begin the assessment by answering a few family questions, listed below. If you don't know the answers, it's a great time to have the conversation with family members who may have that information. These will begin to give you a picture of your risk for future disease.
1. Mother/Father Still alive? If so, is she/he receiving care for any diseases? If deceased, what did she or die of, and at what age?
2. If your grandparents are no longer living, what caused their death? Do you know if they were being treated for any other diseases?
3. Have you lost any siblings—at what age, and from what disease?
4. What other diseases run in your family? Who had them, and at what age? As an example, a younger brother may have been diagnosed with prostate cancer that is now cured. Still, it's important to note that the disease has occurred.

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