DIALYSIS DEFINED

DIALYSIS DEFINED
Dialysis is the clinical purification of blood by dialysis, as a substitute for the normal function of the kidney.
It's the process of removing waste products and excess fluid from the body. Dialysis is necessary when the kidneys are not able to adequately filter the blood.
Dialysis allows patients with kidney failure a chance to live productive lives. there are two types of dialysis: Hemodialysis and Peritoneal dialysis.
Each type of dialysis has advantages and disadvantages. Patients can usually choose the type of long term dialysis that best matches their needs.

Dialysis is the medical procedure to remove waste or toxin from the blood and adjust fluid and electrolyte imbalances by utilizing rates at which substance diffuse through a semipermeable membrane:

a: The process of removing blood from artery (as of a kidney patient), purifying it by dialysis, adding vital substances, and returning it to a vein- called also hemodialysis.

b: A procedure performed in the peritoneal cavity in which the peritoneum acts as the semipermeable membrane- called also peritoneal dalysis

During hemodialysis, you will be hooked up to a machine that takes over the kidneys' job of filtering blood.
Before the first session, the doctor will need to create an entrance into one of your vessels so your body can be connected to the filtering machine during each visit. this is called a vascular access. It is a place on your body where blood cam be removed and then returned. this can be done by;

• connecting an artery to a vein to create a larger blood vessel area, called a fistula 
• joining (grafting) an artery and vein together using a soft plastic tube
• inserting a thin plastic tube into a large vein in the neck or groin area of the leg; this type of access is temporary. 

When your kidneys are healthy, they clean your blood. they also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, you need treatment to replace the work your kidneys used to do. Unless you have a kidney transplant, you will need a treatment called dialysis.

Experts recommend creating an access weeks or moths before your first dialysis session so it ha s a chance to heal properly before using it.

How long each hemodialysis session lasts depends on;

• How well your kidneys work
• how much fluid you gain since your last dialysis session
• how much waste has gathered in your blood since lst dialysis session 
• your weight
• the type of hemodialysis machine being used

SIDE EFFECTS OF DIALYSIS

The kidney dialysis treatment itself usually does not cause any pain or dicomfort. However, some patients may develop low blood pressure, which can lead to headache, cramping, nausea, and vomiting. This usually goes away after a few treatments.

If you are on dialysis, you may also feel like:

• You have less energy. Dialysis can cause you to feel tired.
• You are depressed. depression is a common problem among many patients on dialysis. but it can often be treated. Talk to your health care provider if you are feeling depressed.
• You may also feel like you have less time to get things done. Kidney dialysis require strict scheduling and adjustments to lifestyle, which can disrupt your ability to work or enjoy everyday activities. This may be frustrating for you or your family. Counselors may be able to help you cope.

Most patients on hemo-dialysis require treatments three times a week  for three to five hours or more a day.
this is often done at a dialysis center or hospital, although some patients on hemodialysis- along with a family member or friend- maybe taught how to perform the procedure at home. Your health care provider will discuss your options and determine which setting is best for you.

Patients who are on peritoneal dialysis have a little more independence, since this type does not have to be done at a clinic. It can be performed while you go about your daily activities or sleep.

Catheter- related infections are common concern for people who are on peritoneal dialysis.
Keeping your catheter area clean and bacterial-free helps prevent dangerous infection. If an infection affects the peritoneal cavity, you will not be able to continue with peritoneal dialysis.

Tips for preventing an infection include:

• Always wash your hands before touching your catheter,
• Wear a surgical mask when performing an exchange
• Use an antiseptic wipe to clean your access site
• Check your supplies for signs of contamination

WHAT IS A RESIDENTIAL CARE HOME.

WHAT IS A RESIDENTIAL CARE HOME.

A residential care home is a long-term care facility devoted to providing lodging, meals and care to elderly and/or disable adults. also known as adult family homes. board and care homes or personal care homes, residential care homes are small in scale, typically housing no more than 10 residents at a time.
Most care homes are located in single-family homes in residential neighborhoods. Residents share common areas such as a living room and dining room, but will generally also have their own private room.

When to consider a Residential Care Home

Residential care homes are occupied by seniors with a variety of ages, health conditions and genders.
Many residents require assistance with basic self-care, such as dressing and bathing, and need 24-hour supervision. This intensive level of care is often hard for a senior's family to provide within the home, especially if family members do not live nearby.
A decline in physical mobility may also necessitate a move to a residential care home.
residential care homes are designed with seniors' needs in mind and can make getting around much easier and safer fpr elderly residents.
Declining health is another big reason many seniors move into a residential care home. Care home workers are trained extensively in emergency response as well as in maintaining health for seniors with a variety of chronic conditions such as diabetes, heart disease, Alzheimer's or multiple sclerosis. the staff may also offer physical therapy or other rehabilitative services on site.
Recovery process is easier and faster in the calming familiarity of the similar home environment
Family support and participation: Your loved one also has the control and ability to lead a meaningful , independent life.
Professional caregivers are committed to involving your family in the care process and keeping everyone in clear communication. This includes routine calls or visits with your loved one at no additional charge.
Your peace of mind: When you bring these professional caregiver into your loved one's life, you're doing more than premium care for your loved one. you'e also ensuring peace of mind for you.

HOW TO CHOOSE A QUALITY RESIDENTIAL CARE HOME

HOW TO CHOOSE A QUALITY RESIDENTIAL CARE HOME

The best residential care homes will emphasize their efforts to promote and maintain an independent and healthy lifestyle as much as possible, rather than simply taking care of basic medical needs. A good home should offer a wide range of community and social activities in addition to basic services.
It is important to look for a residential care home that provides many levels of care. once a senior has moved into their new home, it will be best if they can stay there as their needs increase. Fortunately, many residential care home offer this feature.

Quality homes will offer a high quality of life for their residents, including spacious, well-decorated rooms and communal areas, handicap-accessible design, and healthy, appetizing food.

Paying for a Residential Care Home

Most residential care home will charge an "all-inclusive" monthly rate that includes the cost of care, room, board, activities and supplies,. Seniors who resides in a residential care home may often pay less over the course of their stay ae compared to a larger assisted living community, which offers the same type of services, because mane assisted living communities charge extra fees for care services. The average monthly cost of an assisted living community in the U.S.A. in 2010 was $3293.00 although priced vary widely across the country.
While using the personal savings of a senior and/or family is the most common way to apy for care, residential care homes are more than other types of long-term care facilities to accept Medicaid. Veterans benefits and long-term care insurance are other ways to finance a stay in a residential care home.

considering your options.

Chances are if you're researching senior care, you've heard a lot about senior housing options such as a nursing homes, assisted living, adult day care, retirement community, or continuing care retirement community, 

These elderly care options all have unique benefits, however, at home care is often the preferred choice for seniors who wish to age in place in their own home. your financial, social, and health situation will often determine which environment you choose.

Depending on your loved one's needs, you may opt for him or her to receive non-medical in home care to provide them with services throughout the day when you're unable to attend to their needs.

When families choose the in home option of aging they are often choosing to keep the family together.

Residential care homes are a great choice for seniors because they offer the dignity and fulfillment that comes with independence, while also ensuring safety, health, dignity and convenience.

 

 

YOUR GREATEST WEALTH IS YOUR HEALTH

YOUR GREATEST WEALTH IS YOUR HEALTH

Health is wealth. There is nothing  in our life that is more valuable than good health. without health there is no holistic, no happiness, no hope and no peace. 
A healthy person with bad health cannot fully enjoy the pleasure of being wealthy.

Health is more than money, and sweeter than honey. Money cannot buy health and happiness. A healthy person remains in a state of bliss and happiness.

A person with sound health enjoys a stable life that also include a healthy mental condition. Our health depends upon several factors, such as food, pollution, sleeping habits, mental condition, air, water, and sunlight. Morning walks and physical exercises are very helpful for the fitness of our mind and body.
We should take proper care of our health, body, spirit, and soul, so that we can enjoy the complete holistic life offers.

When we are ill, our bad health robs us of sound sleep and appetite. life becomes a miserable for one and a burden for significant others. On the other hand, a healthy person enjoys good food and sound sleep.for him the world is a beautiful place. and life is good.

A healthy person feels the goodness of life and works hard to realize his dreams. He never complains.
He is always happy and cheerful. Though, he may be poor, he may have to work very hard to earn his living, but even the richest man would envy him for his good health.

It is your primary responsibility to take care of yourself, live healthy, eat healthy food, be active, drink enough amount of water, avoid smoking and alcohol,  exercise regularly, avoid accident and injury to self and others.

YOU ARE IN CHARGE IN CHARGE DON'T MESS IT UP !

ARTHRITIS AND YOU

WHAT IS ARTHRITIS

Painful inflammation and stiffness of the joint.
Arthritis is inflammation of one or more of your joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age.
The most common types of arthritis are osteoarthritis and rheumatoid arthritis.
Typically, pain, aching, stiffness and swelling in and around one or more joints characterize rheumatic conditions. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body.
Rheumatoid arthritis and lupus, can affect multiple organs and cause widespread symptoms.

Although the word "arthritis" means joint inflammation, the term is used to describe around 200 rheumatic diseases and conditions that affects joints, the tissue that surround the joint, and other connective tissue.

The most common form of arthritis is osteoarthritis. Other common rheumatic conditions include gout, fibromyalgia and rheumatoid arthritis.

symptoms

The symptoms of arthritis usually appear gradually but they may also occur suddenly. arthritis is most commonly seen in adults over the age of 65 but it can also develop in children and teens.
Arthritis is more common in women than men and i those that are overweight.

PAIN: Arthritis pain can be constant, or may come and go.
SWELLING: The affected joint may become red and swollen, feeling warm to the touch
STIFFNESS: Stiffness is a typical arthritis symptom, especially when waking up in the morning or after sitting at a desk or riding in a car for a long time.
JOINT STIFFNESS: Difficult moving a joint or getting up from a chair should not be hard or painful.

DISABILITY
Impairment in the ability of people with arthritis to perform essential daily tasks may interfere with their work, their purpose in their community, or the care they can provide for their family.

PHYSICAL EXERCISE

Physical activity and exercise have been shown to benefit people with people with arthritis by improving pain, function and mental health.

RISK FACTORS:

Certain factors have been shown to be associated with a greater risk of arthritis. Some of the risk factors are modifiable while others are not. 

NON- MODIFIABLE RISK FACTORS:

AGE: The risk of developing most types of arthritis increases with age
GENDER: Most types of arthritis are more common in men women. Gout is more common in men than women.
GENETIC: specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis (RA), systemic lupus erythematousus (SLA) and ankylosing spondylitis.

SYMPTOMS OF DEPRESSION

WHAT ARE SYMPTOMS OF DEPRESSION?

• Difficulty concentrating, remembering details, and making decisions
• Fatigue and decrease energy
• feelings of guilt, worthless, and/or helplessness
• feelings of hopelessness and/or pessimism
• insomnia, early morning wakefulness, or excessive sleeping
• irritability, restlessness
• loss of interest in activities or hobbies once pleasurable, including sex
• overeating or appetite loss
• persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
• persistent sad, anxious, or "empty" feelings
• thoughts of suicide attempts

WARNING SIGNS OF SUICIDE INCLUDE:

• TALKING ABOUT KILLING OR HARMING ONE'S SELF
• expressing strong feelings of hopelessness or being trapped
• an unusual preoccupation with death or dying
• acting recklessly, as if they have a death wish (e.g. speeding through red lights)
• calling or visiting people to say goodbye
• getting affairs in order (giving away proved possessions, tying up loose ends.)
• saying things like "everyone would be better off without me" or "I want out"
• A sudden switch from being extremely depressed to acting calm and happy

depression carries a high risk of suicide.anybody who expresses suicidal thoughts or intentions should be taken very, very seriously. Do not hesitate to call your local suicide hotline immediately. call 1800-784-2433 or 1-800-273-8255 or the deaf hotline at 1-800-799-4889

HOW DEPRESSION AFFECTS

THE DIFFERENT FACES OF DEPRESSION.

Depression often looks different in men and women, and in young people and older adults. an awareness of these differences helps ensure that the problem is recognized and treated.

Depression in men.

Depressed men are less likely than women to acknowledge feelings of self-loathing and hopelessness. instead, they tend to complain about fatigue, irritability, sleep problems,, and loss of interest in work and hobbies. Other signs and symptoms of depression in men include anger, aggression, violence, reckless behavior, and substance abuse.

Depression in women.

Rates of depression in women are twice as high as they are in men. this is due in part to hormonal factors, particularly when it comes to premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD) postpartum depression, and postmenopausal depression. As for signs and symptoms, women and more likely than men to experience pronounced feelings of guilt, sleep excessively, overeat, and gain weight. women are also more likely to suffer from seasonal affective disorder.

Depression in teens 

While some depressed teens appear sad, others do not. in fact, irritability- rather than depression- is frequently the predominantly symptom in depressed adolescents and teens. a depressed teenager may be hostile, grumpy, or easily lose his or her temper. unexplained aches and pains are also common symptoms of depression in young people.
left untreated, teen expression can lead to problems at home and school, drug abuse, self loathing- even irreversible tragedy such as homicide violence or suicide, But with help, teenage depression is highly treatable. 

depression in older adults

The difficult changes that many older adults face- such as bereavement, loss of independence, and health problems- can lead to depression, especially in those without a strong support system. however, depression is not a normal part of aging.

Postpartum depression

Many new mothers suffer from some form of the "baby blues." postpartum depression. Postpartum depression usually develops soon after delivery.

depression carries a high risk of suicide.anybody who expresses suicidal thoughts or intentions should be taken very, very seriously. Do not hesitate to call your local suicide hotline immediately. call 1800-784-2433 or 1-800-273-8255 or the deaf hotline at 1-800-799-4889

NEW WARNING ON OVER THE COUNTER PAINKILLERS. (OTC)

New warning on over the counter painkillers (OTC). NSAIDs are among the most common pain relievers in the world. And lately, they're among the most controversial. 
If you are one the more than 29 million Americans who regularly use painkillers like ibuprofen and naproxen - including over-the-counter brands like advil ,motrin and aleeve - the government has new words of warning for you: Using these drugs increases your risk of heart and stroke.
Studies reviewed  by a Food and Drug Administration advisory panel last year found mounting evidence that NSAIDs, or non-steroidal anti-inflammatory drugs, increase the risk of heart attack, stroke and heart failure whether or not a person has heart disease. Those with a history of heart problem are at the highest risk "no matter who you are, your risk increases," says Bruce Lambert director of the of the Center for Communication and Health, who specialize in drug-safety communication. 

NSAID - or nonsteroidal anti-inflammatory drugs -- are among the most common pain relief medicines in the world. Every day more than 29 million Americans use them to soothe headaches, sprains, arthritis symptoms, and other daily discomforts, according to the American Gastroenterological Association. And as if that wasn't enough, in addition to dulling pain NSAIDs also lower fever and reduce swelling.

But how do those little pills do so much? And if they're so good in some ways, why do they also raise the risk of heart problems in some people? The answer is complicated. Even researchers don't fully understand how NSAIDs work.

 A new warning on prescription and over-the-counter NSAIDs will point out that the increased risk can occur even within the first few weeks of taking the drug and might rise with high doses taken for an extended period of time. The new warning does not apply to either aspirin or acetaminophen

RISKS

Most people who use NSAIDs don't have any serious problems with them. But in some -- especially those who need pain relief regularly -- there can be a downside.

• Gastrointestinal Problems

When you swallow a pill, it affects your whole system, not just the part that hurts. So while an NSAID may do a great job of easing your pain, it may also be having other effects -- some of them unwanted -- in other parts of your body.

The most common risk of standard NSAIDs is that they can cause ulcers and other problems in your esophagus, stomach, or small intestine.

• High Blood Pressure and Kidney Damage

How can NSAIDs affect your blood pressure? NSAIDs reduce the blood flow to the kidneys, which makes them work more slowly. When your kidneys are not working well, fluid builds up in your body. The more fluid in your bloodstream, the higher your blood pressure. It's that simple.

If you take NSAIDs in high doses, the reduced blood flow can permanently damage your kidneys. It can eventually lead to kidney failure and require dialysis.

• Allergic Reactions

NSAIDs can also cause extreme allergic reactions, especially in people with asthma. Experts aren't sure why. Many specialists recommend that people who have asthma stay away from any NSAID, especially if they have sinus problems or nasal polyps.

Talk to your doctor before taking an NSAID if any of these risk factors apply to you: You have any of these health problems:

• decreased kidney or liver function, or an uncontrolled liver problem (such as hepatitis)
• ulcer, gastritis (inflammation of the stomach lining) or stomach bleeding now or in the past
• low platelet count
• Crohn's disease or ulcerative colitis
• asthma or chronic lung disease
• reflux disease (also known as GERD), indigestion or hiatal hernia
• high blood pressure, congestive heart failure or a past stroke or heart attack
• You are allergic to aspirin, other NSAIDs, or sulfa drugs, or have nasal polyps (linked to a greater chance of NSAID allergy)
• You take blood thinners or corticosteroids (see “Drug interactions” below)
• You are pregnant, may become pregnant, or are breast-feeding
• You drink more than seven alcoholic drinks per week or more than two in a day
• Your age is 65 or older

Doctors have long warned not to give aspirin to children under age 12, but teens with a virus also should avoid drugs containing aspirin. There is a risk of Reye’s syndrome, a rare but deadly illness that can affect the brain and liver.

 Restrict NSAID's use to more severe cases of pain. If you do take them, stick to the lowest effective dose for the shortest time possible.

 

PAINKILLER OVERDOSE

If you are currently taking an opioid pain medication, here's what you need to know to use it safely and effectively
Older Americans are at high risk of running into trouble for several reasons,
For one, they're more likely to suffer chronic pain and to be prescribed an opioid drug for it. 
Second, the body's ability to clear drugs from the system declines with age, so a safe dose for younger people can be an overdose for older patients.  
The danger is compounded when people are taking several different drugs that have to be cleared through the liver or kidneys - such as medications for heart disease or diabetes - as many older people do. "Adding opioid pain medications to a stew of other drugs is a very risky venture.
One challenge with opioid painkillers is the exceedingly narrow line between benefit and harm h
some chronic pain patients can benefit from low doses of opioids,

Start low and go slow
older adults should start with half or even one-quarter of a standard dose.
the irony is that despite decades of prescribing , researchers still know little about the actual risks and benefits of taking .
we know that people develop tolerance over time, which means you need a bigger and bigger dose.

Tell you doctor about other meds you take
One of the biggest risk factors for overdose and death from opiates is mixing them with alcohol
or other medications. the combination of benzodiazepines (sometimes prescribed for anxiety or insomnia) and opioids is especially hazardous.

Follow up frequently
To monitor how you're doing,your doctor may need to see you frequently, in some cases monthly. Your doctor may also order a urine test to measure opiate levels in your system.
Doctors need a lot of expertise in prescribing and monitoring patients on these drugs. 

Be realistic
 Don't expect any medication to be a magic bullet. Most only ease pain, and all of them have risks. often pain management doctors can't eliminate the pain. But can help people with chronic pain live their lives as fully as possible.Everything comes down to how you are functioning. if your pain medication helps you function, great. If it's making you groggy and you're still in a lot of pain, you need to come off the medication. 

Keep medication safe.
Opioid pain relievers are a frequent target of thieves, who then sell them on the street. 
Store pain killers in their original packaging in a locked cabinet or lock-box, and keep track of how many you've taken.

In conclusion 
What we've learned is that throwing medication at chronic pain isn't going to make it go away.
There are clear risks to using these drugs. Even non-steroidal anti-inflammatory drugs, or NSAID, can be hazardous.
Lastly, learn to live with a certain amount of pain, accept it and try to live as full a life as you can. 
Restrict NSAID use to more severe cases of pain, stick to the lowest effective dose for the shortest time possible.

46 AMERICANS DIE EACH DAY FROM PAINKILLER OVERDOSES

Death for ages 55 - 64 rises 700%
After years of suffering from a degenerative back condition, Betty worried that she was already taking too many pills. But when her doctor reassured her that a long-acting opioid medication called Oxycontin would fight her pain without any negative repercussions,she decided to try it. At first the pills helped.as their effectiveness diminished, though, she had to take more pills to get any relief at all. "within even months I was taking 280 milligrams a day," says Tully, 68, who lives in Chicago. "that's the equivalent of 56 percocets a day. i was completely addicted." 

HOOKED ?

When a new doctor balked at refilling her prescription, she discovered what heroin addicts go through when they can't get a fix. "My body was screaming for the drug. My brain was screaming for it. Health experts have long warned of a growing epidemic of addiction and overdose related to opioid prescription pain meds (morphine, oxycodone and hydrocodone are the most common). 

statistics

Everyday, 46 Americans die from using prescription painkillers, In recent years, older Americans have increasingly fallen victim. Between 1993 and 2012, the rate of hospitalizations for prescription pain pill overdoses increased fivefold among people 45 to 85- much faster than for younger adults, according to the data  from the Agency for Healthcare Research and quality. the rate of overdose deaths for adults ages 55 to 64 soared sevenfold. The group with the highest death rate was 45 - 54 age group, more than four times the rate for teenagers and young adults. And those statistics probably underestimate the true toll the epidemic of pain pills is taking on older Americans. 
fact
If a young or middle-aged person doesn't wake up in the morning, the death immediately looks suspicious and the medical examiner is called in. "But when an older person with multiple medical problems doesn't wake up, death is more often attributed to natural causes, even when the true cause is an accidental opioid overdose. 

who is at risk ?

Older Americans are at high risk of running into trouble for several reasons, 
For one, they're more likely to suffer chronic pain and to be prescribed an opioid drug for it. 
Second, the body's ability to clear drugs from the system declines with age, so a safe dose for younger people can be an overdose for older patients.  
The danger is compounded when people are taking several different drugs that have to be cleared through the liver or kidneys - such as medications for heart disease or diabetes - as many older people do. "Adding opioid pain medications to a stew of other drugs is a very risky venture.

Opioid pain medications can also prove deadly for older patients who have trouble keeping track of their pills. If someone on an 80 milligram dose of oxycodone forgets they took it and takes another, there's a good chance of a fatal overdose, 

Good intention gone bad
Opioid pain medications can help for acute pain- following an injury or surgery, for example, when they provide relief while the body heals, The can also control pain at the end of life. But because of the risk of addiction and overdose, opioids traditionally were rarely prescribed for cases of chronic pain.
That changed in the late 1990s with new campaigns that encouraged doctors to take chronic pain more seriously. 

Backed by the American pain society, the American Academy of Pain Medicine and other professional groups, the campaigns had the laudable goal of encouraging doctors to be more aggressive in relieving chronic pain, which afflicts an estimated 100 million Americans. 
One campaign, called "Pain is the fifth vital sign,"suggested that pain should be considered as important an indicator of health as blood pressure or pulse. But the push for wider use of painkillers was largely financed by drug-makers with a vested interest in making money, and they vastly understated the risks of addiction and greatly overstated the effectiveness of these drugs. Physician were given the impression that the drugs are far safer and more effective for chronic pain than they actually are.

Trick or treat

Between 1996 AND 2002, Purdue pharma, the maker of Oxycotin,funded more than  20,000 educational programs for doctors, many of them promoting long-term use of opioids for chronic pain.
For more than a decade, we were told that these medications are safe and effective. 
The campaign worked. over the next 15 years, the rate of opioid pain reliever use more than doubled in the U.S. consumption of oxycodone !


CULLED FROM AARP BULLETIN SEP.2015

HELP PREVENT MEDICAL MISTAKES:

Most diagnostic errors occur because doctors lack the patient,'s complete medical history.

I always urge people to learn their full family medical history, because it helps doctors detect conditions that can be hereditary, like heart disease and cancer. You don't want to be so busy that you forget to your own health history. Most diagnostic errors occur because doctors lack the patient,'s complete medical history.

You have the right to access your health information.

call any doctor you have seen in the past 5 years (if you can back further eve better) and ask for your medical records. these files contain much more than just your vitals; they include consent forms, physician's orders, test results, pathology reports, and immunization records. the information could help specialists avoid repeat testing (and spare you unnecessary radiation from scans) or connects the dots to a diagnosis another doctor might have missed. You may have to fill out some paperwork or even pay a small fee (for postage or copies of x-ray or MRI films). but don't let that deter you.

Get second opinion if you still have the time

Unless you're being wheeled into the operating room as you read this, seeking a second opinion or conducting your own additional research might be your best best. Americans never do so, yet research suggests that in up to 30 percent of pathology cases, second opinion can lead to a correct diagnosis.

Search  : Stop worrying that you'll offend your doctor. Smart physicians know that smart patients seek out other pints of view before making major decisions. Begin your search for a second opinion by contacting local chapters of medical associations that specialize in your condition - for example, the American diabetes association or the Lupus Foundation of America. They can help connect you with specialists who practice in your area. what should you do if your first two doctors don't agree? Get a third opinion.

White coat silence. 

Some physician whip through appointment in the time it takes to get a coke from the vending machine, but there need for speed isn't the only thing causing quick visits.there's also a phenomenon know as white-coat silence,which refers to patients' tendency to clam up in the presence of a doctor.

one reason people don't ask questions is that they fear being seen as difficult. Yet a lack of communication

could lead doctors to mistake your silence for comprehension when they explain test results or procedures.
Ask, and ask and ask questions;  it's your appointment ask question. You have already been charged for it !
List all the questions you'll like to ask, and make two copies-- one for you and one for the doctor. That way you won't forget important queries, and your doctor will know what information you want to cover. I also suggest bringing a back up: Ask a family member or a friend to go with you to an appointment. Not only will this person serve as a second set of  eyes and ears, she/he may have questions you would never think to ask.
Safe medication: Two thirds of patient visits end with the doctor pulling out the prescription pad, It's no wonder, then, that more than 10 percent of Americans are currently taking five or more medications. that's a lot of pills to keep straight.
According to the American Food and Drug Administration (FDA), medication errors (like receiving the wrong dose or taking drugs that don't mix) cause at least one death each day and account for about 103 million injuries a year- a truly alarming figure, considering that such casualties are largely preventable.
if you are taking it, take it with you, (including over the counter supplements) or better still snap pictures of your prescription labels with you camera phone and bring them to your appointment.
take advantage of your pharmacist, she's in best position to sound the alarm on potentially dangerous drug interactions.

Is there another option? 

So let's assume you've received the right diagnosis. there are several alternatives for care , often ranging from the conservative (wait and see) to the aggressive (surgery), and each approach comes with its own risks and benefits. mind you, doctor don't always do a good job of informing you of all your choices. and that can lead to what's known as 'preference misdiagnosis'- when you doctor makes an assumption about which treatment you will want and as result, presents you with only a narrow range of options. 

before signing off on any treatment plan, request information about all available options. One choice may not be better than the other; what does matter is finding the path that best fits your life. says DR Oz