America's Top Physicians

Finding A Top Physician

Choosing a Physician is an important decision. Thus, our goal is to assist you in making that decision.

First of all, when selecting a Physician, you may want to begin your search several different ways:

       Ask family, friends, neighbors and/or co-workers.

Contact your local Chamber of Commerce or Better Business Bureau for reputable Physicians that specialize in the area of medicine that you have a need for.

Contact your city, county or state medical agencies for names of qualified Physicians. Contact and ask for referrals from medical associations. Many are listed in this publication.

Ask your family doctor. He or she is in constant contact with all kinds of health care professionals and will be able to provide you with recommendations.

We recommend that you interview the Physician and ask the following:

How long have you been in practice?

Is your staff friendly and accommodating?

What are the procedures if we need a doctor in the middle of the night or on a weekend?

Do you have an associate that covers for you when you are not available?

Do you have more than one office and if so, how is your time divided between offices?

What kind of continuing education do you utilize?

Do you accept phone calls during office hours?

How do you stay current on the latest drug prescriptions available and medical testaments?

What types of insurance coverage do you accept?

How do you handle billing? Do you require payment at the time of visit?

Discuss your family medical history and particular problems you are concerned about.

After you have consulted a few Physicians you should have a good idea which one you felt most comfortable with and best answered your questions.

How Physicians Were Selected

Consumers' Research Council of America has compiled a list of Physicians throughout the United States by utilizing a point value system. This method uses a point value for criteria that we deemed valuable in determining top health care professionals.

The criteria that was used and assessed a point value is as follows:

Experience:

Each year the Physician has been in practice

Training:

Education and Continuing Education

Professional Associations:

Membership in Professional Medical Associations

Board Certification:

Completing an approved residency program and
passing a rigid examination on that specialty

Simply put, Physicians that have accumulated a certain amount of points qualified for the list. This does not mean that doctors that did not accumulate enough points are not good Physicians; they merely did not qualify for this list because of the points needed for qualification.

Similar studies have been done with other professions using a survey system. This type of study would ask fellow professionals who they would recommend. We found this method to be more of a popularity contest. For instance, professionals who work in a large office have much more of a chance of being mentioned as opposed to a professional who has a small private practice. In addition, many professionals have a financial arrangement for back-and-forth referrals. For these reasons, we developed the point value system.

Since this is a subjective call, there is no study that is 100% accurate. As with any profession, there will be some degree of variance in opinion. If you survey 100 patients of a particular Physician on their level of satisfaction, you will undoubtedly hear that some are very satisfied, some moderately satisfied and some dissatisfied. This is really quite normal.

We feel that a point value system takes out the personal and emotional factor and deals with factual criteria. We have made certain assumptions. For example, we feel that the more years in practice is better than less years in practice; more education is better than less education, being board certified is better than not being certified, etc.

The Top Physician list that we have compiled is current as of a certain date and other doctors may have qualified since that date. Nonetheless, we feel that the list of top Physicians is a good starting point for you to find a qualified family health care specialist.
No fees, donations, sponsorships or advertising are accepted from any individuals, professionals, corporations or associations. This policy is strictly adhered to, ensuring an unbiased selection.

Immunization

Immunization is a method of developing resistance within the human body for specific diseases using microorganisms that have been killed or modified. Immunization is also known as vaccination or inoculation. Immunization has drastically reduced the number of serious and deadly diseases. The success of vaccines speak for themselves. In 1962, the year before measles vaccine was introduced, there were over 500,000 cases reported. Currently less than 100 cases per year are now reported. The number of cases of Meningitis in the United States for children and infants has dropped 96% since the the vaccine was introduced in 1988.

A vaccine may consist of a living organism that have been purposely weakened or altered. The microorganisms have been modified enough so that the human body will create immunity and not get the actual disease. The theory of vaccinations are based on the ability of a person's immune system to respond much faster and more effectively to a microorganism the second, third or fourth time that the immune system confronts the invading organism. Some immunizations protect a person for their entire life. Many other vaccines, such as Tetanus, require booster shots at required intervals to provide continued protection.

The American Academy of Pediatrics and the U. S. Public Health Service recommends a series of immunizations beginning at birth. For your convenience we have provided a Recommended Childhood Immunization Chart in a separate chapter. Check with your Pediatrician for any risks and side effects associated with the vaccines that could affect your child.

Hepatitis A

Hepatitis A is a disease that affects the liver like other types of Hepatitis. Hepatitis A is a caused by a virus found in feces and bowel movements and is spread through personal contact, or drinking and eating contaminated food or water.

Unlike Hepatitis B, Hepatitis A does not cause long-term illness or liver damage. Signs of Hepatitis A include fever, vomiting, stomach pain, loss of appetite, tiredness, dark urine and jaundice (yellowish tone to the skin and eyes). Blood testing is required to determine which type of Hepatitis is present.

Hepatitis A vaccine requires two doses. The first dose can be given to children two years of age or older and the second dose should be given six to eighteen months after the first dose.

Hepatitis B

Hepatitis B is a disease that affects the liver. Some people who have the virus Hepatitis B never feel sick, while others have symptoms that can last for a few weeks. These symptoms include jaundice (yellowish tone to skin and eyes), pain in muscles, pain in joints, vomiting, diarrhea, loss of appetite, and tiredness. In the United States alone there are over one million chronically infected with the Hepatitis B virus. Many of these chronically-infected people will suffer from serious health problems such as Cirrhosis or liver cancer. The Hepatitis B virus is the leading cause of liver cancer in the world.

Hepatitis B is spread through contact with body fluids and blood of an infected person. This disease is also spread by sharing personal items like toothbrushes and razors with an infected person. Another way that this disease is spread is through unprotected sex and needle-sharing associated with drug use.

You can protect your child by getting them vaccinated with three doses of the Hepatitis vaccine. A newborn should get the first vaccine between birth and two months old, the second vaccine between one and four months and the third vaccine between six and eighteen months of age.

HIB (Haemophilus Influenza Type B)

HIB disease was the leading cause of bacterial Meningitis in children under five years of age. Approximately 12,000 children contracted Meningitis (inflammation of the covering of the brain) as a result of HIB. About 25% of these children suffered permanent brain damage and close to 5% died.

HIB is a bacterial disease that is spread through the air by coughing and sneezing. When the bacteria enters the blood system or lungs it is then called "invasive" HIB disease. This type of HIB can cause complications that lead to Pneumonia, Arthritis and Epiglottitis. Most of the time this type of HIB occurs in children under the age of five.

Great success has be realized with the Haemophilus Influenzae Type B vaccine. The first vaccine came out in 1985 and soon afterward the disease began to disappear. In 1985 there were over 20,000 cases of HIB and now there are only a few hundred cases per year.

Children should get three to four doses of the vaccine: The first dose is recommended at two months of age, the second dose at four months and the third dose between twelve and fifteen months of age. Children who are over five years old do not need the HIB vaccine.

Polio

Polio is caused by a virus that resides in the throat and intestinal tract. Polio is spread through contact with feces and bowel movements of an infected person. Polio was one of the worst diseases in the past century. In 1916 it had killed over 6000 people and had left over 27,000 paralyzed. Today, there is no Polio in the United States but it is still common in other parts of the world.

Some children who get Polio become paralyzed. This type of Polio is called paralytic Polio. It can start out like a common cold, and soon the victim will develop severe muscle pain. Paralysis starts within the first week and most often affects the muscles in the legs. Some children can recover but most will become permanently disabled. Once contracted there is no treatment for Polio.

Children should get four doses of IPV (Inactivated Polio Vaccine). The first dose should be administered at two months of age, the second dose at four months, the third dose between six and eighteen months and a booster between four and six years of age.

DtaP (Diphtheria, Tetanus and Pertussis)

DtaP is three vaccines, Diphtheria, Tetanus and Pertussis, combined into one. A child needs five DtaP vaccines for maximum protection. The first three shots should be given at two, four and six months of age, the next vaccine at fifteen to eighteen months and a booster between the ages of four and six.

Diphtheria is a bacterial disease that resides in the mouth, throat and nose of an infected person. The disease is spread through the air by coughing and sneezing. This disease was a major cause of childhood sickness and death. In 1920 over 150,000 were infected with Diphtheria and about ten percent of them died. Today there are only a few cases a year.

Tetanus is a bacterial disease that can live anywhere and can be found in soil, dust and manure. Tetanus enters the body through cuts and scratches on the skin. It can get through even a tiny pin-prick but it is more common with deep puncture wounds or cuts. Tetanus produces a poison in the body that causes muscle spasms in the arms, neck, legs and stomach. It has been known to cause such powerful muscle contractions that it will actually break a child’s bones. Tetanus is not contagious.

Pertussis, also known as 'whooping cough', is a very contagious disease and is common in the United States. It is caused by a bacteria that resides in the mouth, throat and nose. Pertussis is spread via the air by coughing and sneezing. This disease causes such severe coughing that it can continue until the air is extracted from the lungs, causing a person to make a loud ‘whooping’ sound as they gasp for air. Children have be known to turn blue from lack of air, vomit and experience problems eating and drinking.

Pneumococcal Disease

Pneumococcal disease is a bacterial disease that kills more people in America each year than all other vaccine-preventable diseases combined. This disease is the leading cause of bacterial Meningitis. Over 200 children die from invasive Pneumococcal disease each year.

This disease is spread through the air by coughing and sneezing. There are over 90 strains of the Pneumococcal bacterium. Pneumococcal disease is the leading cause for all middle ear infections in children. It is becoming more resistant to antibiotics, making the vaccination increasingly important.

Children should get four doses of the vaccine. One dose at two, four and six months of age and the last dose between twelve and fifteen months. It will not prevent all, but many of the ear infections caused by the Pneumococcal bacteria.

MMR (Measles, Mumps & Rubella)

The MMR is a combination of three vaccines in one, Measles, Mumps and Rubella. This vaccine works well and should protect a child for the rest of their lives. Children should get two doses of the MMR vaccine. The first dose should be given at twelve to fifteen months of age and the second dose at any time twenty eight days or more later.

Measles is a deadly disease that kills over one million people a year through out the world. Most children get a rash and a cold and need to stay home for a few days. Approximately ten percent of children with Measles get an ear infection, and five percent will get Pneumonia.

Measles is caused by a virus that spreads very easily to any child that is exposed it. Measles is airborne and is contracted through coughing, sneezing and close-contact conversation. Before the Measles vaccine in 1963 there were over 500,000 cases reported each year and over 3 million cases went unreported. Today there are only a few hundred cases a year.

Mumps is a virus that is spread through the air via coughing, sneezing or close-contact conversation. Children get Mumps through others who are already infected. Common signs of Mumps is swelling of the cheeks and jaw and many sufferers get a headache and fever. Approximately ten percent of children who get Mumps also get Meningitis, but generally Mumps is a mild disease.

Rubella is also known as 'German Measles' and '3 day measles'. Rubella strikes children, teenagers and adults who have not been vaccinated. The Rubella vaccine was first licensed in 1969. Prior to that, in 1965, there were 12 ½ million people who contracted the disease. Today there are only a few hundred cases reported per year. The biggest threat of Rubella is to unborn babies; If a woman gets Rubella during the first few months of pregnancy there is an 80% chance that the baby will have some type of birth defect.

Varicella (Chicken Pox Vaccine)

Chicken Pox is caused by a virus and can be spread very easily from person to person. The virus is airborne and is contracted through coughing, sneezing and close-contact conversation. Chicken Pox is generally a mild disease but serious problems can still occur. The Chicken Pox blisters can become infected and as a result, some children contract Encephalitis (infection of the brain).

A single dose of the Varicella vaccine is recommended for children between the ages of 12 to 18 months. Children who miss this vaccination can still get it up to the age of thirteen. Data suggests that the vaccine is 70 to 90% effective in preventing Chicken Pox and 95% effective in preventing a serious outbreak of the disease.

Immunization Schedule



Birth

1
month

2
months

4
months

6
months

12
months

15
months

18
months

2
years

4 to 6
years

Hepatitis B
Shot 1

Shot 2

Shot 3

HIB
Shot 1

Shot 2

Shot 3

Polio
Shot 1

Shot 2

Shot 3

Shot 4

DtaP
Shot 1

Shot 2

Shot 3

Shot 4

Shot 5

Pneumo
Shot 1

Shot 2

Shot 3

Shot 4

MMR
Shot 1

Shot 2

Varicella

Hepatitis A

Shot 1

Hepatitis A

Shot 2

Shot 2
6 to 18 months after the fist shot

Common Surgical Procedures

Thyroid Surgery
Thyroid experts advise that people over the age of thirty five be thyroid tested. Experts have concluded that women are seven times more likely than men to develop a thyroid problem. Age is also another major factor. Women at the age of sixty have a one in five chance of having a thyroid problem. The post-partum and menopausal periods are times when a woman is most vulnerable to thyroid disorders.
Many symptoms of a thyroid disorder are common symptoms of other health conditions. These symptoms do not mean that you have a thyroid disorder, but you should be aware of them so you can determine if you should be tested by your Physician.

Some common symptoms include:

A high or low pulse rate      Fatigue and exhaustion

Anxiety-Panic Attack

Low sex drive     High or low blood pressure     Insomnia

Heart palpitations     Irregular menstrual cycles

Rapid weight gain or loss despite exercise and diet

Mood swings      irritability

There are various reasons for thyroid surgery. Common reasons for thyroid surgery include:

      When a woman is pregnant and her hyperthyroidism cannot be controlled and regulated by any other means.

When breathing and swallowing is difficult due to enlarged thyroid nodules.

When cancerous cells have been discovered near or on the thyroid gland.

In most cases thyroid surgery is not complicated and the actual surgery takes less than two hours. It is now common for this type of surgery to be performed on an outpatient or overnight basis. There are three types of thyroid surgery performed. They are as follows:

Thyroid Lobectomy:	The removal of approximately one quarter of the thyroid gland
Subtotal Thyroidectomy:	The removal of approximately one half of the thyroid gland
Total Thyroidectomy:	The complete removal of the thyroid gland

Most thyroid patients resume work within seven to fourteen days following surgery. Generally, the only major restriction will be no swimming. You will be encouraged to move about as soon as possible. Eating and drinking can be a discomfort and a soft diet is usually prescribed until it has had time to heal.

Thyroid replacement drugs will almost always be prescribed for the remainder of the patient's life. It is common to be tested a month after starting hormone replacement drugs to make sure that you are not taking too much or too little. A patient following this surgery should carefully watch for signs of hypothyroidism which symptoms include fatigue, feeling run-down, depressed, muscle cramps and weight gain. Good patient/doctor communication and patient follow-up is essential for a good and complete recovery.

Angioplasty

Angioplasty is a procedure performed during a heart catheterization. The atherosclerotic blockages in the coronary arteries are compressed against the vessel wall by expanding a balloon from within the artery. The angioplasty procedure is an invasive method of opening blocked arteries that are restricting and impeding blood flow. When the balloon is inflated, the plaque blocking the interior arterial wall is compressed and remains compressed, clearing space so the blood flow volume can increase.

The angioplasty method is a less invasive procedure as compared to a bypass surgery. Angioplasty has less risk and the recovery period is much quicker. Your cardiologist will tell you if you are a good candidate for this procedure. The cardiologist will take into consideration your age, severity of the blockage and your overall physical condition.

Angioplasty procedures have been performed for the past 25 years. Results show that patients are doing better today because of advanced drug therapies and new advanced techniques that are better able to detect the exact locations of the blockages.

In the early 1990's surgeons started using stents. Stents are tiny wire mesh tubes which are inserted permanently at the location of the blockage. The use of stents have been highly successful in reducing the possibility of arterial collapse and the renarrowing of the artery which is called restenosis. Seasoned doctors who perform this procedure are able to install stents in one or more arteries with a high degree of success.

Coronary Artery Bypass Graft Surgery

Coronary bypass surgery is very successful in relieving angina. This surgical procedure is highly invasive which requires the opening of the chest, routing the blood through a heart lung machine, transplanting new vessels and stopping and restarting the heart. Bypass surgery requires taking large blood vessels from the patients legs, stomach or chest and grafting them to the front and back of the blocked arteries.

During a bypass procedure the heart-lung machine takes over the functions of the heart and lungs. This is done so the heart can be carefully stopped and the surgeon can work in a blood-free environment. The heart-lung machine keeps oxygen-rich blood flowing through the body. It receives the blood and removes the carbon dioxide and other waste products, warms and/or cools the blood and adds oxygen as it pumps the blood through the patient's body. At the conclusion of the bypass surgery, the heart is restarted and the heart-lung machine is disconnected.
New advances in bypass surgery are continuing. A minimally invasive bypass surgery technique is being tested with promising results. This new procedure requires the surgeon to work on the front of the heart through a four inch incision while it is beating slowly. Another type is that the heart is stopped and a surgeon uses a fiberoptic scope that is passed through a 4 ½ inch incision and the surgeon works on all sides of the heart by viewing a video image. This less invasive procedure would be less expensive and requires a much shorter hospital stay.

Rhinoplasty

Rhinoplasty is plastic surgery of the nose. This procedure is very common and you are a good candidate for this procedure if:

The nose is crooked or off-center
Nostrils are excessively wide or flared

A bump or high point on the nasal bridge

The nose is too large for the face

The nasal tip is sagging or thickened/ enlarged

Many surgeons prefer not to operate on teenagers until they have completely stopped growing. Each case is individual and needs to be discussed in detail with your surgeon.

The actual procedure usually takes between one and two hours. Rhinoplasty can be performed under local or general anesthesia depending on what procedure you and your surgeon have decided upon. The skin of the nose is separated from the bone and cartilage and then is sculpted to the desire shape. Many times the incisions are made on the inside of the nose and it depends on each particular surgeon and what needs to be exactly done.

You will experience facial discomfort for the first twenty-four to forty-eight hours. It is common for your face to feel swollen and to have a headache. It is usually recommended to stay off of your feet for the first 24 hours and get proper rest. By applying cold compresses, swelling and aching will be reduced to a minimum. Slight bleeding will occur and blowing your nose is discouraged for the first week.

Arthroscopic Surgery

Until recently, treatment, diagnosis and examinations were difficult in orthopedic injuries. The arthroscope has made it possible for surgeons to treat joint injuries quickly and effectively. The arthroscope is a small fiber optic medical device used for viewing. This high-tech instrument consists of a tiny lens and video with a light source.

The arthroscope is inserted through a very tiny 1/4" incision into the joint. The incision is called a portal. Other portals in the immediate area are used for the insertion of other medical instruments used in the surgical procedure. An Arthroscopic Surgeon can correct and diagnose a variety of problems such as ligament tears, arthritis and other joint-related problems. The portals leave very little scars and many times are unnoticeable.

Gallbladder Surgery

Each year over 500,000 Americans have gallbladder surgery. One type of gallbladder surgery, called a Laproscopic Cholecystectomy, is used in 95% of gallbladder removal surgeries. The surgeon inserts a miniature video camera and surgical instruments through tiny incisions in the abdomen. The video camera transmits images to a video monitor, giving the surgeons a close up and detailed view of the various organs and tissue. While using the camera as his eyes, the surgeon separates the gallbladder from the liver, ducts and other tissue. The cystic duct is cut and the gallbladder is removed through one of the small incisions.

Laparoscopic surgery is preferred since abdominal muscles are not cut. This results in a much quicker recovery and sometimes requires only one night in the hospital. However, an open surgery is sometimes required due to problems. They call this an open surgery because it requires an incision that is 5 to 9 inches long in the abdomen. This is considered a major surgery with up to a one-week stay at a medical facility.

Vasectomy

A vasectomy is a simple surgical procedure that causes sterility. Over 500,000 men in America choose to have this procedure done as a permanent form of birth control. Vasectomy is nearly 100% effective.

A vasectomy makes men sterile by keeping the sperm out of the fluid that is discharged through the penis during sex. The sperm are the male's reproductive cells in men. When sperm meet with a woman’s egg, pregnancy results. The sperm passes through tubes called vas deferens to other glands and mixes with seminal fluids to make semen. A vasectomy blocks the vas deferens so the semen does not contain sperm. Without the sperm a pregnancy can not occur. Men consider a vasectomy for the following reasons:

Their mate's health could be in jeopardy if by a future pregnancy.

They want to enjoy the act of sex without causing a pregnancy.

They do not want a child in the future.

Other methods of birth control are unacceptable.

They do not want to pass on any hereditary illnesses.

It is easier, safer, faster and more cost effective than to
have their mate have a tubal sterilization.

This simple surgical procedure takes about twenty minutes to perform. Your family doctor or local hospital can assist you in finding a surgeon to perform this procedure. Most men will recover with little to no time off work. Many of theses procedures are scheduled on a Friday and the patient can return to work the next Monday morning.

Vasectomy (No scalpel)

The no-scalpel vasectomy was developed in China over 25 years ago. Since that period over 10 million men have had no-scalpel vasectomies. A small puncture is made in the skin with a specially designed clamp, then the vas deferens are clipped and divided. The hole is so small that sutures are not required. There is less bleeding, discomfort, swelling and chance of other complications. Using the no- scalpel technique, the complication rate for a vasectomy procedure has gone down to 0.4% as compared to 3.1% with the standard incisional technique. The no scalpel surgery takes about 12 to 15 minutes under local anesthesia and is an office procedure

LASIK Surgery

LASIK, or "LAser in SItu Keratomileusis" is the most common refractive surgery procedure used to correct poor vision. This procedure is great for people who are tired of wearing glasses or who have a difficult time wearing contact lenses. Many people who are susceptible to getting eye infections from contact lenses will opt for this surgery.

The actual procedure is fast and virtually painless. First, anesthetic eye drops are put in your eye. After a few moments the eye drops will start numbing the nerves of the eye. A suction ring is then placed over the center of the cornea. The suction creates pressure in the eye which is required for the microkeratome to function properly. The microkeratome is a highly sophisticated instrument that is of paramount importance in the LASIK procedure. The instrument has an extremely sharp blade that moves back and forth at a very high speed. It actually shaves a thin layer of the cornea and folds the cornea back. The part of the cornea that is uncut acts as a hinge.

At that point the suction ring and the microkeratome are removed. The next instrument used is the excimer laser. This laser uses a cool ultraviolet light beam to precisely remove very minute pieces of tissue from the cornea to actually reshape it. A properly shaped cornea will focus light into the eye and onto the retina, resulting in clear vision.

The last step is folding back the cornea into its original position. The eyes heal very quickly and vision will improve immediately.

When opting for this procedure, finding a Physician is very important. Even with the highly technical and sophisticated excimer laser and microkeratome, the Physician is still the most important part of the procedure. Therefore, choosing a Physician should take a lot of thought and consideration. Many consumers can be fooled by the clever advertisements they hear on the radio or see on TV. For instance, it is common for vision correction facilities to advertise that they have performed over 20,000 procedures. Although this may be true, it does not mean that the Physician performing your surgeries has done all 20,000 procedures. Therefore, find out how many surgeries the actual doctor performing your surgery has done. We suggest that he or she has done a minimum of 300. We also suggest asking your family Physician or friends for any recommendations when searching for the right surgeon.

Also, feel free to ask your Physician questions; Most healthcare professionals don’t mind. Here are a few questions you may consider asking:

How many procedures have you performed?

How long have you been performing the LASIK procedure?

What is your complication rate for LASIK treatment?

Who will perform my pre-treatment testing?

Who will perform my post-treatment follow up?

Allergies

What is an Allergy?

An allergy is a reaction of the body to foreign substances such as dust, pollen, insect bites, drugs, animal fur, animal excretions, smoke, plants, feathers, cosmetics, chemical pollutants, and various kinds of foods. It is estimated that over 40 million Americans suffer from some type of allergies. It is common for people to think that they have a cold or flu, only to find out that they have an allergy. Many times the symptoms are very similar.

Symptoms generally include watery eyes, sneezing, nasal congestion, itchy skin, rash and upset stomach. Most allergies are reactions to substances that are generally harmless. When your immune system reacts to an allergen that has been absorbed into the body, the body now treats the allergen as a harmful invader and causes the white blood cells to produce antibody molecules called Immunoglobulin E (IgE). When this series of events happens it causes the body to release Histamine, which can cause allergic symptoms such as watery eyes, sneezing and itching.

Diagnosis of Allergies

Allergies are diagnosed from the patient's medical history, skin and patch tests to help identify the allergen. Physicians inject common allergens just below the skin in separate sections to see which substance is causing redness and swelling . This test determines which allergens the person is sensitive to.

Mold Allergies

Mold allergies are very common. The sources of mold in the home are found where there is moisture. Common places are in damp basements, closets, refrigerator drip pans, house plants, air conditioners, humidifiers, garbage pails, shower stalls, toilets, old foam rubber pillows, and plumbing leaks. Humidity promotes the growth of various molds.

Weight Control

Weight control is an important part of our culture. We are reminded daily in our society that being overweight is not "in" or fashionable. Just look at TV or any type of media advertising and you will soon see that being thin and in good shape is what is popular.
Your primary goal should be to have a healthy body. Healthy bodies come in different shapes and sizes. Weight control is just a part of having a healthy body. Other factors include your diet, nutrition and the amount and kind of exercising you are getting. Displayed later on in this chapter is a height/weight chart that will serve as a guideline.

When you see your family doctor, they will check your height, weight, and blood pressure, blood lipids, (cholesterol, triglycerides), and blood sugar (for people with diabetes). All of these involve medical conditions related to weight. Proper weight control and weight management can help provide for a healthy body.

Obesity

Obesity is basically a medical condition that signifies the excess storage of body fat. It is normal for the body to store fat tissue under the skin and around joints and organs. Fat is essential for good health because it provides energy when the body demands it and provides insulation and protection for vital organs. It is the accumulation of too much fat that poses the health problems of obesity. These health problems include diabetes, hypertension, stroke, heart disease and arthritis.

The United States has one of the highest percentages of obese adults. It is estimated that over 36% of adults in America are obese. Obesity is most common among minorities, especially minority females. Over 50% of African-American and Mexican-American women are obese. Over 20% of children between the ages of 6 to 17 fit in the obese category.

A primary concern of obesity is the risk of developing disease. Obese people are twice as likely to develop high blood pressure and over 70% of heart disease cases are linked to excess body fat. Obese women are twice as likely to develop breast cancer and 40% more likely to develop colon cancer. Close to 80% of Type II or non-insulin dependent diabetics are obese.

Obesity is partially determined by genetic makeup. Research has revealed that basal metabolic rate and the size and number of a person's fat cells help in determining the amount of weight loss that is possible. When calories from food intake equal the amount of energy that the body requires to function the weight remains the same. However, when more calories are consumed than the body needs, the body will store the extra calories, resulting in weight gain.

Diet

Diets are the most common treatment for obesity. There seem to be countless diets that are promoted and it is recommended that your weight control diet be supervised by a your family doctor. Most health care professionals will recommend a diet that consists of 1200 - 1500 calories per day. People who are over 40 pounds overweight may require a more aggressive approach and may be put on a restricted diet of 500 to 800 calories per day.

There many types of weight loss medications on the market today but there are also many side effects that include insomnia, anxiety and irritability. Your family doctor can evaluate your particular condition, health issues and can recommend weight-loss medications under the right circumstances. Used correctly, they can be very effective in the treatment of overweight people.

Exercise

Exercise should be an important part of your weight management plan. Calorie reduction alone is not a complete plan will not result in long-term weight loss. Regular exercise is a long-term plan for continuing weight reduction. Exercise will also improve some of the medical conditions associated with obesity which include high cholesterol levels, high blood pressure and diabetes.

A long-term exercise plan sometimes requires lifestyle and behavior modification, which can be hard for many obese people to accept. Successful weight management plans require strong discipline to control eating urges and to implement exercise plans. New habits need to be learned and many old bad habits need to changed, such as food types consumed and unproductive eating habits.

When choosing an exercise program, the person should consult their family doctor. The exercise program will be designed around the person's work capacity, which will be determined by your doctor. Exercise tests using the treadmill or stationary bicycle are the most common ways to determine and measure work capacity. Once your work capacity has been determined, an exercise program can be recommended. The formula will include what your training heart rate should be and how much intensity should be expended during your workout.

An exercise program can be the most important part of your weight management program because it will give you so many other added health benefits. Many studies show a direct correlation between physical fitness and mental achievement.

Weight Chart

The following charts provide healthy weight ranges for different body sizes and builds:

WOMEN

Height Small Frame Medium Frame Large Frame

4' 10" 102 - 111 109 - 121 118 - 131

4' 11 103 - 113 111 - 123 120 - 134

5' 0" 104 - 115 113 - 126 122 - 137

5' 1" 106 - 118 115 - 129 125 - 140

5' 2" 108 - 121 118 - 132 128 - 143

5' 3" 111 - 124 121 - 135 131 - 147

5' 4" 114 - 127 124 - 138 134 - 151

5' 5" 117 - 130 127 - 141 137 - 155

5' 6" 120 - 133 130 - 144 140 - 159

5' 7" 123 - 136 133 - 144 143 - 163

5' 8" 126 - 139 136 - 150 146 - 167

5' 9" 129 - 142 139 - 153 149 - 170

5' 10" 132 - 145 142 - 156 152 - 173

5' 11" 135 -148 145 - 159 155 - 176

6' 0" 138 - 151 148 - 162 158 - 176

MEN

Height Small Frame Medium Frame Large Frame

5' 2" 128 - 134 131 - 141 138 - 150

5' 3" 130 - 136 133 - 143 120 - 134

5' 4" 132 - 138 135 - 145 140 - 153

5' 5" 134 - 140 137 - 148 144 - 160

5' 6" 136 - 142 139 - 151 146 - 164

5' 7" 138 - 145 142 - 154 149 - 168

5' 8" 140 - 148 145 - 157 152 - 172

5' 9" 142 - 151 156 - 160 155 - 176

5' 10" 144 - 154 151 - 163 158 - 180

5' 11" 146 - 157 154 - 166 161 - 184

6' 0" 149-160 157 - 170 164 - 188

6' 1" 152-164 160 - 174 168 - 192

6' 2" 155-168 165 - 178 172 -197

6' 3" 158-172 167 - 182 176 - 202

6' 4" 162-176 171 - 187 181 - 207

Pregnancy

Pregnancy begins when a male's sperm fertilizes a female's egg and it implants in the lining of the female uterus. Pregnancy affects the female's hormonal patterns and this results in one of the first signs of pregnancy, a menstrual period. Other symptoms include breast swelling and tenderness, fatigue, frequent urination, nausea, mood swings and weight gain.

A normal pregnancy lasts approximately forty weeks, or 280 days, after the beginning of the last menstrual period. Sometimes a woman goes into labor before the expected date of birth, resulting in a premature birth. Approximately seven percent of pregnancies result in premature births. Births are considered premature when the baby is delivered prior to 37 weeks of pregnancy.

There are three stages of pregnancy, referred to as trimesters. Since there is forty weeks of pregnancy they are divided into three equal parts.

First Trimester

The first 14 weeks of pregnancy are referred to as the first trimester. The first signs of the pregnancy may be nausea, tenderness and increased size in the breasts, and color of the areola.

2 weeks

The sperm and egg join in the fallopian tube.

3 weeks

The unborn baby is only one-sixth of an inch long but is rapidly developing.
The backbone, spinal cord and nervous system are forming.

4 weeks

The menstrual cycle has stopped.
The amniotic fluid that cushions the fetus begins to form.
Nerve growth begins.

5 weeks

The embryo is the size of a raisin.
The placenta begins functioning.
The neural tube develops that will soon mature into a complex brain.

6 weeks

On the 26^th day the heart begins to beat.
Embryo is now 1/4 inch long.
Major organs start to develop.
Nausea, fatigue and frequent urination begin.

7 weeks

Hands and feet are shaped like little paddles.
Heart has divided into right and left chambers.
Heart is beating @150 beats/minute.
Major muscle system has begun to develop.
Baby now has its own blood type.

8 weeks

Unborn baby is now called a fetus.
Fetus is now 3/4 inch long.
Baby’s head appears much larger.
Baby’s veins are visible.
Ears begin to take shape.

9 weeks

Organs, muscles and nerves begin to function.
Hands begin to develop fingers.
Feet begin to develop toes.

10 weeks

The fetus weighs 1/3 ounce.
Wrists and ankles have formed.
Genitals have begun to form.
Baby's blood is oxygenated through the placenta.

11 weeks

Major organs are fully formed, including liver, kidneys, intestines and lungs.
Baby's head is half the size of the whole fetus.
Fetus is 2" long and weighs ½ ounce.

12 weeks

The brain is fully formed and baby can feel pain.
Eyelids cover the eyes but will not open until the seventh month.
Hair on head has developed.
Kidneys are developed and begin to secrete urine.

Second Trimester

The second trimester is filled with tremendous growth and development. The mother should start to feel better and have more energy.

13 weeks

Baby now has unique fingerprints.

14 weeks

Muscles lengthen and become organized by
kicking and other movement.

15 weeks

Baby now has taste buds.

16 weeks

Fetus weighs six ounces and is 5 ½ inches long.

17 weeks

Circulatory system and urinary tract are working.
Lungs can inhale and exhale amniotic fluid.

18 weeks

Fetus now weighs 6 ounces.

19 weeks

With ultrasound the baby's sex can now be determined.

20 weeks

Baby can hear.
Sensory development advances.

21 weeks

Fetus now has a white sticky coat
to protect skin and ease delivery.

22 weeks

Fetus is now 7 ½ inches long.
Fetus weighs 3/4 of a pound.
Eyebrows and lids are fully developed.

23 weeks

Fetus is 8" long.
Fetus weighs one pound.

24 weeks

Baby practices breathing by breathing in amniotic fluid.

25 weeks

Fetus weighs 1-1/4 pounds.

26 weeks

Fetus makes breathing movements.

27 weeks

Fetus weighs 2 pounds.
Fetus is 11" long.

Third Trimester

During the final trimester the mother will probably gain 9 to 13 pounds and will probably feel tired and need to rest more frequently.

28 weeks

Baby can open his eyes and suck his thumb.

29 weeks

Fetus weighs 3 pounds.

30 weeks

Brain growth is now very rapid.

31 weeks

Baby’s lungs and digestive tract are near maturity.

32 weeks

Baby weighs 4 pounds.
Baby can turn its head.

33 weeks

Fetus is 18" long.
Fetus weighs 4-1/4 pounds.

34 weeks

Baby weighs 5 pounds.

35 weeks

Baby is now 19.5" long.
Baby weighs 5-1/2 pounds.

36 weeks

Baby weighs 6 pounds.

37 weeks

Baby is 20" long.

38 weeks

Pregnancy is considered full term from this point on.