Health

What You Need to Know About Eye Pain

Eye pain is common, but it’s rarely a symptom of a serious condition. Most often, the pain resolves without medicine or treatment. Eye pain is also known as ophthalmalgia.

Depending on where you experience the discomfort, eye pain can fall into one of two categories: Ocular pain occurs on the eye’s surface, and orbital pain occurs within the eye.

Eye pain that occurs on the surface may be a scratching, burning, or itching sensation. Surface pain is usually caused by irritation from a foreign object, infection, or trauma. Often, this type of eye pain is easily treated with eye drops or rest.

Eye pain that occurs deeper within the eye may feel aching, gritty, stabbing, or throbbing. This kind of eye pain may require more in-depth treatment.

Eye pain accompanied by vision loss may be a symptom of an emergency medical issue. Call your ophthalmologist immediately if you begin to lose your vision while experiencing eye pain.

What causes ocular pain?

The following may cause eye pain that originates on the surface of the eye:

Foreign object

The most common cause of eye pain is simply having something in your eye. Whether it’s an eyelash, a piece of dirt, or makeup, having a foreign object in the eye can cause irritation, redness, watery eyes, and pain.

Conjunctivitis

The conjunctiva is the tissue that lines the front of the eye and the underside of the eyelid. It can become infected and inflamed. Often, this is caused by an allergy or infection.

Though the pain is usually mild, the inflammation causes itchiness, redness, and discharge in the eye. Conjunctivitis is also called pink eye.

Contact lens irritation

People who wear contact lenses overnight or don’t disinfect their lenses properly are more susceptible to eye pain caused by irritation or infection.

Corneal abrasion

The cornea, the clear surface that covers the eye, is susceptible to injuries. When you have a corneal abrasion, you will feel as if you have something in your eye.

However, treatments that typically remove irritants from an eye, such as flushing with water, won’t ease the pain and discomfort if you have a corneal abrasion.

Injury

Chemical burns and flash burns to the eye can cause significant pain. These burns are often the result of exposure to irritants such as bleach or to intense light sources, such as the sun, tanning booths, or the materials used in arc welding.

Blepharitis

Blepharitis occurs when oil glands on the eyelid’s edge become infected or inflamed. This can cause pain.

Sty

A blepharitis infection can create a nodule or raised bump on the eyelid. This is called a sty or a chalazion. A sty can be very painful, and the area around the sty is usually very tender and sensitive to touch. A chalazion isn’t usually painful.

Cataracts

Cataracts happen to be another of the most widely existing eye problems. The formation of cloudy areas in the eye lens is referred as the cataracts. Light passes through a clear eye lens to your retina (just like a camera), where images are processed. With cataracts affecting your eye lens, light cannot pass through to the retina smoothly enough.

As a result, you are unable to see as clearly as people without cataracts and may also notice a halo or glare around lights at night.

Signs and Symptoms of Cataracts

Most of the times, the formation of cataracts is a slow process, lacking typical symptoms like pain, tearing or redness of eyes. Some other symptoms include:

• Blurred, clouded or dim vision
• Problem seeing at night
• Problem seeing through light and glare
• Seeing ‘halos’ around lights
• Frequently changing contact lens prescription or eyeglasses
• Faded view of colors

Treatment Options

Through early stages of cataracts, new eyeglasses, antiglare sunglasses, magnifying lenses and brighter lighting can help. If not, surgery turns out to be the only effective treatment, which involves removal and replacement of cloudy lens with an artificial one.

Dry eyes

Diagnosis

Tests and procedures that may be used to determine the cause of your dry eyes include:

A comprehensive eye exam. An eye exam that includes a complete history of your overall health and your eye health can help your doctor diagnose the cause of your dry eyes.

A test to measure the volume of your tears. Your doctor may measure your tear production using the Schirmer test. In this test, blotting strips of paper are placed under your lower eyelids. After five minutes your doctor measures the amount of strip soaked by your tears.

Another option for measuring tear volume is the phenol red thread test. In this test, a thread filled with pH-sensitive dye (tears change the dye color) is placed over the lower eyelid, wetted with tears for 15 seconds and then measured for tear volume.

A test to determine the quality of your tears. Other tests use special dyes in eyedrops to determine the surface condition of your eyes. Your doctor looks for staining patterns on the corneas and measures how long it takes before your tears evaporate.

A tear osmolarity test. This type of test measures the composition of particles and water in your tears. With dry eye disease, there will be less water in your eyes.

Tear samples to look for markers of dry eye disease, including elevated matrix metalloproteinase-9 or decreased lactoferrin.

Medications

Prescription medications used to treat dry eyes include:

• Drugs to reduce eyelid inflammation. Inflammation along the edge of your eyelids can keep oil glands from secreting oil into your tears. Your doctor may recommend antibiotics to reduce inflammation. Antibiotics for dry eyes are usually taken by mouth, though some are used as eyedrops or ointments.

• Eyedrops to control cornea inflammation. Inflammation on the surface of your eyes (cornea) may be controlled with prescription eyedrops that contain the immune-suppressing medication cyclosporine (Restasis) or corticosteroids. Corticosteroids are not ideal for long-term use due to possible side effects.

• Eye inserts that work like artificial tears. If you have moderate to severe dry eye symptoms and artificial tears don’t help, another option may be a tiny eye insert that looks like a clear grain of rice. Once a day, you place the hydroxypropyl cellulose (Lacrisert) insert between your lower eyelid and your eyeball. The insert dissolves slowly, releasing a substance that’s used in eyedrops to lubricate your eye.

• Tear-stimulating drugs. Drugs called cholinergics (pilocarpine, cevimeline) help increase tear production. These drugs are available as pills, gel or eyedrops. Possible side effects include sweating.

• Eyedrops made from your own blood. These are called autologous blood serum drops. They may be an option if you have severe dry eye symptoms that don’t respond to any other treatment. To make these eyedrops, a sample of your blood is processed to remove the red blood cells and then mixed with a salt solution.

You Can Treat Some Eye Problems at Home

Many eye problems need an ophthalmologist’s medical knowledge. They have years of clinical and surgical training. But there are eye problems that you can treat safely at home, as long as they are simple. Here are a few problems that can respond to home treatment, with tried and true remedies.

Black eye

You can usually treat a black eye  at home. But if there are more serious symptoms of black eye, see an ophthalmologist. These signs include:

• blurred vision;
• blood in the eye; or
• an inability to move the eye.

To reduce swelling and ease pain the first day, apply an ice pack to the eye for 15 to 20 minutes at a time, once every hour. If you don’t have an ice pack, use a bag of frozen vegetables or ice cubes wrapped in cloth. The cloth protects your skin from freezing. Don’t put a raw steak or other raw meat on your eye. Despite what you’ve seen on television and in the movies, there’s no scientific basis for this. In fact, the bacteria in raw meat poses a high risk of infection.

Pink eye (also known as conjunctivitis)

A virus causes most cases of pink eye. These cases don’t respond to antibiotics. Viral conjunctivitis will disappear on its own. Have your ophthalmologist diagnose your particular case. Reduce the discomfort of conjunctivitis by applying cool compresses to the eye.

If your conjunctivitis is bacterial, follow your treatment plan. This usually involves antibiotic eye drops. In either case, you should take steps to reduce the chance of passing the problem on to someone else. Conjunctivitis is highly contagious. Follow these tips to prevent the spread:

• Don’t share towels, handkerchiefs or cosmetics.
• Change pillowcases frequently.
• Wash your hands often.

Eye allergy and seasonal allergy

Just as you can get nasal allergies, you can get eye allergies that leave your eye red, itchy and teary. Limiting your exposure to the source of your allergy — whether it’s pollen, pets or mold — can help relieve symptoms. If you can’t remove the source entirely, there are ways to reduce its effect with eye allergy treatments.

If pollen bothers you:

• Don’t use a window fan, which can draw pollen into your house.
• Wear sunglasses when you go outside.

If dust is the problem:

• Use allergen-reducing covers for your bed.
• Use artificial tears, which temporarily wash allergens from your eyes.
• Use over-the-counter anti-allergy eye drops to lessen the symptoms.

Eye Injury Treatment

An object such as a piece of glass or metal is sticking out of the eye.

1. For Chemical Exposure

• Don’t rub eyes.
• Immediately wash out the eye with lots of water. Use whatever is closest — water fountain, shower, garden hose.
• Get medical help while you are doing this, or after 15 to 20 minutes of continuous flushing
• Don’t bandage the eye.

2. For a Blow to the Eye

• Apply a cold compress, but don’t put pressure on the eye.
• Take over-the-counter acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain.
• If there is bruising, bleeding, change in vision, or it hurts when your eye moves, see a doctor right away.

3. For a Foreign Particle in Eye

• Don’t rub the eye.
• Pull the upper lid down and blink repeatedly.
• If particle is still there, rinse with eyewash.
• If rinsing doesn’t help, close eye, bandage it lightly, and see a doctor.

Things You’re Not Supposed To Know About Chiropractors

Their education is equal to their medical colleagues … and might be better in some areas.

This might be difficult to accept, but chiropractic students spend markedly more hours in the classroom than medical students, especially in the areas of anatomy, physiology, orthopedics, and x-ray. Of course, their training is different since “Chiros” concentrate on muscles, bones, joints, and nerves. Their education only touches on medication, emergency situations, etc. Many are beginning to think this gives them a better background in physical rehab.

They do more than crunch backs and necks

While chiros are known for treating back and neck problems with joint manipulation, most are well versed and board certified to perform physical therapies. They are also licensed to function as primary care physicians. Based on their education many use nutrition as a form of treatment.

It’s safe

Even though ghost stories of adjustments gone wrong are common, the actual risk of injury from chiropractic treatment is rare. Generally, the malpractice insurance that doctors have to pay is based, among other things, on their field. Chiropractors as a group pay the less for malpractice insurance than any other type of physician. Why? Lawsuits claiming injuries or negligence are less common against chiropractors.

They took the AMA to court — and won — twice

For decades chiropractors were campaigned by the AMA (American Medical Association) as not being “real doctors” and met fierce resistance from medical organizations. Chiropractors claimed the AMA was trying to snuff out the competition with fear tactics and bogus research. The U.S. Supreme Court agreed with them in 1987… and again in 1990. It was found that the AMA was guilty of illegal antitrust activities against the chiropractic profession, ordered an injunction on their activity, and forcing them to print the courts findings in the Journal of the American Medical Association.

M.D.’s and D.C.’s are now working together

It’s becoming more common to find integrated offices, where M.D.’s, D.O.’s, and D.C.’s are working side-by-side. Many medical offices now try to provide multi-specialty approaches to treatment. With natural forms of treatment becoming more popular, drugless forms of treatment have become preferred by many over pain-medication.

Things To Ask When Checking Out Chiropractors

• ”Does the office offer a free consultation?

• ”Ask if they have digital x-ray available onsite, because they’re dealing with the spine.

• ”Ask how long the doctor has been in practice, as experience is important. Ask if the doctor participates regularly in continuing education.

• ”Does the office or doctor use any advanced technology like Class IV laser? Cold laser is the antiquated laser.

• ”Some of them use only one tool. If all you have a hammer, everything looks like a nail. That happens a lot in our profession. Does the doctor use one technique or a more comprehensive, holistic list of tools? Is the doctor certified in any soft tissue modalities, which complement the skeletal modalities. Typically, muscular/skeletal mean you treat all of that.

• ”Do they offer a reduced fee membership model? That’s the wave of the future.

• “Have they treated your specific condition before, if you know what it is?”

• “People should find someone who has an affiliation with a larger corporation like American Chiropractic Association.

• “Look for someone who’s not ordering imaging right away, unless there are certain red flags that indicate you need imaging.

• “You want to find someone who’s goal-oriented for you, someone who will help encourage an active treatment plan, who will help restore you to a normal function not just treat pain.

• “You don’t want someone who encourages the use of lumbar support or braces for long-term prevention of back pain, but will teach you how to learn and exercise so you don’t need a chiropractor.

• “Look for interdisciplinary care. As a chiropractor, I should be part of someone’s healthcare team. The skills and knowledge I possess and continue to learn should be complementary to what they receive from their physician. If you can’t tell the difference between the care you receive from a chiropractor and a physical therapist, you’re in the right place, though our study is broader.

• “They should be open to referring people out. If I possess the skills and tools that will help patients the most, I’ll keep them in house, but if I know they can receive better care elsewhere, then I’d send them elsewhere.

• “There’s a formula to care for everyone. Some have intermittent bouts of back problems, but if we can develop a formula such as a frequency of spinal adjusting and exercise, and mindfulness to know what it needs at certain times, you’ll likely have better results.

• “Go online and read reviews. People tend to post pretty honest things about their experience.”

• “You want someone who will sit down and explain treatments. They will use insurance instead of saying it’s a cash-only plan.

• “Read the chiropractor’s biography online to see if that will be a good fit. They might say what they’re into and that can help. It’s a good way to take a look. You can see the certifications that can include if they do taping, soft tissues, ultrasound and other modalities. You can gauge a lot about a chiropractor through their website.

• “A lot of times, they have tours. You can see how their office looks. You want to be comfortable with the provider, like with any provider.

• “A lot of people, when they call here and ask to speak with the doctor, that’s not a bad thing. The doctor may not be able to speak with you that minute, but you know it will be a good fit if they’ll call you back before you come into the office. It should be all about the patient.”

• “If it’s a worker’s compensation injury, you’ll have to see if they accept those. Some don’t.

• “If it’s a cash or general insurance basis, the best way is by word-of-mouth. Talk with family members and friends. See who keeps them moving.

Things You Need to Know Before Visiting a Chiropractor

Considering you’re always on the go, it’s no surprise that your crazy-busy lifestyle morphs your body into an achy, stiff mess on the reg. Perhaps you’ve thought about seeing a chiropractor but aren’t sure if it’s a great idea given last year’s news cycle about a woman who died after visiting one. But it’s time to clear the air. Here’s everything you should know about seeing a chiropractor, from choosing the right one for you to all the safety precautions you should consider upfront.

“The practice is founded on the premise that the nervous system controls every other aspect of the human body, so a properly functioning nervous system allows for the body to function optimally.” Besides back and neck pain, chiropractors can help with things like radiating pain, numbness, tingling, burning, and tendonitis

Adjustments are done manually (using hands) or mechanically (using a small instrument), and involve applying force to the joints, bones, and muscles in and around your spine to improve overall physical function.

While research from the Annals of Internal Medicine shows chiropractic care for musculoskeletal conditions can help back pain (in some cases, more than pain killers), there’s been little to no widely accepted research showing that chiropractic treatments are effective for any other conditions—say, ear infections or insomnia

board-certified in integrative and holistic medicine. That said, if it’s something you’re interested in, don’t be afraid to bring it up with your doc—they should at least take the time to consider whether chiropractic care could serve as an appropriate alternative therapy for your issue, says

What’s the truth about chiropractors?

Chiropractors attend graduate-level health colleges to treat disorders of the bones, nerves, muscles, and ligaments. They graduate as doctors of chiropractic degrees, but they are not medical doctors.

While chiropractors are widely known for treating back and neck pain, they also treat bone and soft tissue conditions. In this article, we explore myths and truths of chiropractic care. We also describe the training that chiropractors undergo, how safe these treatments may be, and the research behind the practice.

What certifications must chiropractors have?

A common myth is that chiropractors do not undergo a significant amount of training. In fact, they typically complete about 8 years of higher education before they are licensed. Chiropractors tend to have 4 years of undergraduate education.

hiropractic program specifics

Divided by year, a chiropractic graduate program usually involves:

First year: Courses in general anatomy, chiropractic principles, biochemistry, spinal anatomy.

Second year: Courses in chiropractic procedures, pathology, clinical orthopedics, imaging interpretation, and research methods.

Third year: Courses in clinical internships, integrated chiropractic, pediatrics, dermatology, practice management, and ethics and jurisprudence.

Fourth year: A clinical internship, in which a student studies under a chiropractor and completes rotations in a hospital or veterans’ clinic.

WHAT IS CHIROPRACTIC CARE AND WHY IS IT SO IMPORTANT?

So have you guys ever heard when you talk to your friends “Man, I went to the chiropractor and it was the most amazing thing ever. They cured my diabetes.” No, you don’t hear that do you? Or you’ll have some people that’ll say “The chiropractor is the  most amazing thing ever, they made my sciatica go away.” But if you spend enough time talking to people about chiropractic you really will get stuff like “Wow I feel better, I move better, I function better, I don’t get sick as often, my chronic disease is doing better.”

a chiropractor and I just want to take a quick second today to talk about what chiropractic is and what chiropractic isn’t. I think the hard part about that is that people think when they go to the doctor, they have something they want to get rid of. Right? They say they have back pain and want to get rid of it. Or they have high blood pressure and want to get rid of it. But what if the problem isn’t that when you go to the doctor you have something you need to get rid of. What if the problem is you’ve lost something you should have and that’s affecting your body’s ability to function properly?

Chiropractic is about function, it’s about the ability of your body functions. The first thing we should talk about it “what is health?” And traditionally what we’re taught is that health is about looking good or feeling good.  “As long as I feel good then I’m healthy.” But is that really what health is? Don’t we all know people who feel good in the morning? They wake up, like my grandfather, but then have a stroke by noon? So they felt great that morning yet still end up in the hospital by noon that day. Or how many people wake up that morning and feel fantastic and then go to the doctor that same day and they go “Oh by the way your blood work came back with cancer” cause you can’t feel cancer and you can’t feel heart disease. So just quickly, so we’re on the same page, health has nothing to do with how you look or how you feel.

Although that’s how our culture or our society judges health. If you look up health by definition, the World Health Organization defines health by function. So, if your body is 100% then you have health. So the World Health Organization’s definition of health is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” For my patients in my practice the reason why we get such overall health change is because we teach them how to get their bodies functioning optimally. I always say in the office, “health is not owned, it’s rented. And you’re paying rent on your health everyday.” So every day you’re either doing things to improve the quality of the function. Eat right, exercise, get your spines adjusted. Or you’re not doing anything about your health and instead of building health or optimizing function, you’re actually getting sicker over time. If that makes sense.

So, that all being said, we all know that we should eat right, because eating right builds health and function. We should exercise, because exercising builds health and function. There’s even old sayings by our grandparents. “You are what you eat” right? So, we know that we’re supposed to eat right we’re supposed to exercise. One thing is that when I talk to people in the community and when my patients first come into the office, they don’t realize that your spine dictates the function of your health. It’s just one more piece of the puzzle that people don’t know needed to fit there.

CHOOSING THE RIGHT VETERINARY CLINIC LOCATION

Are You Planning to Open or Relocate an Existing Veterinary Practice?

Choosing the right location for your business is one of the most important decisions that you will make in your career as a veterinarian; with many important factors that should be considered. Here are a few to keep in mind for optimal success

The Visibility of Your Veterinary Clinic

The location of your veterinary clinic can provide valuable exposure and marketing opportunity. However, choosing commercial real estate in a high visibility location may also drive up rental rates and other operating expenses. Consider the amount of visibility that a location can offer your practice. Would your business’ signage be easily visible? How much traffic passes by? Be sure to consider both vehicle and foot traffic.

Convenience for Customers

Consider how convenient the location would be for your customers to access and park. For example: if the building is located on a stretch of highway, can people traveling in both directions easily access and exit the building without a complicated detour? Is there a parking lot or garage dedicated to the building? Is street parking available? How far will your customers have to walk from parking to your office? Often they will be carrying a pet carrier or walking an animal which can make longer walks from the car uncomfortable and inconvenient.

Clinic Growth Potential

The actual veterinary office space is just as important (if not more) than the physical location of your clinic. Consider if the space is sufficient for your practice needs. What are your long and short term growth plans? Is there room to grow if you decide to expand your veterinary services? For instance, you may find that you will need additional space for kennels, training or examination rooms. Will the space permit a comfortable waiting room area for your customers and their pets? Finding a space that meets your size and business growth requirements should play a key role in your decision. Squeezing into a space that is too small at the onset will work against you in the long run; make sure that the space can accommodate your veterinary clinic for the foreseeable future.

Is the Space the Right Fit for Your Clinic?

In addition to layout, the quality of the space is equally important. Will you take over a vanilla shell or an already-built-out veterinary practice? Does the space include modern features or will it require renovation? Will you need to make any specific improvements such as electrical, plumbing, or structural changes to accommodate your veterinary equipment, supplies and practice plans?

Choosing a rabbit veterinarian

It is important that you go to a rabbit-knowledgeable veterinarian for any medical issues with your rabbit. While many veterinarians may be very good at treating cats and dogs, they may not be knowledgeable in exotic care as rabbits are not usually among the species covered in veterinary medical school. Rabbit physiology and tolerance to medications is very different than cats and dogs and cannot be treated in the same manner. Incorrect treatment can easily be fatal.

If you cannot find a rabbit-savvy veterinarian within a reasonable distance, find a dog/cat veterinarian that will be willing to consult a specialist over the phone to properly diagnose and treat your rabbit. Otherwise, it may be wise to reconsider pet rabbit ownership if no acceptable nearby resources are available.

The following are some questions you can ask your potential veterinarian to see if they are well-qualified to treat rabbits:

Do you treat rabbits?

Approximately how many rabbits do you see a year?

What percentage of the rabbits you see are indoor companions? Outdoor pets? Show/livestock animals? Veterinarians that often see rabbits as livestock will usually recommend euthanasia for any ill rabbit. If you see this type of veterinarian, you will most likely have to do a lot of educating about your rabbit’s role in your family and the lengths to which you are willing to go to keep him healthy.

What is the best way to prevent GI stasis? The answer is to provide unlimited hay, brush often, and give plenty of exercise.

What diagnostic tools and treatments do you usually use for GI slowdowns? What is your success rate? Surgery should be a last resort. X-rays should be taken if an obstruction is suspected. Motility drugs such as Reglan and Propulsid should only be prescribed if no obstructions are found. A good veterinarian will suggest supportive measures such as subcutaneous fluids, abdominal massage, and keeping the rabbit warm. Rabbits that need to syringe-fed should be given Critical Care, canned pumpkin (100% pumpkin only, not pie filling), a softened pellet mixture, baby foods, or some combination of these. The vet may also suggest oral fluids including Pedialyte or Gatorade. Pain medication such as Metacam and Banamine can also be appropriate.

What types of surgery have you performed on rabbits? What is your success rate? What type of anesthetic do you use for rabbits?

Should rabbits be fasted before surgery? The answer is no; rabbits should never be fasted as they cannot vomit.

Are you available for after-hours emergencies?

Financial assistance

In the case that you are unable to obtain enough money due to extenuating circumstances, can provide a proof of income, and are still willing to take your pet to the veterinarian, explain your financial situation to the vets that you contact and see if you can mutually work something out. Often, vets may have some sort of charitable account or will be able to work out a payment plan for you. Otherwise, contact local shelters and rescues to see if they can help subsidize your bill or direct you to a fund that will.

Vet-to-vet consultations

In the case that you have no local rabbit-savvy vets available, an amenable local non-rabbit-savvy vet can instead call one of the listed veterinarians below for a consultation to help diagnose your sick rabbit.

How Do I Find a Good Veterinarian?

Before you even bring your new dog home, take them to the veterinarian you have already selected. Annual shots and examinations are a must for keeping your dog healthy.

Choosing a Vet

Choose a vet whom you are comfortable with and who will answer your questions

Try to get word-of-mouth recommendations. Asking other clients isn’t always effective because they may not have had any unusual or challenging health problems with their pets, and vets that can be OK for routine stuff often are less impressive with unusual stuff

Call vets in your area and ask the vet techs, not the vets themselves, whom they would recommend other than their own current employer. Another good source is groomers, because they tend to hear a lot of stories from their clients.

If you find the recommended vet is very expensive, she probably owns the practice. Try one of the associates. They tend not to run up the bills so much, and a good vet will usually hire good associates as well.

How to pick the right vet for your pet, for the right price

Doing a little research could save you big bucks when choosing a veterinarian, according to a local consumer group

Undercover shoppers for Washington Consumer’s Checkbook have found substantial price differences for numbers of services. For example, to spay a 7-month-old, 25-pound dog, there was a price difference of more than $740 between the highest and lowest prices quoted.

Another example: price quotes ranged between $111 and $871 for routine teeth cleaning of a 4-year-old, 65-pound dog. What you pay is not necessarily a reflection of the quality of care your animal receives, according to Checkbook surveys of area subscribers to Consumers’ Checkbook and Consumer Reports.

Before deciding to stick with a veterinarian, Checkbook.org recommends visiting the location and keeping these points in mind:

Do they listen?

Do they offer advice on prevention, care/self-help?

Do they spend enough time with you and your animal?

Are they asking a lot of questions to evaluate your pet’s needs?

Do the vet and staff appear to genuinely care about animals?

Choosing a veterinarian convenient to your home can also make appointments and emergency care more practical. Another aspect to consider is checking hours of operation and arrangements for care in case of an emergency, according to Checkbook

Great veterinarians / How to know when you’ve found one

A few years ago, a leading consumer magazine did for veterinarians what it does for new washing machines: It told you how to find the really cheap ones. The problem is, my pet is not a household appliance; she’s a member of my family. She can’t be exchanged for another one if she is broken beyond repair. That’s why I’m not interested in a cheap vet, I want a good one.

Whether you’re trying to choose a new veterinarian or evaluating the one you already have, it doesn’t pay to focus first on cost and convenience. Instead, I suggest evaluating your veterinarian primarily on the basis of how well he practices veterinary medicine.

Be warned, it can be a little difficult trying to make this determination, especially if you’re not already that vet’s client. But trust me — if you want easy parking, low cost and a nice bedside manner, you can get it from just about anyone who likes animals. The thing you can only get from a vet is medical expertise.

As conventional wisdom tells us, the practice of medicine is both art and science. No vet is going to go his entire career without getting something wrong, missing a diagnosis or even just having a bad day. But that doesn’t mean that there aren’t some reasonably objective markers that set the great veterinarians apart from the rest. Here are a few that I’ve found extremely helpful over the years.

Experience

Great veterinarians have experience, although there’s no hard and fast rule about how much is ideal. Many mediocre or even poor vets have been in practice a long time, while some newer practitioners are more up-to-date and enthusiastic about medicine.

Tips for choosing a plastic surgeon

If you are considering plastic surgery, you have some decisions to make. While many people spend a lot of time thinking about the procedure and the potential results, there is something much more important to consider. That is the choice of the right plastic surgeon. Not every physician is qualified or experienced in every procedure and choosing the right plastic surgeon isn’t as simple as getting a referral. Referrals and internet research can give you a place to start but as a potential plastic surgery patient, you have a lot at stake – your safety and your appearance. You need to carefully evaluate the surgeon before you make the choice.

Expertise

All plastic surgeons should be certified by the American Board of Plastic Surgery or Royal College of Physicians and Surgeons of Canada. Plastic surgery is a highly, complex specialty that requires years of education and training. Board certification also allows you to ensure that a physician will meet safety requirements and has the medical skills needed but it is only the beginning. Asking your surgeon about his or her professional involvement in teaching, speaking or writing about the procedure you are considering will tell you that he or she is up-to-date on new techniques and technology

Experience

In addition to the right training and education, your physician should have experience performing the type of surgery you are considering. Some surgeons specialize in particular procedures, and your procedure type should be in his “top three.” A good rule of thumb is that he or she should have performed this type of procedure once or more per week for five years or more. Plastic surgery is a complex art and the surgeon needs to stay in practice. Having done a number of procedures over a number of years will help ensure that he or she has the skills that you need.

Exceptional Results

When most people think about plastic surgery – they think about the results they hope to get but not every plastic surgery story ends well. If you have ensured that your potential surgeon has the expertise and experience, you are on your way to choosing the right doctor but he or she also needs to produce exceptional results. Most plastic surgeons keep a file of “before and after” pictures which you should examine. Make sure these include at least two examples of “after” photos taken a year or more post-surgery.

By considering these three E’s, you have taken care of the physical part of your plastic surgery but there is more. Your plastic surgeon should be personable as well. The difference between a good plastic surgeon and a great one can be credited to his interaction with his patients. For that evaluation, we have the three C’s and three A’s.

How to Find the Right Cosmetic Surgeon for You

Your choice of cosmetic surgeon will be a choice you live with for years, if not your entire life. A successful procedure will make you feel more like yourself and give you greater confidence for years to come. On the other hand, ending up in the hands of an inexperienced surgeon increases your chances of having poor results, which can lead to additional costs, time, and heartache.

Make sure the cosmetic surgeon is board certified

Many people think they can depend on state medical boards to ensure that surgeons are qualified to perform the procedures they advertise, but that fact is that the government does not require a surgeon to be specifically trained in the procedures they offer. This problem is most acute in the area of cosmetic surgery, as many doctors with general surgery or other medical training hop on the cosmetic surgery bandwagon in pursuit of greater profits.

Confirm the surgeon’s experience in the specific procedures you want

Each area of cosmetic surgery requires different skills: you can imagine how operating on a nose with bone, cartilage, and breathing passages would be quite different from operating on a breast, which is primarily comprised of soft tissue. Given this, cosmetic surgeons can have subspecialties within the field. Choose a surgeon who is board certified in cosmetic surgery and has substantial experience in the procedure you are considering.

Choose a surgeon whose aesthetic sense appeals to you

We all know that what one person finds beautiful may be unattractive to another. For this reason, you can’t just trust a friend’s recommendation or solely depend on the cosmetic surgeon’s experience. You need to look carefully at the results for each surgeon you interview.

Pay attention to how the surgeon and staff make you feel

Surgery is a big deal, and there can be curves in the path to your new look. You need to feel 100% comfortable with your cosmetic surgeon and their support team. Choose a cosmetic surgeon whom you like and trust completely with your safety and results.

Insider Tips for Finding a Plastic Surgeon You Can Trust

Victoria Cross, a 57-year-old from Montgomery Village, Maryland, considers her breast reduction the best thing she’s ever done for herself. “When I woke up from the surgery and sat up, it was the first time in a very long time that I didn’t feel any pulling in my chest and my shoulders weren’t hurting,” she tells SELF. Cross, who had the procedure at the age of 45, was a D cup in high school and a G cup by the time she had her surgery. Now she’s a proud C cup and has never looked back.

But one of the reasons she waited until her 40s for the procedure was because of the difficulties involved in finding the right surgeon for the job. “Part of the reason for the length was convincing some of the offices that I wanted to ‘interview’ the doctor,” she explains. In other words, she wasn’t willing to sign the paperwork and meet her handler while she was lying on the operating table. This, experts agree, is a very important part of the process, and one that shouldn’t be ignored.

talk to friends, family members, and acquaintances who’ve had work done to get recommendations.

First, consider those close to you. Has anyone had work done? If you’re comfortable, reach out to him or her for advice. “A trusted friend or family member can give you an honest rundown of the entire process, from the consultation with the doctor and the surgery itself to the recovery process,” says Alyssa R. Golas, M.D., plastic surgeon at NYU Langone Health in New York City.

Do your homework by reading up on reviews of surgeons in your area.

As one does this day in age, Issy Ryan, 38, of New York City, took to the Internet before settling on a surgeon to carry out her liposuction procedure. “For me knowledge is power, so I read review after review to get a sense of previous patients’ experiences and help me get to know a little bit about how each surgeon ‘operated,’ both in and out of the operating room,” she tells SELF.

Make sure to view everything on the Internet with a healthy dose of skepticism.

Golas says that while reviews on Yelp and RealSelf.com, and the social media pages of patients can be great resources, they can also be a source of misinformation. “Anonymous reviews (especially negative ones) may be used by a patient to seek revenge or advance his or her own agenda instead of as a way of sharing knowledge and personal experience with other potential patients,” she says.

Choosing the Right Cosmetic Surgeon

First, you should interview two or three surgeons whose specialties match your needs. The surgeons should be board-certified and members of one of these professional organizations

There may be qualified surgeons in other professional organizations, but these are the primary groups that certify that doctors are qualified to perform cosmetic surgery.

Personal recommendations are important. Ask friends for referrals if they have gotten a similar procedure. Get opinions from your family doctor and other doctor acquaintances. Surgical technicians and operating room nurses are an excellent source for information about a surgeon’s skill in the operating room.

Remember, cosmetic surgery is a highly competitive field. Don’t be confused by groups claiming to be “the only” or “the best” because this excludes many surgeons who may be better choices for your particular issues. Ask about their fellowship training — specialized training in specific procedures. Check with your state’s medical board to verify the surgeon’s board certification, education, and license. And check whether disciplinary action has been taken against the surgeon.

Questions to Consider Before Selecting Your Cosmetic Surgeon

At this point, you may have narrowed your choices to one or two cosmetic surgeons. It is now time for the consultation

Tips to Pick the Right Plastic Surgeon

What is the doctor’s training and certification? Any practicing physician may call him- or herself a cosmetic surgeon or may advertise that he or she performs cosmetic procedures. Only physicians who are certified by the American Board of Plastic Surgery have received years of specialized training in plastic surgery (both cosmetic and reconstructive surgery) and have passed rigorous examinations to demonstrate their competence in the field. The American Society of Plastic Surgeons Web site has a feature to help you locate plastic surgeons who are board certified in the field.

What is the doctor’s experience with the particular procedure you are considering? Ask how many times he or she has performed the procedure and if he or she has received specialized training in the particular area. How long has the physician been performing the particular operation? Remember that not all surgeons will be experts in every area. A doctor who is an expert in breast augmentation surgeries may have little experience with nose reshaping.

At which hospital does the doctor perform the procedure? Are you comfortable with being treated in this hospital? Is the hospital accredited?

Does the doctor ask you about your reasons for having the procedure, and are you comfortable talking openly with this doctor? A good cosmetic surgeon will explain all alternatives to the procedure and will not pressure you into making a rapid decision.

Does the doctor answer all your questions clearly and fully? Your doctor should be frank about issues such as recovery time, potential side effects, risks, and realistic expectations for the outcome of the procedure. While “before and after” photos make a convincing statement, be sure to ask if the photos represent typical results