Wellness Wednesday Tip: Improving Your Physical Health

Physical health and wellness are key to our overall well-being. Physical health is the condition of your body and how well it functions, from the strength of your heart and lungs to your ability to fight infection and move without pain.

Physical wellness is a proactive approach that emphasizes lifestyle choices that sustain energy, resilience, and functional capacity over a lifetime.

The tenets of physical health and wellness are important for keeping your body functioning properly. They include:

  • Watching what you put into your body
  • How much physical activity you get
  • Maintaining a healthy weight

These tenets are positive health habits that can help you decrease your stress, lower your risk of disease, and increase your energy.

Here are some strategies to help you improve your physical health:

  • Increase your physical activity
    • Set specific goals for your physical activity
    • Take the stairs instead of the elevator
    • Take a walk on your lunch break
    • Set an alarm to go off every hour as a reminder to move around for a minute or two
    • Keep moving while watching TV
    • Take an online exercise class
  • Eat a healthy and nutritious diet
    • Eat a variety of foods, such as fruits, vegetables, whole grains, beans, seeds, lean meat, seafood, eggs, milk, yogurt, and cheese
    • Limit foods that are low in vitamins and minerals
    • Cut down on sugar by choosing foods with little or no added sugar
    • Get more fiber
    • Replace saturated fats in your diet with unsaturated fats, such as olive, canola, or other vegetable oils instead of butter, meat fats, or shortening
    • Avoid foods high in salt, such as canned, smoked, or processed foods. Choose fresh poultry, fish, and lean meat instead
    • Choose more complex carbs such as starches and fiber, which can be found in whole-grain breads, cereals, starchy vegetables, and legumes
  • Reach your weight loss goals and maintain a healthy weight
    • Weigh yourself
    • Calculate how many calories you need for your healthy goals
    • Record your daily food intake and physical activity
    • Set specific goals
    • Choose healthy meals and physical activities you enjoy
    • Plan activities with friends or family
    • Be patient
  • Build healthy habits
    • Plan and identify unhealthy patterns, and set realistic goals
    • Change your surroundings and find ways to make healthier choices by removing temptations
    • Ask for support by finding family, friends, co-workers, neighbors, or support groups
    • Speak with a mental health professional if you are experiencing severe depression, anxiety, or burnout
  • Build muscle safely
    • Start slowly, especially if you haven’t been active for a while
    • Pay attention to your body when you experience exhaustion, sore joints, or muscle pains, which is a sign you are overdoing it
    • Use small amounts of weight to start and add more weight slowly over time, while focusing on your form
    • Use smooth, steady movements to lift weights into position, and don’t jerk or thrust weights
    • Avoid locking your arm and leg joints in a straight position
    • Don’t hold your breath during strength exercises
    • Ask for help by looking for a group class at a local gym, recreation center, or find a trainer
  • Combat age-related changes
    • Commit to a healthy diet
    • Drink plenty of fluids
    • Move more
    • Get plenty of sleep
    • Limit alcohol use
    • Avoid tobacco products
    • Visit the doctor regularly

If you would like to improve your physical health, or experience medical problems while doing so, you can schedule an appointment with a doctor at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

How Heart Disease is Different in Women Than it is in Men

Heart disease can be deadly for anyone, as it is the most common cause of death for both women and men in the U.S.  

Heart disease refers to several types of heart conditions. There are three types of heart disease:  

  • Coronary artery disease is the most common heart disease, caused by a buildup of plaque in the walls of the arteries that supply blood to the heart and other parts of the body. After menopause, women are at a higher risk of coronary artery disease because of hormonal changes.   
  • Arrhythmia is a condition in which the heart beats too slowly, too fast, or irregularly. A common example is atrial fibrillation.   
  • Heart failure happens when the heart is too weak to pump enough blood to support other organs in the body. This condition is serious, but it doesn’t mean the heart has stopped beating. 

While heart disease can occur in everyone, women face unique risks, largely due to differences in anatomy and hormones, such as estrogen. Estrogen protects the heart in the premenopausal years as it relaxes the arteries and promotes good cholesterol. This changes when a woman begins menopause and estrogen levels decline, increasing the chance of cardiovascular risk factors, such as high cholesterol and hypertension.  

Other heart disease risk factors include: 

  • Obesity 
  • Smoking 
  • Emotional stress and depression  
  • Diabetes 
  • Lack of physical activity 
  • Pregnancy complications 
  • Family history of early heart disease 
  • Other health conditions, such as autoimmune diseases and inflammatory conditions 

Over 60 million women (44%) in the United States are living with some form of heart disease, and it can affect them at any age. However, the prevalence of heart disease in women starts going up around the age of 65, which is about ten years later than men, presumably due to the lasting positive effects of estrogen. 

Women are more likely to have other heart attack symptoms and have a higher chance of developing symptoms from heart failure. Although some women may not show any symptoms, others may experience:  

  • Angina is usually felt as a dull or heavy chest discomfort or ache  
  • Pain in the neck, jaw, or throat  
  • Pain in the upper abdomen or back  

These symptoms may happen when you are resting or active. Women may also have other symptoms, including:  

  • Nausea  
  • Vomiting  
  • Tiredness that won’t go away or feels excessive  

In some women, the first signs and symptoms of heart disease can be:  

  • A heart attack, which occurs when blood flow to the heart muscle is reduced or blocked 
  • Palpitations  

Treatment for heart disease is similar for women and men, and can include medicines, angioplasty and stenting, or coronary artery bypass surgery.  

However, there are differences in heart disease treatment for women and men, including: 

  • Women are less likely to be treated with aspirin and statins to prevent future heart attacks than men are 
  • Women are less likely to have coronary artery bypass surgery than men. This may be because women have less obstructive disease or smaller arteries with more small vessel disease 
  • Cardiac rehabilitation can improve health and aid recovery from heart disease. However, women are less likely to be sent to cardiac rehabilitation than men are. 

Living a healthy lifestyle can help reduce the risk of heart disease. Here are some ways to live a heart-healthy lifestyle: 

  • Controlling blood pressure, blood sugar, and cholesterol  
  • Eating a healthy diet 
  • Exercising and keeping a healthy weight 
  • Managing stress 
  • Getting quality sleep 
  • Quitting smoking or stopping the use of tobacco products 
  • Limiting alcohol consumption 

If you are experiencing symptoms of heart disease, you can receive treatment at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486. If there is an emergency, call 911 immediately. 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

How as Few as Two Cigarettes Per Day Increases Risk of Heart Disease

Smoking tobacco products, such as cigarettes, is the leading preventable cause of disease and death in the United States. According to the American Cancer Society, an estimated 480,000 people die from cigarette smoking in the U.S. each year, with many of them dying from cancer. What’s more, people who smoke die about ten years earlier than those who have never smoked.  

Smoking doesn’t just cause cancer. It can also cause several other diseases and can damage nearly every organ in the body, including the lungs, blood vessels, reproductive organs, bones, mouth, eyes, and skin. 

Smoking tobacco can also damage the heart, as it can increase a person’s risk of developing heart disease. 

According to a study conducted by researchers at Johns Hopkins University, who looked at the smoking habits of more than 300,000 adults for almost twenty years, it was discovered that men and women who smoked as few as two cigarettes daily had a 60 percent increased risk of death from any cause compared to those who never smoked. 

Additionally, the study also found that the group of smokers participating in the study had a 50 percent risk of heart disease.  

According to Dr. Jennifer Miao, a cardiologist at Yale University, “tobacco use is a very well-established risk factor for heart disease. It really damages the blood vessel lining and accelerates the development of plaques and coronary disease.” 

Smoking can also cause heart rhythm issues, such as atrial fibrillation and stroke. 

Unfortunately, the study found that cutting back on cigarette smoking may not be enough to undo the harm it causes. Despite current smokers having a higher risk of death than former smokers, former smokers still had an increased risk of heart disease more than twenty years after they had stopped smoking, according to the study. 

According to the Centers for Disease Control and Prevention, quitting smoking is the most important action a person could take to improve their health, as it reduces the risk of premature death and smoking-related diseases, such as heart disease, cancer, and chronic obstructive pulmonary disease (COPD). 

Treatments such as smoking cessation counseling and nicotine replacement therapy medications, including over-the-counter patches, gum, lozenges, and prescribed inhalers and nasal sprays, can help manage nicotine withdrawal symptoms and cravings, and help you quit smoking.  

Flushing Hospital Medical Center provides extensive assistance for people willing to quit smoking. It offers a free smoking cessation support group and one-on-one sessions, both in person and by phone. For more information, please call 718-206-8494.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

How Making Lifestyle Changes Can Reduce the Risk of Chronic Diseases

According to the World Health Organization (WHO), chronic diseases, also known as non-communicable diseases, are conditions that tend to have a long duration and result from a combination of genetic, physiological, environmental, and behavioral factors.

Chronic diseases are the leading cause of death worldwide. These diseases include:

  • Cancers
  • Cardiovascular disease, such as heart attacks and strokes
  • Chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and asthma
  • Diabetes

A person’s lifestyle and daily habits can increase their risk of developing a chronic disease. About 80% of chronic diseases are driven by a person’s daily habits. These include:

  • Tobacco use, including the effects of exposure to second-hand smoke
  • Unhealthy diets, including excess salt, sugar, and fats
  • Excessive alcohol use
  • Insufficient physical activity

These habits can contribute to metabolic changes that can increase a person’s risk of chronic disease, including:

  • Hypertension
  • Obesity
  • Diabetes
  • High cholesterol

Making the following lifestyle changes is one of the best ways to address harmful habits and help prevent chronic diseases.

  • Dietary changes include eating whole, unrefined, and minimally processed plants. Eating plant-based foods can help reduce diabetes, heart disease, and the risk of cancer
  • Increasing physical activity by engaging in a recommended 150 minutes of moderate-intensity activity each week
  • Getting a good, restful night’s sleep of about seven to nine hours. This can be achieved by:
    • Having a consistent bedtime and waking up on time, even on weekends
    • Being physically active
    • Limiting alcohol and caffeine
    • Putting digital devices away 90 minutes before bedtime
    • Keeping your sleeping area cool, dark, and comfortable
  • Reducing stress by practicing mindfulness, meditation, and gratitude can help relieve stress and improve your physical and mental health.
  • Staying socially connected with friends and family can help keep you emotionally and physically healthy.
  • Quitting smoking, or never starting, lowers the risk of serious health problems, such as heart disease, cancer, Type 2 diabetes, and lung disease, as well as premature death
  • Limiting alcohol use can reduce health risks that excessive drinking can lead to, such as high blood pressure, various cancers, heart disease, stroke, and liver disease

By avoiding these risks and getting good preventive care, you can improve your chance of staying well, feeling good, and living longer.

For more information on how you can make lifestyle changes, you can schedule an appointment with a doctor at Flushing Hospital Medical Center’s Ambulatory Care Center by calling (718) 670-5486.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Smoking and Oral Health

Most people know that smoking is bad for their health. It causes many different health problems and fatal diseases. However, many people don’t realize the damage that smoking does to their mouths, gums, and teeth.

Smoking can lead to tooth staining, gum disease, tooth decay, tooth loss, and in more severe cases oral cancer. Smoking can also lead to other dental problems, including:

  • Bad breath
  • Cavities
  • Inflammation of the salivary gland openings on the roof of the mouth
  • Increased buildup of plaque and tartar on the teeth
  • Increased loss of bone within the jaw
  • Increased risk of white patches inside the mouth called leukoplakia
  • Delayed healing process following tooth extraction, periodontal treatment, or oral surgery
  • Lower success rate of dental implant procedures

If you smoke cigarettes or use other types of tobacco products, quitting is an important health decision to make for many reasons. Here are some tips to help you quit smoking:

  • Set a quit date
  • Seek support
  • Find healthy alternatives
  • Remove triggers
  • Consider nicotine replacement theory (NRT)
  • Stay positive
  • Reward yourself

Enrolling in a smoking cessation program can greatly improve your chances of quitting successfully.

For more information about smoking cessation programs or to register for our program, call: (718) 206-8494.

If you’re experiencing dental health problems, it is important to visit a dentist to ensure you’re receiving the most effective treatment possible. To schedule an appointment at Flushing Hospital Medical Center’s Department of Dental Medicine, please call (718) 670-5521.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Five Tips to Help Quit Smoking

Tobacco is the single greatest cause of multiple diseases and premature deaths in the USA today.  It kills more Americans each year than alcohol, crack, heroin, homicide, suicide, car accidents, fire and AIDS combined.

Smoking cigarettes affects many aspects of health. Tobacco smoke contains about 7000 chemicals, including low concentrations of such strong poisons as ammonia, cyanide, arsenic and formaldehyde.  It also contains 69 carcinogens – substances that are known to cause cancers in humans. Direct association has been established between smoking and cancers of the lung, mouth, nose, throat, larynx, esophagus, colon and rectum, stomach, pancreas, cervix, bladder, kidney and blood.

The Smoking Cessation Team at Flushing Hospital Medical Center suggest five common sense steps to provide the best chance for quitting smoking for good:

  1. Get ready: set a quit date and throw out all cigarettes and ashtrays from your home.
  2. Get support: tell your family, friends and doctor about quitting plans; search the internet for advice.
  3. Learn new behaviors: distract yourself from the urge to smoke; exercise or go for a walk.
  4. Get medication: combining medication like nicotine patches or Zyban with behavioral adaptation and family support quadruples your chances of success.
  5. Be prepared for relapse and difficult situations– most people try to quit a few times before   succeeding.

If you would like to learn more about quitting smoking call the Flushing Hospital Medical Center’s Smoking Cessation Team at 718-670-3146.

 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Great American Smokeout

On November 16, 2017, the Flushing Hospital Medical Center’s Smoking Cessation Team joined with the American Cancer Society and participated in The Great American Smokeout. The Smoking Cessation Team hosted an informational table in the hospital’s lobby.

The Great American Smokeout is designed for you to have a chance for you to make a plan to quit smoking.  Did you know that by quitting for even one day, you will be taking an important step toward a healthier life and can reduce your risk of getting Cancer? Well, you can!

Tobacco is the single greatest cause of multiple diseases and premature deaths in the USA today.  It kills more Americans each year than alcohol, crack, heroin, homicide, suicide, car accidents, fire and AIDS combined. There are an estimated 480,000 deaths in the United States annually that are due to tobacco use. It is the only legal consumer product that is lethal when used exactly as recommended by the manufacturer.

Smoking cigarettes affects many aspects of health. Tobacco smoke contains about 7000 chemicals, including low concentrations of such strong poisons as ammonia, cyanide, arsenic and formaldehyde.  It also contains 69 carcinogens – substances that are known to cause cancers in humans. Direct association has been established between smoking and cancers of the lung, mouth, nose, throat, larynx, esophagus, colon and rectum, stomach, pancreas, cervix, bladder, kidney and blood.
In the United States, Illnesses caused by smoking cost more than 300 billion dollars per year in direct medical care and lost productivity. Smokers pay twice as much for life insurance and will die on average of 13-14 years earlier than non-smokers. It costs tobacco companies approximately 5 cents to produce a pack of cigarettes.

Many lung conditions are either caused or aggravated by cigarette smoke. It irritates bronchial airways and stimulates mucous production leading eventually to decreased elasticity and functional failure. Patients suffering from COPD, Asthma, Chronic Bronchitis or Emphysema have a much higher risk of dying when repeatedly exposed to smoke.
Smokers are also at greater risk for cardiovascular disease. Smoking damages blood vessels making them stiff and narrow, obstructing blood flow which results with elevated blood pressure, heart attacks, strokes, kidney failure or chronic skin changes.

Pregnant women exposed to tobacco smoke have increased risk of complications like miscarriage, premature birth, and brain and lung damage in developing baby. Sudden infant death syndrome is three times more likely if mother smoked during pregnancy.
Secondhand smoke is the smoke exhaled by smokers or given off by a burning cigarette or pipe. Inhaling secondhand smoke is as hazardous as smoking a cigarette. There is no safe level for secondhand smoke exposure established. People can inhale it at work, homes, cars or public spaces and have all the complications mentioned above.

Smoking tobacco is an addiction similar to heroin and cocaine. It can be successfully treated but the majority of cases require three or more attempts. Quitting smoking offers a chance of feeling better and living longer.  Studies have shown that five, common sense steps, provide the best chance for quitting smoking for good:

  1. Get ready: set a quit date and throw out all cigarettes and ashtrays from your home.
  2. Get support: tell your family, friends and doctor about quitting plans; search the internet for advice.
  3. Learn new behaviors: distract yourself from the urge to smoke; exercise or go for a walk.
  4. Get medication: combining medication like nicotine patches or Zyban with behavioral adaptation and family support quadruples your chances of success.
  5. Be prepared for relapse and difficult situations– most people try to quit a few times before   succeeding.

If you would like to learn more about quitting smoking call the Flushing Hospital Medical Center’s Smoking Cessation Team at 718-670-3146.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

World No Tobacco Day at FHMC

May 31, 2017, is World No Tobacco Day.  On this day, the World Health Organization (WHO) asks that healthcare providers highlight the negative effects that smoking can have on a person’s health.  This year’s theme is “Tobacco – a threat to development.”

Flushing Hospital Medical Center (FHMC) is participating in World No Tobacco Day by hosting an educational forum on how to quit smoking and the negative effects smoking has on your health.  The informational forum was provided for employees, hospital visitors and community members.

To further help those who want to quit, the FHMC Smoking Cessation Team can host classes in both English and Spanish and work out an individualized quit plan the Asian Community to help make the transition from smoker to non-smoker easier.

If you are interested in quitting, you can contact the Flushing Hospital Medical Center’s Smoking Cessation Navigators. Call 718-670-3146 for more information.

 

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Benefit of the Annual Physical

The greatest benefit of an annual physical is knowledge for both you and your physician.  An annual visit establishes a baseline for your personal health.  Armed with this information, your doctor can detect unhealthy trends before they become risk factors.

Nearly one third of the population with a chronic disease is unaware that they have the disease.  According to the Partnership to Fight Chronic Disease, as many as 100,000 lives could be saved each year by increasing preventive care services.

Health screenings, such as blood glucose and blood pressure tests can easily detect the two most chronic conditions, diabetes and hypertension before they cause serious health issues.  The Centers for Disease Control cites that seven out of every 10 deaths are caused by chronic disease.  Proper management of these conditions can prevent unnecessary hospitalization.

In order to get the most out of your annual physical, take a moment to prepare:

  • Make a list of your health concerns
  • Make a list of all the medications you are taking
  • Get a copy of your medical records and your family medical history

Dozens of Patient Care Specialists, on staff at Flushing Hospital Medical Center, are ready to provide you with your annual check-up.

Flushing Hospital is a certified Patient Centered Medical Home (PCMH) in its Ambulatory Care Center. The Center offers more than 50 outpatient general and specialty services for children adolescents and adults.

Flushing Hospital’s ambulatory care services accepts most major insurances, is centrally located and has convenient patient hours.  Call 718-670-5486 to schedule an appointment.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

True of False: Smoking Cigars is Safer Than Cigarettes?

Cigarette sales are beginning to see a decline while cigar use has been rising steadily.  This is partly attributed to the growing belief that cigars are a safer alternative to cigarettes.  Many smokers perceive cigars as having fewer health risks because the smoke is not inhaled into the lungs, but is instead sucked and kept in the mouth for the taste. However, the most concerning misconception among smokers is the belief that cigars are safer because they do not have a Surgeon General’s health warning as cigarettes do.

Research has proven all of these beliefs to be untrue. Cigars do not require health labels because they are not as regulated as cigarettes. Furthermore, they contain some of the same hazardous chemicals such as arsenic and can have the same negative health effects.

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Cigars contain high levels of the addictive substance nicotine. Nicotine can enter the body by being inhaled into the lungs and can also be absorbed through the lining in the mouth. Cigars are also known to contain more tar than cigarettes. Tar contains the carcinogen (cancer-causing substance) benzo(a)pyrene. Cigar smokers are at a high risk for developing cancers of the mouth, larynx and esophagus.

Cigar smoke has been linked to other health conditions such as oral, lung and cardiovascular disease. Chronic cigar smokers may be twice as likely to be at risk for COPD (chronic obstructive pulmonary disease). They may also face a higher risk of premature death caused by aortic aneurysms and damage to the heart.  Cigars can also wreak havoc on dental health by causing tooth loss, bad breath and stained teeth.

The National Cancer Institute has determined that cigars are no safer than cigarettes and there are no safe tobacco products. There is also no safe level of tobacco smoke exposure. For this reason and others previously discussed, the best option for smokers to improve their health and prevent the risk of developing chronic diseases is to stop smoking.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.