Patient Education
Patients who are supported with education, as well as a strong patient-physician relationship, and proactive medical care will be successful in promoting the reversal of their disease, risk factors, and chronic ailments for improved quality of life.

Common Questions, and Topics of Interest

Questions and Answers About the Pap Test

Comments by Dr. Castellanos: The approach our practice takes to pap smears is the “enhanced pap testing” which takes advantage of new technologies that increase the effectiveness of Pap testing. Unilab is now using the TriPath AutoPap® system to evaluate conventional pap smears as well as the Cytyc ThinPrep® PapTest™, which is a liquid based collection system. The ThinPrep test is able to eliminate problems that regularly plague the conventional pap smear. By using the ThinPrep test, cellular material is kept well preserved and free of air-drying artifacts, as well as nearly eliminating the obscuring of cellular detail due to inflammation, blood, or thickness.

The ThinPrep sample can also test for Human Papillomavirus (HPV) and we will test for HPV when medically indicated. To read more about the connections between HPV and pap smears, as well as other resources regarding pap smear tests can be found at the American Society for Colposcopy and Cervical Pathology’s patient education page.

In addition to providing our patients with “enhanced pap testing” we also provide colposcopic evaluations. A colposcope is an instrument that allows us to magnify the face of the cervix in order to visually identify malignancies. Often times a coposcopy can allow us to identify lesions visually, before they would appear on the results of a pap smear. Therefore we offer colposcopy to our patients on a regular basis, and are able to diagnose early pre-cancerous and cancerous changes involving the cervix, vaginal wall, and entroitus.

For more information regarding the pap smear please visit the following links:
Questions and Answers about the Pap Test from the United Kingdom's National Cancer Institute
Questions and Answers about Pap Test results from Estronaut, a forum for women's health

Questions and Answers About the Treadmill Tests Administered by Dr. Castellanos

Comments by Dr. Castellanos: The treadmill stress test is used to evaluate a patient's level of exercise fitness in a safe manner. This test entails following a protocol that all physicians west of the Mississippi adhere to known as Bruce's Protocol. What this protocol involves is calculating 85% of the patient's maximum predicted heart rate, and use this number as a guide to help avoid overexertion by the patient. We also try to keep patients from exceeding a systolic blood pressure of 200 for safety reasons.

Traditionally doctors are trained to go through five stages of Bruce's Protocol. These stages start at 1.7 miles per hour at a 10% grade, then increase in increments to 5 miles per hour at a 18% grade. What we do in the office is to modify this protocol in order to see what the patient's level of fitness is, in order to insure that the exercise program they are following as part of their lifestyle change program, is a safe amount of exercise.

Our experience here in the office has been that when a patient returns to repeat the Treadmill Stress Test after a year, they are often able to perform at higher levels of intensity and/or higher stage levels of the protocol. These performance gains are due to the reversal of vascular disease, weight loss, lower blood pressure and having less of a reliance on medications.

When we need more information in terms of stress testing we refer to other testing including full scale treadmill stress testing, thallium scan treadmill testing, echocardiograms, and also ask for a cardiac consultation when necessary.

Using the above approach of stress testing in the office, we have not had any incidents of injury, heart attacks or strokes, while patients are performing these tests.

For more information about the Treadmill Stress Test please visit the following link:
Medline Plus Encyclopedia entry for Exercise Stress Test (a service of the U.S. National Library of Medicine and the NIH)

Organizations and Others Resources

The American Academy of Family Physicians (AAFP), a national medical organizations representing more than 93,700 family physicians, family practice residents and medical students.

Woman's Health Homepage (AAFP)

Men's Health Homepage (AAFP)

Kid's Health Homepage (AAFP)

Senior's Health Homepage (AAFP)

Healthy Living - Information and advice for patients on a range of topics, from healthy eating to addictions to vaccines.

Smart Patient Guide - Concise and well-organized information on numerous topics for patients such as managing their healthcare, understanding health insurance and end-of-life issues.

A useful guide to Over-the-Counter Medicines

Drug Information - search for prescription or over-the-counter drug information

Dictionary of medical and health terms

WebMD blends award-winning expertise in medicine, journalism, health communication and content creation to bring you the best health information possible.

MayoClinic.com - Mayo Clinic is a not-for-profit medical practice dedicated to the diagnosis and treatment of virtually every type of complex illness.

American Heart Association - Our mission is to build healthier lives, free of cardiovascular diseases and stroke. That single purpose drives all we do. The need for our work is beyond question.

The New York Times Health Guide - Comprehensive reference and special reports about diseases, conditions, tests, injuries and surgeries

PRIMED Patient Education Center - The mission of the Pri-Med Patient Education Center is to provide patients with multimedia access to reliable medical information at and beyond the point of care.

Discovery Health - Discovery Channel's Companion Health Site

National Institute of Diabetes and Digestive and Kidney Diseases

Baby Center - The leading destination on the Internet for new and expectant parents.

KidsHealth.org - KidsHealth is the largest and most-visited site on the Web providing doctor-approved health information about children from before birth through adolescence. Created by The Nemours Foundation's Center for Children's Health Media.

AIDSinfo - AIDSinfo is a U.S. Department of Health and Human Services (DHHS) project that offers the latest federally approved information on HIV/AIDS clinical research, treatment and prevention, and medical practice guidelines for people living with HIV/AIDS, their families and friends, health care providers, scientists, and researchers.

DailyStrength - Most everyone has a serious personal challenge themselves or has someone close to them that does. DailyStrength is a collection of safe, anonymous, online support groups focused on over 500 specific challenges to help people overcome their personal challenge or support a loved one through theirs.

NIH's Medline Plus - MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations.

NIH's National Center for Complementary and Alternative Medicine - The mission of NCCAM is to: Explore complementary and alternative healing practices in the context of rigorous science. Train complementary and alternative medicine researchers and Disseminate authoritative information to the public and professionals.

WholeHealthMD - Dedicated to providing the best in complementary and alternative medicine. All of our information is developed by a team of leading board- certified doctors and specialists.

Lab Tests Online - Lab Tests Online has been designed to help you, as a patient or family caregiver, to better understand the many clinical lab tests that are part of routine care as well as diagnosis and treatment of a broad range of conditions and diseases.

Vaccine Information - The Immunization Action Coalition works to increase immunization rates and prevent disease by creating and distributing educational materials for health professionals and the public that enhance the delivery of safe and effective immunization services.

National Institutes of Health - NIH is the steward of medical and behavioral research for the Nation. Its mission is science in pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability.

Google Health - Health Links from the Internet's Top Search engine.

Health on the Net Foundation MedHunt - HON has become one of most respected not-for-profit portals to medical information on the Internet.

Health on the Web: Finding Reliable Information - “Don’t believe everything you read.” It’s an old warning that is especially true for health-related information you find on the World Wide Web. The Web can be a great resource when you want to learn about a specific disease or health condition. You can also find tips on staying healthy. But among the millions of Web sites that offer health-related information, there are many that present myths and half-truths as if they are facts.

The Medical Library Association's User's Guide to Finding and Evaluating Health Information on the Web - This guide outlines the collective wisdom of medical librarians who surf the Web every day to discover quality information in support of clinical and scientific decision making by doctors, scientists, and other health practitioners responsible for the nation's health.

The Family Health Advocate Web site discusses issues such as the patient-centered medical home and the cost of health insurance -- issues that matter to both FPs and their patients. The site provides links for patients to contact their legislators, as well as tips to make the most effective contact possible.

Physicians Committee for Responsible Medicine

American Academy of Anti-Aging Medicine

American Society for Colposcopy & Cervical Pathology

American Diabetes Association

Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women

Women and Cardiovascular Disease

Organizations Working to Fix the American Health Care System

Alliance for Health Reform - www.allhealth.org - This is a non-partisan information sourse dedicated to the premise that every citizen of the United States should have access to affordable health care.

Families USA - www.familiesusa.org - This is a watchdog group that moniters government actions regarding health care, as well as publishing reports that analyze and present solutions to the health care problems in America.

AARP - www.aarp.org/legislative - Here is a link to AARP's legislative affairs department, which advocates for affordable health care and perscription drugs.

Health Care for All - California - www.healthcareforall.org - This group is a supporter of the single payer health care idea, and is a sponsor of California legislation that would implement a single payer health care system in California.

Interesting Articles and Additional Information

Drinking water linked to lower heart disease risk

Quality of Health Care: "Q-Pack"

Walking Compared with Vigorous Exercise for the Prevention of Cardiovascular Events in Women

Medicare payment cuts: It's time for Congress to act

Breakfast Reduces Diabetes, Heart Disease

6 reasons to eat breakfast: Benefit your waist, your brain and your mood.

Vitamins: More May Be Too Many

Fast-food sellers under fire for helping supersize people

The Daily Walk or the Daily Pill?

Questions and Answers About Vitamin B12