Family Medicine

PSA

How the Test is Performed A blood sample is needed. How to Prepare for the Test Make sure your health care provider knows all the medicines you are taking. Some drugs cause your PSA level to be falsely low. In most cases, no other special steps are needed to prepare for this test. How the Test will Feel You may feel slight pain or a prick when the needle is inserted. Afterward, there may be some throbbing or a slight bruise. These soon go away. Why the Test is Performed Reasons for a PSA test: This test may be done to screen for prostate cancer. It is also used to follow people after prostate cancer treatment to see if the cancer has come back. If a provider feels the prostate gland is not normal during physical exam. Measuring the PSA level can increase the chance of finding prostate cancer when it is very early. But there is debate over the value of the PSA test for detecting prostate cancer. No single answer fits all men. Before having the test, talk to your provider about the pros and cons of having a PSA test. Ask about: Whether screening decreases your chance of dying from prostate cancer. Whether there is any harm from prostate cancer screening, such as side-effects from testing or overtreatment of cancer when discovered. If you choose to be tested, the PSA is most often done every year to screen men: From ages 55 to 69, if no risk factors are present. Starting around age 40 to 45 if they have a higher chance of developing prostate cancer. A family history of prostate cancer (especially a brother or father) and being African-American are more common risk factors. Normal Results The PSA test result cannot diagnose prostate cancer. Only a prostate biopsy can diagnose this cancer. Your provider will look at your PSA result and consider your age, ethnicity, medicines you are taking, and other things to decide whether your PSA is normal and whether you need more tests. A normal PSA level is considered to be 4.0 nanograms per milliliter (ng/ml) of blood. For men in their 50s or younger, a PSA level should be below 2.5 in most cases. Older men often have slightly higher PSA levels than younger men. What Abnormal Results Mean A high PSA level has been linked to an increased chance of having prostate cancer. PSA testing is an important tool for detecting prostate cancer, but it is not foolproof. Other conditions can cause a rise in PSA, including: A larger prostate Prostate infection (prostatitis) Urinary tract infection Recent tests on your bladder (cystoscopy) or prostate (biopsy) Catheter tube recently placed into your bladder to drain urine Recent intercourse or ejaculation Your provider will consider the following things when deciding on the next step: Your age If you had a PSA test in the past and how much and how fast your PSA level has changed If a prostate lump was found during your exam Other symptoms you may have Other risk factors for prostate cancer, such as ethnicity and family history Men at high risk may need to have more tests. These may include: Repeating your PSA test, most often sometime within 3 months. You may receive treatment for a prostate infection first. A prostate biopsy will be done if the first PSA level is high, or if the level keeps rising when the PSA is measured again. A follow-up test called a free PSA (fPSA). The lower the level of this test, the more likely it is that prostate cancer is present. Other tests may also be done. The exact role of these tests in deciding on treatment is unclear. A urine test called PCA-3. A blood test called the Prostate Health Index (PHI). An MRI of the prostate may help identify cancer in an area of the prostate that is hard to reach during a biopsy. If you have been treated for prostate cancer, the PSA level can show if treatment is working or if the cancer has come back. Often, PSA level rises before there are any symptoms. This may happen months or years beforehand.

Restless Legs Syndrome

Your legs may become uncomfortable when you are lying down or sitting. Some people describe it as a creeping, crawling, tingling, or burning sensation. Moving makes your legs feel better, but not for long. RLS can make it hard to fall asleep and stay asleep. In most cases, there is no known cause for RLS. In other cases, RLS is caused by a disease or condition, such as anemia or pregnancy. Some medicines can also cause temporary RLS. Caffeine, tobacco, and alcohol may make symptoms worse. Lifestyle changes, such as regular sleep habits, relaxation techniques, and moderate exercise during the day can help. If those don't work, medicines may reduce the symptoms of RLS. Most people with RLS also have a condition called periodic limb movement disorder (PLMD). PLMD is a condition in which a person's legs twitch or jerk uncontrollably, usually during sleep. PLMD and RLS can also affect the arms. 

Tendinitis

Tendons are flexible bands of tissue that connect muscles to bones. They help your muscles move your bones. Tendinitis is the severe swelling of a tendon. Tendinitis usually happens after repeated injury to an area such as the wrist or ankle. It causes pain and soreness around a joint. Some common forms of tendinitis are named after the sports that increase their risk. They include tennis elbow, golfer's elbow, pitcher's shoulder, swimmer's shoulder, and jumper's knee. Doctors diagnose tendinitis with your medical history, a physical exam, and imaging tests. The first step in treatment is to reduce pain and swelling. Rest, wrapping or elevating the affected area, and medicines can help. Ice is helpful for recent, severe injuries. Other treatments include ultrasound, physical therapy, steroid injections, and surgery.

Wrist Injuries and Disorders

Your wrist is made up of eight small bones known as carpals. They support a tube that runs through your wrist. That tube, called the carpal tunnel, has tendons and a nerve inside. It is covered by a ligament, which holds it in place. Wrist pain is common. Repetitive motion can damage your wrist. Everyday activities like typing, racquet sports or sewing can cause pain, or even carpal tunnel syndrome. Wrist pain with bruising and swelling can be a sign of injury. The signs of a possible fracture include misshapen joints and inability to move your wrist. Some wrist fractures are a result of osteoporosis. Other common causes of pain are Sprains and strains Tendinitis Arthritis Gout and pseudogout

Walking Problems

We walk thousands of steps each day. We walk to do our daily activities, get around, and exercise. Having a problem with walking can make daily life more difficult. The pattern of how you walk is called your gait. A variety of problems can cause an abnormal gait and lead to problems with walking. These include: Injuries, diseases, or abnormal development of the muscles or bones of your legs or feet Movement disorders such as Parkinson's disease Diseases such as arthritis or multiple sclerosis Vision or balance problems Treatment of walking problems depends on the cause. Physical therapy, surgery, or mobility aids may help.

Tailbone Disorders

The tailbone is the small bone at the bottom of your backbone, or spine. Tailbone disorders include tailbone injuries, pain, infections, cysts and tumors. You rarely break your tailbone. Instead, most injuries cause bruises or pulled ligaments. A backward fall onto a hard surface, such as slipping on ice, is the most common cause of such injuries. Symptoms of various tailbone disorders include pain in the tailbone area, pain upon sitting, pain or numbness in the arms or legs due to pressure on nerves in the tailbone area, and a mass or growth you can see or feel.

Finger Injuries and Disorders

You use your fingers and thumbs to do everything from grasping objects to playing musical instruments to typing. When there is something wrong with them, it can make life difficult. Common problems include Injuries that result in fractures, ruptured ligaments and dislocations Osteoarthritis - wear-and-tear arthritis. It can also cause deformity. Tendinitis - irritation of the tendons Dupuytren's contracture - a hereditary thickening of the tough tissue that lies just below the skin of your palm. It causes the fingers to stiffen and bend. Trigger finger - an irritation of the sheath that surrounds the flexor tendons. It can cause the tendon to catch and release like a trigger.

Foot Health

Each step you take involves a complex network of bones, muscles, tendons, and ligaments. This, combined with all of the weight they carry, explains why feet can have problems. To keep your feet healthy: Examine your feet regularly Wear comfortable shoes that fit Wash your feet daily with soap and lukewarm water Trim your toenails straight across and not too short Your foot health can be a clue to your overall health. For example, joint stiffness could mean arthritis. Tingling or numbness could be a sign of diabetes. Swelling might indicate kidney disease, heart disease, or high blood pressure. Good foot care and regular foot checks are an important part of your health care. If you have foot problems, be sure to talk to your doctor.

Sciatica

Sciatica is a symptom of a problem with the sciatic nerve, the largest nerve in the body. It controls muscles in the back of your knee and lower leg and provides feeling to the back of your thigh, part of your lower leg, and the sole of your foot. When you have sciatica, you have pain, weakness, numbness, or tingling. It can start in the lower back and extend down your leg to your calf, foot, or even your toes. It's usually on only one side of your body. Causes of sciatica include A ruptured intervertebral disk Narrowing of the spinal canal that puts pressure on the nerve, called spinal stenosis An injury such as a pelvic fracture. In many cases no cause can be found. Sometimes sciatica goes away on its own. Treatment, if needed, depends on the cause of the problem. It may include exercises, medicines, and surgery.

Spine Injuries and Disorders

Your backbone, or spine, is made up of 26 bone discs called vertebrae. The vertebrae protect your spinal cord and allow you to stand and bend. A number of problems can change the structure of the spine or damage the vertebrae and surrounding tissue. They include Infections Injuries Tumors Conditions, such as ankylosing spondylitis and scoliosis Bone changes that come with age, such as spinal stenosis and herniated disks Spinal diseases often cause pain when bone changes put pressure on the spinal cord or nerves. They can also limit movement. Treatments differ by disease, but sometimes they include back braces and surgery.