Sports Medicine Testing Overview:
In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing and will often recommend further testing as needed. Our clinic does request some testing that is and not commonly performed in more "mainstream" medical clinics. 24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and Candida antigen testing are commonly recommended by our medical staff. Some of these are discussed in detail in the links in this section.
What to Expect on Your First Visit:
First office visits typically last 45-60 minutes. Your doctor will review your intake form with you and gather a detailed medical history. A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other doctors. Specialty laboratory testing may be recommended. Most clients are offered an initial protocol consisting of nutritional supplementation, dietary and life style recommendations.
First Visit: Blood Test
To assess and identify kidney, liver, blood sugar and other key factors such as blood cholesterols. The results are explained to the patient, giving him/her a fuller understanding of the blood chemistry, so that they may take control.
Patients are required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8pm the previous evening. On the day of the appointment, any prescribed medication should be taken with water as normal.
Patients are recommended to bring food to eat after the blood sample has been taken. Diabetics should advise the clinic, and separate arrangements will be made.
First Visit: Urine Analysis
To establish exactly how the kidneys are functioning. Patients are required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hours fasting period prior to the appointment.
A recommended timetable is that the first urine of the day should be excluded, than all subsequent urine for the next 24 hours collected in clean plastic containers. (If collection starts at 8am, this process must be followed until 8am the following day.) Eg. Appointment 10am Friday, fasting commences Thursday 8pm. Urine collection starts Wednesday 8am. until Thursday 8am.
Containers should be clearly labeled with the patient's names and brought to the clinic at the time of their appointment.
First Visit: Resting ECG for Doctors Report
The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.
The doctor in charge reports any findings in his medical notes.
Specific Sports Medicine Testing:
Exercise Stress Test
What is an Exercise Stress Test?
An exercise electrocardiography is a procedure that screens your heart's responses to physical exertion and need for oxygen. This test is a useful tool for determining the appropriate degree of exercise or physical activity for a person. During this procedure, the electrical heart activity, heart rate, heart rhythm and blood pressure are observed and recorded by an electrocardiograph while walking on a treadmill or while pedaling on a stationary bike. Electrocardiograph electrodes will be attached to the skin during the test.
Indications and Contraindications
An Exercise Electrocardiogram is used to:
- Determine how well your heart tolerates activity;
- Evaluate the function of your heart and valves;
- Determine your likelihood of having coronary artery disease (blocked arteries); and
- Evaluate the effectiveness of your cardiac treatment plan.
Exercise electrocardiograph also evaluates the cardiovascular abnormalities of athletes in competitive sports. This test is done to evaluate undiagnosed conditions, physical fitness, ventilation, gas exchange and cardiovascular function.
The Exercise Electrocardiograph is contraindicated to patients who have the following conditions:
- Unstable angina
- Arrhythmias
- Aortic valve stenosis
- Impaired lung and motor function
- Myocardial infarction
- Congestive heart failure
- Anemia
- Patients who are recently taking Viagra
How do you prepare for an Exercise Stress Test?
Do not eat or drink anything except water for 4 hours before the test. Also avoid smoking for 4 hours before the exercise stress test. Do not drink or eat caffeine products (soda, chocolate products, coffee or tea) for 24 hours before the test. Caffeine will interfere with the results of your test.
Notify the physician of any medications as you might be asked to discontinue them before testing. Since many over-the-counter medications contain caffeine (such as diet pills, and Excedrin), do not take any over-the-counter medication that contains caffeine for 24 hours before the test. Ask your physician, pharmacist or nurse if you have questions about other medications that may contain caffeine.
Do not take the following heart medications on the day of your test unless your physician tells you otherwise or if the medication is needed to treat chest discomfort:
- Beta blockers (Tenormin, Lopressor, Toprol)
- Isosorbide dinitrate ( Sorbitrate)
- Isosorbide mononitrate (Indur, Monoket)
- Nitroglycerine (Deponit, Nitrostat)
Your physician may also ask you to stop taking other heart medications on the day of your test. If you have any questions about your medications, ask your physician.
Wear comfortable clothes and shoes suitable for walking. Do not bring any valuables with you and remove all jewelry and metallic objects from your body.
How does it feel? How long will it take?
You will be encouraged to exercise until you are exhausted. It is normal for your heart rate, blood pressure, breathing and perspiration to increase. This information will allow your physician to assess your heart's ability to function.
As you stop exercising you will feel little unsteady when getting off the treadmill and onto the exam table for the echocardiogram.
If you begin to notice chest discomfort, excessive shortness of breath, lightheadedness, irregular heart beats or other symptoms of concern, tell the stress lab personnel immediately.
The appointment will take about 60 minutes. The actual exercise time is usually between 7 and 12 minutes. You might feel a cold sensation while the electrodes are being attached to your skin. The blood pressure cuff that will be put on your arm may feel tight at times when your blood pressure is being recorded.
Expected effects after the test:
The Exercise Electrocardiograph is relatively safe with very minimal after-effects. It is very rare to experience mild chest pain and discomfort, dizziness, and shortness of breath.
Special instructions after the test:
Patient must lie in supine position after the test in order to rest. You may be able to do your normal activities after the test. However, avoid taking a hot shower for one hour after the test to avoid dizziness and fainting.
Results:
Normal findings:
- Patient is able to reach and maintain a heart rate of 80% of target heart rate for a specific age and gender.
- Absence of cardiac symptoms and electrocardiograph changes.
- No arrhythmias, ABGs or hemodynamic pressures.
Abnormal findings:
- Unsteady blood pressure, presence of heart murmurs, irregular heartbeats and abnormal electrocardiogram tracings.
Notes:
- Inform your physician if you are taking insulin to control your blood sugar. Follow your physician's instructions on how to take them on the day of the test.
- Exercise electrocardiograph works by increasing the heart rate to your appropriate target heart rate. Chemical stress testing is recommended to patients who are unable to exercise.
- In order to properly diagnose cardiovascular disease, complete physical examination, electrocardiogram results, medical history and symptoms of heart disease must all be evaluated.
The Right Diagnosis and Treatment for Sports Medicine
Once the comprehensive review is completed for each patient, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.
Patients Medical's Personal Approach to Sports Medicine
Our doctors and our team at Patients Medical will regularly monitor your progress and track the effectiveness of your program making adjustments if necessary. Our goal is to support you and advise you every step of the way.
We work in conjunction with your existing doctors. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer's, Diabetes, Parkinson's, Multiple Sclerosis, anxiety, depression, and heart disease; the primary objective of our staff is prevention and early detection of disease.
Next Steps:
Poor health can significantly affect your life. Improve your life by changing to good health. Call our patient coordinator at 1-212-679-9667 or click on Request an Appointment to schedule an appointment with one of our doctors for evaluation and testing.
We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, NYC, New York, NY 10017.
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Article Last Updated: 06/26/2009