Vital Signs

With a few tools and an eye for observation, you can help detect and monitor health problems in your family. Everyone needs to know how to take a temperature and count pulse and respiration rates. It is also good to learn how to take your own blood pressure. You may even want to learn to do simple ear exams. The tools you need are inexpensive and usually come with instructions.

Temperature

A normal temperature ranges from 97.6° to 99.6° and for most people is 98.6°. Temperature varies with time of day and other factors, so don't worry about minor changes.

Whenever a person feels hot or cold to your touch, it is a good idea to take and record his or her temperature. If you have to call your doctor during an illness, knowing the exact temperature will be very helpful.


There are four ways to take a temperature:

• Orally (in the mouth)


• Rectally (in the anus)


• Axillary (under the armpit)


• Using an electronic oral or ear thermometer or temperature strip

Unless otherwise specified, all temperatures in this site are oral Fahrenheit readings. If you take a rectal or axillary temperature, adjust it accordingly. Rectal temperatures are the most accurate.

Oral temperatures are recommended for adults and children age six years and
older.

• Clean the thermometer with soapy water or rubbing alcohol.


• Hold it firmly at the end opposite the bulb and shake the mercury down to 95° or lower.


• Do not drink hot or cold liquids beforehand.


• Place the bulb under the tongue and close the lips around it. Do not bite it. Breathe through the nose and do not talk.


• Wait three to five minutes.

Rectal temperatures are recommended for children younger than six years or anyone who cannot hold an oral thermometer in the mouth. Use only a rectal thermometer. Rectal temperature is 0.5° to 1° higher than oral temperature.

• Clean the thermometer and shake it down (see above).


• Put Vaseline or another lubricant on the bulb.


• Hold the child bottom-up across your lap.


• Hold the thermometer one inch from the bulb and gently insert it into the rectum no more than one inch. Do not let go. Hold it right at the anus so that it cannot slip in farther.


• Wait for three minutes.

Axillary temperatures are less accurate and about 1° lower than oral. They are safer for small children who will not hold still while you use a rectal thermometer.

• Use either an oral or rectal thermometer. Shake it down below 95°.


• Place the thermometer in the armpit and have the child cross her arm across the chest and hold her opposite upper arm.


• Wait five minutes.

How to Read a Thermometer

• Roll the thermometer between your fingers until you can see the thin ribbon of mercury. Note that the thermometer is marked from 92° to 108°.


• Each large mark indicates one degree of temperature. Each small mark indicates 0.2°.

Electronic thermometers are convenient and easy to use. They are quite accurate, but some are expensive. Temperature strips should only be used to measure axillary (armpit) temperature. They are inaccurate when used on the forehead.

Taking a Pulse

The pulse is the rate at which your heart is beating. As the heart forces blood through your body, you can feel a throbbing in the arteries wherever they come close to the skin surface. The pulse can be taken at the wrist, neck, or upper arm.

Certain illnesses can cause the pulse to increase, so it is helpful to know what your resting pulse rate is when you are well. The pulse rate rises about 10 beats per minute for every degree of fever.

• Count the pulse after the person has been sitting or resting quietly for 5 to 10 minutes.


• Place two fingers gently against the wrist as shown (don't use your thumb).


• If it is hard to feel the pulse in the wrist, locate the carotid artery in the neck, just to either side of the windpipe. Press gently.


• Count the beats for 30 seconds, then double the result for beats per minute.

Counting Respiration Rates

Your respiration rate is how many breaths you take in a minute. It increases with fever and some illnesses. The best time to count respiration is when a person is resting, perhaps after taking the pulse while your fingers are still on his or her wrist. The person's breathing is likely to change if the person knows you are counting it.

• Count the number of times the chest rises in one full minute.


• Notice whether there is any sucking in beneath the ribs or any apparent wheezing or difficulty breathing.

Measuring Blood Pressure

Blood pressure is the force of the blood pulsing against the walls of your arteries. The pressure when the heart beats is called the systolic pressure (the first number in blood pressure readings). The pressure between beats, when the heart is at rest, is called the diastolic pressure. A blood pressure reading below 140/90 is considered normal for an adult over 18.

Most people with good hearing can learn to measure blood pressure using a stethoscope and a blood pressure cuff (sphygmomanometer). Electronic blood pressure cuffs are also available, which do not require a stethoscope or goodhearing.

• Ask your pharmacist to recommend a blood pressure kit and show you how to use it.


• Regular in-home blood pressure monitoring is recommended for anyone who has heart disease or high blood pressure.

Screening and Early Detection

Another way to protect your health is to detect an illness early, while it is still easy to treat. You can do this in two ways: by getting periodic medical exams from health professionals and by becoming a good observer of your own body and health.

Periodic Medical Exams

Many doctors used to recommend a complete physical every year. Now, most doctors recommend specific medical exams based on age, sex, and risk factors. These exams are more effective than the annual physical in detecting treatable illness.

The schedule of medical exams helps you decide which tests are valuable for you and how often you should have them.

The Tests for Early Detection Chart includes specific recommendations for adults age 19 and older. The chart is based on the Report of the United States Preventive Services Task Force. Other organizations may make different recommendations. The most appropriate schedule of preventive exams is one you and your doctor agree upon, based on your health conditions, values, and risk factors.

The recommendations apply to people of average risk in each age category. You may be at higher risk for certain diseases. Family history (whether your relatives have or had the disease), other health problems, or behaviors such as smoking all increase your risk. Talk with your doctor about whether you need more frequent exams.

Periodic self-exams are also an important part of staying healthy.

Flexible Sigmoidoscopy

Flexible sigmoidoscopy is a screening test for precancerous polyps and cancers of the colon and rectum. The sigmoidoscope is a flexible viewing instrument that is inserted into the rectum to examine the lower bowel. The exam takes about 10 to 15 minutes, is only mildly uncomfortable, and is very safe.

Having flexible sigmoidoscopy exams reduces your risk of dying from colorectal cancer. Most experts recommend that you have a flexible sigmoidoscopy exam around age 50. After the first exam, they disagree about how often you should have repeat exams. Recommenda-tions range from every three years to every 10 years or less often. In addition to screening, doctors sometimes wish to examine the colon to check for the cause of rectal bleeding, diarrhea, or constipation.

Other Recommended Tests and Exams

Infants

Well-baby visits are recommended at two weeks and at 2, 4, 6, 9, 12, 15, 18, and 24 months of age. Your doctor may recommend a different schedule. Babies at high risk for hearing problems may be tested during this time.

Children Age 2 to 5

Discuss the frequency of visits with your health professional. A vision test is recommended at age three to four. Some childhood immunizations are also given at this age.

Regular blood pressure checks are recommended after age three and may be done during visits for other reasons.

Children Age 6 to 18

Discuss the frequency of visits with your health professional. A tetanus booster is recommended at age 15. Annual blood pressure checks are recommended and may be done during any visit.

Pap tests are recommended starting at age 18 or before age 18 if a female is sexually active.

Pregnant Women

Discuss the frequency of visits and testing with your doctor. During the first prenatal visit, blood tests, urinalysis, blood pressure, and screening for hepatitis B are recommended. Additional tests are needed during the pregnancy.

†Experts are uncertain of the effectiveness of routine testing for this age group.

‡Experts are uncertain about approaches for people who have a family history of particular diseases, and for other higher-risk groups. If you have a family history of cancer or heart disease in close relatives, discuss it with your doctor.

These screening test guidelines are adapted from the Guide to Clinical Preventive Services, U.S. Preventive Services Task Force, 1996.

Prevention and Detection: Ten Ways to Stay Healthy

Prevention works! You and your family can save a lot of pain, worry, and money by avoiding health problems in the first place. If you can't prevent a problem altogether, the next best thing is to discover it early, when it is easy to treat. This chapter helps you do both.

Ten Ways to Stay Healthy

1. Immunize. Immunizations are the best bargain in health care. When you immunize, you prevent illness for your family and help prevent epidemics in your community. SeeImmunizations.
2. Keep moving. Any way you define it, fitness is essential to good health. Even moderate exercise makes a huge difference both in how you feel and what illnesses you get. See Your Personal Fitness Plan.
3. Eat right. Eating a well-balanced, low-fat diet of wholesome foods will keep you energetic and free of many illnesses. See Nutrition. Consider breast-feeding your baby to help keep him or her in the best health.
4. Control stress. Even with a hectic and hurried lifestyle, you can prevent stress from undermining your health. See Stress and Distress.
5. Be smoke-free. Smokers who quit gain tremendous health benefits. So do people who avoid secondhand smoke. SeeQuitting Smoking.
6. Avoid drugs and excess alcohol. When you say "no" to drugs and limit what you drink, you prevent accidents and illnesses and avoid a lot of problems for yourself and your family.
7. Put safety first. Safety at home, at work, and at play; safe driving; firearm safety; and safe sex will all help keep you healthy.
8. Pursue healthy pleasures. Take naps, relax during meals, play with kids, care for a pet--they all can add to your health.
9. Think well of yourself. A good self-image is the foundation of good health.
10. Promote peace. Peace on earth begins at home. Seek nonviolent ways of resolving conflicts at home, at school, at work, and in your community.
    

Studies Reinforce the Importance of Fiber

The National Cancer Institute along with the U.S. Department of Agriculture have recommended consumption of 20g to 35g of dietary fiber. It is estimated that men and women in this country between the ages of 19 to 50 typically consume only 12g to 17g of fiber daily, which is extremely inadequate. Research studies are continuing to show that people who consume more fiber decrease their risks of developing heart disease and colon cancer.

Have You Heard About TMG?

You probably have not heard much about Trimethylglycine (TMG), otherwise known as betaine. In studies, this little known nutrient has demonstrated benefits for liver function and homocysteine level. A healthy liver is important because it helps our body break down harmful substances such as alcohol and toxic chemicals. Healthy homocysteine levels lower risk of stroke, heart attack and dementia.

Brain Health at the Cellular Level

It is well proven that once we reach midlife, brain cells start dying. By the time we are in our 70's - 80's we have lost a great amount of brain cells that control movement, memory, cognitive function, etc. Mitochondria are thought of as the "power plants" within our cells. Parkinson's disease is the second most common neurodegenerative disorder affecting more than one million people in this country. Perhaps the best studied disease regarding mitochondrial dysfunction would be that of Parkinson's disease. Researcher Dr. Beal indicates there are several nutrients shown in studies to have promising benefits for mitochondrial disorders.

Role of Vitamin K in Bone Health

We hear a lot about the need for calcium, magnesium, and Vitamin D to maintain bone density and prevent bone loss, especially as we age. In a 3-year study of Vitamin K (K1), the group of patients that were given K1, in addition to other vitamins and minerals with bone health benefits, showed a significant reduction in bone loss associate with the hip bone prone to fracture as we get older.