How To Thrive In ’25

For a healthy new year, don’t just ignore that medical issue that’s been worrying you— get it checked out. Here’s the lowdown on a dozen such concerns.

“Should I see a doctor about that?” It’s a question we’ve all asked ourselves, whether our concern was a funny-looking mole or a family history of cancer. To help you answer that question, we’ve brought together some of Bergen’s best doctors, who share their insights here about when to make an appointment and which diagnostic tests may unlock the secret of what ails you.

1. IF YOU’RE CONCERNED ABOUT: WEIGHT GAIN . . .
you’re not alone. More than 75 percent of Americans are either overweight, defined as having a body mass index (BMI) between 25 and 29.9, or obese, with a BMI of 30 or higher. (You can ascertain your BMI online at cdc.gov/bmi/adult-calculator)

When to see a physician: There’s no magic number, but, says Mina Shaker, M.D., chief of internal medicine at Holy Name Medical Center in Teaneck, “The higher up you are on the scale, the more you should be concerned,” because excess weight can contribute to illnesses ranging from diabetes and heart disease to cancer. Dr. Shaker notes that if you’ve put on more than 8 to 10 pounds over a one- to two-month period, you should definitely see your doctor because you could be suffering from an underlying issue such as thyroid disease.

Tests and possible treatments: Your doctor will likely run a blood workup to see if another condition is responsible for the gain and ask about medications that may also contribute to it. You may be asked to track your food intake and activity to see if changes in diet and exercise might solve the problem. Otherwise, you may be a candidate for one of the new GLP-1 agonists such as Ozempic and Wegovy, which could help you lose about 15 percent of your overall body weight. (A caveat: Data indicate that you’ll need to stay on the medication permanently to keep from regaining the weight. And if you’re depressed and a stress eater, taking a GLP-1 agonist could actually increase your depression.) If you need to lose more than 15 percent, your doctor may suggest bariatric (weight-loss) surgery.

2. IF YOU’RE CONCERNED ABOUT: YOUR SLEEP . . .
you might consider moving to Maine or Minnesota, where, according to the Centers for Disease Control and Prevention (CDC), only about 30 percent of residents are sleep deprived, as opposed to some 39 percent in New Jersey. But wherever you live, sleep problems are on the rise, and they can contribute to a host of conditions, ranging from depression and memory problems to a weakened immune system and even wrinkles.

When to see a physician: It may be time, says Srikant Kondapaneni, M.D., a pulmonologist with the Englewood Health System, “if you’re unable to get seven to nine hours of sleep each night, struggle to fall asleep (indicating insomnia) or wake up feeling tired and fatigued despite sleeping (suggesting poor sleep quality).”

Tests and possible treatments: Your doctor may use the Epworth Sleepiness Scale, which is designed to measure daytime sleepiness. If a medical issue such as apnea or narcolepsy is suspected, you may benefit from an overnight sleep study, a test that records biologic functions during slumber. Treatments could include changes in pre-sleep habits (such as a ban, before bedtime, on the blue light emitted by computer and tablet screens), use of a device designed to facilitate nocturnal breathing, such as a continuous positive airway pressure (CPAP) machine.

3. IF YOU’RE CONCERNED ABOUT: LONG COVID . . .
and you don’t have COVID at the moment, the best way to avoid long COVID is to protect yourself from the virus itself by staying up to date with vaccinations. That way, even if you do contract the condition, you’ll likely have a less severe bout and perhaps avoid long COVID, advises Ashwin Jathavedam, M.D., an infectious disease specialist with Englewood Health, who notes that “people who have never been vaccinated seem to have a higher risk of severe episodes of COVID, as well as long COVID developing.”

When to see a physician: Contact your doctor if your COVID symptoms haven’t resolved after about four weeks and you have one or more of the main symptoms of long COVID—fatigue, limited exercise capacity, shortness of breath, muscle pains, sleep disturbances, brain fog and difficulty concentrating—or other, less common chronic symptoms, like alteration of bowel habits, headaches, dizziness and vertigo.

Tests and possible treatments: There’s no test yet for long COVID, so, says Dr. Jathavedam, “It’s a diagnosis of exclusion—usually the doctor will run tests to make sure there’s no underlying alternative disease process that would explain the symptoms.” Treating long COVID generally means treating the symptoms, so you’ll likely be directed to an appropriate specialist or specialists: heart and lung doctors if you’re experiencing shortness of breath, for instance. According to the CDC, many people with long COVID see symptoms resolve within three months of its onset, and studies show that, on average, cases of long COVID are less severe now than they were a couple of years ago.

4. IF YOU’RE CONCERNED ABOUT: YOUR SKIN . . .
you should know that the three most common skin issues are eczema (a group of conditions causing irritation and inflammation), acne and skin cancer. You already may be treating the first two with over-the-counter medications, such as azelaic acid and hydrocortisone cream.

When to see a physician: For eczema, “if you have red, itchy skin that’s starting to cause cuts or bleeding, I would advise seeing your dermatologist for treatment before it gets out of hand and affects your daily life,” says Ali Hadi, M.D., a dermatologist with Englewood Health. For acne, he suggests seeing a dermatologist if pimples take many days to go away and leave scars. Signs of skin cancer that require immediate medical attention include growths that are new, enlarging, changing, bleeding or darkening.

Tests and possible treatments: Your dermatologist will conduct a physical exam and may perform a skin biopsy. If cancer is found, depending on the type and position, treatment may include surgical removal, radiation therapy, topical chemotherapy and, if you have persistent melanoma, a newer procedure such as TIL (tumor-infiltrating lymphocyte therapy), which boosts immune response. For acne not responding to over-the-counter treatments, your doctor may suggest a prescription retinol (a form of vitamin A) and for eczema, a prescription steroid.

5. IF YOU’RE CONCERNED ABOUT: CANCER . . .
know that the four most common kinds are breast, colorectal, lung and prostate—and be aware of risk factors. “The risk factor that’s common to all four,” says Jamie Koprivnikar, M.D., a hematologist/oncologist with Hackensack Meridian Health, “is family history.” For breast cancer, she says, risk factors also include advanced age, alcohol consumption, high BMI, taking prescribed estrogen and progesterone, early-onset menopause and late-life, full-term pregnancy. Inflammatory bowel disease and cystic fibrosis can predispose you to colorectal cancer, which is more common in African Americans and is being detected more often now among people under 50. Risk factors for lung cancer include smoking and exposure to secondhand smoke, radon and asbestos. African Americans and those exposed to Agent Orange are at greater risk for prostate cancer.

When to see a physician: Consult your doctor if you have any of the following symptoms: for breast cancer, nipple discharge or a breast lump; for colorectal cancer, blood in the stool or a change in bowel habits; for lung cancer, coughing up blood, night sweats, or unintentional weight loss; for prostate cancer, slow or weak urine stream, frequent or painful urination, blood in the urine, prostate pain, loss of bladder or bowel control or ejaculation issues.

Tests and potential treatments: To spot any of these cancers early, follow your doctor’s guidelines for regular tests such as mammograms, colonoscopies, chest X-rays and prostate-specific antigen (PSA) blood tests. All of the above tests may be used to diagnose cancer—as well as others, such as breast ultrasound for breast cancer and a chest CT (computed tomography) scan for lung cancer. As with most cancers, possible treatments include surgery, chemotherapy, radiation and immunotherapy.

6. IF YOU’RE CONCERNED ABOUT: A CHRONIC COUGH . . .
while your first worry may be lung cancer, you could, in fact, be suffering from postnasal drip, acid reflux, asthma (yes, you can develop asthma at any age), COPD (chronic obstructive pulmonary disease) or lung scarring.

When to see a physician: A cough is considered chronic if it lasts more than eight weeks, and that’s when you should see a doctor. A caveat: “Even if it’s been less than eight weeks, if you’re having other symptoms such as shortness of breath or chest pains, or if you’re bringing up a lot of phlegm, you should be seen immediately,” says Wanda Choy, M.D., chief of pulmonary medicine with Valley Health System.

Tests and possible treatments: You’ll likely have a chest X-ray and possibly a pulmonary function test, in which you’ll breathe into a mouthpiece to determine how well air is moving in and out of your lungs. The doctor also may check your sinuses (for postnatal drip) and your esophagus (for reflux). Treatments could include medications for postnatal drip, reflux or asthma or surgery along with chemotherapy, radiation therapy and/or immunologic therapy for cancer.

7. IF YOU’RE CONCERNED ABOUT: SHORTNESS OF BREATH (DYSPNEA) . . .
you may be feeling it as chest tightness, difficulty taking a deep breath, or gasping for air—different people experience this problem in different ways.

When to see a physician: “If it’s very out of the ordinary for you, you should be seen,” says Dr. Choy. “If it’s come on gradually and is worsening over a couple of months, you should also be seen.” If you own a pulse oximeter—a device that clips onto your finger and measures the amount of oxygen in your blood—and it reveals that your oxygen level is below 95, you should see a doctor.

Tests and potential treatments: A pulmonologist will do an X-ray and test your blood oxygen with a pulse oximeter. You’ll also likely have an electrocardiogram (EKG) to determine if the problem is heart related; if the EKG indicates a possible heart problem, the doctor may order a CT scan. A pulmonary function test (see “chronic cough,” above) will likely be done, and blood tests may be ordered to check for thyroid problems and anemia, both of which can cause dyspnea. Treatments could include medications or, if a growth is causing the problem, surgery. See “heart health,” below, for possible treatments for cardiovascular problems.

8. IF YOU’RE CONCERNED ABOUT: HEART HEALTH . . .
you may already be aware that heart disease is the leading cause of death for all Americans—though the rate of heart disease is lower in Bergen than in most of the rest of New Jersey and the country at large.

When to see a physician: According to Ernest Chang, M.D., a cardiologist with Valley Health System, you should see your doctor if you experience shortness of breath, especially on exertion; chest pain that may radiate to the neck, jaw, or down the left arm; palpitations (the feeling that your heart is racing, thumping, or skipping beats) or swelling in the lower leg. “Patients with a high-risk underlying condition such as diabetes, high cholesterol, or a strong family history of heart disease like heart attack, atrial fibrillation, arrhythmia or heart failure should be on high alert for these symptoms,” says Dr. Chang.

Tests and potential treatments: Your doctor may start with an EKG to check your heart’s rhythm. That might be followed up with an echocardiogram, an ultrasound of the heart, to see the structure of the heart and assess the function of the heart muscle. You might also be given a cardiac CT scan or MRI (magnetic resonance imaging test) to check for blockages in the coronary arteries, and/or a stress test, to see how the heart functions under exertion. Treatments include catheterization to find blockages and open them up with a tiny wire-mesh tube called a stent, replacement of a damaged heart valve with a prosthetic valve, and ablation for arrhythmia, in which a thin, flexible tube is inserted into the heart and either heat or cold is used to create scars that will block the arrhythmia. Whatever your diagnosis, it’s important to talk to your doctor about possible nonsurgical interventions as well; research has shown that the two most effective ones are sticking to a Mediterranean-type diet and increasing your activity.

9. IF YOU’RE CONCERNED ABOUT: FORGETFULNESS . . .
keep in mind, says Dr. Shaker, that “by far the most common reason for forgetfulness over age 50 is mild age-related cognitive impairment, and you can do a lot to slow that down, including caring for your mental health, eating well, exercising, reducing toxins such as alcohol and smoking, and even doing puzzles and mental exercises.” A recent report in The Lancet revealed that lifestyle changes like these can reduce your risk of dementia by as much as 40 percent.

When to see a physician: It’s good to see your doctor regarding any memory-related worries, advises Dr. Shaker, if only to ease your worries.

Tests and potential treatments: Your doctor will likely administer the MoCA (Montreal Cognitive Assessment) test, in which you’ll be asked to perform a series of tasks such as drawing a clock and finding commonalities between objects (oranges and apples, for example). If the test indicates significant memory loss, your doctor may order bloodwork and/or imaging tests to see if an underlying medical issue, like thyroid disease, a brain tumor or a vitamin deficiency, is to blame. If the MoCA test is inconclusive, your doctor may repeat it at intervals to determine if your memory is declining. While most types of dementia (for instance, those caused by Alzheimer’s, Parkinson’s and vascular diseases) can’t be cured, their progression can be slowed with drugs such as cholinesterase inhibitors and memantine.

10. IF YOU’RE CONCERNED ABOUT: FALLING . . .
you already know that finding yourself on the ground is more than just embarrassing: In fact, falls are the greatest cause of injury among those 65 or older. A recent study showed that if you can’t stand on one leg for more than 10 seconds, you’re twice as likely to die over the next seven years as people with better balance. (But you can reverse that risk with balance exercises.)

When to see a physician: “If you’re falling consistently, you should see your doctor,” says Dr. Shaker, who says there are many causes for frequent falls, including muscle weakness, balance issues, gait problems, a blood pressure drop on standing (which can be caused by anemia, muscle weakness or hypertension medication) and even tripping hazards around the house.

Tests and potential treatments: Your doctor will likely start with three simple tests: asking you to stand on one leg (to test balance), to go from sitting to standing five times in a row (to test strength) and go from sitting to walking to sitting (to test gait). You’ll probably be prescribed physical or occupational therapy or at-home exercises to improve the areas that need help, and your doctor may also change your medications, advise a change in footwear and/or send you to a podiatrist.

11. IF YOU’RE CONCERNED ABOUT: JOINT PAIN IN THE SHOULDER, KNEE OR HIP. . .
you may have begun to curb activities that trigger discomfort, and perhaps you’ve applied some over-the-counter topical pain relievers.

When to see a physician: “When pain becomes functionally limiting—when you’re finding it hard to do the things you need to do, like standing, walking, dressing and using the toilet, or the things you want to do, like hobbies and sports, that’s a tipping point to see a doctor,” says Naimish Baxi, M.D., a physiatrist at the Hospital for Special Surgery in Paramus.

Tests and potential treatments: You’ll be given an oral history interview and a physical exam. After that, your doctor may take X-rays to see whether you have damage to the joint, and if so, how extensive it is. You may be prescribed physical therapy to strengthen the muscles that support the damaged joint or medication—most likely a nonsteroidal anti-inflammatory such as ibuprofen. Your physician may also suggest cortisone shots, which ease pain by reducing inflammation. He or she may also try hyaluronic acid injections to lubricate the joint. If arthritis and pain in your shoulders, hips or knees are severe, you may be helped by joint replacement surgery, which, Dr. Baxi says, “has come an incredibly long way, in terms of outcomes, even over the past decade.”

12. IF YOU’RE CONCERNED ABOUT: DEPRESSION . . .
you may be feeling more than just temporarily down. While depression can have many causes—from a chemical imbalance in the brain to a difficult life situation to a traumatic event that occurred recently or in the past—it’s definitely a biochemical reaction.

When to see a physician: “As mental health professionals, we recommend that people seek professional help when they notice that their symptoms are interfering with day-to-day functioning,” says Darian Eletto, a licensed professional counselor who is chief clinical officer, behavioral health, at Bergen New Bridge Medical Center. If you’re finding it hard to take care of yourself or others, deal with daily responsibilities or even get out of bed in the morning, you may be clinically depressed.

Tests and possible treatments: A therapist will talk with you to help you find the approach that’s best for you. That may be one of the most popular and efficacious forms of talk therapy known as cognitive behavioral therapy (CBT), which aims to make clients aware of negative patterns of thinking. Other talk-based therapies that can help with depression are solution-focused therapy, a goal-directed approach utilizing the client’s answers to a series of questions, and dialectical behavioral therapy, especially useful for those who experience emotions very intensely. Drug therapy may be combined with talk therapy or used on its own. Usually, a therapist will begin with one of the selective serotonin reuptake inhibitors (SSRIs) like Zoloft or Prozac because, says Eletto, “they’re very mild and have fewer side effects than other medications.” But finding the right antidepressant is, she stresses, a matter of trial and error. If it appears that you’re suffering from seasonal affective disorder (SAD), a type of depression associated with the waning light of winter, you may be prescribed talk therapy and/or a mild antidepressant and asked to take practical measures like spending more time outside or installing a special kind of indoor light that mimics daylight.