By LAURAN NEERGAARD, Associated Press

WASHINGTON (AP) — It’s not unusual for a 20-something to text Mom in a panic from the doctor’s office, seeking help answering a question. And patients of any age can struggle to recall all their medicines — or forget to mention a concern.

Getting the most out of a doctor’s visit requires some advance preparation. Even the professionals plan ahead.

“It is really hard — even for me as a doctor going to see my own family doctor — to remember the things that I wanted to bring up,” said Dr. Sarah Nosal, president of the American Academy of Family Physicians. “The worst is when you’ve had that moment with your doctor” only to recall another problem after walking out, she said. “You’ve lost that time.”

Her top tip: Bring a list of symptoms and questions to show at the start of the visit. The first item should be your top concern, but seeing the full list helps your doctor prioritize what’s most medically urgent.

“I’m actually going to be able to see, is there a red flag?” explained Nosal, who has some advice about prepping for a typical primary care visit.

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Your primary care doctor monitors your overall health

Some illnesses require specialists like a cardiologist or rheumatologist. But regardless of your age or how healthy you are, research has long shown that a relationship with a primary care provider is important for overall health. It might be a family physician like Nosal, who cares for all ages, or an internist. Some patients choose gynecologists, geriatricians, or have a primary care team that includes nurse practitioners or physician assistants.

Primary care is more than preventive checkups to help avoid illness, such as vaccinations, cancer screenings or health advice. It also includes detecting and treating common problems like high blood pressure, and helping to find and coordinate specialty care.

“That ongoing relationship also helps me know your ‘normal,’” Nosal explained. “If something’s different or changes or you feel off, when you tell me that information and I also have known you over time, we can really figure out together what’s going on.”

Quiz your family before the appointment

Young adults navigating health care on their own for the first time may need help filling out forms with their personal medical history. Have you ever had general anesthesia? Is your tetanus shot up to date?

If you still have access to the patient portal at your former pediatrician’s office, you can see records of vaccinations and prior illnesses, or you may have to request them or quiz parents.

For all ages, family medical history is critical — and needs regular updating. Ask what diseases your close relatives have had and how they fared. For example, if Type 2 diabetes runs in the family, or Grandma had a stroke, or someone had cancer at a young age, that information could help tailor your preventive care, Nosal said.

Fill out your paperwork ahead of the visit

Filling out paperwork from home makes it easier to check medicine bottles for the name and dose. Include both prescription and over-the-counter medicines, pills or creams — and don’t forget vitamins and supplements.

Why are the latter important? Some can interact with prescription medicines. Nosal cited some patients whose longtime treatments quit working after they started taking turmeric, a spice also sold as a supplement.

Also before your visit, check if the doctor received records of recent lab tests, hospitalizations or visits to other health providers, since electronic medical records aren’t always automatically shared.

Keep a running list of questions before a doctor visit

Some symptoms are bad enough to prompt an urgent visit. But if you’ve got a checkup coming, whether it’s routine or to follow up on health problems, start a list of questions in advance.

Notice a pain when you move a certain way? Or chatting with a friend who just got a colonoscopy and wonder if you’re due? Pop those on your list right away, before you forget — and be specific in describing symptoms.

Nosal keeps a running list on her phone and, ahead of visits with her own doctor, sends it as a heads-up through her patient portal. Patients also can include their list on visit check-in forms.

The idea is to address the most urgent questions first, rather than patients running out of time before raising a key concern. Nosal said questions about mental or sexual health and wellness especially tend to come up at the last minute.

Whatever the medium, “please bring that list,” she said. “That’s the most critical of all pieces.”

It’s OK to ask again

People may know to ask questions about treatments, such as how well they work and what side effects to expect. But it’s also important to understand why a doctor makes a particular diagnosis or, conversely, isn’t as worried about a symptom as you might be.

Don’t hesitate to say, “Explain to me what else could be going on,” Nosal advised. “What would be the next step? How would you evaluate that for me, to know if it’s this or that?”

Most health advocacy groups also advise bringing along a friend or relative, especially if you have serious or multiple health problems. They can help ask questions and take notes.

“Whether you are 20 or you are 85, you will not remember everything from your medical visit,” Nosal said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

NEW YORK (AP) — Stocks are off to a mixed start on Wall Street as traders return from the Christmas holiday.

The S&P 500 edged up 0.1% in the early going Friday. The index is holding on to a modest gain for the week. The Dow Jones Industrial Average was little changed, and the Nasdaq composite rose 0.2%, helped by gains in several Big Tech stocks like Nvidia. Crude oil fell, while gold and silver continued to rise.

Trading was expected to be light at the end of the holiday-shortened week. European markets were mostly closed, as were several Asian markets.

Japan’s Nikkei climbed 0.7%.

By Katie Kelton, CCC, Bankrate.com

When Whitney Catalano filed for Chapter 7 bankruptcy in 2022, she was self-employed, living in an apartment she couldn’t afford and carrying $60,000 in credit card and personal loan debt. For her, bankruptcy looked like freedom.

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“I felt very overwhelmed by money,” she says. “I wanted to clear myself of this chapter and really restart from a clean slate.”

Catalano is one voice in a chorus of TikTok accounts lauding bankruptcy. It goes something like this: People in their 20s and 30s film their stories of filing for bankruptcy, calling it the best decision they ever made. Or in modern meme talk: “‘You look happier.’ Thanks, I filed for bankruptcy.”

Now 32 years old, Catalano says she’s built a good credit score and been able to secure apartments and new credit cards that she pays off. She owes no debt.

Bankruptcy might sound like a golden ticket out of debt, but there are consequences. And TikTok certainly shouldn’t be your primary source of financial advice. I talked to a lawyer and a credit counselor to learn about alternatives to bankruptcy and what to know before filing.

Bankruptcy filings are on the rise

Data shows the TikTok trend is indeed playing out in real life.

While the U.S. Bankruptcy Courts reports overall bankruptcy filings are much lower today than in the early 2000s — for example, around 310,600 Chapter 7 filings in 2024 versus 1,139,600 in 2010 — numbers are up since the Fed raised rates in 2022.

Student loan payments are due again. Inflation remains stubbornly high and holiday spending is around the corner. The job market is cooling. Housing costs are up.

Janet Swope, credit counselor of 30 years, runs an agency that offers a state-approved course for people considering bankruptcy. Her client list grows each year, and that includes a recent uptick in younger clients.

This bankruptcy lawyer offers alternatives to filing

Bankruptcy isn’t to be taken lightly. Even though it’s Michael DuPont’s job to help clients file for bankruptcy, he starts by going over alternatives.

A LegalShield provider attorney at Wagner, Falconer & Judd, Ltd, DuPont saw more reluctance to file bankruptcy when he started practicing law 35 years ago. “It is more socially acceptable today,” he says. Still, here’s what he suggests trying before filing.

You might be able to negotiate debt settlement with your lender, either by yourself or with the help of a credit counselor or debt settlement company. There are even AI tools that will negotiate for you. Negotiation can lead to a smaller lump-sum payment, lower interest rate or forbearance.

Or, you could get a lower interest rate and relief from debt collectors with a debt management plan through a credit counseling agency. In this situation, a credit counselor will negotiate with your lenders for you. Then, you’ll make a single monthly payment to the credit counseling agency, who will repay the lenders on your behalf.

These solutions can be quicker, less expensive and have less impact on your credit.

Bankruptcy doesn’t come without risks

Bankruptcy can offer short-term relief with long-term aftermath.

First off, it might cost more than you think to file. The filing fee starts at $313, but hiring an attorney can cost $1,000 to more than $5,000. You also might have to pay for the required education courses.

The two types of bankruptcy for individuals are Chapter 7 and 13. Chapter 7 requires you to sell certain property to pay off creditors, before wiping away the remainder of your unsecured debt. Chapter 13 lets you make a single monthly payment to a trustee under a new repayment plan lasting 3 to 5 years. And you get to keep your property.

Then there’s the matter of credit. Catalano says her credit score increased after filing when her debts were cleared and credit utilization dropped. But a Chapter 7 bankruptcy stays on your credit report for up to 10 years, and a Chapter 13 bankruptcy for up to 7 years. That means any time you apply for an apartment lease, new credit card, car loan or mortgage, the lender may ask about the mark or deny you automatically. And even if you get approved, you might end up with a very high interest rate or other suboptimal loan terms.

Your assets can also be at risk, depending on which type of bankruptcy you file. Chapter 7 requires you to sell non-exempt assets for cash to repay lenders. Exemptions vary by state, but your home, car and belongings could all be fair game. Chapter 13 lets you keep your assets as long as you make the payments decided on in court.

Finally, know that certain types of debt like child support, taxes and student loans can’t be discharged in bankruptcy.

To file or not to file, that is the question

Friends, TikTokers and even credit counselors can’t tell you whether or not to file for bankruptcy. For legal advice, talking to a lawyer is your best bet.

If you’ve considered alternative options but bankruptcy is what’s left on the table, here’s how DuPont suggests proceeding.

First, consider the type of debt you have. Unsecured debt, like credit cards and medical bills, can be eliminated with Chapter 7. But secured debt, like a mortgage or car loan, means your assets can be taken away unless you work out a new repayment plan with Chapter 13.

Then there’s the means test. If your income is below the state’s median income for your household size or your expenses leave you with little disposable income, you can qualify for Chapter 7 bankruptcy. If you fail the test, you’d need to consider Chapter 13.

Here are a couple examples from DuPont of when bankruptcy could make sense:

— Chapter 7: You don’t have many secured assets, like a home, and you have large medical or credit card bills on which the lender’s unwilling to negotiate.

— Chapter 13: You bought a home at a rate you can’t afford and are now faced with foreclosure.

Don’t feel guilty, says a credit counselor

Swope says there’s one thing her bankruptcy clients have in common — remorse.

During the first consultation, clients want to apologize for their debt spiral or mortgage foreclosure. “I try to get people to understand there’s no guilt,” she says. “Things happen.” Swope tells me the common culprits of bankruptcy are medical debt, job loss, divorce and credit card debt from basic expenses that income can’t cover.

Swope helps clients know their rights and crunch their numbers. Most don’t have a complete picture of their income compared to expenses and total debt. Her clients’ credit reports are also usually in bad shape.

“They need to rebuild somewhere,” she explains. “So are they going to [file] a bankruptcy and rebuild, or are they going to rebuild the credit report that’s already really damaged?”

A look at life after bankruptcy

Catalano decided the consequences of bankruptcy were worth it for her. “I couldn’t see myself spending the next 3 to 5 years still in the debt cycle, trying to pay it down,” she says.

After filing, she says she was able to rent from a private landlord by explaining her situation and showing her positive history of rent payments. And she was approved for a credit card from her bank, which allowed her to start rebuilding credit.

In the meantime, Catalano’s working full-time again and has adopted new habits to stay out of debt. She tracks her budget monthly. She plans ahead for large purchases. And after cutting expenses while filing for bankruptcy, she’s kept her costs low. “My spending and saving always perfectly fit in my income,” she says.

If you decide to file, you’ll need to rebuild credit after bankruptcy. Be prepared to make future credit card and loan repayments on time and in full, and stick to a budget to avoid racking up more debt.

But remember, “Time takes care of things,” Swope says. The further away you get from filing, the less it hurts your future.

So no, bankruptcy isn’t a get out of jail free card. There are monetary and opportunity costs to weigh against the relief of a $0 debt balance. For some young people, bankruptcy may be the first step toward a fresh start. For others, it may be only one of several better options. Only you — and a legal professional — can decide what’s right for your financial future.

©2025 Bankrate.com. Distributed by Tribune Content Agency, LLC.

By CALEIGH WELLS and AYA DIAB, Associated Press

The holiday season will soon come to a close, but the busiest time of the year for product returns is just beginning.

The National Retail Federation estimates 17% of holiday purchases will be sent back this year. More retailers are reporting extended return windows and increased holiday staff to handle the rush this year.

A major driver for returns is uncertainty. When we buy for other people, finding what they want is a bit of a guessing game. Online purchases have higher return rates because finding the right size and color is tough when you’re just staring at images on screens.

“Clothing and footwear, as you can imagine, because fit is such an important criteria, they have higher rates of returns,” said Saskia van Gendt, chief sustainability officer at Blue Yonder, which sells software designed to improve companies’ supply chain management.

Returns come with an environmental cost, but there’s a lot consumers and companies are doing to minimize it.

The impact of returns

If a company sells a thing, it’s probably packaged in plastic. Plastic is made from oil, and oil production releases emissions that warm the planet. If that thing is bought online, it’s put on a plane or a train or a truck that usually uses oil-based fuel.

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If you buy a thing and return it, it goes through most or all of that all over again.

And once those products are back with the retailer, they may be sent along to a refurbisher, liquidator, recycler or landfill. All these steps require more travel, packaging and energy, ultimately translating to more emissions. Joseph Sarkis, who teaches supply chain management at Worcester Polytechnic Institute, estimates that returning an item increases its impact on the planet by 25% to 30%.

Roughly a third of the time, those returns don’t make their way to another consumer. Because frequently, it’s not worth reselling.

If, for example, you get a phone, but you send it back because you don’t like the color, the seller has to pay for the fuel and equipment to get the phone back, and then has to pay for the labor to assess whether it has been damaged since leaving the facility.

“It can be quite expensive,” said Sarkis. “And if you send it out to a new customer and the phone is bad, imagine the reputational hit you’ll get. You’ll get another return and you’ll lose a customer who’s unhappy with the product or material. So the companies are hesitant to take that chance.”

Something as expensive as a phone might get sold to a secondary or refurbishment market. But that $6 silicone spatula you got off Amazon? Probably not worth it. Plus, some stuff — think a bathing suit or a bra — is less attractive to customers if there’s a chance it’s been resold. The companies know that.

And that’s where the costs of returns are more than just environmental — and consumers wind up paying. Even free returns aren’t really free.

“Refurbishment, inspection, repackaging, all of these things get factored into the retail price,” said Christopher Faires, assistant professor of logistics and supply chain management at Georgia Southern University.

What consumers can do about it

If you want to reduce the impact of your returns, the first move is to increase their chances of resale. Be careful not to damage it, and reuse the packaging to send it back, said Cardiff University logistics and operations management lecturer Danni Zhang.

If you have to return something, do it quickly. That ugly Christmas sweater you got at the white elephant office party has a much better chance of selling on Dec. 20 than it does on Jan. 5. Zhang said it’s not worth the cost to the company to store that sweater once it’s gone out of season.

Another tip: in-person shopping is better than online because purchases get returned less often, and in-person returns are better, too — because those items get resold more often. Zhang said it reduces landfill waste. Sarkis said it reduces emissions because companies with brick-and-mortar locations spread out across the country and closer to consumers thus move restocked goods shorter distances.

“If I can return in-store, then I definitely will,” Zhang said. “The managers can put that stuff back to the market as soon as possible.”

Obviously the best thing consumers can do is minimize returns. Many shoppers engage in “bracketing behavior,” or buying multiple sizes of the same item, keeping what fits, and returning the rest.

“This behavior of bringing the dressing room to our homes is not sustainable,” said Faires.

If you’re buying for someone else, you can also consider taking the guesswork out of the equation and going for a gift card.

“I know we do really want to pick up something really nice to express our love for our friends or our family. But if we are more sustainable, probably the gift card will be much better than just purchasing the product,” Zhang said.

What businesses can do about it

Sarkis wants to see companies provide more information in product descriptions about the environmental impact of returning an item, or how much of the purchase price factors in return costs.

“But I don’t know if they want to send a negative message,” he said. “If you’re telling someone to stop something because of negative results, that’s not going to sell.”

Sarkis and Zhang both say charging for returns would help. Already Amazon is requiring customers pay in certain situations.

On the tech side, Blue Yonder’s recent acquisition of Optoro, a company that provides a return management system for retailers and brands, uses a software to quickly assess the condition of returned products and route them to stores that are most likely to resell them.

“Having that process be more digitized, you can quickly assess the condition and put it back into inventory,” said van Gendt. “So that’s a big way to just avoid landfill and also all of the carbon emissions that are associated with that.”

Clothing is returned most often. Many sizes do not reflect specific measurements, like women’s dresses, so they vary a lot between brands. Zhang said better sizing could help reduce the need for returns. On top of that, Sarkis said more 3D imaging and virtual reality programs could help customers be more accurate with their purchases, saving some returns.

The Associated Press’ climate and environmental coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.