It's a new year, and many of my patients are coming in for their annual check-ups. Maybe you're scheduled to visit your doctor for your annual physical as well. I always like to remind my patients of the old Ben Franklin adage - "an ounce of prevention is worth a pound of cure." Nothing could be truer where your health is concerned. Prevention, however, comes in many forms, from making sure you get the optimal nutrition, rest, and exercise to being proactive and getting the right medical tests to screen for any possible issues.
If you're over the age of 50, the following medical tests are smart-thinking health screening:
Complete Physical Exam: This involves the following:
• weight taken
• urine sample
• heart and lungs checked by listening with a stethoscope
• blood pressure taken
• routine EKG and chest x-ray
Important Blood Tests: Routine blood work is almost always done with a physical exam. This is the CBC, or complete blood count, that measures hemoglobin/hematocrit, red blood cell indices which can screen for anemia, and white blood cells which can warn of an infection. The differential in the CBCmeasures different components in your blood to see where abnormalities may lie.
A BUN, or blood, urea, nitrogen, measures how well your kidneys are working. Electrolytes, monitors sodium, potassium, magnesium, chloride levels and show if you're dehydrated, deficient in these crucial minerals, or perhaps, retaining water as can happen in heart or kidney disease.
A hemoglobin A1c, test measures glucose levels in your blood. Too high (over 6.0) can mean a possible diabetes or prediabetic condition. Thyroid testing can screen for a too low thyroid which can cause depression, weight gain, fatigue, cold intolerance, and slow heart beat. Too high thyroid can cause palpitations, anxiety, intolerance to heat, arrhythmias and be a risk factor for heart disease. C-reactive protein and/or homocysteine levels are markers for inflammation and possible heart disease. Cholesterol screening can show if you are at high risk for heart disease depending on HDL and LDL levels.
Immunizations: A tetanus toxoid needs to be updated every 7 years. This is important especially if you work around your house or at your job where you might come in contact with rusty nails, metal, dirty conditions etc. Also, if you are at risk for getting the flu and/or pneumonia, you may want to get a Pneumovax vaccine for pneumonia and an influenza vaccine.
Colon Screening: This can include Hemoccult stool cards (especially if you see blood during toileting) and/or a colonoscopy to screen for polyps or possible other colon abnormalities. If you have a family history of colon cancer and/or have been experiencing changes in bowel habits, pain, etc, it is important to have a colonoscopy.
Skin Cancer Screen: Especially if you spend a good deal of time in the sun and/or see age spots or other darkened areas of skin, or changes in moles on your body.
Just For Women: In addition to the above, women over age 50 need these specific tests:
• WC (waist circumference): The cut off is 35". Higher than that and you could be at risk for metabolic syndrome and/or heart disease that may affect women during menopause. Usually, overweight/belly fat is the culprit and risk decreases if you can get below 35".
• HPV with Pap: Also called DNA with Pap. This test screens for HPV, or human papillomavirus, the virus responsible for cervical cancer. This test is routinely negative for over 95% of women who are tested but can find cervical cancer early. If negative, testing every 3 years is acceptable.
• Pelvic Exam: Checks the state of your uterus, ovaries, rectum, and how well your pelvic organs are supported. Generally, a stool blood test is also done. Or, if you prefer, you can be given the Hemoccult cards and take them home and do the sample testing yourself and return the card to your doctor's office to be read for results.
• Breast Exam: Likely you are doing self-exams at home all the time, but a breast exam done by your doctor should be done at least once or twice a year.
• Bone Density Exam. This is a very quick, noninvasive, painless test where you lie on a table and a scan runs slowly over your body and measures the density of your bones. If you are a small boned/framed low weight woman you need closer monitoring for bone health.
• Hormone testing: Should be done to determine if you are menopausal or premenopausal, and/or if hormone replacement therapy may be needed depending on your symptoms. Bioidentical hormone replacement uses natural sources of estrogen to alleviate symptoms.
• Mammogram/Thermography: Women should get a screening mammogram by age 50. If you are not in a high risk group (carry the BRCA gene and/or have a family history of breast cancer) you may be able to wait 2-3 years without getting another one. Thermography is a new breast cancer screening device that uses heat sensing to detect abnormalities. Many health practitioners feel it is safer than traditional mammograms.
• Just For Men: Men over age 50 also need the following specific tests:
• PSA, or Prostate Specific Antigen: This screens for possible prostate cancer. However, not all elevated PSA tests mean prostate cancer. Sometimes a condition called Benign Prostatic Hypertrophy can cause the PSA to be elevated yet the tissue is noncancerous.
• Testosterone levels: Should be done especially if you are experiencing fatigue, depression, low libido. If you have low testosterone, or "low T", you can replace with testosterone shots or using natural therapies.
Some of my patients joke that getting older means getting more and more medical tests. I'm not going to sugar coat it; the list is a bit lengthy. The good news is that, if testing is done regularly, you can be sure you are on the right track in your quest to stay healthy long into your old age. The biggest plus, however, is that they allow you to find problems early enough to have a successful outcome in treating them. In fact, some of my patients, after their yearly exam and tests, go out and celebrate or give themselves a special treat! Works for me!