Myths About My Body: Things to Check Up Beyond the Annual
Question
Are there things I should ask my doctor to check up if they haven’t during my annual?
Answer
Many of us don’t go to the doctor unless we’re sick, or we need a form filled out, or maybe an immunization. But check-ups are important – especially as we age – because prevention is always so much more preferable than waiting until you need treatment!
Depending on your age, varying guidelines exist as to what to cover with your doctor at a regular checkup. Seventy-five percent of chronic diseases are lifestyle-related >> this is a big deal because it means that what you eat, how much you exercise, if you smoke, how you manage stress, if you wear sunscreen and how much you sleep can all directly affect your risk of disease. Wow!
While you can and should do a lot to keep yourself healthy, there are some tests that you can have done when seeing your doctor to also keep you healthy, either by picking up something early and/or helping to prevent it in the first place.
What follows is a brief checklist for you to review before seeing your physician this Fall:
Immunizations
I am huge fan of vaccines because not only do they help to keep you healthy, but because of something called herd immunity—they also help to keep those around you healthy (especially helpful if you are near small children, the elderly or those who are immunocompromised). As NPR aptly put it, vaccines are our civic duty, especially to protect those just mentioned.
Get a flu shot this Fall (and every year)! It can be a life or death situation. 80,000 Americans died from the Flu last year & it wasn’t just the elderly, children, or immunocompromised. Still think you don’t need it? Here are 5 reasons to reconsider.
Make sure you continue to get a tetanus shots every 10 years as an adult
Hepatitis B and varicella vaccines: your doctor can check if you already are immune, and if not, you can be vaccinated
Chickenpox as a kid is bad enough; you don’t want shingles as an adult! Most everyone over 50 should get the zoster vaccine.
While the pneumonia vaccine is recommended for those over 65, it is also recommended for those over 19 who may be at increased risk for pneumonia.
Heart health
Heart disease is still the number one cause of mortality and there is so much you can do to prevent it, and to treat it!
Check your blood pressure annually
Cholesterol: Make sure you have a baseline level between ages 17-21, then start screening based on risk: high risk age 25 for men, 35 for women; low risk age for 35 men and 45 for women
Tobacco: Quit! We all know better by now than to smoke. Second hand smoke is also a risk.
Exercise: Just do it (thanks, Nike!). Strive for 10,000 steps a day, or 150 minutes a week of moderate exercise.
Diabetes: check a fasting glucose level, especially if you have elevated blood pressure or cholesterol or are overweight.
Aspirin used to be prescribed for primary prevention of heart disease but new date has recently shown the risks are greater than the benefits.
STD/sexual health
While ideally condom use would be universal, the reality is that STDs are on the rise again. Do your part and make sure that you are getting tested, especially if you have risk factors.
Bone Health
We reach our peak bone mass in our early thirties. By menopause, when our estrogen supplies lower, we lose even more bone mass. While vitamin D, calcium and exercise are great, get screened for osteoporosis at age 65, or earlier if you have risk factors. No one wants a fracture and there are available therapies if your bone density is low.
Bone health checks are also crucial if you have been diagnosed with, are undergoing treatment, or have been suffering from an eating disorder for over a year. For womxn, this is especially the case if there has been a cessation of menstruation or amenorrhea. The menstrual cycle is a critical part of bone health as when hormones are low, calcium is leached out of the bones to maintain homeostatic functions. If this is the case for you, ask your doctor about checking your bones with a DEXA scan.Mental Health/Substance Use
While it may be difficult to talk about depressed moods, or not feeling safe, or drinking too much or eating disorders, etc, it is so important to bring these important issues up with your doctor.
Cancer screening
Get checked periodically for cervical cancer: the guidelines are changing so be sure to discuss with your doctor > either a pap smear, or just a test for HPV (the virus responsible for causing cervical cancer) or co-testing with both periodically
Mammograms: again, check with your doctor because depending on your personal circumstances, you may need a screening mammogram as early as age 40 or not until age 50.
Colon cancer screening guidelines are changing; it used to be recommended for the general population to either get screened starting at age 50. The repeated interval then varies depending on what test you and your physician choose (i.e. colonoscopy, sigmoidoscopy, fecal occult blood test). Recent data suggests that earlier screening may be warranted. Check with your doctor; depending on your own risk factors you may want to be screened earlier.
Sunscreen: wear it. Period. Most of us don’t wear it and when we do, we forget to reapply it. Skin cancer is largely preventable with this simple measure.
About the Author
Beth Ricanati, MD is the Science & Medicine Editor of The Thirlby. Her debut book, Braided: A Journey of a Thousand Challahs chronicles her journey of a thousand challahs and one woman’s quest for wellness and peace. This physician-mother has built her career around bringing wellness into women’s everyday lives, especially busy moms juggling life and children. She has practiced at the NY-Presbyterian/Columbia University Medical Center, the Cleveland Clinic, and now at the Venice Family Clinic. In addition, her writings have appeared in peer-reviewed medical journals and many lifestyle blogs. Ricanati lives in the Los Angeles area with her family and one challah-loving dog.
