Health Basics 101
Originally published: 01.01.08 by Alan and Pamela Davis
The truth in medicine is always changing — education will enable you to make sound medical choices.
Dr. Alan W. Davis, M.D., and Dr. Pam H. Davis, M.D., have dedicated themselves to helping HVACR Business readers better understand the world of medicine.
Like you, they are experts in their fields.
Alan is an orthopedic surgeon and sports medicine physician affiliated with The Cleveland Clinic Foundation. He is a member of the National Board of Medical Examiners, American Academy of Orthopaedic Surgeons, and the American Orthopaedic Foot and Ankle Society. He also is head team physician of the Cleveland Barons Hockey Club and travels internationally for USA hockey.
Pam is a practicing dermatologist at MetroHealth Medical Center in Cleveland, Ohio, and is an assistant professor at Case Western Reserve University. She is the former chairwoman of the Department of Dermatology at MetroHealth. Currently, she is a member of the American Board of Internal Medicine as well as the American Board of Dermatology and is a member of the American College of Sports Medicine.
Every day you are faced with myriad decisions about your business. You educate yourself on the issues at hand in order to make sound choices. One business decision you can’t ignore is
We can honestly tell you that even as physicians, we are often amazed at the discordant information available to all of us.
Indeed, a popular mentor of ours once explained to us that “The truth in medicine is always changing.”
We have now practiced long enough to understand this. With the evolution of medical knowledge and the progression of technology, much of what we learned in medical school is old information. Therefore, this changes our evaluation and treatment of patients.
In the upcoming issues we would like to address some pertinent health-related concerns that we feel all adults should know. There is a sense of positive power that comes with knowledge about your health and well being.
Do note that the following guidelines are just that – guidelines. Everyone’s bodies are different. To gain the most accurate view of your overall health, a continuing partnership with your doctor is paramount.
As a primer, let’s start with health maintenance — or The Body Manual.
Unfortunately, our bodies don’t come with owner’s manuals. If they did, they would certainly mimic a car owner’s manual or an hvacr service agreement.
A car is a sizable investment and most of us are aware of what it takes to keep it running well. We put stickers on the windshield to remind us to change the oil. We keep the fluid levels up. We fill the tank with gas when needed.
When you sell an hvacr unit you explain to your customers that maintenance is necessary to keep the unit running optimally, and you provide them with literature to outline the basics.
We need to think about our bodies in the same way. We need regular diagnostic tests, periodic check ups, premium fuel and sometimes even repair visits. Since we are not born with a maintenance manual, we are going to give you the most recent guidelines as it pertains to health screening in 2008.
Many of the recommendations pertain to both men and women and some are sex specific. Let’s start with guidelines that pertain to both sexes first.
Physical Exam – General recommendations are to have a complete physical once every five years from age 20 to 45, every two years from age 45 to 65 and yearly there after.
The physical examination consists of obtaining vital signs and a complete hands-on check of all body systems. A thorough history should be taken to evaluate for symptoms of illness.
Dental Visits – Cleaning and checkups are recommended every six months.
Eye Exam – After the age of 40 it is necessary to visit your eye doctor about every two years. If you have vision problems or diabetes, you may require more-frequent visits.
Colon – All patients should have a colonoscopy at age 50, and every 10 years after this. If there is a family history of colorectal cancer, this should start earlier — age 40 or so. In-office tests for blood in the stool should be performed annually. It is an inexpensive and decent screening test that will alert your physician to potential problems. Early detection is the best defense.
Skin Exam – Since hvacr contractors spend a lot of time outdoors, it is wise to get in the habit of routinely looking at your own skin (in addition to thorough in office checks) for any new or changing moles or other spots you just can’t explain. Skin cancer can be fatal, but early detection will significantly increase your odds of survival.
Vital Signs – Keeping track of heart rate and rhythm, blood pressure and respirations, and also height and weight are critical to keeping the body in line. Blood pressure should be checked at each physical and with any visit to the doctor. There are very few symptoms of high blood pressure, but damage can be significant if untreated. Have this checked often. It goes without saying that all of us need to keep track of our weight as adults; particularly insidious weight gains or losses. To achieve the most benefit, you should consult with your doctor to determine the appropriate goals for your body. Men and women are different and each patient is different, so general numbers won’t mean much unless all other vital statistics are factored in.
Electrocardiogram – This is a test done in the office that evaluates indirectly the electrical activity of the heart. It is a good idea to get a baseline around the age of 40. Follow up will be determined by your doctor.
Cholesterol – This is a simple in-office blood test. A healthy level is below 200. Have your cholesterol first checked by age 20 and then every five years thereafter. If your cholesterol level is found to be abnormal, a full lipid panel is suggested and should be followed regularly. A lipid panel usually measures three different kinds of lipids in the blood, all of which are related to cholesterol. There are two types of cholesterol – HDL and LDL.
High-density lipoprotein (HDL) is known as “good” cholesterol, because high levels of HDL seem to protect against heart attack.
Low-density lipoprotein (LDL), known as “bad” cholesterol, can slowly build up in the inner walls of the arteries that feed the heart and brain. Together with other substances, it can form plaque — a thick, hard deposit that can narrow the arteries and make them less flexible.
CRP – C-reactive protein (CRP) is highly correlated with risk of heart disease. There are no official guidelines for this lab, but if there is a family history of heart disease you may want to ask your physician to check this for you via a simple blood test.
Prostate Exam – A digital rectal exam is recommended every three to four years after age 40 along with a PSA (prostate specific antigen) blood test. This is a good screening test for prostate cancer. These tests are recommended yearly after age 50.
Testicular Exam — Monthly self exams are recommended for all men, regardless of age. Any swelling, mass or change in texture of the testicles should be checked by a physician.
Mammogram and Self Exams – A baseline mammogram is recommended at age 40 and then yearly thereafter. A woman should examine her own breasts for lumps monthly starting at age 20 and have a physician do the exam every two to three years until age 40 and yearly after this.
Pap Smear/Human Papillomavirus (HPV) testing – Women should have an annual Pap test and exam from the start of sexual activity until age 30. After age 30 women should have a Pap test with an HPV test every three years. The HPV test specifically looks for evidence of infection with the HPV virus. Certain subtypes can be associated with cervical cancer.
Bone Density Testing – This is recommended for all women after menopause or at least by the age of 65. Women who are thin or who smoke or drink excessively or who have a family history of osteoporosis should have the test earlier.
This is a non-invasive radiologic test that evaluates bone density or mass. This may seem like a lot of information but a good physician should be keeping track of this for you. All you have to do is make the appointments. And in the age of the Internet, many doctors will e-mail you your results complete with full definitions of all statistics.
You wouldn’t expect homeowners to fully understand the technology and theory behind their air conditioning and heating units. And doctors don’t expect you to have medical-degree knowledge. The key is to look for warning signs and be diligent about maintenance.
In the next column, we will discuss what you should be looking for in a physician. Some traits are easily identifiable, others require a bit of intuition.
Alan is an orthopedic surgeon and sports medicine physician affiliated with The Cleveland Clinic Foundation. He is a member of the National Board of Medical Examiners, American Academy of Orthopaedic Surgeons, and the American Orthopaedic Foot and Ankle Society.
Pamela is a practicing dermatologist at MetroHealth Medical Center in Cleveland, Ohio, and is an assistant professor at Case Western Reserve University. She is a member of the American Board of Internal Medicine as well as the American Board of Dermatology and is a member of the American College of Sports Medicine.
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