Health

Checkups That Can Save Your Life

by Kate Wicker

Yet when it comes to personal health, we're far less inclined to get regular "tune-ups." In fact, Americans receive only half of the recommended care called for in medical guidelines, according to a recent study by RAND Health, an independent health policy research organization.

At the first sign of a runny nose or fever, we flock to the doctor in droves. However, when we're full of vim and vigor, the last place we want to be is a doctor's office. "When people feel healthy, they don't like to go looking for problems," says Dr. Coleman King, an internist at the Medical College of Georgia. "I'm guilty of that myself. I'm 47 and I haven't been going for routine exams until this year."

The problem with reserving doctor visits only for times when you "feel" sick is that many conditions surreptitiously creep into your life and don't begin causing problems until they've progressed. You can't feel high blood pressure (also called hypertension), for example, but the longer your blood pressure stays elevated and goes undetected and untreated, the higher your risk for heart attack and stroke. "Hypertension is the silent killer because so many people don't realize they have it," says Dr. King. "It's important to get your blood pressure checked about every two years because high blood pressure is extremely common."

The bottom line is preventive screenings like regular blood pressure checks can identify a previously undiagnosed condition or risk factor. Knowing what you're up against allows you to make lifestyle changes to prevent complications and gives your doctor the ability to intervene with early medical treatment if necessary.

After the age of 18, you should schedule periodic checkups and certain routine screenings depending on your age and medical history, according to Dr. King. "If you feel healthy, you probably are," he says. "But there's always a chance that you have something brewing inside that's easily detected and easily treated." If you're ready to take charge of your health, read on.

Cardiovascular Disease Screenings

Cardiovascular disease is the number one killer of Americans, according to the American Heart Association. Fortunately, controlling high blood pressure and cholesterol levels can significantly slash your risk of heart disease and stroke. One in four Americans has high blood pressure, so it's no surprise that blood pressure screening every two years is highly recommended for all adults.

Your blood pressure should also be checked at every doctor appointment-even if you're there for the sniffles. The test is easy and painless and gauges how much effort your heart must exert to move blood throughout your body via blood vessels. High blood pressure is defined in an adult as a blood pressure greater than or equal to 140 mm Hg systolic pressure (the top number in your reading) or greater than or equal to 90 mm Hg diastolic pressure (the bottom number).

Discovering you have high blood pressure can be a shock. "I just happened to have my blood pressure checked and was asked, 'How long have you had high blood pressure?' I said, 'I don't have high blood pressure,'" Dr. King says. "I always thought there was nothing wrong with my blood pressure. I exercise. I'm not overweight. But then I started checking it and it was high."

The good news is high blood pressure is often controlled with simple lifestyle changes like making healthier food choices, managing stress, exercising regularly and kicking the smoking habit. There are also medications available to lower blood pressure.

Healthy cholesterol levels stack the odds in your favor as well. "You should get your cholesterol checked every five years," Dr. King says. A simple blood test known as a fasting lipoprotein profile can measure your total cholesterol level, which includes "good" and "bad" cholesterol. HDL is the good cholesterol while LDL is the culprit behind clogged arteries. A total cholesterol of 200 mg/dL or higher puts you at greater risk for cardiovascular disease.

Cancer Screenings

Cancer-perhaps more than any other disease-strikes fear in people's hearts. For many, just hearing the word conjures up the image of sickly, bald patients enduring the rigors of radiation and chemotherapy while clinging to life. But thanks to new treatments and advanced diagnostic screening tests, a cancer diagnosis is no longer a death sentence.

When cancer is detected early through various screening tests, treatment is far more likely to be successful. But before you run to a specialist begging for a full body scan to rule out cancer, be forewarned: Becoming a paranoid hypochondriac who lives in constant fear of the big "C" word isn't productive or practical. "Not every test is necessary or even helpful. You hear about these people who go to the Mayo Clinic to get a CAT scan, but there's just no evidence that it helps [save lives]," Dr. King says. "Having a slew of tests performed isn't always in someone's best interests. You'll often have false positive results that lead to unnecessary further testing. You can also have false negative results where people can be falsely reassured and leave thinking, 'Oh, I'm fine.'"

Nevertheless, there are certain cancer screenings that do save lives. Take colorectal (or colon) cancer screenings. According to the American Cancer Society, the single best way to reduce your risk of dying from colon cancer is to begin having routine screenings once you hit 50. (Earlier screening is recommended for people with a family history of the disease.) Colon cancer is often curable or even preventable with early detection of precancerous lesions. The five-year survival rate for colon cancer is 91 percent when discovered in its early stages.

There are two primary ways to screen for colon cancer. A flexible sigmoidoscopy, recommended every five years for people with average risk, examines only the lower third of the colon and rectum and is combined with checking the stool for blood. The medical establishment generally recommends a full colonoscopy, which examines the entire colon and rectum. If you opt for a full colonoscopy, you'll need to schedule one every 10 years beginning at age 50.

Unfortunately, the thought of having a long tube inserted up the rectum after having fasted and guzzled a harsh laxative is enough to keep many patients away from a colonoscopy. But mild discomfort is a small price to pay for a potentially lifesaving procedure. "I've had two patients recently who ended up having surgery and were hopefully cured from colon cancer just because we sent them for screening," Dr. King says.

Two important cancer screenings for women are mammograms and Pap smears. "We know that mammography reduces the chance of a woman dying of breast cancer," Dr. King says. "Starting at age 40, you ought to start thinking about having a mammogram." A mammogram takes an x-ray of the breast and is the best way to spot lumps or other changes in breast tissue.

In addition, women should receive an annual Pap smear-a test that's been proven to save lives by detecting cervical cancer and precancerous changes. "Pap smears should begin with adulthood or sexual activity," Dr. King says. Once you've had several normal Pap smears, the test may be performed less frequently at the discretion of your physician.

Men don't have to worry about Pap smears, but Dr. King does recommend a yearly prostate-specific antigen (PSA) test for men over 50. The simple blood test is used to detect prostate cancer. Although there is some controversy about the effectiveness of the test in improving prognosis, it's still widely used. Finally, both men and women should also incorporate a complete skin exam into a yearly doctor visit to check for skin cancer-the most common form of cancer in the United States.

While there's no need to be stricken with cancer phobia, taking time to be tested for colon and breast cancer can go a long way in catching the diseases in their earliest, most treatable stages. "We're always looking for ways to detect cancer at an early stage, so why not take advantage of the technology that's out there if it could potentially save your life?" Dr. King asks.

Diabetes Screening

About seven years ago, 58-year-old Brad Zimmerman of Loganville, Ga., discovered he had type 2 diabetes during a routine physical exam. He's not alone. The waistlines of most Americans are widening, so is the number of people diagnosed with type 2 diabetes. According to the American Diabetes Association, 18.2 million people have diabetes and nearly one-third of them are unaware that they're living with the disease.

When a person has type 2 diabetes, the body fails to properly use insulin, a hormone released from the pancreas that is needed to convert sugar, starches and other food into energy. Over time elevated blood sugar levels lead to complications like kidney damage, heart disease and blindness.

Zimmerman quickly learned that diabetes-especially when it's detected early-is highly manageable with lifestyle changes. "The first thing I did after my diagnosis was research type 2 diabetes and find out what I was dealing with," he says. "I found out that diet and exercise were key to controlling the advance of type 2 diabetes."

Armed with knowledge, Zimmerman developed an action plan and lost more than 40 pounds by adopting a low-carbohydrate, low sugar diet and regular exercise program. Although Zimmerman learned the importance of a healthy lifestyle the hard way, he hopes others won't need a diabetes diagnosis as a wake-up call. "You have to take personal responsibility for your own health," he says.

One way to do this is by getting your fasting plasma glucose checked every three years once you reach 45. The test identifies individuals with type 2 diabetes as well as those who have pre-diabetes, which means having blood glucose levels that are higher than normal but not yet elevated enough to be diagnosed as diabetes. Research shows that people diagnosed with pre-diabetes who take action to manage their blood glucose can delay or even prevent type 2 diabetes from ever developing-something Zimmerman says is well worth the effort. "Type 2 diabetes is a very progressive and dangerous disease, but it's definitely controllable and even avoidable-if you change your lifestyle," he says. "If you don't, you risk full-blown diabetes and all of its side effects."

Wellness Checkups

Gone are the days when a patient religiously goes in for an annual physical, dons a papery gown and, after some poking and prodding, leaves with a clean bill of health. "It's now debated whether getting annual physical exams is a worthwhile thing to do," explains Dr. King. "We just don't have good evidence that coming in every year for a routine physical really prevents disease." That being said, a periodic wellness exam is definitely worth your time and offers perks beyond diagnosing a covert condition. "Often a doctor will be seeing someone with an upper respiratory infection and screening him for something else wouldn't be a priority. Doctors are pressed for time. On the way out the door, a doctor might say, 'Hey, get your cholesterol checked,' but that's all you get,'' Dr. King explains. "That's a good reason to make a routine appointment. You'll have more time to sit down and talk about things like, 'What should I be doing now that I'm this age to keep myself healthy?'"

A wellness exam also gives you a chance to strengthen the partnership with your physician or to establish a relationship with a new caregiver who can become familiar with your medical history and be more attuned to your physical well-being. More than just a quick checkup, a comprehensive exam allows your doctor to assess your medical outlook and recommend lifestyle changes if you have risk factors for certain diseases. What's more, the visit gives you an opportunity to address any questions or concerns you might have. Physicians can discuss screening tests unique to your circumstances such as the need for a bone density test if you're a woman who has reached menopause and are at risk for osteoporosis. Best of all, most insurance companies now pay for preventive visits as part of their coverage. "If a preventive visit is in your policy, there's no reason not to take advantage of it," says Dr. King.

If your insurance doesn't provide coverage for a preventive or wellness visit, keep an eye out for community health fairs. "Health fairs are a great way to check your health. They usually offer free services for things like blood pressure and cholesterol checks," Dr. King says. "If you do find something abnormal, then you can make a follow-up appointment with a doctor."

Most health providers recommend getting a wellness exam every two to three years. This timeline may vary depending on your medical history. During the visit, your blood pressure and weight will be checked. In addition, expect to be examined from head to toe. Your doctor may listen to your heart and lungs, examine your abdomen, feel for lymph node enlargement, look for swelling in the legs and order labs like blood tests. To make the most out of your visit consider the following: