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Preventive Medicine for Adults

by Sarah Cimperman, ND

Benjamin Franklin said, "An ounce of prevention is worth a pound of cure." He was right. As the prevalence of chronic diseases such as cardiovascular conditions, type two diabetes mellitus and cancer continue to rise, preventive medicine is more important than ever. A healthy diet and lifestyle are essential, but your doctor also plays a significant role. Routine exams and tests can detect physical and biochemical changes that precede illness, offering an opportunity to address abnormalities before conditions fully manifest. This detailed guide to all the ages and stages of adults’ lives can help make the most of medical visits. The following guidelines apply to healthy adults; certain conditions or risk factors may require more frequent monitoring.

Ages 18 to 20

By age twenty, everyone should have at least one full physical exam and routine laboratory testing. Lab tests should include a complete blood count to assess white and red blood cells; a lipid profile to measure cholesterol, triglycerides, homocysteine and cardiovascular risk; a chemistry and metabolic panel to measure blood glucose, electrolytes, minerals, proteins, nitrogen elements and liver enzymes; a thyroid panel to assess thyroid function; and any other tests your doctor feels are necessary.

Every year, skin exams should be performed by a primary care physician or dermatologist to detect moles or other lesions that may need to be monitored during future examinations. Doctors may recommend more frequent check-ups for individuals at high risk of developing skin cancer and those who have suspicious lesions or have had skin cancer in the past. Every month, adults should perform their own skin exams, observing every inch of skin and enlisting the help of a mirror or significant other to examine areas that are difficult to see.

Women should have a primary care physician or gynecologist perform a clinical breast exam every year and do their own self breast exam every month, as demonstrated by their doctor. Annual pelvic exams should be initiated as soon as women become sexually active and include Papanicolaou tests, also known as Pap smears, which detect pre-cancerous changes to the cervix. Men should have a primary care physician perform a clinical testicular exam every year and should perform a self testicular exam every month, as demonstrated by their doctor.

Ages 21 to 39

Adults in their twenties and thirties should have a complete physical exam and routine blood tests every three to five years. They should continue yearly clinical skin exams and monthly self skin exams.

Women should continue annual clinical breast exams, pelvic exams and Pap smears, as well as monthly self breast exams. Women who become pregnant should follow the recommendations of their obstetrician for exams and tests. Also, by age thirty-five women should have a baseline mammogram. Men should continue yearly clinical testicular exams and monthly self testicular exams.

Ages 40 to 49

Adults in their forties should have a complete physical exam and routine blood work every three years and a clinical skin exam every year. They should continue monthly self skin exams and begin yearly clinical rectal exams and stool tests to screen for blood and abnormal growths.

Women should continue monthly self breast exams and yearly clinical breast exams, pelvic exams and Pap smears. Additionally, women should receive a mammogram every two years. When women enter perimenopause, testing for hormone levels can confirm the transition and help doctors make recommendations to ease symptoms. Men should continue clinical testicular exams on a yearly basis and self testicular exams on a monthly basis.

Ages 50 to 65

Adults in their fifties and early sixties should have a complete physical exam and routine blood tests at least every two years. Clinical skin exams, rectal exams and stool tests should be performed every year. Self skin exams should be done every month. Additionally, a proctosigmoidoscopy should be performed every three to five years to screen for colorectal polyps, cancer or other abnormalities.

Women should continue annual breast exams, pelvic exams and Pap smears, as well as monthly self breast exams. Mammograms should be performed on a yearly basis. Men should continue yearly clinical testicular exams and monthly self testicular exams, and begin yearly testing of blood levels of Prostate-Specific Antigen (PSA).

Ages 66 and Beyond

Adults over the age of 65 should have a complete physical exam, including skin and rectal exams, and routine blood and stool tests every year. They should continue monthly self skin exams. Proctosigmoioscopies should be performed every three to five years.

Women should continue to have yearly clinical breast exams, pelvic exams, Pap smears, and mammograms, as well as monthly self breast exams. Men should continue yearly clinical testicular exams and PSA testing as well as monthly self testicular exams.

Making the Most of Medical Visits

There are several ways to make the most of visits to your doctor. Bring along detailed records of medical conditions that have been diagnosed, medicines that have been prescribed, immunizations that have been given and your family medical history. Heredity is a significant risk factor for many diseases and your doctor may ask you if certain illnesses, such as heart disease, diabetes, cancer, osteoporosis, allergies, blood disorders and metabolic conditions, have affected any of your family members. Also keep copies of tests that have been performed. If you are going to see a doctor who did not order the tests you have had done, bring along copies or arrange for the results to be transferred to their office prior to your appointment.

Write down your questions. Medical visits can be short and it can be easy to forget issues you wanted to discuss with your doctor. Bringing a list of your concerns can give your physician a full picture of your current condition and help prioritize issues in the time available.

If you have a chronic condition that requires monitoring, keep track of significant measurements. People with hypertension should keep records of blood pressure readings and those with diabetes should record blood glucose levels. If you are visiting with a naturopathic doctor, nutritionist or other holistic-minded practitioner, keep a diet diary the week prior to your appointment and bring it with you to the appointment.

Finally, always tell your doctor about any medicines are taking, whether natural or pharmaceutical. Bring along any prescriptions and/or supplements you are taking that were not prescribed by the doctor you will be seeing so she or he can be sure of the ingredients. This will help identify any side effects or potential interactions. The more information your doctor has, the better she or he can diagnose problems and seek solutions.




Dr. Sarah Cimperman is a Doctor of Naturopathic Medicine in private practice in New York City. For more information, call 646-234-2918 or visit www.drsarahcimperman.com.


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