Preventive Exams

Prepared by Don Hall, DrPH, CHES

1999 - 2000 LifeLong Health TM

Strategy for Good Health

1. A healthy lifestyle (primary prevention)
- eat well - be physically active daily - avoid substances or practices that harm health

2. Regular health exams (secondary prevention)

- check regularly for any abnormalities - early diagnosis and treatment for disease
1999 - 2000 LifeLong Health TM 2

Preventive Exams
Health exams need to be done regularly to be effective. How often you have them depends on your Age and gender Current health status/risks Your preventive care should include health and lifestyle counseling that also takes into account your age, gender, current health, and health risks.
1999 - 2000 LifeLong Health TM 3

Preventive Exams - Teens

Two of the greatest health hazards facing teens are accidents and suicide. Therefore . . . Assess how the teen is coping with life, and provide encouragement and understanding. Emphasize the importance of wearing seatbelts.
1999 - 2000 LifeLong Health TM

Emphasize the importance of wearing a helmet when biking or rollerblading. Discuss not smoking. Discuss not drinking alcohol. Discuss prevention information about teen pregnancy Discuss prevention of HIV infection.
4

Preventive Exams - Women

The health issues of concern for a 55-yearold woman include
osteoporosis breast cancer heart disease. Maintaining strong bones Screening for breast cancer Blood tests for cholesterol Weight management tips Physical activity guidelines Good eating habits

Good preventive counseling would include information on:

1999 - 2000 LifeLong Health TM

Components of a Good Preventive Exam

1999 - 2000 LifeLong Health TM

Basic Health Tests

Health history Physical exam Weight check including
Height and weight Body mass index (BMI)
Healthy range 18.5-24.9 Overweight 25+ Obese 30+ Underweight < 18.5

Waist girth, high risk: women 35+ inches/men 40+ inches

1999 - 2000 LifeLong Health TM 7

Health Tests Continued

Blood pressure check
Less than 135/85 recommended (140/90+ is high BP)

Cholesterol check
Total cholesterol, less than 200 recommended HDL cholesterol, men 45+, women 55+

Blood sugar test, recommended for people age 40+ (earlier if high risk). A fasting test of
110+ indicates impaired glucose tolerance 126+ indicates diabetes
1999 - 2000 LifeLong Health TM 8

Colorectal Cancer Check

About 130,000 people will get colon cancer this year and some 56,000 will die from it. The American Cancer Society recommends everyone age 50+ have - a yearly test for blood in the stool - a flexible sigmoidoscopy and digital rectal exam every 5 years, or - a colonoscopy and digital exam every 10 years
1999 - 2000 LifeLong Health TM

People at High Risk

1. Family history of hereditary polyposis (numerous polyps in the colon). 2. Longstanding ulcerative colitis. 3. History of colon cancer in a parent or sibling. 4. Personal history of large polyps. 5. Prior history of endometrial, ovarian, or breast cancer.
9

Pap Test for Women

A regular Pap test helps detect early signs of cervical cancer. About 14,500 new cases and 4,800 deaths from invasive cervical cancer happen each year. The American Cancer Society recommends
An annual Pap test for all women who are sexually active, or 18+ years old After 3 normal consecutive tests, and if low risk, less frequent tests may be OK; ask your doctor
1999 - 2000 LifeLong Health TM

Women at High Risk

1. Sexually active at early age 2. Multiple sex partners 3. Cigarette smoking 4. African-American women

10

Mammogram for Women

175,000 breast cancer cases are expected this year and 43,000 deaths Recommendation ACS
- breast self-exam monthly, 20+ - clinical breast exam every 3 years at age 20+, yearly after 40 - mammogram yearly after 40 (the Amer. Geriatric Society recommends every 2-3 years after 65)
1999 - 2000 LifeLong Health TM

Women at High Risk

1. Family history of breast cancer (mother, sister) 2. Over 30 and no births 3. Obesity 4. Personal history of ovarian or endometrial cancer 5. High alcohol intake
11

Prostate Exam for Men

179,000 cases of prostate cancer are discovered each year, and 37,000 deaths. Recommendations, beginning at age 50:
digital rectal exam annually PSA test annually
1999 - 2000 LifeLong Health TM

Men at High Risk 1. Family history of prostate cancer 2. African-American men 3. Obesity
PSA Normal Ranges Age Whites Blacks < 50 0-2.5 0-2.0 50-59 0-3.5 0-4.0 60-69 0-4.5 0-4.5 70+ 0-6.5 0-5.5
12

Immunizations
All children should be upto-date on immunizations Adults should have:
tetanus shot every 10 years people 65+ need a pneumonia shot every 10 years annual flu shots are recommended for all over 65 (or for anyone who doesnt want the flu)
1999 - 2000 LifeLong Health TM

Childrens Immunizations
Hepatitis B Diphtheria, tetanus, pertussis
(DTP)

H. influenza type b Poliovirus Rotavirus (a major cause of sporadic, acute enteritis in infants) Measles, mumps, rubella
(MMR)

Varicella (chickenpox)
13

Hearing and Vision Check

Hearing
The doctor should inquire about hearing loss Hearing tests should be done when appropriate If you have hearing loss, you should be counseled on the availability of treatment and treatment options You should be referred for treatment when appropriate
1999 - 2000 LifeLong Health TM

Vision
Periodic vision testing is recommended, as needed, especially past age 40 (more often in elderly) Vision checks should include screenings for glaucoma retinal problems (regularly in diabetics) cataracts
14

Dental Exams
Visit a dental care provider on a regular basis (as recommended by your dentist) Good dental exams include counseling on
daily brushing using a fluoride tooth paste daily flossing good nutrition
avoid frequent snacking get adequate calcium eat lots of fruits & veggies
1999 - 2000 LifeLong Health TM 15

Sign in a Dentist Office

You dont have to floss all your teeth, just the ones you want to keep.

Lifestyle Assessment and Counseling

Effective interventions that address personal health practices are likely to lead to substantial reductions in the incidence and severity of the leading causes of disease and disability in the U.S. Primary prevention as it relates to such risk factors as smoking, physical inactivity, poor nutrition, alcohol and other drug abuse, and inadequate attention to safety precautions holds greater promise for improving overall health than many secondary preventive measures such as routine screening for early disease.
U.S. Preventive Services Task Force
1999 - 2000 LifeLong Health TM 16

Lifestyle Counseling

Areas That Need Counseling

Substance use
Tobacco use/exposure Alcohol/drug use and abuse, especially as it relates to
driving swimming boating after use

Smoking is the leading cause of preventable death in the United States. People exposed regularly to secondhand smoke have a 25% greater lifetime risk of dying from heart disease.

1999 - 2000 LifeLong Health TM

17

Lifestyle Counseling

Diet and Exercise

Saturated fat and cholesterol in the diet Intake of fruits and vegetables, 5+ per day Whole-grain breads and cereals, 6+ per day Adequate calcium intake, especially in teens (1,300 mg/day) and postmenopausal women (1,200 mg/day)
1999 - 2000 LifeLong Health TM

Weight management Regular physical activity

Everybody needs to accumulate at least 30 minutes of moderate intensity physical activity on most, preferably all, days of the week.
CDC and American College of Sports Medicine
18

Lifestyle Counseling

Injury Prevention
Use lap/shoulder belt in the car Wear helmets when biking or roller bladding Install smoke detectors in sleeping areas Ensure safe storage or removal of firearms in the home
1999 - 2000 LifeLong Health TM

Fall prevention strategies with elderly in the home shower/tub hand grips using a cane or walker hand rails adequate lighting exercise programs to strengthen muscles, improve gait, balance
19

Lifestyle Counseling

Sexual Behavior
Preventing sexually transmitted disease (STDs) Preventing AIDS Preventing unintended pregnancies Current Trends Approximately 3 million teens contract an STD each year in the United States. About 1 million teens get pregnant each year.
20

1999 - 2000 LifeLong Health TM

Lifestyle Counseling

Womens Health Issues

Healthy pregnancies
Good nutrition and taking folic acid during child-bearing years Avoiding smoking and alcohol use

Hormone replacement issues after menopause Good bone health

1999 - 2000 LifeLong Health TM 21

Lifestyle Counseling

Mental/Emotional Health Needs

Stress and coping Depression Overall happiness and satisfaction with life Emotional concerns
worry, fear, anger, resentment, anxiety
Signs of Depression Depressed most most of the day Change in appetite or weight loss Sleep patterns upset Loss of interest in things that used to give you pleasure Loss of energy, feel worn out Feel worthless or excessive guilt Find it difficult to concentrate or think clearly Often feel agitated or lethargic Keep thinking of death or suicide
22

Spiritual concerns
1999 - 2000 LifeLong Health TM

Opportunity for Questions

Its important that you understand any health problem you have
ask for clarification if needed ask for specific guidance, what you should do ask for help in making lifestyle changes

Work in partnership with your doctor be a team player Take charge of your health and achieve your goal of health and wellness
1999 - 2000 LifeLong Health TM 23

END
http://sanatate.virtualave.net

1999 - 2000 LifeLong Health TM

24