"Health-Assessment? Useful "tests" at 40?

[SumpChump]

I'm just coming up on 40 and when I think about it... other than eye screenings, vaccinations, and general physicals I really don't think any "watchfulness" has been a part of my care. Our local clinic goes through doctors so quickly that I never have a real "provider" of health care. I just keep retelling my thankfully short story to each new person when I happen to meet them when I am sick every two years or so. Like a broken record, they get a short amature recollection by me... of my medical history... they shrug and the 15 minute apt for my small ache is over.

I don't have any current longterm disease, never a broken bone, had one very odd kidney infection and then a reaction to the awful drug "Cipro", but other than that nothing.

However, my father and his father suffered from high blood pressure... me not so far... mostly good a few times a year it reads borderline. My father suffered an aortic tear which I have no clue if it is hereditary and it's impossible to even get ahold of anyone who KNOWS if this is something I should be scanned for. I literally can't get anyone on the phone who can in ten seconds say... yes or no to getting checked for something related to that.
My father had prostate cancer and I have a benign enlarged but the urologist shrugs it off and says "your too young for any problems" "I don't want to get a false positive at such a young age and then have you take surgical action on a small cancer that wouldn't even kill you by 80".

So other than those two situations above, which I don't really mean as the center of my question here,.....

Are there recommended scans, tests, XYZ to try to finagle my doctor to get tested for me?

Please note, I am not a hypochondriac, I am a regular working stiff about 25lbs overweight according to the crazy government charts, I don't do drugs, I don't drink heavily, I am monogamous, I am as bland , safe and Midwestern as you can get.

I just think... "NOBODY KNOWS ME MEDICALLY"

I don't want to have all this technology around me in this the richest country in the world and find out when it's too late that I have some pancreatic cancer or something (just picked that as a random example).

 

[Mr Nice]

Just the regular blood, cholesterol , blood pressure checks at that age....

 

[Blueskies123]

at about 40 someone moderately over wight will start showing high cholesterol and need to think about going on statins.

 

[bullwinkle]

A glucose tolerance test for pre-diabetes would be a good idea-if I had been smarter & taken it younger, I could have avoided it.

 

[AirgunSavant]

I'd go for the $149 screenings that are in your area.
Check your local paper.
I started having issues in my early 40's that no one found or cared enough to search further. Eight years later it almost killed me and the bills after insurance have me near death now.

That simple range of inexpensive tests years ago could have saved me 2 weeks in ICU and probably around $60K out of pocket.

Do it now, not later!

 

[JTK]

Originally Posted By: Mr Nice
Just the regular blood, cholesterol , blood pressure checks at that age....


^ This, plus maybe a baseline EKG and a PSA test in with the blood work.

 

[wallyuwl]

While not a physician, I'm a PhD in a medical related field. So take what I say for what it is worth.

Just get a regular physical with standard blood labs, PSA test, and an ECG. At your age and with the things you've said blood pressure if your biggest thing to monitor. In general blood pressure is much more important than cholesterol, and there are a lot of studies that show that higher cholesterol and being a littler heavier than what is "healthy" according to the govt. charts is in fact better.

Other than what to get done at your visit, the biggest things health-wise are exercise, including weight training. And eat well: lean animal products (so choose sirloin over prime rib) and vegetables and fruits. Grains, for the average person, are the biggest thing in the diet that will lead to heart disease. And most people eat a lot of them. There is no such thing as a "healthy whole grain." Our body treats grains in a similar way as table sugar, whether it be white bread or wheat bread, and that is bad. Carbohydrates should come from fruits and vegetables.

 

[cat843]

Find a doctor who has time for his patients and go with what you and he/she decide.

 

[turtlevette]

Originally Posted By: AirgunSavant
I'd go for the $149 screenings that are in your area.
Check your local paper.


The Lifeline screenings. If you want to go a step further do a upper body MRI. Call around and negotiate a price. The Shields MRI that Teddy Brewski advertises out here are reasonable.

 

[UncleDave]

Go find a cheap MRI and get a whole body scan done.

Yearly blood, urine tests and physicals missed kidney cancer in me and I lost a kidney as a result. My family doctor of 15 years missed it, I missed it.

If Id have found it earlier I would have only had to remove a piece of it the bad kidney and would still have 2 kidneys.

UD

 

[Oldmoparguy1]

Given your situation with doctor roulette, I would have a paper copy of all medications including OTC things and a list of health actions, basically answers to the repetitive questions you will get with each new doctor. I did that for several years, until I signed on with a senior health care group which is now all online. Can save you a lot of explaining.

 

[69GTX]

If your cholesterol numbers are in check that's a plus. Having a high HDL is probably more important than a slightly high LDL. The ratio is important. So is the ratio of total cholesterol to triglycerides. These should all show up on your normal annual blood work. Get used to knowing what's optimum. You can control this stuff to a large degree with diet. I whole heartedly agree with the above recommendation to cut back on junk and processed foods. And most grains are processed and contribute to blood sugar level spikes. I avoid wheat and have substituted quinoa (which is actually a fruit). Wheat, cow's milk, sugar, trans fats, are some of things that we don't need after we're kids...if at all.

Learn how to mix your foods properly with the right balance of good fats, proteins, and carbos (ie I don't mix heavy carbo's with protein as they tend to interfere with each other's digestion). Half the people who get heart disease have normal cholesterol. So that's not THE answer. As part of your blood work I'd try to also include at least once a homocysteine and HS-CRP test. Both are better body inflammation markers than cholesterol. The best source to determine your body's actual age, is probably calcification of your arteries, tissues, and organs. The annual physicals don't do anything like that. But they should at least once every 10 years or so.

To get a jump start on your knowledge I'd recommend Prime Time Health by Dr. William Sears....or something similar. PTH was just a superb summary of so many important topics that us layman can understand. Your library should have some books about "optimum health." I just picked up Fuhrman's "Super Immunity" from the local library. Once you read your first book on the whys, you'll want to read another. Most people are full of nutrition and health myths. I wish I had done it at age 40 instead of many years later. I was first told about an enlarged prostrate in my 30's and did nothing...not even a change in diet to slow the growth, if that's possible. By age 55 it was a big problem.

Learn about how to achieve max health now, rather than in 15-20 years when your body starts telling you it's time. You might be able to slow things down by 5-15 years. If you want optimum health one thing you probably need is Vit D3 in the 40-70 range, not the 30+ min the govt recommends. Your physical won't include a D3 test (vit D 25-Hydroxy in ng/ml). I'd ask for it. Chances are you are in the 15-30 range like much of the northern US population.

Other things I watch include, blood glucose levels (std on lab work), triglycerides to HDL ratio, total chol/HDL ratio, Vit D3, and PSA. If your blood pressure is not a rock steady 115-120/75-80 I'd work to lower it there with better diet, exercise, and stress reduction/moderation. And getting rid of the extra 25 lbs. would certainly do that. If that 25 lbs includes a bunch of belly fat, that's not good. Belly fat surrounding organs is a much higher health risk than just the fact you weigh a bit more. Belly fat produces a concoction of chemicals that is not good. That same 25 lbs in your legs, shoulders, back, arms, etc would be of much less risk.

Like I said, read a good health book. The first one I ever read was Kevin Trudeau's Health book which generated numerous lawsuits against him. He's in jail now I think. But, that book jump started my interest in what's good and bad for us and WHY. If you don't the WHY, you probably won't fix it. You're young with years of healthy living in front of you. I had wish I had figured this stuff out 20 years sooner than I did. Why don't they teach these basics in junior or senior high school where it can do some good. One class in one semester is all it would take. I've probably read 2 dozen books now, the last one was Guy Daniel's review of current nutrition best practices and guidelines (2012). I actually attended his free seminar. But, that book is much more technical for many folks. You can't do anything if you don't poke around.

Sorry for the length. But this is important stuff. The local $99-$149 scanning groups that are currently in vogue can certainly detect a 1 in 100 issue. But, they also do this to drum up business or order up further tests that will cost hundreds to thousands more. If you're the 1 in 100, then it's a lifesaver. The best defense for that undetectable early cancer that none of us see coming is in prevention. Optimize your diet and the rest of your lifestyle and you will lower the odds tremendously. Even the water you drink and the air you breath is part of that equation. What we can't change is our pre-disposition via genes our parents gave us. The rest is just the roll of the dice. My dad had prostrate cancer at 65 but beat it. Another cancer got him 13 years later. Diabetes and High BP runs in our family too. Stuff to watch.

Do the annual PSA's. I started mine at age 40. They've been low ever since. If that starts jumping it's a fairly good warning signal, though not close to 100% accurate. A colonoscopy at age 50 is another early detection device. Do what you can and don't worry about the rest. Age is still on your side. Both your parents had high BP so you have the pre-disposition. Do what you can now to keep your arteries from stiffening/calcifying. They first noticed higher BP in my 20's. Good luck.

 

[69GTX]

Your Dad's aortic tear could have been the consequence of years of untreated high blood pressure. John Ritter died fairly young a few years back due to something similar to this. As I recall that was just a weakness he probably had for decades and it finally just went. No one knew. More the luck of the odds than anything else?

Lowering your risk factors is what you want to do. If you're eating the standard mid-western diet, that's probably not very good. Find out what the optimum diet is and see how much of that you can achieve. If you're not doing lots of greens (romaine, red leaf, chard), celery, carrots, cabbage, broccoli/cauliflower, garlic/onions, spices, avocado, EVOO, apples, bananas, berries, oranges, lemon, sweet potato, tomato/tomato sauce, oats/quinoa/buckwheat/bulger, almonds/walnuts, pumpkin/sunflower seeds, beets, eggs, beans that you cook, fish (salmon), green teas, etc. then things can be spruced up. You don't see much wheat-pasta-sugar-salt-fried-cow's milk anything in the recommended items. More fish and less red meats. Chicken is in between. Get the stuff without hormones and antibiotics. Once a week drop one lousy food and replace it with a better one. I used to love canned white tuna (mercury) on wheat bread with regular mayo for lunch. At the time I though it was healthy. These days I eat salmon. If I have tuna in a can it's the dark stuff. I make my own mayo with humus, avocado, olive oil, minced garlic/onion, and apple cider vinegar for taste. That old mayo tastes like sheer poison now. If we have a hankering for a crunch dip, the humus and red cabbage works ok. Once you start, it's easy to improve.

 

[SumpChump]

Originally Posted By: 69GTX

Other things I watch include, blood glucose levels (std on lab work), triglycerides to HDL ratio, total chol/HDL ratio, Vit D3, and PSA. If your blood pressure is not a rock steady 115-120/75-80 I'd work to lower it there with better diet, exercise, and stress reduction/moderation.


Thank You!!

 

[69GTX]

The medical insurers are geared towards minimum cost. They treat symptoms and prescribe medications and surgery. Prevention is not as high on their list...it should be. I think that 50% of cancers and heart disease could be eradicated just by avoiding processed/fast foods. That's about as cheap a cure as you can find.

At my worst (50 lbs higher), my blood glucose levels were in the 100-105 range which is borderline. I think at 120 or so they start calling you pre-diabetic or diabetic. My brother's level was recently 95 and his doctor cautioned him about it. He's now in the 80's due to a slight diet change. Less McD's and more home cooking. My own fasting levels average 73-78. I'm still a chocoholic and it's a weekly battle to keep that stuff under control. Better to be a motor-oil-aholic. Interesting that 1-2 oz of real dark chocolate a day is actually preventative (60% cacao or higher). I have mine with almonds (and sometimes dried figs) which makes a nice snack. Better BP control is helped by potassium. Add foods that are higher in it. Celery has been known to moderate BP a bit, so does garlic. It's no coincidence I eat those now. Same with sweet potatoes, bananas, salmon, melon, etc. all being high in Potassium.

A popular myth is that we all need a ton of calcium for health, especially from milk. Not true from what I've read. The nations with the lowest heart disease and osteoporosis have some of the lowest blood calcium levels on earth. If anything, Americans get way too much calcium. Soda helps to tear down calcium from your bones. Then some of that calcium ends up in soft tissues.

 

[Eddie]

Annual physical to include: BP & heart rate, total cholesterol & Triglerides, glucose, kidney & liver function, lung function and ? This establishes a base line for future tests. Ed