An Apple A Day: Wellness Exams

Preventative medicine is one of the most undervalued parts of medicine. How can one measure the value of not having a disease? The bible tells us that our days are numbered yet we don’t know how many of them we have. The Bible, science, and history all have warned us of the things that can rob days from us: tobacco use, alcoholism, uncontrolled cholesterol, diabetes, hypertension, slothfulness, gluttony, pneumonia, and cancer.

This post is about what you should have done depending on your age and stage of life. Keep in mind that insurance plans vary and all that is recommended may not be covered by your plan. Also, different specialty societies (such as the American College of Gynecology or American College of Physicians or American Urologic Association) may have different recommendations than the US Preventative Task Force. I have compiled the recommendations that I feel are most useful, and even these can vary depending on patient’s medical and family history. It is important that you consult with your primary care physician to discuss the screenings and vaccines that are appropriate for you.

General Wellness:

Each year:

  • Body Mass Index (BMI)
  • Blood pressure
  • Cholesterol
  • Diabetes
  • Alcohol misuse
  • Depression
  • Tobacco use
  • Flu shot
  • Lung cancer screening  (low-dose computed tomography (LDCT) in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years)

Every other year:

  • Vision (starting at age 40)

Every 10 years:

  • Colonoscopy (at age 50 or earlier if indicated by family history)
  • Tetanus vaccination (Tdap once in adulthood- also given to women during pregnancy and immediate family of infants)
  • Hepatitis C (1-time screening for HCV infection to adults born between 1945 and 1965)
  • Shingles vaccine (recommended to those 50 or older who have not had singles in past 6 months)
  • Pneumonia vaccines (2 different vaccinations needed after age 65 or earlier if patient is at risk due to conditions such as asthma, COPD, diabetes)

Women’s Wellness:

Each year:

  • Mammogram starting at age  40 (earlier if indicated by family history)

Every other year:

  •  Bone density starting at 65 years old (starting at age 60 if risk factors present)

Every 3 years:

  • Pap smears starting at age 21; after age 30, women can opt for every 5 years if done with HPV co-testing; discuss with your OB/GYN what is the best for you

Men’s Wellness:

Each year:

  • Prostate specific antigen, also known as  PSA starting at age 55
    • *Prostate cancer screening is highly debated topic right now. The US Preventative Task force state that men between 55-69 should discuss the benefits of this test with their physician before having it done. Often times men have to pay out of pocket because some insurance plans no longer cover it.

Once:

  •  Abdominal aortic aneurysm screening (between the age of 65-75 if smoked >100 cigarettes during lifetime)

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