An Update for My Patients

It has been a busy month for me, but I am relieved to finally have a plan in place. I will begin working with Baptist on September 30th with the plan of seeing patients beginning October. We are working quickly to get everything in place so that I can get started seeing patients again. I will post contact information as soon as we get my schedule set up!

Again, thanks to my patients for being so encouraging and supportive as I took the time to carefully evaluate the many job opportunities I was presented this last month. Thank you to the physicians, lawyers, and business owners that gave me wise counsel as I evaluated each opportunity. I ultimately chose the option that was best for me, my family, and my patients and would allow me to continue to practice internal medicine in Madison.

Thank you for your prayers during this unexpected transition. I continue to grow during this time and I have come to enjoy the bits of quiet stillness gifted to me these few weeks. As I stated in my previous post, I have grown as a person, as a mother, as a wife, as a believer in Christ, as a servant, as a physician, as a friend, and as a leader in my community and in healthcare. I have learned so much about myself and who I am apart from medicine, but also within the medical community. The 6 weeks away from my job have taught me that physician is not my identity, but that my identity is in Christ. Physician is my role. I am enough and I am satisfied in Him and it does not matter whether I am employed or not. I look forward to getting started at Baptist in Madison, with new perspective and renewed energy. See y’all soon!

The New MSMA

Annual session is one of the highlights of the Mississippi State Medical Association’s calendar. The presidential inauguration and gala never disappoint. But let me tell you… this year was on a whole different level. This year, they chose to celebrate Women in Medicine in an entirely separate event. Jill Gordon and co went all out. The anticipation for the event was high. It was the chatter of the medical community.

“Are you going to the gala?”

“Do you have extra tickets?”

“I can’t wait!”

“Are you getting hair and make up done?”

“What does your dress look like?”

Insert the girliest glam talk here.

And if any of you know me well, you’re probably laughing at this point because you know this is not my jam. I do not do parties and galas and formal dresses and make up.

Usually there are disappointments when expectations are high, but this event surpassed all of the expectations. It was very well done. Everything was perfect down to the red carpet entry.

Photobombed by President Dr. Mansour!

But the fun didn’t end there! The presidential dinner and gala was the next night. I got to see Dr. Michael Mansour pass the torch to Dr. Clay Hays.

The next morning was the awards ceremony. I was honored to be a member of the MSMA physicians leadership academy this past year and I was awarded 2019 Doctor of Distinction.

If the past year has taught me anything, it has been to step out and be bold. Get uncomfortable. Get your glam on. I had so much fun. I met so many new friends. Looking forward to the next celebration! If you are a physician and not involved with the MSMA, you are missing out on so many wonderful opportunities. Join us in moving medicine forward in Mississippi!

Spring Fever: PollenNation

Spring time brings beautiful flowers, lush green grass, and gentle warm breezes. In Mississippi, it can also bring snow, floods, and mosquitoes all in the same week. Jackson, Mississippi is one of the nation’s worst places for allergy sufferers. It routinely ranks in the top 3, often times at the #1 spot. I have asked a friend and colleague, Dr. Chelle Pope Wilhelm, to discuss surviving allergy season in Jackson.

Many people attribute their sinus congestion, cough, runny nose, and sore throat to the rapidly changing weather. While that may play into it somewhat, it has more to do with allergens than the barometer.

What is an allergy?

An allergy is an inappropriate immune response to normal exposures that we encounter every day.  Essentially, allergies occur when a person’s immune system mistakenly identifies common exposures, such as pollen and animals, as harmful.  This immune reaction causes allergic inflammation in susceptible people, and this inflammation causes the allergy symptoms.

What causes us to have allergies?

Essentially, there is no one answer to this question.  Many people encounter the same exposures every day and never develop any allergy response.  One theory (the hygiene hypothesis) is that children are not exposed to the same degree of infectious agents, such as bacteria, in today’s world, and this is affecting how the immune system develops.  Some scientists are studying how the bacteria in our guts affect the development of allergic disease.  While no one really knows why some people develop allergies and others do not, the biggest factor in determining this is genetic history.  Atopy (allergy) tends to run in families.  When a parent or a sibling is affected by allergies, a person’s risk is increased that they too will develop allergies.  

What are the symptoms of seasonal allergies?

The most common symptoms of seasonal allergies are typical hay fever symptoms, including runny nose, nasal congestion or stuffiness, nasal itching, and drainage down the throat.  People also tend to have eye symptoms (allergic conjunctivitis), including burning, itching, and watering of the eyes.  Many people will also develop a common allergic rash called eczema.  Of course, the most concerning symptoms are those associated with asthma, including shortness of breath, cough, wheezing, and chest tightness.  Not all patients with allergies develop asthma, but they do have a higher risk compared to those without allergies.

What are the most common causes of allergies?

The most common causes of allergies are pollens, including tree pollen, grass pollen, and weed pollens.  Outdoor allergens like these have particular seasons when they are more prevalent.  For instance, tree pollen typically is prevalent in the spring season, while grass starts to become a problem in summer.  Weed pollens are typically found in the fall season.  Other common allergens are dust mites and animal dander (typically cats and dogs).  These allergens are present year-round and are typically indoor sensitivities.

At what point should I seek help from a physician?

There are numerous over the counter options to help treat the symptoms of allergies.  Typically, over the counter antihistamines are first line treatments.  However, if these medications are not effective at eliminating your symptoms, you should see your physician.  Your physician can help guide other treatments to hopefully get you some relief. There are some prescription medications that may help.  Allergies can cause a lot of problems outside of just a stuffy nose.  Allergies can affect your sleep and, in turn, affect your day to day activities.  It is always best to seek care from your physician sooner rather than later if typical over the counter antihistamines are not effective.  Most importantly, if you are having any symptoms of asthma, including chest tightness, cough, shortness of breath, or wheezing, you need to be seen by your physician.

At what point should I consider asking for a referral to an allergist?

If your physician has trouble controlling your daily symptoms with standard therapy, typically 1-2 allergy medications, he or she will typically suggest that you see an allergist to discuss other treatment options.  One benefit of seeing an allergist early is that you can identify your triggers and learn tips and tricks on how to adjust and minimize your daily exposures.  Anytime you have asthma symptoms that are not controlled with standard treatments provided by your primary care physician, you should consider seeing an allergist.  An allergist can help determine common triggers of asthma and work with your primary care physician to help manage your asthma with other types of therapy when needed.  

How do you get tested for allergies?

You first need to be seen by an allergist to have a thorough history taken that can guide the next steps.  Typically, people will be tested for allergies by skin prick testing.  This is where the allergist will use a small plastic device to scratch the skin with the different environmental allergies in your local area.  This test is done in the allergist’s office and the results are available to discuss with the doctor during that visit.  The other option for allergy testing is to obtain lab work to look for allergies.  This is typically done if there is another health reason that prevents skin testing from being done safely.  These results are usually available a few days later.

What happens if you do have allergies?

If you are found to be allergic on testing, certain avoidance measures can be recommended depending on your triggers.  A treatment plan that is tailored to you and your seasonal symptoms can be discussed and planned.  Allergen immunotherapy is also available and very effective.  Allergen immunotherapy is what most people know as “allergy shots,” and these are tailored to each person’s individual triggers.  We also have sublingual immunotherapy available for some select allergies.  Sublingual immunotherapy is a tablet that is placed under the tongue daily for treatment of allergies.  

I used to never have allergies when I was little, now I seem to be allergic to everything. What happened to me?

It is a common misconception that allergies and asthma are childhood illnesses only.  Allergies and asthma are not simply childhood illnesses.  These illnesses can affect any age group.  Yes, many people develop the issues in childhood and carry these through life.  Others have trouble in their childhood years and then get a break from symptoms for a few years, only to go on to have recurrence of symptoms later in life in their 30s or 40s.  However, many people have never had any issues with allergies or asthma at all until the symptoms hit in adulthood.  It is common to see people of all ages develop symptoms without any childhood history.  We even see it develop in the retirement years.  Unfortunately, this misconception may delay some people from seeking care because they do not believe having these issues at their age is possible.  Allergies are possible at any age.

Dr. Wilhelm received her bachelor of science degree in Microbiology from Mississippi State University in Starkville, Mississippi, in 2003.  She received her medical degree from the University of Mississippi Medical Center in Jackson in 2007.  She completed her residency in Internal Medicine at the University of Mississippi Medical Center in Jackson in 2010, where she was chief resident in the Department of Internal Medicine from 2010-2011.  She completed a fellowship in Pulmonary Medicine at the University of Mississippi Medical Center in 2013, followed by a fellowship in Asthma and Allergy at the University of Mississippi Medical Center in 2015.  She was an assistant professor at the University of Mississippi Medical Center from 2015 until joining Mississippi Asthma and Allergy Clinic in July 2017. 

Dr. Wilhelm is certified by the American Board of Internal Medicine, the sub-board of Pulmonary Medicine, and the American Board of Allergy and Immunology. 

A native Mississippian, Dr. Wilhelm is active with the American Lung Association.  She is married with one daughter.

2018 Reading Challenge: Books 71-78

Crucial Conversations: 5⭐️

I had to read this for a leadership class. I feel like this ought to be required reading for a marriage license. Great tools taught in this book.

Peter Pan: 2⭐️

Creepy. Peter Pan is a punk. Poor Wendy. I started reading this aloud to Coy, but had to quit when Tinkerbell started cursing Peter and then attended a fairy orgy. Srsly…. don’t read it. Especially don’t read it to your kid.

Christmas Eve 1914: (audiobook) 3⭐️

Cool story. Neat narration. Glad it was free though.

Selected Poems from Emily Dickenson: 1⭐️

Poor Emily would’ve benefited so much from Zoloft or Prozac. This book was like pulling teeth. I got my book of poetry marked off the reading challenge with great difficulty- thanks Modern Mrs. Darcy for the 2 weeks of melancholy.

I Am Watching You: (kindle) 3⭐️

This type of book is just not my jam. It wasn’t terrible, but I just don’t like being creeped out. The world is creepy enough without giving me more things to be creeped out about.

The Kitchen House: (audiobook) 5⭐️

This may have been my first pre-Civil War historical fiction and it was excellent.

Of Mess and Moxie: (audiobook) 5⭐️

I laughed so hard on my commute every day. She is the narrator which makes it even better. Lord have mercy, this may make the top 5 of 2018. 🤣🤣🤣

The Unkillable Kitty O’Kane: (kindle) 4⭐️

I think this was a free book from amazon prime first reads. It was unexpectedly entertaining. Initially I thought it was going to be a book with some hidden socialist and feminist agenda, but I was wrong.

Winter is Coming: Sepsis

What is sepsis?

It is not a specific illness with one specific cause, but is a syndrome (a constellation of symptoms that occur together). It is caused by an infection that results in a chaotic inflammatory response.

What causes sepsis?

Sepsis is caused by viruses, bacteria, and fungi. Often times, bacteria in the blood, called bacteremia, is the cause of sepsis.

What are the symptoms of sepsis?

  • Temperature >100.4 F or <96.8 F
  • Heart rate greater than 90 beats per minute
  • Respiratory rate greater than 22 breaths per minute
  • On labs, white blood count is usually very high or very low

In severe sepsis, there is evidence of organ failure that needs to be quickly corrected. Someone with severe sepsis may be confused or lethargic, have trouble breathing, have decreased urine output, be very flushed or cool and clammy.

How do you know if you have sepsis? What tests would need to be run if there is concern for sepsis?

Sepsis is usually diagnosed in the hospital or clinical setting. There are many tests that may be run if a physician is concerned for sepsis since it can’t be so deadly.

  • Lab work: blood counts, liver function, kidney function
  • Cultures: urine cultures and blood cultures
  • Imaging: X-rays, ultrasounds, or CT scans may be necessary to isolate the source of infection.
  • Echocardiogram may be necessary if there is confirmed bacteria in the blood. This test will ensure that no bacteria has infected the heart valves.

How do you treat sepsis?

  • Antibiotics: Initially the physician will start “broad spectrum” antibiotics that target many types of bacteria and can reach most areas of the body. As the infection is isolated and identified, then antibiotics are narrowed down to only those that are necessary.
  • Surgery or procedures may be necessary to rid the body of infection. Abscesses must be drained.
  • Supportive care: IV fluids are always given to ensure that the patient’s blood pressure stays high enough to prevent organ damage. If this proves ineffective, physicians must start medications which artificially keep the blood pressure up. These must be infused through a special IV that goes in through the neck or chest and blood pressure must be monitored through an arterial like, which is usually inserted in the wrist.
  • Sometimes patients will need a ventilator to breathe for them or dialysis if their kidneys temporarily stop working.

Who is at risk?

  • Age >65
  • Those on immunosuppressive drugs (chemotherapy, long term steroids)
  • Patients with cancer
  • Patients who have diseases that cause immunocompromise (HIV, renal failure, liver failure)
  • Diabetic patients
  • Obesity

Can it be prevented?

Seek attention immediately if you think you may have an infection.

Prevent infection by washing your hands frequently and getting your vaccinations. Immunizations are key in preventing infection!

If you are a patient who is at risk for sepsis, ensure that the people closest to you do not come around when they are sick. Ask them to get their vaccinations in order to protect you.

Winter is Coming: Pneumonia

What is pneumonia?

It is an infection within the lungs. Typically, the small air sacs within the lungs fill with fluid or pus.

Is it serious or life threatening?

It can be. It can be mild or so severe that it requires hospitalization. Sometimes it is so severe that it causes sepsis and the patient to be dependent on a ventilator.

What are the symptoms?

  • chest pain with breathing or coughing (pleurisy)
  • cough, with or without phlegm
  • fatigue
  • fever and chills
  • shortness of breath
  • lethargy

In adults older than 65, infections can cause confusion or bizarre behavior. It can also cause lower than normal body temperature as opposed to high fever.

What is the cause of pneumonia?

Bacteria and viruses are the most common cause. We classify pneumonia based on what is causing it and where you got it. We will focus on the “community-acquired” pneumonias.

  • Streptococcus pneumoniae is the most common cause of bacterial pneumonia in the United States. It can occur on its own, but it often times happens after one has a cold virus or the flu.
  • Walking pneumonia is caused by mycoplasma bacteria. It is typically less mild than other types of pneumonia. (It is usually not bad enough to cause someone to take to their bed, hence the term “walking pneumonia”.)
  • Viruses are the most common cause of pneumonia in kiddos below the age of 5. It is usually mild, but can become serious.

There are also hospital-acquired, health care-associated, and aspiration pneumonias, but these will not be addressed in this article.

Who is at risk?

Children less than 2 and adults over 65 are the individuals at greatest risk. Naturally, diseases that affect your lungs will leave you more prone to infections. Therefore, COPD, asthma, and heart disease put you at increased risk. Smoking also greatly increases your risk since smoking damages the cilia that help “clean” your bronchi.

Does going outside with wet hair and bare feet cause pneumonia?

No, but your grandma was right. You don’t need to go outside with we hair and bare feet.

How does the doctor know if I have pneumonia?

We will listen to your history and do a physical exam. Listening to you explain your symptoms and listening to your lungs can tell us a lot about what is going on. Usually we will get a chest x-ray to confirm our suspicions.

How do you treat it?

Antibiotics are generally required to treat pneumonia. We also use cough medications to treat the cough and tylenol (acetaminophen) or motrin (ibuprofen) to treat the pain and fever.

Do I need an X-ray to see if it “cleared up”?

No, because it can take months before your x-ray looks normal again, even when the infection is gone. If you continue to exhibit symptoms after your antibiotics are complete, we will usually order a CT scan for a more detailed image and see if anything else is going on.

How do I prevent it?

  • Vaccines: If you have lung disease, diabetes, heart disease, or you are over the age of 65, you need to get your pneumonia vaccines. Also, getting a flu shot will help protect you.
  • Quit smoking!
  • Wash your hands!
  • Get plenty of sleep, eat a healthy diet, and exercise regularly to keep your immune system strong!

Winter is Coming: Bronchitis

Bronchitis is one of the most common conditions treated in my office during the fall and winter.

Chronic bronchitis is a different topic. It is a sub-type of Chronic Obstructive Pulmonary Disease, or COPD. This post will describe the more common occurring acute bronchitis. This post also does not necessarily apply patients who may have compromised immune systems.

What exactly is “bronchitis”?

Bronchitis means inflammation of the bronchus, or the large airways of the lower respiratory tract. This inflammation causes a cough that lasts five days or more. It typically resolves on its own within 1-3 weeks.

How do you get bronchitis?

Bronchitis is mostly caused by respiratory viruses. These are spread by contact with other infected individuals or with surfaces that have been contaminated by sick individuals.

What are the most common causes of bronchitis?

Flu and the common cold are the most common causes of bronchitis. RSV, which can be very troublesome in little ones, is also a frequent cause of bronchitis.

How does a doctor diagnose bronchitis?

Bronchitis is a clinical diagnosis. A doctor must examine the patient and listen to the lungs to ensure that there is nothing more serious going on as well. Often times, the patient will have a upper respiratory infection that precedes the symptoms of bronchitis. My patients most often say, “It moved into my chest.”

How do you treat bronchitis?

We cannot cure bronchitis directly, but we treat the symptoms until it resolves on its own. There is no medication we can give to cure a virus. Tamiflu will shorten the duration of the flu virus, but it still wreaks havoc on your bronchi and causes bronchitis. The bronchitis can last up to 6 weeks after the flu.

At what point would a physician be concerned that it is more than just bronchitis?

Pertussis is one thing that concerns physicians as more and more parents refuse to vaccinate their children. Pertussis is especially dangerous for infants, small children, those with respiratory disease, and adults over 65. Pertussis is characterized by fits of coughing, “whooping” on inhalation, and vomiting after a particularly violent coughing fit. This usually lasts more than two weeks.

Walking pneumonia is also a concern when there is a lingering cough. This will be further addressed in the next post on Pneumonias.

If a patient develops fever, fast respiratory rate, becomes lethargic, or wheezing, further examination and x-rays may be warranted.

What can mimic bronchitis?

Post nasal drip syndrome, reflux, asthma, heart failure, and lung cancer can all cause a chronic nagging cough that can mimic bronchitis. If a cough lasts longer than 3 weeks, you should be evaluated by your physician.

Full Circle Fitness: Freestyle Fitness with Antonio Knight

This past week I sat down and talked with Antonio Knight, owner of Freestyle Fitness. He specializes in individualized fitness and nutritional plans for people and also more specialized coaching. I know he produces good results, because I’ve seen it in some of my patients! His clients experience weight loss, increased energy, decreased sugar levels, decreased blood pressure, and better cholesterol.

Antonio Knight got his start in fitness through his love for sports, particularly football. Knight was a versatile athlete who played three positions at Tuskegee University — strong safety, punter, and back up Quarterback.
After finishing his football playing career, Knight transitioned into coaching at Tuskegee University (TU) Tigers. He coached there for 5 seasons and then found himself in Jackson at Jackson State University (JSU). He coached with the Tigers football program for 10 seasons.  During that his coaching years, he served as the secondary defensive coach, special teams coach, and linebackers coach. He was also the recruitment coordinator for JSU while he was there. During Knight’s last three seasons at JSU, his linebackers were among the team’s leading tacklers. With more than 15 years of collegiate coaching experience, and eight years of nutrition and fitness training under his belt, Knight rears winners. He has used his experience in the sports arena to train and help his clients achieve their goals.


Antonio, how did you get into training and nutrition?

I started training over 15 yrs ago while coaching and being in a town without a fitness gym. At the end of each season I would train my senior defensive backs, getting them ready for the NFL combine or Pro Day. I’ve always been conscious about what I eat and drink, but I really started studying nutrition after my mother’s 2nd stroke, finding out my family’s history with diabetes and hypertension.

What do you love most about your job?

I love seeing the transformation of my clients physically, but most of all mentally, becoming more concerned with their way of eating and living. This is what I love most about my profession.

Explain to us what your clients usually come to you to accomplish?

My clients usually come to me to accomplish weight loss, fit test preparation, and a positive mindset change.

What services do you provide?

As owner of Freestyle Fitness 29, I offer Fitness training, Sport specific skills and agility training, Nutritional guidance, Meal prep, and Life coach.

Do you do personalized fitness programs and nutrition plans that people can take with them (for example- would my out of town patients be able to come to you and get a plan to take and do in their hometown where your type services are not available)?

Yes, I most definitely do personalized fitness programs and nutritional plans because no two people are the same (body types, surroundings, training availability, food preferences, and way of life).

You’re a pretty athletic dude and your site talks a little bit about your time at Tuskegee, but what were your greatest learning moments there?

My hear greatest learning moments at Tuskegee are learning to use what I had to reach unforeseeable goals whether on or off the field. Learning to adapt to my environment coming from fast pace Louisiana to small town Tuskegee.

As a former football coach, do you also help young athletes prepare for the next level?

Of course I do, that’s one of the ways I started my training passion. I’ve also trained professional basketball players.


What are your words of wisdom to someone who MUST lose weight for their health but are intimidated by the gym scene?

My words of wisdom would be, Freestyle Fitness 29 meets you where you are. You only get 1 time to live so why not invest in the one thing you’ll have the rest of your life which is your body! So I go to some of my clients until I build them up mentally.


You can get in touch with Antonio Knight. Simply choose your method of communication below!
IG: @Freestylefitness29
Facebook: Freestyle Fitness 29
Phone: 601.862.4787

Full Circle Fitness: OrangeTheory Fitness

When my mom moved to Madison, she started working out. She had never lived in a town where this was a possibility and I was thrilled! I was so very supportive and I did not ask a lot of questions (I didn’t want to be the annoying doctor kid). Then one of my super fit friends (like “fit” as in “she runs half marathons while 7 months pregnant”-fit) said that she worked out with my mom. I was immediately intrigued. What in the world was my mom doing working out with Ms. Pregnant Marathoner? She has been lifting weights, rowing, and running on a treadmill?! That is when I started asking questions.

Where can fitness fanatics and exercise newbies do the same workout with near equivalent results? Orangetheory Fitness. And I have drunk the kool-aid.

I sat down and talked with my favorite Madison OTF instructor, Karen. She makes me hate life for about 28 minutes each Friday during the treadmill segment, but then I sing her praises for the rest of the weekend because I feel fantastic. So many times I have wanted to quit, but she is super encouraging when you are “feeling uncomfortable”. She will give us the ins and outs of OTF: how and why it works.

Can you explain the Orangetheory?

Orangetheory Fitness (OTF) is a total-body, heart-rate-based, interval training workout. It is based on the science-backed idea that if you challenge your body at the right intensity for the right amount of time, your body must work extra hard to replace the oxygen lost during exercise. This increases both metabolism and calorie burn (even after the workout is over.)

Why does this work for all fitness levels?

Orangetheory provides an individualized experience, and each person is encouraged to work at his or her own pace. Members wear heart-rate monitors during class, which display real-time performance data on screens in the studio. Intensity is based on each person’s individual heart rate zones, and coaches lead the workouts to help you know when to push yourself, preventing both over and under training.

What if someone has physical limitations?

In the weight room, coaches provide options tailored to an individual’s needs to ensure exercises are effective but safe. Instead of the treadmill, members may use a strider or a stationary bicycle, which are low-impact options for those with orthopedic restrictions or injuries.

Are the weights necessary? Why not just do a whole hour of cardio?

Strength training is an important part of overall health and fitness. It helps reduce fat, increase lean muscle, strengthen bone, and burn calories. Plus, since our muscle mass naturally declines as we age, strength training helps to counteract this process.

Is OTF a way to completely take care of my fitness needs to get me into good physical condition?

Absolutely. Not only does OTF offer a total body workout that incorporates both cardiovascular work and strength training, individual workouts focus on endurance, strength, power, or a combination of these. The workout changes everyday, so you’ll continue to challenge your body (and never get bored!)

Is OTF a good way to cross-train if you are preparing for marathon, Ironman, cycling, etc?

Yes, and we have many members who do use their OTF workouts as part of their training for specific sports or athletic events. Our members have the opportunity to focus on hill work, speed work, and build endurance on the treadmill, as well as add variety and expand their training by incorporating the rower, bike, strider, and a wide range of equipment in the weight room.

Is OTF only for women?

Definitely not! OTF provides a great workout for both men and women, and we have many male members. (Don’t worry, we have plenty of heavy dumbbells in the studio!)

What is your single best piece of advice for someone who wants to get in shape, or has been told by their doctor that they NEED to shed some weight, but is intimidated by gyms?

Find a community, because it will provide the encouragement, accountability, and fun that will help you stick to a new program. When it comes to reaching your goals, support matters. If you know someone is going to send you that “Missed you at the 8:45 class!” text, then it’s a lot harder to blow off the workout. OTF combines the benefits of group exercise with the individual attention and experience of working with a coach. People of all ages and fitness levels, including those who are not comfortable in a traditional gym setting, have found their fitness tribe at OTF.

Karen Nabavi is a Fitness Coach at Orangetheory Fitness in Madison, MS. She is passionate about helping others achieve their health and fitness goals, whether they are long-time athletes or just starting down this path for the first time. She is a NASM-certified personal trainer and an AFAA-certified group fitness instructor. She has a bachelor’s degree from Wake Forest University, and a master’s degree from Georgetown University. She lives in Rankin County with her husband and two boys, ages 5 and 6.

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.


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