Three Tips for a successful annual physical
In years past, our personal physicians treated us from birth to death. These doctors knew our family history, our health history, pretty much everything about our lives. These practitioners had no choice but to look at the entirety of an individual’s health and not just a set of symptoms that they could match with a diagnosis in a book. They knew that a complete physical included looking at and correlating how you feel and what you were experiencing with what they find in exam and blood work. A thorough exam included a good blood work up and a physical and any other diagnostics related to the individual’s condition. I believe this is not only good medicine it is good preventive medicine.
Both time and medicine has moved on. The family doctor that treated everything from sniffles to cancer is now a system of specialized practitioners that treat only within their specialty. As the patient and the consumer, we must also change and become our own medical coordinators and advocate. Understanding and working within that premise here are a few tips on how best to be your own advocate without a medical degree.
“Practicing medicine as an art and not be about business!”
Tip 1
Keep copies of everything you have done every year in a single file. It becomes the record of your past health which can reveal clues to how to stay healthy by comparing results from one year to the next.
Because I look at labs from year to year, I have recognized serious changes in basic annual screenings that other doctors have not picked up. It is the comparison from year to year that reveals the valuable data that can be used to diagnose a health issue when put in the right hands. You can carry your past and present into a specialist and present the whole picture.
Tip 2
Reading beyond the numbers
Each year millions of us dutifully head into our primary care provider to get out annual physical. For most of us we walk away with no actual information on our current health. The feed back if we get anything at all is, “everything looks great” or “time for cholesterol medication”. Some practitioners will offer a little dietary feedback, but it is mostly generic and doesn’t actually get us where we want to go which is usually off the medication and healthy.
My goal is to arm you with the information you need to either ask the right questions at your next appointment or seek the advice you need to address health issues that your annual labs should be helping you prevent.
A recent example of this occurred when a patient of mine with a Leukemia diagnosis delivered her yearly labs following a physical, on my desk for review, and I was horrified to see only a CBC with differential. Her MD had only looked at her red and white blood cells. When we sat down together, I asked when the last time she had had her blood sugar checked, a lipid panel done or her liver enzymes checked, her response was, not for years and certainly not since she was diagnosed with Leukemia. This woman's health care provider is looking at her through a keyhole.
In years past when we have gone for our annual physical certain basic exams were performed as a screening process. If anything were out of order we would return for a deeper assessment of that issue, more blood work a differential diagnostic. Blood tests can be diagnostic in and of themselves for some disorders and for other health issues when correlated with symptoms and more advanced diagnostics they provide a great tracking devise as we return to health. The trend from year to year is fewer and fewer blood tests are performed and ultimately the warning signs of impending disease are being missed.
Before your next physical have a plan, know what you should be looking at and for, and ask to have the labs run. You may get the brush off in some cases but even a good basic lab done and then read by a functional medicine practitioner can make a difference in your long-term strategies for health and longevity.
My recommendations for an annual basic screening
· fasting glucose
· lipid panel
· CBC and differential
· Ferritin
· metabolic 14 panel
· liver
· kidney
· thyroid.
· Vitamin D
With this basic panel we have a good cross section of how our blood chemistry is fairing and how the systems of the body are working independently and together.
Tip 3
Know what “Extra” testing to ask for.
Additional testing based on your health history
Do you suspect Thyroid issues or are you taking thyroid medication?
Add Free T3, Free T4,
Thyroid antibodies.
Have diabetes?
Add and A1C
Fasting insulin level
Have high cholesterol or high Blood Pressure
Add CRP
LDL break down with HDL
Another frequently told story in my office is the patient, usually female over 30 who has gone year after year and asked for a thyroid screening because she has low body temperature, fatigue, loss of libido, hair thinning, mood swings and cannot seem to lose weight. She believes she has a thyroid issue because she has done her research and she knows she has many of the symptoms. The additional testing is a starting point for Hashimoto’s disorder (an auto-immune thyroid condition)
In this case the practitioner runs a lipid panel to check her cholesterol and a TSH. If the results of the TSH fell into the normal range even if it was borderline high or low, she was dismissed with no thyroid issue and instruction to eat less and exercise more because the test was negative for thyroid. She may need to work on her health, but what happened to the older more artful method of practicing medicine and screening a patient with the symptoms of thyroid dysfunction with a little more thorough testing.
These 3 tips are the basics you will need for an annual physical to screen for your current health condition. If you have other health complaints, be sure and express them, don’t downplay them, and ask what the appropriate testing might be. If you do not feel you are being heard, or your concerns are being brushed aside, please find another practitioner.
This is your health, and you may only have one chance to change the course and outcome. Just because you do not have a medical degree does not mean you don’t know what is going on in your body, after all you do live in it.
This is your health; this is your life. Take charge of it.