How well do you know thyself, doctor? Find out with these tests.
Veterinary staff often make the worst patients. We’re often so bad because we rarely, if ever, visit a human doctor unless we’re near death. And that upsets me because that’s the wrong time to start thinking about your health.
Every day we encourage pet parents to bring their pets to us for yearly routine or wellness examinations. We recommend annual blood and urine tests to detect hidden diseases. We explain to clients that these measures help extend their pet’s longevity and quality of life. We remind clients that regular veterinary visits are part of being a responsible pet parent. But we forget all of this when it comes to our own health. What’s up with that?
You are the most important member of your personal healthcare team. It’s up to each of us to monitor, analyze and even schedule on own healthcare needs. I’ll be the first to admit that I sometimes question the thoroughness of many physicians’ physical examinations. I’ll also be the first to admit that you can’t complain about your doctor unless you visit them first.
Perhaps the most important part of my twice-yearly trek to my trusted pill-pusher is the diagnostic tests I undergo. Here are ten of the most common tests I think every busy veterinary clinic team member should have routinely:
1. Physical examination.When was your last weigh-in? What about height, waist measurement, BMI or waist-to-height ratio? Your doctor may not measure these basic parameters, but you should ask for them.
When your doctor examines your eyes, ears, nose and throat, ask if there are any additional hearing or vision tests you should have based on your age. Chances are, you won’t need more than a simple pupillary light response and eye chart, but you never know. This is especially important if you have a family history of hearing loss, glaucoma, macular degeneration or cataracts.
When your doc listens to your chest, ask such questions as, “How’s my rhythm?” and “Any valvular disturbances?” or other questions that indicate you know more than what end of stethoscope goes into your ears. Many times when physicians know we’re paying attention, they provide better care (sound familiar?). I’ve also had my doctor pull out his way-cool smartphone ECG to prove that all’s well with my heart. Pay attention and know your normal resting heart rate and blood pressure. Subtle changes in these values can signal problems.
Make sure your lymph nodes are checked and pulses palpated. If you’ve got any nagging pains or aches, moles, lumps or bumps, or anything else you’re just not sure about, now’s the time to bring them to your doctor’s attention. Many busy practitioners won’t look at your skin unless you ask them. I always tell my veterinary clients, “Subtle signs can be significant.” The same goes for us.
Your doctor should feel your abdomen carefully and evaluate basic strength and flexibility (more on that later). The bottom line is, the value you get out of a physical examination is equal to you interest in it. Like veterinarians, physicians are thrilled when someone expresses interest in what they’re doing. If your doctor doesn’t do something, it’s your responsibility to ask for it. After all, it’s your health.
2. Urinalysis. Ask for it. We don’t call it “liquid gold” for nothing.
3. Blood tests. For those of us over the age of 30, these basic biomarkers become vitally important to early recognition of disease and maintaining optimal health:
> Cholesterol and triglycerides. When it comes to knowing your numbers, you should know your last total cholesterol level, LDL, HDL and total cholesterol/HDL ratio. Triglycerides should also be included with cholesterol. Recommendations on cholesterol testing frequency vary from yearly to every five years. If you’re overweight or have a family history of atherosclerosis or heart disease, opt for more frequent checks.
> Glucose. Another important number to memorize is your fasting blood glucose. Even high-normal blood glucose is something I think you should take seriously, as it may be related to a host of inflammatory or other medical issues.
> ALT, AST, LDH and alkaline phosphatase. These are indicators of basic liver function, but may also be associated with muscle and bone issues.
> Uric acid, calcium, phosphorus, potassium and sodium.
> BUN, creatinine and GFR. These are indicators of kidney function.
> Total protein and albumin. These are typically associated with liver function.
> CPK. This enzyme is found in skeletal and heart muscles and the brain.
> TSH. This measures thyroid function. (Doctors may add additional thyroid function tests.)
> Fibrinogen. Elevations in fibrinogen have been associated with heart disease.
> Homocysteine. This has been associated with heart disease, stroke, Alzheimer’s disease, colon cancer and osteoporosis. Regular testing is a bit controversial, but I believe it’s important to monitor my own homocysteine.
> hsCRP. This C-reactive protein is an important inflammatory biomarker. There are other forms available , so ask your doctor what they prefer.
> White blood cell (WBC) count, hematocrit and hemoglobin.
> PSA and pap smears. Yep, you still should have your PSA checked. Though controversial, it’s still considered an important component of prostate cancer screening.
4. Rectal exam and female gynecological exam. Important? Absolutely. Fun? Hardly. Guys, please start early if you have a family history of prostate disease.
5. Mammography. Most women should have at least one mammogram by age 35 (earlier and annually if they have a family history of breast cancer). My interpretation of the literature is that women with no personal or family history of breast cancer should have a mammogram at age 35, every other year between ages 40 to 49 and annually after age 50. Women with a history of breast cancer should start having mammograms annually around age 30, if not earlier as advised by a doctor. So when in doubt, ask. Many general practitioners simply won’t remember your grandmother died of breast cancer.
6. Colonoscopy. Typically begins after age 50. The tests are getting better refined, less unpleasant and obtrusive, and more sensitive.
7. “Fast CT Scan” and Stress test. The coronary artery calcification (CAC) score is valuable for people with a history of heart disease, metabolic syndrome or other risk factors. If you don’t know about it, ask your doctor.
8. Dental exam. A dental exam isn’t only for cavities, silly. Make sure your dentist is searching for any masses or abnormal tissue. If you’re over 50, be sure to ask for a more thorough exam—your dentist won’t be offended.
9. Psychological exam. Are you stressed? Have you talked to anyone about it? I hope talking to others about our mental state has lost some of the negative stigma of yesteryear. It’s healthy to share your feelings—good or bad, happy or sad.
10. Strength and flexibility tests. Ask and ye shall receive. Chances are, your GP will refer you to a physical therapist who can accurately assess your basic physicality. This is way beyond “touch your toes” testing. I’ve undergone extensive strength and flexibility testing over the past decade, and I’m amazed at how high-tech and thorough my physical therapy team is. In fact, every member of my family has undergone these tests to better understand how we can optimize our fitness and improve our weaknesses. Most insurance policies will cover this when ordered by your doctor (co-payments may apply).
Start with these basic tests every year to begin tracking your health status. In the next 10 years, these tests will begin to look as ancient and inaccurate as smoke signals when personalized genomic testing becomes widespread (woo-hoo!). Until then, what gets measured really does matter—and your health matters most. Now, start getting to know yourself better.