The Physical

How important is this annual visit?

The yearly physical exam is a medical tradition between patient and doctor, a time spent focused on preventive medicine.  

During physical exams, doctors screen for disease, assess future potential health problems and update immunizations, explains Dr. Kathryn Reilly, a family medicine provider with OU Physicians. Additionally, doctors often take the opportunity to encourage a healthy lifestyle and to develop a deeper doctor- patient relationship, adds Reilly.  

“A physical exam is important and intended to improve your health,” offers Reilly. A physical could be more accurately thought of as health maintenance exam, she adds.

But how necessary is this annual visit to your health? New research suggests the frequency necessary may vary widely based on each patient’s needs.

“The frequency of physical exams depends on the patient’s age and sex,” confirms Reilly.

Newest trends call for the patient to be separated into groups based on age, sex and risk level.

Newborns and children up to age 2 are growing so rapidly that they should see a doctor often. After age 2, yearly exams are still necessary. At age 6, however, kids can begin to see the doctor every other year, suggests Reilly.

Eighteen- to 30-year-olds are advised to have at least two exams during this 12-year span. There are, however, tests that need to be performed more often.

“Everyone should have their blood pressure checked every two years,” advises Reilly.

Additionally, women in this group should have routine gynecological exams at least every three years, says Reilly.   

Past age 30, the risk of heart disease begins to rise, so, more frequent exams may be necessary.

“Men over age 34 and women who have a risk for heart disease should have cholesterol checked every five years,” says Reilly.

Between 40 and 65, the list of recommended tests begins to lengthen, adding a mammogram every one to two years and a colonoscopy every 10 years, beginning at age 50.

At 65, the yearly exam begins once again.

The new guidelines may seem more complicated. However, they have been designed to better address patient health and reduce unnecessary tests.

“There is little to no evidence that the yearly physical provides any benefits for most patients,” says Reilly.

Of course, general physicals aren’t the only regular checkups recommended by health professionals. Dental health and vision are also important to maintain. Generally speaking, it’s recommended that one sees a dentist for a cleaning and check-up every six months – more frequently in the case of persons with existing issues. One’s vision should be checked every two years between the ages of 18 and 60 and annually after age 60. Those at risk for vision issues or who already wear contact lenses should also have annual vision check-ups. – Lindsay Cuomo

The Aging Caveman

Does eating like our ancestors affect health long-term?

If it was good enough for the cavemen it’s good enough for us, right? After all, they eked out plenty of provisions when there were no grocery stores and stayed around long enough to propagate future generations, so perhaps they were on to something.

The perception of the caveman diet is that they consumed a mostly protein-rich, meat-filled diet.  

In recent years, however, many researches believe that the modern “caveman’s diet” would be filled with wild plants, legumes, grass-fed beef and seafood, which is often identified as the Paleo Diet. Even with the new revelations on diet, many still prefer meat at every meal.

What is popular in nutrition today may not be the case tomorrow, but heavy meat consumption has always been a hot topic.

“It is well-known that red meat carries with it an increased risk of colon cancer and probably other GI cancers as well,” says Dr. Joel Grubbs, a physician with INTEGRIS Family Care Coffee Creek.

“In my mind, this is a moderation issue. Red meat as part of your overall diet plan is not a bad thing, and I would say the same thing about carbohydrates.”

He recommends sticking to brown carbs and whole grains as much as possible.

While researchers are split on the health benefits of red meat and extreme protein consumption, there is a general consensus that a high intake of fresh fruits and vegetables is a wise choice. In other words, if the majority of the food on your plate won’t wilt or rot, your diet is probably out of balance. – Corrie McGee

Just Do It

Is exercising really a miracle drug?

We all know we need to exercise, but that means a lot of things to a lot of people. Does walking count as much as running? Do we need to break a sweat or is simple activity just as effective? One thing is for certain: The effects of exercise go well beyond the physical benefits of weight loss.

“(Exercise) truly is the miracle drug,” says Dr. Joel Grubbs, a physician with INTEGRIS Family Care Coffee Creek. “If we could package this as a medication, we probably wouldn’t need a lot of other medications.”

Multiple studies show clear benefits of regular exercise that reach across heart disease, diabetes, high cholesterol, Alzheimer’s and cancer, to name a few.

It’s important to clarify what “regular” exercise means. According to Grubbs, the amount of activity used in these studies was about 150 minutes per week, which is essentially 30 minutes five times a week.

He adds that there is a “more is better” component to this; however, it’s not clear yet how much more benefit there is. The good news is that it doesn’t seem to matter what type of exercise you choose, which means there is something here for everyone, from the tennis player to the bird watcher.

Aerobic exercise, such as walking, jogging, swimming or weight-lifting programs can be effective.

There is a tried and true formula of 220 minus your age, then taking 85 percent of that number as your maximum heart rate. Before you pull out that calculator, Grubbs recommends starting out slow and working up.

“If you do too much too fast, you probably won’t like the way you feel, and you might quit before giving yourself a good chance.

“Remember, baby steps,” he adds. – Corrie McGee

What To Vaccinate

Which shots are most important in adulthood?

Vaccines are often associated with children, but as we get older, several are recommended for adults to maintain good health.

The flu shot is the most well-known vaccine for adults. It is recommended that adults receive the shot annually in November or December.

“It has been proven beyond doubt to make a big difference in the death rate from flu in the U.S.,” shares Dr. Joel Grubbs, a physician with INTEGRIS Family Care Coffee Creek.

He adds that the pneumonia vaccine is important for people that have a chronic disease that impairs immunity or ability to fight infections, such as those with diabetes and heart disease, as well as those 65 and older. It is also recommended that adults 60 years and above receive the shingles vaccine whether they’ve had the disease or not, as it is a continued risk. Though it’s more of a risk for those over 60, there are a high number of adults in their 40s and 50s that are affected as well.

Vaccines that may be needed due to lifestyle, health or job risks include hepatitis A/B as well as the meningococcal vaccine. Along with these shots, women and men under the age of 26 are also encouraged to get the HPV vaccine.

Lastly, experts recommend receiving a tetanus booster shot once every 10 years. This is part of younger booster shots, but just because you were vaccinated as a child doesn’t mean you are covered for a lifetime.

It’s important to know vaccine history because there can be overlaps of vaccines that weren’t available when adults were younger.  – Corrie McGee

In The Genes

Can genetic testing keep you healthy?

Preventive medicine is frequently touted as the best way to stay healthy. Routine exams assess our current health and risk level for future ailments. Genetic tests take screening to another level by looking for gene abnormalities. Certain abnormalities can show a predisposition to a particular disease or can confirm a diagnosis.

“Genetic testing tests for defined gene mutations that place a person at significantly increased risk,” says Dr. Denise Rable, director of breast surgery at St. John Medical Center.

“The idea is the genes don’t function properly,” continues Dr. Coty Ho, medical director of hematology and oncology at St. John Medical Center.

There is a wide variety of genetic testing available. Predictive testing can show if you have inherited a genetic risk factor to a particular disease. For example, a simple blood test could screen for the BRCA gene, which would show a high risk for breast and ovarian cancer, shares Ho.

“Genetic testing results can be helpful in planning treatment,” says Rable. “The results can more accurately define an individual’s risk and guide subsequent screening and possibly preventive interventions.”

“From a medical standpoint, it often means more surveillance or aggressive treatment is needed,” says Ho. “But, the results can be more complicated on the personal level.”

The emotional consequences can be quite difficult, cautions Ho.

“It can cause a lot of stress in the family,” says Ho. “We do not take genetic testing lightly. That’s why we recommend a visit with a genetic counselor.”

Genetic testing is only recommended for those with a strong family history of a particular disease.

Genetic testing might be beneficial if there is a high occurrence of a certain type of cancer within your family, especially if they were diagnosed at an early age.  

Additionally, someone with a limited family history might consider genetic testing, adds Rable.

“Genetic testing for appropriately screened individuals is covered by most insurance companies,” says Rable.

Genetic testing is still a limited science.

“We often hear about genetic testing and cancer, but we haven’t been able to identify a specific gene for most cancers,” admits Ho.

“Ninety five percent of cancers aren’t linked to a specific gene,” shares Ho.

The science is simply not advanced enough yet, says Ho.

And, often, results only show a predisposition not whether you will certainly develop the disease.

“It is a fairly easy procedure,” says Ho. “It is very easy to do, but the results are a bit more complicated.” – Lindsay Cuomo

Seeking Whole Health

Should I consider a mental health evaluation?

According to the Oklahoma State Department of Mental Health and Substance Abuse Services, one in four American adults has a diagnosable mental illness, but less than one-quarter of that percentage gets any type of mental health attention, let alone appropriate treatment. Caring for mental health is as important as caring for physical health, shares Dr. Ahsan Khan, an OU Physicians psychiatrist.

“People are very familiar with the concept of routine physical health screening, but the notion of a regular mental health screening is not well established,” explains Khan. “In general, taking care of one’s mental health is not a top priority because of lack of knowledge and stigma associated with mental health.”

A periodic mental health screening helps identify warning signs for common mental conditions like depression and anxiety. Both of which are treatable but if left untreated can result in very serious consequences.

The symptoms of a mental health condition can often be overlooked.

“Sometimes signs and symptoms of depression or anxiety are taken as if someone is moody or as their personality style,” says Khan.

Additionally, some psychiatric disorders present with physical symptoms.

“Patients with depression often complain about being tired, in pain and without energy,” explains Khan. “Early detection of mental disorders will prevent the problems from worsening.”

Many people don’t realize that mental health conditions are treatable.

“Common conditions like depression and anxiety are as treatable as common medical conditions like hypertension,” says Khan.     

Additionally, mental health screenings are quite simple. These screenings can be done at home or by your primary care physician.

“There are many self-evaluating screening tools available on the internet that anyone can use as a starting point to assess themselves,” shares Khan.

Your physician will often use a questionnaire to assess your mental health. Khan encourages patients to answer openly and honestly.

Assessing mental health is just the first step. It is very important to follow through with the treatment your doctor recommends, advises Khan.

“Do not change or stop taking your treatment, unless discussed with your doctor,” cautions Khan.

Premature discontinuation of a prescribed treatment is very common and can result in relapse and a return of the symptoms.

“The patient feels well when they are on their treatment and thinks they don’t need it,” says Khan. “They forget that the very reason they are feeling well is because of the treatment.” – Lindsay Cuomo

Vitamins: The Real Deal

A common sense approach to vitamins renders the debate largely moot.

Every day, it seems, another report or study is announced that either supports the benefits of broad vitamin supplements or diminishes them. Still others border on labeling supplements as utterly fraudulent or worse – hazardous. It’s little wonder that many people are confused.

But Harvard School of Public Health (HSPH) advocates a thoughtful approach to such supplements.

First and foremost, HSPH and most other leading exerts agree that the best way to meet your vitamin needs is nutrition via a diet rich in fruits, vegetables, whole grains, nuts and healthy oils, and low in red meat and unhealthy fats. To ensure adequate ingestion of vitamins, choosing a daily multi-vitamin is a good idea. Check for one with folic acid to fill in a gap that even healthy eating might not fill. HSPH and others also suggest a vitamin D supplement even if it is included in your multivitamin.

Beyond these basics, which effectively help maintain a balanced intake of necessary nutrients, the effectiveness of other supplements is the source of considerable debate. HSPH cautions against mega-doses of vitamins and mega-fortified foods and also against advertised “super” supplements because more doesn’t always equal better, and claims that sound too good to be true probably are.

Always consult with your doctor before beginning or altering a supplement plan, and remember that a well balanced diet should provide almost everything the body needs nutritionally. – Michael W. Sasser

Fit And Fat

Is it possible to be both?

Many define their health solely by the number on the scale, but how much does weight really factor into health? Brooke Rusher, therapeutic exercise specialist with St. John Siegfried Health Club, says being healthy is more about what you are putting in your body and how active you are than your weight.

“Being healthy is more than losing weight and having the best figure,” explains Rusher. “Being healthy includes exercising regularly, eating healthy and keeping a healthy mental attitude.”

Numbers matter, just not necessarily the number we typically focus on. Weight alone won’t give a complete picture.  

“Research suggests a person can be overweight and fit,” counters Rusher. “Overweight people who exercise 150 minutes a week decrease their risk of mortality more than a normal weight person that doesn’t exercise.”  

A better measure of health comes from body mass index (BMI), a measure of fat based on height and weight, and waist circumference, outlines Rusher.

“Women with more than 35 inches around the waist and men with more than 40 inches have an increased risk for heart disease and diabetes,” shares Rusher.

Other important numbers are cholesterol, triglycerides, blood pressure and blood sugar levels.

“Everyone should know their numbers,” advises Rusher.

She encourages individuals to focus on health rather than simply being slim.

“Getting fit is more realistic than getting slim,” says Rusher.

The goal should be to exercise, eat right and stay healthy. That may be achieved at any body weight.  

“Step back and look at what you are putting into your body,” recommends Rusher. “It really does matter.”   

Are you getting enough exercise?

“Everyone should be exercising at least 150 minutes each week,” says Rusher.  “Thirty minutes of continuous exercise daily to maintain weight and 60-90 minutes to decrease body weight.

“Exercise should be at an intensity of somewhat hard to talk. The Talk Test is always a good indication of intensity.  You should be able to say short-winded phrases but should not be able to have a long conversation while exercising.”   

Find a fun activity that’s right for you. Rusher suggests pool exercise, group fitness classes, chair exercise classes, yoga, treadmills or exercise bikes.

“There is a mode of exercise for everyone no matter what: young or old, fit or unfit, healthy or unhealthy,” says Rusher. – Lindsay Cuomo

Sex For Life

Sex has a remarkable number of health boons.

While many surely know the psychological benefits of sex, and some may even be aware of the potential exercise ramifications of an active sex life, there are numerous other advantages, researchers and physicians assert.

Psychological benefits include increased confidence and self-esteem and deeper levels of intimacy with one’s partners. Sex boosts one’s level of the hormone oxytocin, the “love hormone,” which helps build trust and bonds. That same hormone also boosts the body’s set of natural painkillers and promotes better sleep.

Exercise benefits of sex might have been exaggerated at times, but realistically, sex burns 85-plus calories per half hour, so overcoming a pint of Haagen Dazs might be exhausting.

But other benefits abound. Sex can lower stress levels and thus blood pressure. According to a Wilkes University study, sex also has been linked with higher levels of an antibody that can protect against colds and other infections. Meanwhile, a 20-year British study revealed that men who had sex two or more times a week were half as likely to have a fatal heart attack than men who had sex less than once a month, intimating heart health advantages. Also of note to men, a study published in the Journal of the American Medical Association showed that frequent ejaculations – particularly in 20-something men – may lower the risk of getting prostate cancer later in life.

Sex, it seems, isn’t just a vital part of human life – it also enhances and improves lives in ways many not often consider. – Michael W. Sasser

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