Wednesday, September 2, 2015

Healthy woman needs for 30,000 mile checkup

I got an interesting question from a website devoted to health about the requirements for a 30 year old well woman's periodic physical.  Truth is, the points here, allowing for some gender specific information, can benefit men as well, and older folks can also use this as a starting point.  So, no matter who you are, your age or gender, have a look at:

Just to expound on this a bit more than in the article, here are my full thoughts on the subject.

For the healthy woman in her 30s, there are at least a few items which should be screened on an annual basis, in the interests of good health. These may be part of a Women's Wellness examination by a gynecologist, or shared with a primary care physician dealing with the non-gynecologic parts of the examination.

With that Primary Care Physician in mind, I would start with the visit, itself. Having a physician who knows you, your history and yourself, is vitally important. During the conversation of the visit, evidence of anxiety, depression, abuse of multiple types, and social ills may be evident. While you may not want to think about it, these non-physical illnesses are very common, and need to be screened for and acted upon when present.

Turning to the more “routine” physical issues, certainly women in their 30s should have an annual gynecologic screening, to include breast examination and education for breast self-examination, a Pap smear and pelvic examination. Having said that, breast self-examination has come under fire recently as not being effective, and even the annual pelvic examination is seen as unnecessary in some recent studies. See the posting on my blog about this at:  Are routine pelvic exams indicated?

If there is a history of breast cancer before 50 years old in a first degree relative, such as mother or sister, one might consider beginning mammography earlier than the usual starting age of 40 years old. While colonoscopy is not normally started until age 50, the same considerations would be given to an early start if a close relative developed colon cancer at an early age.

General health measures, such as weight, blood pressure, and body mass index should be evaluated as part of a basic examination which should include listening to the heart, lungs, and examining the abdomen for abnormalities. Attention should be paid to any part of the body which demonstrates anything unusual, in form or function. With many spending time in the sun, a good skin check should be done to evaluate for dangerous lesions, potentially cancerous, over the entire surface of the body.

Minimal laboratory evaluations should include a hemogram, to screen for anemia, blood sugar and cholesterol. Many would also screen for thyroid disease, particularly postpartum, as hypothyroidism can be seen often in that population.

One other item that should be checked on an annual basis is an eye examination. Best done by an ophthalmologist, not a local store that sells glasses, your should be examined for any changes to the retina or lens, including those caused by systemic diseases and sun exposure.

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