“Give me a general medical check up please”.
How many times have I heard this question. What do these people
really want? Sometimes it’s a necessity for insurance
cover, but often the question could be rephrased to something
like “Give me a clean bill of health, I want to know
that I am well”. That drops a huge load into any health
practitioners lap. No-one can give you an absolute clean bill
of health, they can only read the signs and guide you to further
treatment or lifestyle changes to remedy what they see on
their examination.
So where do we start? Actually the initial process begins
with the individual long before any doctors consultation.
Three things to consider before you even think about going
off for the all telling lab tests and print outs, are:
Lifestyle truths – smoking, alcohol, fitness, obesity.
Family history – heart, cancers, diabetes etc.
How do I really feel? (Most of the time) – “Fit,
well, content and happy” or “Could be doing better”?
Age, of course, is a huge factor. Those in their 20’s
to 30’s rarely need to have their engines overhauled,
spare parts serviced or replaced, with a quick oil change
to go. Those of us over 40 certainly start to feel the yearning
for some serious assessment to stop the rust and keep performance
up to scratch!
Here are a few simple tests that can keep your engines running
in tip top shape as well as give you the early warning signs
for life threatening conditions that can be prevented or controlled
if treated early.
Ladies only:
Breast Examination – Most breast lumps are found by
women themselves, and not by a doctor. Breast cancer is one
of the biggest killers of women today and along with cervical
cancer, is the most preventable.
You should examine your own breasts every month (at the end
of your period is best as there are fewer hormonal lumps at
this time), and have your breasts examined by a medical professional
yearly. If you are unsure of how to self examine correctly
ask your doctor to show you how.
Women over 50 should have a mammogram performed every 2 years
at a reputable breast screening center.
PAP Smears – A PAP smear is a screen for cervical cancer,
and is performed by scraping a few cells from the cervix for
microscopic examination.
There are several methods used by laboratories to examine
the cells. The older method of smearing the cells onto a glass
slide is still used here, however many centers overseas now
use a method by which the initial sample of cells are spun
out to separate cancerous cells from normal cells. If you
having your smears done here, all well and good, but if you
are one of the lucky few to have the luxury of the overseas
option available to you, take advantage and make it a point
to visit a screening center on your next holiday.
Smears should be performed on a yearly basis, from 18 –
70 years of age, (younger if sexually active). Mid-cycle is
the best time to perform a smear. Sexual intercourse or douching
should be avoided for 24 hours before a smear is performed.
Gentlemen only:
Prostate Cancer – Just when you Gents were thinking
that all the icky stuff was a woman’s problem, we are
going to ask you to bend over!
A simple rectal exam (one gloved finger where the sun don’t
shine!) will detect any early changes in prostate size and
shape.
Prostate cancer is a slow growing tumor, and waiting for symptoms
to develop (difficult urination, blood in urine) may be too
late. Men over 50 should probably have this examination performed
on a yearly basis.
All Of Us:
Skin Check – If discovered and treated early enough,
most skin cancers can be cured. There are 3 main types of
skin cancer: Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma
(SCC), or the dangerous Melanoma.
You should have your doctor. do a skin check once a year from
the age of 20 on.
Seek medical attention for any skin lesion or mole that changes
in shape, color or size; or that bleeds and will not heal.
Don’t forget to regularly check your back, neck and
legs. You may need a friend to do this for you unless you
have a rubber neck!
A small skin biopsy may be needed to diagnose suspicious lesions.
This is a simple painless procedure that is performed in the
Doctors office.
Bowel Cancer Screen – Bowel cancer is second only to
lung cancer in the “top 10 cancer killer chart”.
Early bowel cancer has no symptoms, so screening should begin
in your mid-40’s (especially if you have a family history
or other bowel conditions such as Crohns or Coeliac). If you
notice blood in your bowel motions or the stools are persistently
black in color then you certainly need further assessment.
A Fecal Occult Blood Test (FOBT) is one way of screening.
Three consecutive bowel motions are tested for blood. This
should be done on a yearly basis.
Colonoscopy (Fibreoptic examination of the bowel) is the preferred
screen for those considered high risk, strong family history
or are experiencing symptoms.
Blood Sugar – In Australia 800,000 people suffer from
Type II diabetes and yet 50% of people suffering have no idea
that they have the disease. The statistics would be very similar
in our local community I am sure. The symptoms can be mild
and yet insidious, eventually causing irreversible effects
of heart and blood vessel disease (stroke, kidney failure,
blindness and heart attacks).
A simple and inexpensive fasting blood sugar test will indicate
whether you have this disease.
Cholesterol – It has long been known that levels of
certain fatty acids in the blood stream contribute to the
risk factors for conditions such as coronary heart disease,
strokes etc. While for many people high cholesterol levels
are related to lifestyle factors, others just seem to have
inherited the tendency from their predecessors and will need
medication to lower their levels.
Total Serum Cholesterol levels are measured on a fasting blood
test. Those found to have normal values should be re-assessed
every 2 years over age of 30. Those with elevated levels need
treatment / lifestyle change and regular yearly checks.
Electrocardiogram (ECG) –This test measures electrical
impulses that control your heart beating. An ECG can detect
heart damage or blocks in the normal pathway of electrical
impulses that pass through your heart. Any one experiencing
symptoms (chest pains, shortness of breath, lethargy), or
with a strong family history may want to have this examination
performed.
Electrodes placed on the skin of the chest, arms and legs
will show abnormal heart function, or rhythm. An abnormal
ECG will be followed by other tests to confirm diagnosis.
Blood Pressure – This simple test should be performed
about every 2 years from age 20 – 40 years, and once
yearly from then on. High blood pressure increases risk of
other diseases such as stroke, heart disease, kidney failure
etc. One high blood pressure reading is not diagnostic, but
should be repeated 2 or 3 times before treatment is started
(providing that the initial reading is not dangerously high).
Generally speaking a high reading is considered over 140mmg
(Systolic or top number), or 90mmg or higher (Diastolic reading
or bottom number) i.e. 140/90.
So, are we done now? After being examined, pricked, poked,
plugged in and stressed out…get up off the couch and
enjoy it….life that is! ‘Til next edition stay
happy, stay healthy and stay young!
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
