Though January is traditionally the month that we start making resolutions about how we will be different in the upcoming year, I think we should consider making February our month of focused introspection and self-evaluation. We should ask ourselves during this time: What changes will I make to improve my health?
When contemplating lifestyle changes, my patients always seem to ask me: “Well, doc, where do I begin?” You start at the beginning. An excellent starting point is scheduling a routine physical with your primary care provider. This visit with the doctor will include a history, an examination, and recommendations for future labs and tests.
The history that the doctor obtains is vital in determining risk factors for diseases such hypertension, diabetes, cancers, and high cholesterol. For instance, having a family history of a cardiovascular illness increases your risk of developing conditions such as heart attacks, heart failure, and strokes. When obtaining this history from family members, it also is important to know the age at which your loved one developed the disease. Not sharing family history is a major problem in most families, but this ridiculous practice must stop if we want our families to exist in the future.
After a thorough history is obtained, the provider then examines the patient from top to bottom to identify any abnormal findings. For example, the vital signs (temperature, weight, blood pressure, pulse, and BMI) can provide a great deal of insight on your state of health. Patients with a BMI (body mass index) greater than or equal to 30 are considered obese. Being overweight is a major risk factor for diabetes. Therefore, knowing this information allows the patient and the provider to establish some type of program to help prevent unwanted illnesses secondary to elevated blood sugars. Other physical findings – such as swollen ankles, darkened skin around the neck, and a lack of sensation on the feet – are all signs of congestive heart failure and diabetes.
Following the exam, your doctor will then discuss recommendations and probably order various laboratory tests. Such tests may include a lipid panel and blood sugar. When fasting, your total cholesterol should be less than 200 and your blood sugar should be less than 100. And depending upon the results of those, additional testing may be warranted.
Now at this point, your participation as a patient is even more crucial. Once these findings are addressed, an immediate action plan is necessary. Diet changes, increased exercise, and more frequent monitoring is generally the course of action. However, I have known patients to ignore early warning signs and later present with full-blown disease or end-organ damage. At that point, it is too late.
Denise Hooks-Anderson, M.D., is assistant professor at SLUCare Family Medicine and The St. Louis American’s medical accuracy editor. Email yourhealthmatters@stlamerican.com.
