The Chronicle of the Horse
MagazineNewsHorse SportsHorse CareCOTH StoreVoicesThe Chronicle UntackedMarketplaceDates & Results
 
Results 1 to 17 of 17
  1. #1
    Join Date
    Dec. 2, 2009
    Location
    Michigan
    Posts
    346

    Default What to expect from a 56 year old physical exam?

    Basically, I am less and less enthused with my regular doctor...granted, I am healthy, only see her once a year for my gy exams, but I would think she'd want to do more blood work. My other doctor I switched from did heart enzyme checks, etc., when I was in my late 40's. Someone who has used her for years (and is also considering switching) has told me that you have to tell *her* what you want.

    So, what *should* I be getting at my age besides the standard PAP, etc.

    Thanks!



  2. #2
    Join Date
    Aug. 30, 2001
    Location
    Purcellville, VA
    Posts
    5,904

    Default

    Mammogram, colonoscopy...probably much more, but I am still a few years behind on getting a mammogram.



  3. #3
    Join Date
    Dec. 18, 2006
    Location
    NY
    Posts
    4,057

    Default

    My GP does full bloodwork (not sure what it includes but I know for sure it's the basic blood panel, cholesterol and I think thyroid?), and EKGs annually for everyone over 40 also.



  4. #4
    Join Date
    Feb. 6, 2003
    Location
    NorthEast
    Posts
    24,351

    Default

    This is a GP doc and not an OB?

    If this is a GP doc then you should have annual blood work to check things like cholesterol, etc. BP check. An EKG check. General wellness exam. Also discuss getting annual mammo and colonoscopy. This year she started something new, blowing in some tube and now I forget what the heck that was for. I remember her saying she liked to do this with all patients over 40.

    I'm 43 and those are SOP at my GP appointments. Didn't have to ask for any...actually keep asking, "Is this necessary?" You shouldn't have to ask your GP for anything related to ongoing wellness. They should be telling you what's safest to monitor.
    You jump in the saddle,
    Hold onto the bridle!
    Jump in the line!
    ...Belefonte



  5. #5
    Join Date
    Feb. 27, 2004
    Location
    Posts
    929

    Default

    This spring my GY told me if I wanted a pap smear each year I had to specifically request it otherwise it was now only being recommended every 3 years. This is the new guidelines coming down from above. He didn't say anything about blood work recommendations. I'm on thyroid meds so they have to do some of them. I had heard they were now changing mammograms recommendations. He didn't say in so many words but I could tell he was frustrated. I'm the same age you are. I'm a 12 yr breast cancer survivor and a mammogram is what caught it. I had a colonoscopy at 50 yr. I believe that the push for regular mammograms is responsible for catching so many cases early enough to save them. It may not be your doctor, ask next about these tests.



  6. #6
    Join Date
    Dec. 2, 2009
    Location
    Michigan
    Posts
    346

    Default

    I do get a colonoscopy...every 3 years...my sister had colon cancer. And the annual mammogram. I had to ask for a cholesterol check last year as it had been several years ( I know I am normal/low but still). She does BP, general wellness. I did ask her about why I puke up greasy foods when I do (rarely) eat them..she said she thought it could be my gall bladder, and if I wanted she would schedule an ultrasound, but if not, then I could use it as weight control - I think she was trying to make a joke (she's Dutch) but it didn't set right with me now that I did some reading up on it. I don't have any major attacks, just unload food the way it went down if too rich. Also, I would like to be tested for Lymes...I am tired a lot, sometimes aching joints (but that could be arthritis) - when I told her I felt tired a lot, she asked how active I was (and I am very active) and then she told me to get more rest. I guess as I am typing I'll have to sit down with her and question her to make my final decision..it's just annoying to have to change doctors, but I am getting older and don't want any surprises down the road.



  7. #7
    Join Date
    Apr. 3, 2006
    Location
    Spooner, WI
    Posts
    2,062

    Default

    This is a new era in doctoring. Ultimately YOU are responsible for your own health. I was told that by a doctor during my DH's illness. At 53 I have a few ongoing issues, I make a list to take with me and I ask for everything I want done.

    I now work with lead compounds so next week for my yearly exam I will ask for a heavy metal test.

    Also remember that many doctors are bound by insurance contracts. I'm quite sure I'll be fighting with them (insurance) about the heavy metal test.



  8. #8
    Join Date
    Oct. 1, 2003
    Location
    Nonsuch House
    Posts
    3,491

    Default

    When I moved form NY to VA my new Internist said she does not do EKG and I found out none of the Physicians around here do it as a routine. My Doc is affiliated with UVA, so she's not a rural hick Doc. I do know that for a fact every person in the NY NJ area gets an EKG every year and were surprised no one does it here in VA.

    Can DW or someone in the know explain this "Southern trend" of no EKGs??? My Doc does order mamo, colonoscopy and paps though as a routine.
    RIP Kelly 1977-2007 "Wither thou goest, so shall I"

    "To tilt when you should withdraw is Knightly too."



  9. #9
    Join Date
    Jul. 14, 2000
    Location
    midwest
    Posts
    9,927

    Default

    Funny you bring this up because 6 or 7 years ago my gyn saw a trend with my BP and she said to see my GP. Sure enough, a little something was there which the GP treated and that began the yearly trips to the GP for blood work. I only saw him when the allergies went haywire or I needed a tetanus shot so there wasn't much of a history in the file.

    Good doctors are a blessing but you do have to be your own advocate sometimes for care. That doesn't mean read everything on the internet to try and diagnose a condition but be informed.



  10. #10
    Join Date
    Feb. 20, 2010
    Location
    All 'round Canadia
    Posts
    3,745

    Default

    This is the checklist developed with help from the Canadian Task Force on Preventive Health Care, for the periodic health exam. The tables are on the 2nd page; note that only the items in bold have "good" scientific evidence behind them (so only mammo, colon cancer screen, and some STI checks for specific high risk groups). The items in italics have "fair" evidence (Pap, fasting sugars, BMD).

    http://www.cfpc.ca/uploadedFiles/Hea...nglish2011.pdf

    Lipids are kinda just "done", but there really isn't any weight of evidence for doing them (the AAFP in its evidence-based statement document also makes no recommendation for screening women, unless they're at increased risk), much less for stuff like cardiac enzymes. CRP used to be all the rage a few years ago, but docs who follow evidence-based medicine have been getting away from it.
    So this current doc might actually be following evidence-based guidelines where your previous one threw the kitchen sink at you.

    Note that these are only what's recommended as a screen for the "healthy" patient. Anyone with symptoms should have whatever testing needed to find the cause, it's just no longer a "screen" but a test for cause.



  11. #11
    Join Date
    Nov. 12, 2001
    Location
    Dry Ridge, KY USA
    Posts
    3,051

    Default

    I concur with getting a mammogram, colonoscopy, pap test, BP, general exam and blood work done.

    Having had my gall bladder removed, I agree with the poster who said that greasy food will set it off! My Mom's Doctor told her about the 4 F's, which are fair, female, fat and fourty, as to when we start having issues with our gall bladders. I would definitely get it checked out. If you get gall stones, then it will need to come out anyway.

    I have found that you have to become an advocate for your own health, especially if you have a hidden disease. It took years for doctors in the Cleveland area, including The Cleveland Clinic and University Hospital System, to find that I had Sarcoidosis. Doing hours of research on a treatment (other than the Methotrexate and Prednisone that they wanted me to use), I found the course of treatment which ultimately put me into remission. It took seven years to get to remission. Unfortunately, the remission only lasted for 2 years, but I know what to do to treat the disease now.

    It is extremely frustrating that we have to be responsible for asking for or even knowing to ask for tests that Doctors should already be recommending, as per our age group.
    When in Doubt, let your horse do the Thinking!



  12. #12
    Join Date
    Feb. 6, 2003
    Location
    NorthEast
    Posts
    24,351

    Default

    Also, I would like to be tested for Lymes...I am tired a lot, sometimes aching joints (but that could be arthritis) - when I told her I felt tired a lot, she asked how active I was (and I am very active) and then she told me to get more rest. I guess as I am typing I'll have to sit down with her and question her to make my final decision..it's just annoying to have to change doctors, but I am getting older and don't want any surprises down the road.
    Unfortunately, often doctors don't believe the patients when they say they're active, eat healthy, etc. Especially on the active part. Can't really blame the doctors too much since most patients lie about how active they are. (or that they love fast food, etc)

    Whenever I have a new doctor for something, I have to go through The Talk with him/her. That yes, when I say I'm active I mean You Can't Keep Up With Me.


    This is a new era in doctoring. Ultimately YOU are responsible for your own health. I was told that by a doctor during my DH's illness. At 53 I have a few ongoing issues, I make a list to take with me and I ask for everything I want done.
    I've heard this from time to time also. IMO, it's bullspit. Doctors go bananas when patients google stuff, understandably. So without medical training and without google, webmd, etc...how the hell are we supposed to know what needs to be done and what's a risk???
    Always smart to have a list when you go. If I don't have a list for everything, I forget what the hell I;m doing.


    Can DW or someone in the know explain this "Southern trend" of no EKGs??? My Doc does order mamo, colonoscopy and paps though as a routine.
    That's crazy IMO. Not as if an EKG needs to be done by a specialist/costs a fortune. It's simple and fast done in the office. And heart disease if the #1 killer of women, IIRC. And the further South you go, the higher the percentage of people with heart disease.
    You jump in the saddle,
    Hold onto the bridle!
    Jump in the line!
    ...Belefonte



  13. #13
    Join Date
    Feb. 20, 2011
    Location
    Dutchess county, NY
    Posts
    864

    Default

    I'm an OB/GYN and I do not do any real "primary care". All of my patients also have a GP. I'm in charge of pap screening, clinical breast exam, birth control and mammograms and the GP will do the bloodwork need for cholesterol, DM etc. So if a patient thinks they have strep throat, they go to the GP, if they have problems with menses they see me.

    This may sound a little cold, but in my practice, I see a lot of OB and take OB call, which is at least one, 24 hour, in-hospital shift a week (and 48 hours every fifth weekend). I do surgery at least one half day a week. I need to keep up with advances in surgical equipement, Obstetrical care etc.

    Our office has specialized equipement needed for OB/GYN (ie colposcopy, fetal heart rate monitors, ultrasounds). Honestly, its just not possible to provide quality, state of the art obstetrical, gynecological AND primary care.

    Honestly, if the idea of 2 doctor visits for health screening does not appeal to you, I would recommend having your GP do your pap and mammogram (thats what I do).



  14. #14
    Join Date
    Jun. 25, 2004
    Location
    Carolinas
    Posts
    4,285

    Post

    SOP for my annual exam in NC
    EKG
    BP, Pulse, temp check - this is done at every visit
    listen to heart and lungs
    breast exam
    Check eyes, sinus, ears, and throat
    Manual check of nodes (throat, underarms, etc)
    GYN exam is done annually or sem-annually
    Check of skin-for growths or skin cancer or other fun stuff
    During this time we are discussing my general health
    Standard blood panel, additional work is ordered as necessary

    I am strongly "encouraged", as in appointments are set for me for
    Mammogram
    Bone density scan
    CoColonoscopy

    Don't why ask your DR why a basic EKG is not included. He/she may not believe it is necessary if there is little or no history of heart disease in your family.
    "Never do anything that you have to explain twice to the paramedics."
    Courtesy my cousin Tim



  15. #15
    Join Date
    Jun. 24, 2005
    Location
    Alabama
    Posts
    7,412

    Default

    Auburn-my extensive medical knowledge (just kidding, of course) comes from watching many "ER" reruns and an old British comedy called "Doctor in the House". The five gallbladder signs are : female, fat, fourty, fertile and flatulent. I imagine they leave flatulent off the list now, because no one admits to that probably.

    Everyone needs to find a good GP, and at least at the first exam with the doctor do a full blood panel of glucose, cholesterol, and whatever else you medical history calls for. Sometimes that's the only way they find out something is wrong. Mammograms and colonoscopy depend on baseline and family history. And as I said on the other thread about colonoscopy-no one should die because they don't want to do a colonoscopy or an all over skin check for skin cancer, or whatever else could catch a cancer early.
    You can't fix stupid-Ron White



  16. #16
    Join Date
    Dec. 15, 2005
    Posts
    3,148

    Default

    Read the USPSTF guidelines and bring a copy of the checklist to your visit. Usually, it doesn't make sense to do an EKG or other extra tests because of the risk of false positives in healthy people. The false positive could lead to more invasive testing. For instance, an abnormal CEA blood test could lead to an ultrasound and surgery in a woman who is at low risk of ovarian cancer. The recommendations of the USPSTF are for screenings that are shown to improve health,and to minimize the risk of a risky workup of false positives.



  17. #17
    Join Date
    Oct. 28, 2007
    Location
    NY
    Posts
    3,856

    Default

    "what to expect from a 56 year old physical exam"
    Answer: a very slow doctor.

    Jokes aside, I'm finding my doctor is following some guideline, he says your of the age you should get.. Colonscopy, heart check, whatever. But if I found that once a check up was done, THAT'S IT. I've used my chit, so to speak.
    A colonoscopy found a precancerous polyp, which was removed. The Dr. Said guidelines say you should have your next one in 10 yrs, but I'd like to see you in five. What? I was thinking along the lines yearly from now on.
    Dr.s or managed Health care are "chatty" with their services. And I pay mucho dinero for hip choice.



Similar Threads

  1. What can I expect from my 3 year old?
    By SisterToSoreFoot in forum Dressage
    Replies: 14
    Last Post: Oct. 26, 2010, 03:18 PM
  2. Replies: 22
    Last Post: Oct. 22, 2010, 01:36 AM
  3. What to expect from a 12 year old trailer?
    By Hey Mickey in forum Off Course
    Replies: 3
    Last Post: Mar. 17, 2010, 01:33 PM
  4. Spin-off: What do you expect from a 2-year-old right now?
    By Tha Ridge in forum Hunter/Jumper
    Replies: 20
    Last Post: Jul. 4, 2009, 08:57 PM
  5. Replies: 18
    Last Post: Jan. 1, 2009, 07:40 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
randomness