Routine good health preventive measures
I. Evaluation of gastrointestinal bleeding (Stool for occult blood) - Complete the test on the cards you received in the office and return them to the office. If you need more, just call. This is a simple and safe way to determine if there is any microscopic bleeding from the gastrointestianl tract. If present, it could be due to a variety of conditions, such as hemorrhoids, polyps, ulcers, gastritis, esophagitis, and colon cancer. Foods rich in iron can also turn the test positive. If the test is truly positive, then appropriate diagnostic tests would need to be ordered to determine the cause of bleeding from the gastrointestinal tract.
II. Mammography - This is the best method to screen for breast cancer. It is safe, accurate, and well tolerated. Either the primary care doctor or the gynecologist can order the test. Screening should be done every two years; in certain higher risk women, it should be repeated more often. If any suspicious lesions are found, a physician who specializes in breast disease should be consulted.
III. Diet - All people should endeavor to maintain a low fat, high fiber diet, avoiding excessive caloric intake, even of ìnutritious foods.î Ideal body weight should be the goal as well. Many diverse medical conditions have certain common elements which are encompassed in this type of diet. Implementation of a low fat, high fiber diet is associated with
- Better control of blood sugars in diabetes mellitus
- Lower serum cholesterol and triglycerides (risk factors for coronary artery disease and peripheral vascular disease)
- Lower incidence of cancer of the colon
- Better weight control.
- Better control of reflux esophagitis and peptic ulcer disease
- Better control of gallbladder disease
- Every person's needs and preferences are different. That is why it is not proper to just give a preprinted diet to follow and expect that person to lose weight or show rapid improvement in control of the underlying medical conditions. Each person needs to have an assessment of
- Caloric needs
- Scheduling of meals
- Availability of food and ability to prepare food
- Underlying medical conditions that are affected by food
- It is the policy of the physicians of this practice not to advocate diet pills, liquid protein diets, vitamin therapy, or crash diets that severly restrict food intake to only a few foods. There are serious medical complications associated with such diet plans. The concept of diet often implies a short term deviation from normal eating to achieve a certain goal, usually weight loss. We prefer to encourage a lifetime strategy of eating that is capable of being followed over many years in a variety of circumstances to control of one's medical condition.
- If a person seriously wants to change eating habits for long term good health, then that person should invest the time in reading about proper nutrition and meet with the education nurse or an independent dietitian.
IV. There are no specific guidelines re: chest X-rays, EKGs, or routine lab work.
- Chest x-rays are not a good method to screen for lung cancer. In fact there is no good technique to screen for lung cancer. However, in patients with an occupational exposure or a history of chest x-ray abnormalities, it is not a bad idea to have an x-ray on some periodic basis in an attempt to catch a problem as early as possible. Some patients with known nodules on a chest x-ray need to have films done every 6 months for a period of 2 years.
- Often it is felt to be a good idea to have an EKG, and blood tests on a regular basis (every 2 years) to serve as a baseline for comparison should an acute problem develop. There are a variety of blood tests and the particular studies ordered depend on what the doctor deems necessary based on oneís history and physical examination. For example, men at risk for prostate disease should have a PSA blood test done to help screen for prostate cancer.
V. Exercise stress testing - Prior to embarking on a vigorous exercise program, patients over the age of 40, or those with risk factors or cardiac or pulmonary disease, should undergo an exercise stress test to assess safe limits of exercise.
VI. Pulmonary function testing
- Patients with chronic bronchitis, emphysema, asthma, sarcoid, pulmonary fibrosis, or any chronic respiratory condition should have at least an annual study to serve as a baseline and an assessment of progress.
- Patients with any chronic respiratory condition should have a study prior to any surgery so that appropriate pre-operative medications can be ordered.
