Regular physicals, blood tests, Xrays, Echo's, and Colonoscopies and attention to immunizations can prolong your life and keep you active and comfortable. If we catch an illness early enough, we can often cure it. Many illnesses are preventable. The aging process itself can be delayed by attention to keeping all the organ systems healthy. The following advise is based on four preventive health studies - one study by the American Cancer Society, one by the Canadian Task Force on Periodic Health Exams, another study by Frame and Carlson, and a study bt Breslow and Somers. Also, the GSHP Preventive Medicine Guidelines have also been incorporated in this advise. Both doctor and patient must work together to keep up on all that needs to be done over the years. Annual Physicals: I don't believe in annual physicals. I do a complete physical and update on all your tests everytime I see you. I need to see you at least once a year, but unless it's for a 15 minute sore throat visit, your every 3 to 6 month visits will be 45 minutes and you will get a complete physical and review each time
Examine your entire skin from the soles of you feet to your scalp every 3 months for black,scaly,or changing moles. Women should self-examine their breasts monthly. A doctor should examine the breasts of both men and women yearly. Mammograms are advised yearly after 40 If you had Xray treatments as a child to shrink tonsils,treat acne,or shrink a thymus gland or irradiation for cancer of the head or neck area as an adult or child, a doctor must feel your thyroid gland every 6 months All women should do regular Pap and pelvic exams at the interval recommended by their OB/GYN doctor. Chlamydia and HPV screening is also suggested depending on your age Rectal exam should be done yearly after age 37 by the OB/GYN doctor for women and will be done yearly by me if you are male and over 37. Stool cards for blood will be obtained yearly after age 35. Colonoscopies will begin at age 45 or much earlier if there is a family history of colon cancer or polyps Men should self-examine their testicles for lumps every 3 months, especially between the age of 20 and 40 After age 40, see your eye doctor at least every 3 years to pick up early glaucoma. See the eye doctor yearly if you have Diabetes Check your blood pressure at least yearly. Check your blood pressure with a home meter daily if you have high blood pressure See me at least yearly and I will advise you on which blood tests you need. Complete blood counts, liver and kidney function tests, urine specimens are obtained yearly. Cholesterol, Thyroid and Diabetes checks are done frequently. All new patients are also checked for syphilis, TB, iron storage disease,and gout Patients at risk of heart disease because of their smoking history, family history, cholesterol or blood pressure abnormalities will be encouraged to get calcium scoring of their coronary arteries by Fast CT scanning. It takes 30 seconds and no injections are necessary. If you are under 55, Fast CT may not show uncalcified plaque.  Our office is the only one of two facilities in the area that does IMT (Intimal Medial Thickness) scoring of your neck (Carotid) arteries by Doppler Ultrasound.  Your IMT score may tell me that you are at a high risk for Coronary Heart Disease.
BONE DENSITY: Hip fractures kill more women than breast cancer. Women,at menopause, and men, at 75, should begin regular DEXA bone density scans to find osteopenia and osteoporosis Carotid echo's are done when a noise is audible in the carotids, when there is a diminished pulsation of the carotid, when there are any pre-stroke type symptoms such as visual blurring, trouble speaking, sensory or muscle symptoms, faintness or dizziness Abdominal echo screening can find abdominal aneurysms before they burst, early kidney cancers, gallstones, liver and pancreas problems Chest X-ray yearly after 50. No reason not to with radiation from it equivalent to backround radiation. We find many early cancers from yearly Chest Xrays. Low-dose CT scan of the chest yearly in smokers (or if smoked within the past 15 years) age 55 to 80 years old with a 30-pack year smoking hiistory. Pack years are calculated by the average number of packs per day smoked by the number of years smoked	LIFESTYLE RECOMMENDATIONS: Wear seatbelts. Don't speed. Drive bigger cars - as the fatality rate is directly proportional to the weight of the car. Wait 3 seconds after a red light changes to green before proceeding. Don't drink or take sedating drugs and drive.  Avoid raw seafood - raw oysters and sushi. Avoid eating a lot of tuna, mackerel, swordfish, red snapper because of the mercury. Avoid Mahi-mahi, baracuda, amberjack, grouper, sea bass because of Cigitara (red tide) which is now in the Gulf of Mexico. Wear bug spray especially evenings and early mornings and all day if you are going to subtropical or tropical climates. Key Largo, Florida has Dengue-carrying mosquitos. Dengue Fever, Zika virus and Malaria are still rampant in all tropical countries. Call me for recommendations on shots and antimalarial meds if going overseas or go to CDC.gov/Destinations. Never swim in fresh water in the tropics. Don't swim in areas with strong undercurrents. Learn the "survival bob". Don't pet dolphins (Lobomycosis). Don't swim above Stingrays. Shower nightly (may not help) and examine yourself everywhere if going into tick-infested areas (tall grass, woods, beaches with grass in Connecticut and Nantucket) and put your socks over your pants. A tick in Minnesota can give you Powasa virus in 15 seconds . Avoid gardening without gloves on so that you avoid cat feces (Toxoplasmosis)  if you are pregnant. Avoid going near raccoon feces ( Balisascaris) without a face mask on. Avoid walking near the edge of water with known alligators. Never drink unpasteurized milk or unpasteurized goat cheese Stop smoking. many free programs are available.  Avoid alcohol completely if you have Fatty Liver. Don't drink over 2 drinks a day. Alcohol is bad for the brain  Go to AA, NA or GA if you have an alcohol, drug or gambling problem Always practice safe sex  Lock up your guns