METAIRIE/MANDEVILLE INSTITUTE OF COMPREHENSIVE HEALTH LLC

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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 5 minute sore throat visit, your every 3 to 6 month visits will be 30 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 50 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 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.


  • I advise a Chest Xray yearly after age 50. This is contrary to most preventive health studies' advice because of the cost of picking up one cancer. I don't agree with putting a price on someone's life.  Smokers should be get yearly Spiral CT scans of their chest. Smokers especially need yearly oral cancer screening.
  • IMMUNIZATIONS:
    Get a Varicella titer if you don't know if you ever had Chickenpox. (Adult Chickenpox can kill you).
    Get Rubeola and Rubella titers if you were born after 1956 and don't know if you had your second MMR shot or had titers to prove immunity. (Red measles still occurs in the USA and can kill and German Measles can injure your baby if you get pregnant and don't have immunity)
    Tetanus-diptheria shots must be given every 10 years. The new Adacel or Boostrix, given once to patients, will protect you from Tetanus, Diptheria and Pertussis (whooping cough),
    Everyone, unless under 6 months old, allergic or advised not to for medical reasons, needs a flu shot every October.
    Pneumovax will prevent 23 of the most antibiotic-resistant bacterial pneumonias. We give this shot to everyone with a chronic illness or no spleen and, also, to anyone over 50. However the new recommendation is that we start with Prevnar, which is the children's Pneumococcal vaccine, and then give the adult Pneumovax-23 vaccine. If you have had of splenectomy you need to get The pneumonia shot every six years.
    Meningitis vaccine (Menactra) will now be given to all 11 year olds and should be repeated in 5 years before entering college. Gardisil shots are recommended for all teenagers to prevent HPV oral and cervical cancer. Hepatitis B kills more people in the world than AIDS and the three immunization shots should be give to all children and teenagers and all single adults without immunity and all people going to live for a time in a third-world country.
    I give Hepatitis A shots to everyone because of the Hep A-contaminated vegetables imported into the USA of late (green onions), but especially to people going on a cruise ship or going even briefly to a third world country.
    Get a Zostavax shot if you are over 60, to protect you from Shingles (Herpes Zoster). Your chance of Shingles is one percent each year for the rest of your life. Zostavax will prevent 51 percent of future Shingles, but also prevent 66 percent of the neuritis (nerve-irritation pain)that can last years after a Shingles attack. Shingles that attacks the eye can be devastating, so get your shot soon if you are over 50.





  • BONE DENSITY: Hip fractures kill more women than breast cancer. Our state-of-the-art GE Lunar spread-scan DEXA bone density machine sees the density of both hips and the spine. Women,at menopause, and men, at 70, should begin regular 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






LIFESTYLE RECOMMENDATIONS:
Wear seatbelts. Don't speed. Drive bigger cars. Don't drink or take sedating drugs and drive.
Lock up guns.
Avoid raw seafood - raw oysters and sushi. Avoid 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.
Wear bug spray especially evenings and early mornings and all day if you are going to subtropical or tropical climates or Key Largo, Florida - as Dengue Fever and Malaria are still rampant. Call me for recommendations on shots and antimalarial meds if going overseas.
Never swim in fresh water in the tropics.
Shower nightly and examine yourself everywhere if going into tick-infested areas.