Must-have medical tests

The first month of 2013 has come and gone, but it’s not too late to make a goal of having the healthiest year ever, starting with the must-have tests and screenings doctors advise having on a regular basis.

Even for healthy people, an annual or bi-annual check-up is one of the best preventative tools, said Webster Griffith, registered nurse supervisor at Heartland of Marietta.

“We look for changes over time. That’s why we want to see people frequently. If they get to their physicians and get their routine check-ups and yearly exams, we can monitor those changes,” he said.

It was a combination of a higher than usual blood pressure test and a family history of heart conditions that led Marietta resident Terrie Bain, 63, to seek further testing.

“I went to a heart doctor and wanted him to run some tests,” she said.

The doctor told Bain that while her overall heart health was good, she could benefit from some blood pressure medication.

“I just think it is better to have things checked out and be safe about it,” she said.

Bain’s case is just one example of solving a problem before it starts, but many don’t make it to a doctor’s office as often as advised, for a variety of reasons.

As a graduate of Marietta Memorial Hospital’s School of Radiology, Carlene Hess, 54, knows the importance of getting an annual mammogram, but said she sees a lot of women who try to avoid the important test.

“They are scared, I think…scared of the results or scared because people have told them it is going to hurt,” said Hess, a Marietta native who now works as an X-ray technician in Kentucky.

However, new technology such as digital mammography has made the testing a much more comfortable process, she said.

While the benefits of regular screenings are widely proven, they are not necessarily widely practiced, said Dr. Marcus Nichols, DO of internal medicine and pediatric medicine with the Memorial Health System.

“Unfortunately people do tend to wait until there is a problem,” he said.

People wait for many reasons. Through his work in the Marietta Memorial Emergency Room, Nelson Zinser, ER Tech and Health Unit Coordinator at Marietta Memorial Hospital, has noticed that the largest demographic who skip out on preventative visits are those who do not have insurance.

“Those are the people who don’t follow through because they simply can’t,” he said.

That is one reason that Marietta resident Tina Bruner, 51, has not been to the doctor in more than five years.

“Not having health insurance is bad. Everybody needs it,” she said.

Bruner goes to Quick Care when necessary, but would like to see health insurance become more affordable for everyone, she said.

“Even people on Medicaid are having to use a secondary form of insurance,” she said.

Pricing on various tests and screenings depends on many factors, said Jennifer Offenberger, director of marketing and public relations for the Memorial Health System.

Those factors can include whether a person has insurance, the type of insurance, deductibles, coinsurance or out-of-pocket limits, and the manner in which tests are ordered by the physician, she said.

“Health care is changing to help support the payment of screening tests,” added Nichols.

Still, a good handful of people will always subscribe to the old “if it isn’t broken, don’t fix it” motto, said Zinser.

That is how Marietta resident Vance Glass, 39, feels about it.

“I just don’t believe in going to the doctor if nothing is wrong,” he said.

But, said Zinser, screenings can catch things that might be broken, and simply not yet displaying signs of it.

“If a person takes care of their health while they are still in good shape, then they stay healthier in the long run,” he said.

Deciding on appropriate tests has a lot to do with a person’s risk factors, such as family history, lifestyle choices and weight, Nichols said.

“Screening of a disease is based on the prevalence of the disease. Screening recommendations do change over time,” he pointed out.

Because recommendations vary as to the best time to begin screenings or how often to get them, Nichols recommends talking to a physician about which preventative tests and screenings to pursue.

However, certain health conditions become more prevalent as people’s bodies age, he said. While recommendations vary from one medical organization to the next, there are established tests that individuals should be looking into once they hit a certain age, he said.

Yearly wellness exams should start at age 3, said Nichols, with younger children seeing a physician even more frequently. These check-ups focus less on specific screenings and more on appropriate childhood development, he said.

Still, there are specific tests that doctors will perform for children in certain age groups, he said.

Newborns should get a hearing screening, he said. A forward bend scoliosis test and vision tests are common for adolescents.

“We also broach the topic of self-exams in adolescence,” said Nichols.

Adolescence is a good time to stress the importance of these exams, which should be part of a lifelong habit, he said.

Young women are taught to perform monthly self breast exams and young men monthly self testicular exams, he said.

“In men, testicular cancer tends to be more advanced when found because men don’t pursue the monthly self-exams,” said Nichols.

Mental health screenings can also be important for teens, said Christa Holman, a licensed independent social worker at L&P Services.

However, it is not necessary to do across the board mental health screenings in teens, she said.

“If parents or administrators see concerns in teens there are psycho-social assessments that we can do,” said Holman.

Concerns might include disruptive behaviors, mood swings, or anxiety, and a mental health screening would test for the gamut of disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), she said.

Adults can also be screened for depression if risk factors or current symptoms exist. For example, adults who have noticed insomnia, lethargy or simply decreased enjoyment might want to inquire about a depression screening, said Holman.

One test that is important regardless of risk factors is a cholesterol screening, said Griffith.

Also, men and women in their 20s should start getting cholesterol screenings once every five years, said Nichols.

“Cholesterol plaque develops early and the disease burden is additive over time,” he said, so early cholesterol screening is important.

Frequent blood pressure checks can also help doctors notice irregularities over time and prevent heart problems down the road, said Griffith.

Also twenty-something women should start being tested for cervical cancer with a Pap smear every three years, said Nichols.

And both men and women in their 20s should start self examining their skin for abnormalities.

According to the American Cancer Society, individuals should check their entire body once monthly and look for moles that have one of the ABCDE warning signs: asymmetry, border irregularity, color discrepancies, diameter later than six millimeters and evolving shape, size, or color.

“A physician can perform (a full skin cancer screen) as part of their yearly health visit if necessary,” added Nichols.

In their 40s, women should start getting mammograms once every one or two years, said Nichols.

The prevalence of the disease makes these screenings very important, he added.

“Up to 25 percent of women develop breast cancer by their 80s,” he said.

For males, prostate screenings are not recommended until age 50, said Nichols.

According to the National Cancer Institute, one in six men will be diagnosed with cancer of the prostate during their lifetime.

Marietta resident Zach O’Dell, 48, cited a prostate screening as one of the health measures he thinks is most important.

As a commercially licensed truck driver, O’Dell is required to have a complete annual physical. However, he said he would do the physical regardless because he is a strong believer in preventative measures.

“I’m 48, but I feel 25. Wellness check-ups, not smoking, eating right, that’s all part of taking care of yourself,” said O’Dell.

Eating right and swearing off smoking are two very important preventative measures that individuals can take without seeing a doctor, Nichols agreed.

Another important test for men and women in their 50s is a colorectal cancer screening, said Nichols.

Colon cancer occurs in 6 percent of Americans, he said.

But the good news is, those who have a colonoscopy with normal results do not need to have another one for 10 years, Nichols said.

Patients have other options for colon screenings, such as a sigmoidoscopy or fecal occult, but those screenings need to be done more frequently, he said.

In their mid-60s, females are at a higher risk for osteoporosis. Therefore a yearly bond density test is recommended for women 65 and older.

Finally, it is not a bad idea for men and women in their 60s to start screening for dementia and Alzheimer’s disease, according to health professionals.

“We can screen for some of the early signs and symptoms of that (at L&P),” said Holman.

While there is nothing that is going to reverse the diseases, there are medications on the market to slow their process, she said.