HAVING A CHECKUP - Full extract 

There is great emphasis these days on keeping well. With improvements in diet and exercise, people are definitely taking a more active role in their own health. Having a check-up with your doctor is a good place to start. 

The main aim of a check-up is to detect illness at an early stage, or better still prevent illness occurring in the first place. It is surprising how many conditions are picked up on routine medicals...diabetes, breast lumps, elevated blood pressure, and skin cancers to name few. The check-up is a good time to do routine tests like Pap smears and cholesterol levels. It is also an ideal time to discuss lifestyle factors like smoking, excess weight and stress. Health education is an important part of any medical check-up. 

There is no clear rule about how frequently people should have a check-up. In adults up to about 40 years, a check-up every two years is appropriate. If there happened to be an underlying health problem, more frequent reviews would be necessary. Older adults should be seen every year or so. 

After some general enquiries, the person's health is discussed system by system. Then a thorough physical examination is performed, and relevant investigations are arranged. Here are just a few items that are checked :- 

Blood pressure. About 20% Australian adults have high blood pressure. This increases to more than 50% in adults over the age of 65 years. The role of high blood pressure in strokes and heart disease is very clear. Only 1/2 people with high blood pressure have had the condition diagnosed, and it takes only minutes to check. 

Urine testing.  About 3% adults are diabetic and, again, only 1/2 are aware they have the condition. It is very easy to do a routine test for sugar in the urine. At the same time the urine is tested for any blood and protein that might suggest a bladder or kidney problem. These impregnated paper dipstick tests only take seconds and are part of any full medical check-up.

Pap smears  are recommended in all women who have had intercourse. They should be done every two years up to the age of at least 70 years. Unfortunately, there is a large group of middle-aged women who are not having regular Pap smears. This is a great worry because these women are at risk of developing cancer of the cervix. Younger women do seem more tuned-in to the importance of regular smears. Breast examination can also be discussed and mammograms arranged if required. 

Cholesterol level.  A high blood cholesterol level is an important risk factor for coronary artery disease. Every adult should have it checked occasionally. If it is elevated, more specific tests like HDL and LDL cholesterol levels can be arranged, as can follow-up tests at a later date. If the level is normal it can be checked again after several years. The test becomes less significant with increasing age and is usually not requested in very elderly patients. 

Family history. Certain illnesses have a definite tendency to run in families, for instance coronary artery disease, diabetes, glaucoma, gout, asthma, hayfever and eczema. Likewise, certain types of cancer such as breast, bowel and prostate cancer and melanoma do occur more commonly in some families. Going through the family history is an important part of any medical check-up as it allows for the patient and the doctor to be on the lookout for these conditions before they occur. 

Prostate checks are suggested in men from about fifty years of age onwards. The doctor can check the size and texture of the gland by a rectal examination every year or so. It is a good opportunity to discuss whether there are any urinary stream difficulties. Any problems with urinary flow require a full assessment, sometimes requiring referral to a urologist. A prostate specific antigen (PSA) blood test may also be recommended; this test may help to detect an early cancer of the prostate. During a general check-up, men can also be instructed on how to examine their testicles for lumps. 

Health Tips:
* Maintaining or improving our health should be a high priority. Money spent on a routine check-up is a good investment. 

* Because a medical check-up takes considerably longer than a normal consultation it is best to let the receptionist know in advance.

Dr. Andrew Pattison: Common Consultations
North East Valley Division General Practice, Melbourne, Australia.   Disclaimer
  - Last modified: August 18, 2001