Health Screens
Tedd Mitchell, M.D.

Where I come from people spend a lot of energy espousing the virtues of pickup trucks. An age-old debate revolves around being a “Chevy man” or a “Ford man.” Well, when it comes to that argument I have my bases covered – I own one of each. I have a 1953 Chevrolet pickup (passed down to me from my grandfather) and a 2002 Ford pickup. The other day I was taking the Ford in for a tune-up when it occurred to me that keeping these pickups running in top condition requires time and effort, and knowing what each requires ensures that I give them the care they need. The same can be said when it comes to checkups with the doctor. What you need in the way of evaluations depends on the make and model of your body as well as the age of your chassis!

New makes and models
Like a new vehicle, young, healthy adults seem to run at high performance without much effort. Performance is high even when efforts at maintenance are low. Think about it. We have boundless energy when we are young (in spite of poor behaviors), and we ignore the need for general maintenance. Consequently, preventive heath is not even on the radar screen for many until they hit their 40s. Why? For a couple of reasons. First, we feel good, so we simply don’t make it a priority. Second, it’s not our cultural norm to routinely visit a doctor when we are young adults. This is truer for men than women. While children of both sexes partake in the same amount of preventive services (well-baby checkups, immunizations, screenings at school), by the time children hit late adolescence and early adulthood, many fail to establish on-going relationships with “adult” doctors. It is not uncommon for me to see a patient in his or her 40s whose last checkup was with a pediatrician! While the problem is more pronounced in men, it’s an issue for women as well. But just like that brand new car, carefree young adults need to pay attention to some scheduled maintenance as well.

So what do adults need?

All makes and models (i.e., everyone). Screen periodically for risk factors that lead to heart disease and stroke. These include: measurement of body mass index or body fat percentage (to determine if you are overweight or obese), as well as measurement of blood pressure, cholesterol, and blood sugar (to see if unforeseen risks are lurking that could eventually corrode the system). Counseling for lifestyle behaviors (for example, following an exercise program, smoking habits) and family history round out a preventive pit stop for cardiovascular risks. Identifying these health risks at an early age enables both the doctor and patient to develop a plan of action for reducing the long-term impact of potentially devastating illnesses. A physician who knows your family medical history and personal risk profile is much like the car mechanic who, by understanding the make and model of a particular vehicle, can tell you what its likely pit falls will be over the long haul. For women, breast self-examinations and for men, testicular self-examinations can be lifesavers. This is where you must become a “shade tree mechanic”. Understanding how to perform these examinations is like knowing how to change the oil in the car – it’s easy to do and potentially a lifesaver for the engine.

High-performance vehicles (i.e., women). Today’s woman finds herself constantly on the go. Whether it’s work, husband, children, or household chores there seems to be no rest for the weary. Just when she thinks her life can’t be any busier, she gets that reminder call from the gynecologist’s office that it’s time for her annual visit. Don’t ignore that appointment! That’s the pit crew reminding you engine parts need to be checked, even if everything seems to be motoring along just fine. These preventive medical screens should include pelvic examinations, pap smears, clinical breast examinations by the physician, and mammograms. These pit stops work! We have seen a dramatic drop in death rates from cervical cancer over the course of our lifetime, due mainly to the fact that women are getting screened and problems are being found earlier.

Sports Utility Vehicles (i.e., men). Today’s man is like an SUV. Because he’s built to take more abuse than the average car on the street, he forgets he needs some TLC from time to time (and I don’t just mean the occasional run through the car wash, although he can definitely use that as well!) He works hard, plays hard, and often neglects anything having to do with the health of his vehicle. He powers it with cheap fuel (caffeine, burgers and beer), performs only the most basic of maintenance on it (an occasional jog), and yet he expects his machine to perform off-road maneuvers at the drop of a hat (playing weekend hoops or softball). He ignores the “little” things that he feels are mainly cosmetic (such as increasing weight), because he rationalizes that a little rust on the hood adds “character.” What he doesn’t realize is that ignoring the basics is a recipe for engine disaster down the road. Paying attention to simple things can pay big dividends. Men, now’s the time to revisit the check list: in addition to the baseline checks we talked about earlier, having prostate evaluations (for men over 40) becomes important. Also, it’s time to add another number to your list of things to know – the prostate specific antigen (PSA). Your doctor can help you decide when this blood test for prostate cancer is important for you, but in general, the older you get, the more important it is to know this number.

The “Classics” (i.e., seniors). Like many classic autos of yesteryear, today’s seniors are seeking to maintain attractive bodies, functional engines, and the ol’ git up and go from their youth. Just like you need to treat a classic auto differently than one fresh off the showroom floor, you need to treat a “classic” body differently than one that’s 25 years younger. It’s like I tell many of my senior patients, “You still have the body of a Corvette - it’s just a ’66 Corvette, so it needs to be maintained appropriately.” Certain engine parts are bound to wear with time, regardless of how well you’ve taken care of them, and knowing which engine parts need regular inspection is a giant step in the direction of proper maintenance. So what do people over 50 need to add to their preventive maintenance list? In addition to the gender-specific recommendations we’ve already covered, they now need to undergo evaluations for colon cancer. Various screening tests are available, including “partial” tests like checking stool samples for blood and sigmoidoscopies. More “complete” tests include X-ray studies (lower gastrointestinal X-rays/barium enemas and the new “virtual colonoscopy”). The gold standard for colon cancer screening is still the colonoscopy, and for those with a history of colon problems (rectal bleeding, constipation, change in bowel pattern, abdominal pain), this is the way to go. The same holds true for those with a family history of colon cancer.

When my grandfather gave me his old pickup in 1982, he told me, “Tedd, it won’t hurt this engine one bit to run it without gasoline, but it will tear it to pieces if you try to run it without oil.” Truer words were never spoken when it comes to preventive maintenance. Whether young or old, male or female, “Chevy or Ford”, know the pitfalls of your particular make and model. Know what you can do to maintain the vehicle on your own, and know what requires the advice of the professional mechanic. Doing so lowers the chances of something unforeseen happening and remains the best bet for you to keep the old engine firing on all pistons!

Tedd Mitchell, M.D., is the medical director of Cooper Wellness Program at the renowned Cooper Aerobics Center in Dallas. He is also the vice president and associate medical director of Cooper Clinic. His medical practice focuses on health maintenance and disease prevention through physical fitness and proper nutrition. In June 2002, Dr. Mitchell was appointed by President Bush to serve on The President’s Council on Physical Fitness and Sports.

An active researcher and author, he has published dozens of studies in peer-reviewed scientific journals and serves as both a columnist and medical editor for USA Weekend, which appears in 600 newspapers nationwide and has a circulation of more than 46 million readers. He is co-author of the book Fit to Lead. In addition to his writing, he also lectures extensively to both lay and scientific groups.

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