Habiba Tunau MD

While we are all concerned about COVID let us not forget our general health and all the health screening tests and preventative care we need at this age !  Yes I mean YOU aged 18 and up ! 

Do you actually know what tests you need to stay healthy even before  you have to see a doctor or healthcare provider ?  

Lately I have heard from people who had legitimate  symptoms- non COVID related -that took them to the Emergency room or Urgent care where  they were tested for COVID and sent home. No treatment was offered or followup.  What if they really had something seriously wrong besides COVID? Granted most medical problems do not require the ER but many do,  like chest pain, shortness or breath, significant rectal bleeding, certain infections, severe dehydration,  complications from severe uncontrolled diabetes or kidney disease, mental status changes, severe dehydration and the list goes on. 

Here is my concern: because the healthcare system is overwhelmed by COVID and most providers are focused on this subject You as a patient have to be your own advocate and the advocate of your family members!   Don’t neglect your general health and make sure you get the necessary tests you need to stay healthy.  Of course every state or part of the country is different so please adhere to the  guidelines and common sense to determine if it is safe to see your provider.  At a minimum  you should be able to call your provider’s office or communicate via telehealth or via text message depending on what is available to you.  

Here are some basic health screening tests and preventative care you need  at your age to stay healthy.  I advise you to save this checklist for later reference. 

1. WEIGHT :  You should own a scale and check your weight at least once a week before breakfast in the morning.  If you have certain medical problems like CHF ( congestive heart failure )  or ESRD ( Renal disease ) you may be required to check it more often.  Keep in mind our weight  fluctuates depending on how hydrated you are, how much you ate and  how often you use the bathroom.  Make sure your provider has a record of your weight  to determine if you have gained or lost weight over time.  Keep a log book or calendar to record your values. 
2. BMI : Or Body Mass Index.  You should know this number and so should your provider based on your weight and height.  It helps determine your risk for certain conditions like health disease , sleep apnea or hypertension.  Don’t know your number?  Just google “ BMI Calculator “ and plug in your numbers. For example Normal BMI is less than 25 and obesity is any number greater than 30. 
3. BLOOD PRESSURE :   You should know your blood pressure and have it checked after age 18.  If you are healthy and of average risk it can be checked every 3-5 years after age 18.   By age 40 you should have it checked at least once a year.  If you have high blood pressure or hypertension you should check your pressure at least 1-2x a week and follow your medical providers recommendation.  If it is not well controlled he/she may suggest you check it more frequently.   Please get a digital blood pressure machine that ideally requires an upper arm cuff.    On average Ideal Blood pressure is less than 120/80
4. EYE EXAM :  You should have a comprehensive eye exam every 1-2 years after age 40 adjusted based on your age, risk factors, contacts or glasses.   An eye exam not only checks your vision but also helps detect problems like hypertension, diabetes, glaucoma,  high cholesterol etc  In general if you are 20-40  according to Mayo Clinic you should have an eye exam at least every 5 years. 
5.  DENTAL EXAM : When was the last time you saw the dentist?  Ideally you should see the dentist at least twice a year for a cleaning and also to check for healthy teeth, gums and screen for oral cancer. Smokers and tobacco users are particularly at risk. 
6. MAMMOGRAM : Even before you get a mammogram all women should know what their normal breasts feel like, that way they can alert their provider if anything has changed or feels different.   The American Cancer Society recommends an annual screening  for women ages 45-55 and then every other year after that.  The US Preventative Service Task force recommends a mammogram every other year beginning at age 50.  In some cases mammograms can be offered as early as 40. Talk with your provider about the benefits and limitations to breast cancer screening. You may be offered one of the newer 3D mammograms, please ask about the risks and benefits. 

Keep in mind that most mammograms are performed on women but men can and do get breast cancer!  They too should alert a medical provider if they see any nipple discharge,  new inversion of nipple, skin changes around breast, inward pulling of skin or dimpling that is new and of course any breast pain or lumps. 

7. FECAL OCCULT BLOOD ( FOB)  This test should start no later than 45 according to the American Cancer Society. It  screens for blood in the stool that the naked eye can not see.  A positive test may suggest hemorrhoids, diverticulosis, polyps or even colon cancer.
8. COLONOSCOPY:   This screening test for males and females is usually performed by a gastroenterologist or surgeon and consists of a direct scope and imaging of the colon to detect cancer or other gastrointestinal problems.   For the average person a colonoscopy is done after age 45 or at least by age 50 and then every 10 years after that.  Colonoscopy screening can be continued till age 75.  Screening via colonoscopy is not usually suggested after age 85.   

           For people with a family history of colon cancer they should have a colonoscopy  10 years earlier than when their relative was diagnosed.

9. PSA / PROSTATE SPECIFIC ANTIGEN  Men over 50 should have a PSA.  It is a blood test that can screen for prostate cancer.  Many believe the benefits of testing may not outweigh the harms of treatment so please make sure you have an informed discussion first.  African American men and men who have had a father or brother with prostate cancer  should have a discussion about checking a PSA by age 45 especially since they have a higher risk for prostate cancer. 

Please keep in mind an elevated PSA does not always mean prostate cancer. It can suggest prostatitis which is an infection or it may be the patients “normal” . A persistent elevated PSA should be evaluated by a urologist. 

10.  PAP This is a screening test for cervical cancer and should be done every 3 years after age 21.   After age 30 and until age 65 you should have a PAP test and HPV test at least every 5 years.  Your gynecologist or primary care provider may suggest more frequent pap tests especially if the last one was abnormal.

After age 65 if  you have had normal pap smears in the last 10 years  or if you have had a total hysterectomy not related to cancer then you may no longer need a pap smear.

11. STDS  Are you sexually active ? When was the last time you had an HIV test? Have you had unprotected sex with someone whose status you do not know or have concerns about about a vaginal or penile discharge? Do you have a new painful rash or lesions around your private area?  Please get checked for STDs like gonorrhea, chlamydia and herpes etc  
12. ABDOMINAL ULTRASOUND  This is a one time screening test for anyone over age 65 to screen for an Abdominal Aortic Aneurysm ( AAA ) especially if you or your loved one has a history of hypertension and or smoking. 
13. BONE DENSITY This screening test is usually done to detect the risk of osteoporosis and bone fracture .  It is often called a DEXA SCAN . It tends to focus on the spine and hips.  It is suggested every 2 years after age 65.
14. BLOOD TESTS/ LABS I am sure you are aware that there are so many blood tests available and you will not need most of them, nor will your medical provider order them without due cause.  What lab tests do you need now  or are recommended based on your age? A common misconception is that having “blood tests checks for everything”.  Ask your provider what tests are being ordered.  Here are some general guidelines:

1. Cholesterol:  if you are an adult and certainly after age 35 please have this checked at least once a year.  It may be checked more frequently if you are on medication for it. 
2. Glucose: This should be checked in an  exam as part of screening for diabetes . It is usually part of a panel of tests called a “BMP” that also checks your sodium, potassium and kidney functions.  The  next time you see or speak to your provider please ask about your sugar and kidney function.  Of course if you are diabetic, have kidney disease or heart failure then you are accustomed to these labs being checked several times a year. 
3. Thyroid: Have you had a TSH checked this year to make sure you do not have hyper or hypothyroidism? 
4. Vitamin levels like B12 ,Iron, Magnesium and Vitamin D.  Depending on your age and symptoms your provider may choose to order certain vitamin levels.  

In short when it comes to labs don’t assume your provider has ordered “everything” . Make sure you discuss any new symptoms you have which will guide what tests he/she orders. 

15. VACCINES Are your vaccines uptodate? Most of us assume our vaccines are uptodate or we believe vaccines are just for children.

Consider when was your last Tetanus or Tdap vaccine ?  The CDC recommends a booster every 10 years.  Tdap gives a combined protection against tetanus, diphtheria and pertussis or whooping cough.

Meningococcal vaccine  to prevent meningitis.  This is especially important in teens who are at an increased risk for this often deadly and very contagious disease as it is often spread via saliva and cough. The CDC  recommends routine vaccination for adolescents starting at age 11-12 with a second dose at age 16.   I mention this vaccine as a reminder for all of those who have teenagers/young adults going to college or military. 

Other vaccines you may consider as we head into the fall : Flu vaccine. It would be unfortunate to contract the flu during this pandemic  given the risk of getting both viruses! 

Any seniors may also want to ask their providers about the Shingles vaccine which may be available to some as young as 50.  Shingles as you may know is a very painful and often disfiguring infection.

Pneumococcal vaccine: helps prevent streptococcus pneumonia bacteria infection often responsible for pneumonia.  There are two versions of the vaccine not only for children under 2 but also for those with certain medical conditions like a history of  pneumonia, COPD or emphysema or risk factors including adults over 19 who smoke and certainly those over age 65.   

In summary please use the above list as a guideline to help you stay up to date with your health screening tests and preventative care.  Now more than ever you need to advocate for your health and take responsibility to see that you get what you need.  If you don’t ask for it it may not happen! 

Please feel free to SHARE this post with someone who needs it.  Here is the link to watch me discuss above concerns : https://www.youtube.com/watch?v=nJRL8qyVwqI&t=1s

Thank you for reading about health screening tests and preventative care. Wishing you the best of health now and in the future!

Here is another helpful medical/ health related blog about WHAT’S GOING ON WITH YOUR VAGINA : https://www.habibatunaumd.com/healthfoodinspiration/whats-going-on-with-my-vagina/

• Habiba Tunau MD