Show fcff w® 2J§MnnlOlfiiiifi)g) (n) (PlhiD©oa Only in America do perfectly healthy Is people call on their friendly physician the trip really necessary? By ITIike j I Oppenheim adpitals require one for very patient dismitted) But what can a doctor ITID cover when he goes over someone who feels well? The most common finding in my experience is excessive ear wax Unfortunately for detecting efearly signs of disease it’s not very the Super Bowl and the annual Thanksgiving ike physical is a peculiarly American of phenomenon In other parts the world doctors expect their pato be sick If a person who felt rents I well walked into the office of a British French or Japanese general practitioner and asked for a complete ex-jahe would probably be treated as a fective ! m hypochondriac of Why do Americans (and some jtheir doctors) believe that a regular 'physical exam is important? The likely lanswer is that we have great faith in the powers of science and technology deMany of us feel that a doctor can fect a host of hidden diseases at an early stage when they can be easily treated If this were true an annual physical would be essential But it isn’t true Medical science has made dazzling progress over the past century and can perform miracles in many areas 'However when it comes to finding diseases in people with no obvious symptoms its magic wand is rather physical exam limp A plus- a massive series of laboratory can detect a tests and small number of hidden treatable diseases In fact the 'American College of Physicians unrecently announced that it was necessary for healthy adults to have annual physicals Still the few hidden diseases that can be detected (such as cervical cancer high blood pressure and glaucoma) are major killers or cripplers A regular search for them can be lifesaving That brings up the obvious question: If a complete physical every year isn’t it necessary what is? We can answer doca most easily by going over what tor does during a typical examination The “physical” This is when the doctor taps and probes shines a light in your eyes and ears and listens with a stethoscope It’s an essential procedure when someone is sick (all hoshead-to-to- e - disap-pointing- X-ra- ys ly a freelance writer Dr Mike Oppenheim is Commonsense book recent most whose Health (Wideview) is 10 FAMILY WEEKLY March 23 1962 For example a person may feel very reassured when a doctor listens to' his lungs and finds that they sound normal and yet certain lung diseases don’t produce abnormal adbreathing sounds until they are far vanced Similarly listening to the heart is not a good way to detect heart disease The most important part of a physical on a healthy person is also the most unpopular: the rectal exam Experts agree that a yearly rectal exam for everyone past age 45 will detect several serious diseases at a very early stage In a man the examining finger can feel a small prostate cancer before it has spread In both sexes a doctor 5 can feel percent of all cancers of the colon and rectum Furthermore by smearing a tiny amount of stool on a slide and testing it for the presence of blood he can detect early cancer from anywhere in the bowel (most bowel cancers produce small amounts of blood) Women are urged to have yearly breast exams This is reasonable but women should realize that their own fingers may be far more sensitive than any doctor’s Women who examine themselves monthly detect breast cancer much earlier than those who 10-1- don’t After a physical patients never complain if I’ve left out the rectal ex- am but they’ll speak up if I fail to do “tests” Americans seem to believe blood tests electhat “tests” trocardiograms) are important ways to detect the early signs of disease They’re right about a few but the great majority of tests are useless for individuals with no symptoms of disease Let’s go over them are a poor Regular screening test The annual chest was once considered a good way to detect early tuberculosis but experts (X-ra- X-ra- ys ys X-ra- ys X-ra- y 19th-centu- ry artist Daumier depicted the distasteful side of the physical now agree that the few cases it turns up are not worth the radiation exposure Blood tests With modem automated laboratory equipment a doctor can order 20 or 30 separate tests from an ounce of your blood How useful is this? Not very Many authorities state that no blood test done regularly on a person who feels well is important for detecting hidden treatable disease Others would disagree on one parlevel ticular test: the blood-sug- ar An elevated blood sugar is a sign of diabetes and this elevation can appear years before other symptoms excessive urination weight loss) But adult diabetes occurs mostly in people who are overweight and therefore the test doesn’t need to be done routinely The electrocardiogram This is excellent for evaluating heart disease once it is obviously present but it is not very informative when done on (thirst healthy people Miscellaneous tests Here we strike gold! Three are superb at detecting disease when it is easily treated They are: e check Of all 1 The the sophisticated instruments at a doctor’s command the lowly blood pressure cuff saves more lives and prevents more disease than any other High blood pressure is the leading cause of strokes and a major factor in heart and kidney failure but when detected early and treated high blood pressure poses no threat A yearly check is an excellent for everyone — measure preventive blood-pressur- blood-pressur- e You don’t however need a doctor to do it Use the automated machines available in so many shopping centers and stores If the reading is 14090 or over see your doctor to have it checked again 2 The pap smear Cervical cancer still kills 7000 American women per year yet a pap smear can detect it at an early stage when it is essentially 100 percent curable Every woman should have a regular (follow your doctor’s recommendations) smear from the time she begins having inter- included children - course 3 Tonometry This test involves using a simple instrument to measure the pressure of fluid in the eyeball An elevated pressure is a sign of glaucoma a common cause of blindness Experts recommend yearly tonometry for everyone past age 40 If a thorough annual exam isn’t necessary what is? Though there s no universal agreement many doctors urge the following Everyone should have a “get acquainted” exam A conscientious doctor wants to record basic information about all new patients He or she will spend extra time on the first or second visit to find out about your medical history do an exam and perhaps order some simple lab tests Thereafter follow the guidelines above Remember however that all these recommendations apply to people in good health If you experience disturbing medical symptoms consult your doctor |