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Do you really need an annual check up?

You see your primary healthcare provider for your routine diabetes care. In fact it may seem that between seeing your primary healthcare provider and perhaps some specialists, that you spend most of your time at the doctors’ office.

So is it really necessary to also set aside separate time for an annual physical?

While preparing this blog post, I came across two articles with conflicting views. A study published in the British medical journal in 2012, found that performing annual physical examinations in otherwise healthy individuals showed no improvement in reducing either illness or death from disease. In fact it showed that there was an increase in unnecessary testing and also increased anxiety levels amongst patients who had to undergo these tests.

However another study published in the Annals of Internal medicine in 2002, shared some of the same sentiment that I have in my over 20 years as a clinician.

I like compare an annual physical to the same way most of us maintain our cars . There does not have to be anything wrong with the car, but you should change the oil, rotate the tires rotated, change the fan belt and the air filters etc. It helps improve the longevity of your vehicle. So does having an annual physical examination. Most insurance plans cover an annual physical examination, check with your insurance provider to see if this is a covered benefit for you. If it is not covered, check with your healthcare provider first. Find out what it would cost you. Sometimes a physical examination may be bundled into an affordable ‘wellness package’ which may also include basic screening laboratory tests

The annual physical examination may include

  • Screening tests such as colonoscopy, pap smears, prostate screening and mammograms
  • Blood tests to detect abnormal blood tests such as abnormal cholesterol levels, blood sugar, or thyroid levels
  • Immunizations
  • Screening for mental health issues such as depression

To make the best use of the time, I recommend that prior to your annual physical that you prepare a list of things you would like to go over with your healthcare provider. It is also a good idea to know that the recommended tests are for your age. To go over a list of recommendations you can log onto this website

This is also the time for you and your healthcare provider to develop a deeper understanding of your unique needs. With the way our healthcare system has become so fragmented this is truly a luxury that should not be taken for granted.

Even if you are living with a chronic illness such as type 2 diabetes, let your healthcare provider know that you want to focus on ways to enhance your overall health and well being. Just because you are living with a chronic illness does not mean that this should define your very existence. In fact you should not allow that to happen. You should be proactive in choosing to focus on your overall health and not just the chronic illness.

Do not be surprised to get some push back from your healthcare provider as they may not be used to this concept. This is a good time to focus on creating a lifestyle modification program which covers good nutrition, nutritional supplementation, exercise/movement, your emotional and spiritual beliefs as well as ensuring that you are getting adequate sleep

Perhaps you have started a lifestyle modification program and you need help making lifestyle changes, ask your healthcare provider for referrals. For instance to a health coach especially if your insurance covers this. You may also want to schedule a few sessions with an exercise physiologist or a personal trainer.

Finally, the therapeutic relationship between the physician and their patient is important. The simple act of “laying hands” on a patient can be healing.

My prayer is that as physicians we never let this art die despite what the preventive health guidelines may say otherwise.

Could you have high blood pressure and not even know it?

Hypertension is a very common condition and is also known as high blood pressure.

Hypertension is detected by checking the blood pressure (mm hg)

There are two parts to a blood pressure measurement.

  • The top number is the systolic blood pressure which is the pressure produced in the arteries when the heart pumps blood into the circulation.
  • The bottom number is the diastolic blood pressure and is the pressure measured when the heart relaxes.

Normal blood pressure the systolic blood pressure is less than 120 mm hg and the diastolic blood pressure is less than 80 mm hg. Previously hypertension was diagnosed with a reading 140 over 90.

The American College of Cardiology and American Heart Association recently changed the guidelines for diagnosing hypertension. This means that more people may have hypertension and not even know it.

Elevated blood pressure: 120-129 over less than 80

  • Stage 1 hypertension: 130-139 over 80-89
  • Stage 2 hypertension: over 140 and over 90

Hypertension should be diagnosed not only with the readings obtained when you go to see your healthcare professional, but also with blood pressure readings taken outside the office such as at home or using a special machine called an ambulatory monitoring device which takes the blood pressure several times during the day.

There are several types of hypertension. The most common kind is primary hypertension.

Hypertension increases the risk for damage to the critical organs of the body such as the the heart, kidneys, brain and the peripheral circulation.If your blood pressure falls within the elevated blood pressure range or stage 1 hypertension, your healthcare professional will recommend lifestyle modification such as:

Making changes to your food intake

Too often when people hear or read ‘diet’ they think of restrictions in what they can eat. There is abundant scientific research that shows the benefits of certain foods to reverse or control conditions such as hypertension, heart disease or diabetes.
One example is the mediterranean diet.The mediterranean diet consists of whole unprocessed foods rich in whole grains, fruits, vegetables, nuts, legumes, oils, spices and extra virgin olive oil. There are modest amounts of poultry, fish, red meat and red wine.

Increase physical movement

Exercise not only helps with weight loss, but also the production of nitric oxide which helps to dilate the blood vessels and hence reduce the blood pressure. Exercise also increases the production of endorphins which improves the mood.

Lose weight

If you are overweight or obese, start a plan to gain healthy body weight.
For more information on the difference between overweight and obesity, click here.

Quit smoking

Reduce excess alcohol intake

If you have been informed that you have an elevated blood pressure or hypertension, it may be a time to consider working with a functional health practitioner.