Check vital signs to avoid life-threatening breakdowns

By KATHERINE HOBY

Medical experts often tell us our bodies are like a finely tuned piece of machinery, a high performance car. We wouldn't pour low-grade petrol into the tank, or let the exterior go to ruin, so why let our own bodies go?

But do we really need an annual physical warrant of fitness? And when should people start checking eyesight, bone density, or for women - get a mammogram?

Jonathan Fox is a general practitioner and Auckland faculty chairman at the Royal New Zealand College of GPs. He says while it is important to be vigilant about looking after ourselves, it is also possible to overdo it.

"We can spend an awful lot of money getting lots of tests for no benefit," he says.

"We need to be sensible, our own tests need to be tailored by our doctor, and there are some things worth recording and checking. There are those things that save lives versus those things that it is nice to know about."

Many doctors offer a Well Man / Well Woman check.

"This can be useful for people who don't know where their health is at, and who need an all-over check up."

The first factors in a patient's physical health to be considered are lifestyle-related: How much exercise do you get? Do you smoke, drink alcohol a lot? Have a high-stress job, a family history of certain diseases or conditions?

"Talking about things is an excellent start."

Dr Fox says it is useful for every adult to know their blood pressure and cholesterol level. Everybody should have their blood pressure checked before they are 20, and then every three to five years.

For women on the Pill it will already be regularly checked by a doctor.

All adults in their early 20s should have blood tests to check cholesterol.

Cervical screening is "very very important" for women, says Dr Fox. A woman should have her first cervical smear when she becomes sexually active, then one a year later, and then every three years.

"I'm sure it is not the most pleasant thing but we're talking about things that save lives."

Women between 50 and 70 can have free mammograms. Dr Fox says there is enough evidence that shows starting at 40 has benefits.

"Mammograms? I would say definitely when you get to 50, and probably when you get to 40."

Some women might decide to start having them earlier if there is a history of breast cancer in the family.

Dr Fox is a strong believer in breast self-examination.

"I like patients to get to know their bodies and take responsibility for their own health."

If someone knows their body, and how it functions and looks usually, it is more likely they will notice changes sooner, and can get them checked out.

Also, much larger numbers of women develop osteoporosis - 56 per cent of women compared with 29 per cent of men over 60, which equates to about 260,000 New Zealanders. Older women need to start talking about having bone density checks from their late 40s, Dr Fox recommends.

Not every woman needs them, but again, lifestyle questions need to be asked to determine possible risk - was the woman an athlete in her youth, did she break a lot of bones?

Forming a good relationship with your doctor is vital, especially when addressing sensitive issues, such as sexual health, and prostate problems for men, says Dr Fox.

"Once a man gets to 50 I do talk to them about their prostate.

"It's not an easy topic for some but it helps to have a good relationship with the patient."

There is no evidence that lives are saved by prostate screening but Dr Fox is convinced regular monitoring and good communication helps catch problems early.

"A lot of men are being nagged into talking about their prostate by their wives and its not the taboo it once was," he says.

"I encourage nagging if it gets this result."

People of all ages should constantly check for melanoma - size, shape and colour changes in moles or freckles should be checked by a doctor.

From the late 40s, a patient should also consult an optometrist every two years for an eye test, as glaucoma is a "silent, threatening problem". Again, this depends on family history.

Dr Fox says the cost of a Well Man/Well Woman check varies. At his Meadowbank practice it costs $100 for men, and $110 for women. That buys you 15 minutes with a nurse and 30 minutes with a doctor.

Apart from blood pressure and cholesterol, the regularity and number of most other tests depend on family history and individual lifestyle.

"It is a case by case thing but the keys are: listen to your body, and work on a good relationship with your doctor."

Further reading:
nzherald.co.nz/health