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Age 4-5 years old: an office urinalysis.
Tuberculosis screening, as required in schools and in high risk individuals. Many schools require teachers to get a tuberculosis skin test annually. It should be read by a health care profession 48-72 hours after the test.
Age 11-12: a tetanus/pertussis booster. Adults should have a tetanus booster every 10 years. For people under age 65, the DTAP is available, which includes prohpylaxis against Pertussis. Plain Td/Tetanus boosters are available for people 7 through adult, including people over 65.
For children who have not had chicken pox, a 2nd chicken pox vaccine dose, or booster, is recommended.
Annual flu shots for anyone 6 months through adult.
A pneumovax to help prevent pneumonia for anyone with asthma, some people with diabetes, or for people who are 65 or older. This is given every 5 years.
Hepatitis B immunization to all healthcare workers and children. This is a 3 dose series across six months.
Hepatitis A immunizations are recommended for many food handling people and travelers to foreign countries, including Mexico. This is a two dose series set across 6 months. Some restaurants require this immunization of their workers.
An annual pap smear and well woman exam for women on contraception and/or for women who are sexually active, or starting at age 18. After three normal pap smears and if the woman has the same partner for at least 3 years, then the pap smear can be done every two years. The thin prep is the current pap smear style, and it gives us better results than the old fashioned pap smear.
Breast self exams should be performed monthly by all women from teens onward. Age 40 is the first year that a mammogram is recommended, unless the breast exam demonstrates a lump or mass or unless a person has a strong family history of breast cancer. Age 35 is the recommended age for mammograms for high risk women.
Testicular self exams start in the late teens, and testicular cancers strikes men in their teens through 30s.
A prostate exam starts at age 40 for people who have a family history of prostate cancer or for African American males. Age 50 is the general time for males to start getting a prostate exam.
Colon cancer screening starts at age 40 in people with a family history of colon cancer. Colon cancer screening starts at age 50 for people without a relative with colon cancer. Currently screening consists of a colonoscopy as an outpatient. The 2008 recommendation for polyps is a colonoscopy every three years.
Symptomatic people or in people with a family history of Diabetes Type 1 or 2: a fasting glucose check. Diabetic patients should see a physician at least every 3 months. Asymptomatic people should have a glucose screen every 1 to 3 years, depending on the resource recommendation.
A cholesterol panel every five years, and at least every 3 months in patients with abnormal cholesterol values, starting at age 20, 30, or 35, and sometimes younger, depending on the risk factors. Total cholesterol should be less than 200. Triglycerides less than 150. LDL, or bad cholesterol, less than 130 or less than 100, depending on risk factors. HDL cholesterol should be above 40. Exercise helps raise the HDL cholesterol. Fish oil capsules, oats, garlic, and niacin help help with lipid management. Refrigerate or freeze the fish oil capsules to prevent the fish reflux.
Annual blood pressure monitoring on nonhypertensive patients. Patients who are on blood pressure medication should visit the physician at least every three months.
Annual vision screening for grade school children and adults, including for glaucoma.
Go to a dentist at least twice a year.
Adults: multivitamin/mineral, Vitamin D 5,000 iu/day.
A once-a-day multivitamin is good for children and adults.
A daily intake of an enteric coated aspirin after age 35 or in patients with hypertension. Dosing is 81 mg for women and two of the 81 mg daily for men.
Maintaining an ideal body mass, with a usual value of less than 25. BMP of 25&emdash;29.9 is the overweight range, and BMP of 30 and above is in the obese range.
No more than two alcoholic beverages a day if age 21 or older. One if you are female. A serving is one 12 ounce beer, 5 ounces of wine, or 1 1/2 ounces of 80 proof distilled beverage.
Do not smoke and quit smoking if you do smoke. The patch, gum, and lozenge are over the counter. Prescription methods include Chantix, Welbutrin/Zyban, and Nicotrol Inhalers. Lung cancer is a leading cause of death in the United States.
Wear your protective gear at work.
Wear your seatbelt.
Have smoke detectors in your home.
Exercise 20-30 minutes most days of the week.
Calcium with vitamin D supplements twice a day. The body makes enough vitamin D with exposure to sun 15 min twice a week without sunblock.
Dietary recommendations, general population: 2 cups of fruit daily, 2 1/2 cups of vegetables daily, 2000 calorie diet. Three or more whole grain products daily. Three cups/day of low fat or fat free milk or equivalent products. Consume less than 10%/day of the calories from saturated fats and less than 300mg/day of cholesterol. Choose lean or low fat meats, beans, and dairy products. Limit intake of saturated fats and oils. Canola and olive oils usually are okay choices.
A low sodium diet of less than 2300 mg/day is ideal. Most Americans get between 4000-6000 mg/day.
2005 USDA Daily Recommendations for 2000 calorie diet. For adult males, multiple by 1.15. 2 cups/4 servings/fruit. 2 1/2 cups of vegetables/5 Servings. 6 ounce equivalent of whole grains. Meat and Beans: 5.5 ounce. Milk 2 cups/day. Oils 6 teaspoons. Added sugars: 8 teaspoons. Protein per day: 91 grams, Carbohydrates 271 grams, fat 65 grams
DASH Diet Daily Recommendations for 2000 calorie diet. For adult males, multiple by 1.15. 2 - 2.5 cups/4-5 servings/fruit. 2- 2.5 cups of vegetables/4-5 Servings. 7-8 ounce equivalent of whole grains. Meat and Beans: 6 ounce or less. 4-5 servings/week nuts, beans, and seeds. Milk 2-3 cups/day Oils 2-3 teaspoons. Added sugars: 2 teaspoons. Protein per day: 108 grams, Carbohydrates 288 grams, fat 48 grams
Definitions: fruit serving examples: 1/2 cupfresh, frozen, or canned fruit, 1 medium fruit, 1/4 cup dried fruit, 1/2-3/4 cup fruit juice. Vegetable servings: 1/2 cup includes 1/2 cup of raw/cooked vegetables, 1 cup raw leafy vegetable, 1/2-3/4 cup vegetable juice. Whole grains: 1 slice bread, 1 cup dry cereal, 1/2 cup cooked rice/pasta/cereal. 1/2-1 3/4 cup dry cereal. Meat and Beans: 1 ounce of lean cooked meats, poultry, fish. 1 egg. 1/4 cup cooked dry beans or tofu. 1 tablespoon peanut butter. 1 1/2 ounces baking nuts. 1/2 ounce seeds. Milk: 1 cup low fat or fat free milk/yogurt; 1 1/3 ounce low fat or natural cheese. Added sugars: 1 tablespoon jelly/jam, 8 ounces lemonade; 1/2 ounce candy.
*This list of health screening recommendations are not all inconclusive. Some or all of these items may or may not pertain to a particular patient at The Country Doctor, Ltd. These items may or may not be done at each appointment and may or may not be recommended at a specific age.