By Dr. Jason Goldie – The Family Health Centers
Why dedicate a whole month to men’s health? Well, although men visit the doctor less often than women, it’s just as important for men to routinely screen for certain diseases and conditions and to stay on-track with preventative care. Guys, whether you call it a checkup, a physical or a wellness exam, be sure to visit your family doctor at least every three years. Here’s what to expect at the appointment:
1. Blood pressure check: At almost all doctor visits, your blood pressure will be checked. If you are over 18, your goal blood pressure should be under 140/90. If your blood pressure is somewhat elevated, your provider may suggest lifestyle changes that can lower your blood pressure naturally, such as dietary changes, regular exercise and weight loss. High blood pressure or hypertension is often called a “silent killer” because unchecked high blood pressure over time can lead to a heart attack or stroke.
2. Body Mass Index (BMI) check: BMI is your height against your weight. For more adults, the BMI should be between 18% and 25%, or between 23% and 30% if you are age 65 or older). Higher BMI’s can indicate that you are overweight, obese or morbidly obese. We know that if you are overweight you will have a higher chance of developing diabetes, heart disease, high blood pressure or stroke. Expect your provider to discuss this with you and give you information on losing weight in a healthy fashion.
3. Cholesterol and blood sugar check: You may be asked to “fast” after midnight prior to your visit. This allows your doctor to reliably check your blood cholesterol and sugar levels to make sure you do not have diabetes. You provider may order other tests to monitor medications, to look for other illnesses or to further investigate known disease.
4. Vaccines: Depending on your age, you may be advised to get the HPV vaccine series, a tetanus shot with whooping cough booster (TdaP) and an annual flu vaccine. Starting around age 60, you will be advised to get a Shingles vaccine. After age 65, your provider should discuss the need for a two-shot series that can reduce the severity of pneumonia infections.
5. Hepatitis C screening: Hepatitis C is a type of liver infection that is associated with transmission of bodily fluids. While this can be linked to sex history and IV drug use, it has also been tied to blood transfusions received in the mid-twentieth century. It is recommended that you get screened for Hepatitis C with a simple blood test if you were born between 1945 and 1965.
6. Lung cancer screening: Historically we did not have a reliable way to test for lung cancers before they caused symptoms. In the last few years, a low dose CT scan was developed to spot small cancers while minimizing the risk of radiation to the patient. If you are between the age of 55 and 77, smoked at least a pack per day for 30 years and are still smoking, or quit smoking within the last 15 years, you should get screened for lung cancer. Please remember that if you wait until start having a cough that doesn’t go away, shortness of breath or unexplained weight loss, you’ve waited too long.
7. Colon Cancer screening: If you have no family history of colon cancer, you should start regular testing for colon cancer at age 50. A colonoscopy is considered the “gold standard” for finding colon cancer early. There are alternatives to the colonoscopy, but you should discuss those with your provider. If you have a first degree relative (sibling, mother or father) who has been diagnosed with colon cancer, or two 2nd degree relatives on the same side of your family, then you may need to get screened earlier.
8. Depression screening: Depression often goes unrecognized by patients as well as their providers. You will likely be asked a simple 9-question form that’s designed to detect depression. Be open to options for treatment if recommended.
9. Alcohol screening: Alcohol abuse and dependency can often go unrecognized by patients, families and providers. Screening is recommended annually to help detect this and allow providers to give appropriate counselling on drinking behaviors.
10. Prostate Cancer screening: Prostate cancer is unique to men in that only men have prostate glands. We used to test every man between a certain age who came in for a wellness exam, but now there is a lack of consensus in the medical community on who needs to be checked. Screening is usually comprised of a blood test and a rectal exam to assess for the size, shape and consistency of the prostate gland. I recommend you discuss with your provider if getting checked for prostate cancer is right for you.
11. Coronary artery disease risk: How we look at heart disease and cholesterol has changed in the last few year. We now worry less about what your cholesterol numbers look like on paper. Instead, starting at age 40, your provider will take your cholesterol numbers and along with other risk factors and will calculate a risk score that determines if you need to be on a statin type medication. This is known as ASCVD risk calculation and it helps determine how likely you are to have a heart attack or stroke in the next 10 years. Keep in mind that men are more likely to suffer from heart disease and at an earlier age than women.
12. Abdominal aortic aneurysm (AAA) screening: AAA is a lesser-known disease which is essentially enlargement of the largest artery in your body. This enlargement can lead to a rupture which can be life threatening. If you are male and have ever smoked 100 cigarettes in your lifetime or have a family history of AAA, then you should get screened once with a simple ultrasound test between the age of 65 and 75.
13. Erectile dysfunction: I know that this can be a sensitive subject, but it is important to bring this up to your provider. ED can be caused by several underlying issues including low testosterone or vascular disease. It is important for your provider to be aware of this issue and to look for possible causes.
As you can see, there are plenty of health issues that can affect a man’s quality of life. The good news is that you can work with your family doctor to get the screenings and preventative care that’s right for you. So, men, I challenge you to take your health seriously. Go to your primary care provider and get checked out!