Making an appointment for your annual wellness exam is one of the best things you can do for your health. A visit to your primary care physician is often the first line of defense at preventing major illnesses. These annual visits are also the best way to understanding your overall health.
Family medical history: It’s important to know as much of your family’s medical history as you can. Ask your immediate family members what medical problems run in the family. Is there a history of cancer? Alzheimer’s? Heart disease? Your doctor can assess this information and recommend screening if they feel you are susceptible to a certain condition.
Medications: If you are on medications it’s important to make a list of their names and dosing. It’s even better to bring them all to your visit. Some doctors might already have this information, but if you are switching doctors, this is important to bring up. Don’t forget to also note any over-the-counter medicine and supplements you might also be taking, such as a multivitamin, vitamin D or calcium.
Get vital signs and BMI checked: Your primary care doctor will obtain your vital signs like weight, height, blood pressure, heart rate, respiration rate and temperature during your visit. It is important to make sure you understand what each one means and familiarize yourself with the numbers you should be hitting. Your BMI can be calculated based on your weight and height to determine if you are at a healthy weight. Your doctor can recommend dietary improvements as well as a plan to help you get to a healthy weight.
Labs: Ask your doctor if he or she recommends any labs and if so, make sure you understand why
Vaccines: Are there any vaccines you’re missing or that require a booster? Discuss with your physician for his or her recommendations. If you are visiting a new doctor bring a copy of vaccination records. Your wellness exam is also a good time to get your yearly flu shot if you didn’t get one at the start of the season.
Fasting: Check with your doctor to see if your tests require you to fast the night before. Fasting ensures that your screenings produce the most accurate results. The fasting period usually is 9 to 12 hours before your test. If you can’t go that long without food try to schedule your appointment in the morning.
Mental Health: If you have been experiencing bouts of depression or anxiety, it’s important to speak to your primary care physician. They can provide you with resources to speak with a counselor or discuss if you’ll need further follow up to discuss medications or treatment plan.
Men’s health exams:
- Abdominal Aortic Aneurysm Screening (This is a one-time screening for men between the ages of 65-75 who have a history of smoking.)
Women’s health exams:
- Bone mineral density test (DEXA). Screening exam for osteopenia or osteoporosis. Peak bone mass occurs at age 30 and then begins to decline. Women should have this test starting at age 65, however, some women may qualify for screening earlier based on risk factors such as hysterectomy, steroid use, tobacco use, or hypothyroidism. Screening interval is every 3-5 years.
- Mammogram (Starting at age 40 or sooner if there is a family history of breast cancer.
- Screening interval is every 1-2 years.
- Cervical cancer screening beginning at age 21. Women in their 20’s should get a Pap smear every three years. Women between the ages of 30-65 should get a Pap smear every 5 years with HPV co-testing.
Exams for both men and women
- Colonoscopy (Starting at age 50 and then every 10 years, however, could be less than 10 years for repeat exam based on results- such as precancerous polyps. Screening should be done earlier if there is a family history of colorectal cancer.) Other options for colorectal cancer screening include yearly FOBT (a stool sample that detects blood) or Cologuard (a stool sample that detects blood and molecular markers that signify presence of precancerous lesions). Cologuard screening is every 3 years. A positive FOBT or Cologuard warrant a colonoscopy. FOBT and Cologuard can be done at home, but are inferior to gold standard of colonoscopy performed by a physician as this give real time visualization of the colon.
- Blood glucose test with fasting glucose or hemoglobin
- Vision and audiology exams. A comprehensive eye exam should be done yearly for diabetics and patients with high blood pressure. Routine vision exams are important for all ages. Men and women over 65 should get their eyes tested every one to two years for signs of cataracts, glaucoma, and macular degeneration. Hearing loss is a leading cause of depression in the elderly and can be mistaken for a number of other conditions. A visit to the Audiologist to test hearing can determine if there is conductive (blockage such as wax) or Sensorineural (related to nerves) hearing loss.
- Vaccinations (Men and women over 50 should get the shingles vaccine (ShingrixPneumonia vaccination at age 65 (Prevnar) followed in 1 year by Pneumovax 23. Some health conditions such as diabetes, tobacco use, and COPD warrant Pneumovax before age 65. TDAP (tetanus with pertussis) is recommended in place of tetanus booster once in adult life. This will serve as tetanus booster, but also provide immunization against Pertussis, which is whooping cough. This is now being administered to all pregnant women in the 3rd trimester. Influenza vaccination yearly! Men and women should also get the first dose of the HPV vaccine between the ages of 11-12 and then six to 12 months after the first dose. The vaccine is also recommended through the age of 26. Guidelines regarding vaccination schedules are updated frequently so speak with your doctor to ensure you don’t have any contraindications to being vaccinated or if there are new updates regarding the vaccines.
- Blood Pressure (Starting at age 20 every two years)
- Cholesterol (Starting at age 20 every four to six years. You doctors may recommend you to be screened more often if you are risk factors such as heart disease or stroke.) Based on your age a 10-year risk of heart attack or stroke (ASCVD risk) will be calculated to determine if you will need a cholesterol medication such as a statin. If you are intermediate risk your doctor may discuss a CT calcium score to assess the plaque burden in the arteries of your heart.
- STIs (HIV tests should be done at least once between the ages of 15 to 65. Women who are pregnant should be screened at the start of their pregnancy for HIV as well. Men and women who are sexually active should also be tested for gonorrhea and chlamydia. Patients born between the years of 1945-1965 are recommended to be screened for Hepatitis C. Guidelines are frequently updating as now the USPTF is recommending a universal screening of all patients for Hepatitis C. Discuss with your doctor what screening labs are recommended for you.
Booking your wellness exam should be one of the things on the top of your yearly check list. Not only are you getting yourself checked out but it’s the first step in becoming an active participant in your health. Establish a relationship with a primary care physician who you feel is an advocate for your health and well-being!
Need to book a wellness exam? Book your appointment today by visiting: https://www.ochsner.org/doctors/ashley-ingolia