Body Beautiful (or at least Body Healthy) Checklist
This checklist is not about mere appearances. It is about having a healthy body. Good physical health is probably the best fuel for your energy bucket. Diminished health—from pain, worry, illness—makes you tired. Oh yes it is possible to triumph over these impediments. Franklin Delano Roosevelt was a brilliant strategist despite polio; Helen Keller learned to communicate despite being deaf and blind; my mother published, taught and mothered beautifully despite crippling migraines. But that is the hard way. Better to prevent or alleviate the problem and the fatigue. This is why I offer some facts and measurements along with recommendations about good health and good health practices.
These guidelines aren’t forever—knowledge and science march on—nor do they fit everyone perfectly because everyone has a particular heredity and environment, but the checklist is a reasonable start to maintaining your body as well as it can be. The start is fundamental to conquering the loss of function and the fatigue that can accompany being below par.
Your check-up need not be frequent or fancy. It is just a routine part of having a full energy bucket and a robust life. The whole megillah, once you find a medical home, will take maybe ½ day per year.
First things first: find a medical home, a health professional who listens carefully and who is well-informed. One clue to the former is that she/he is quiet for more than 20 seconds without interrupting your narrative. Clues to the latter include the clinician’s attending professional meetings, reading professional journals, being board certified and re-certified, and perhaps being on a medical school part-time or full-time faculty. You should be sure that your practitioner is free of county or state disciplinary actions, so check your state’s medical board’s web site.
Where can you find this paragon if you don’t already have one? The search is especially challenging because primary care practitioners for adults are in short supply. Go beyond the advice from family and friends. Keep trying! Your search for excellence may lead you to query the local or regional medical society, the most distinguished nearby hospital’s medical staff office or residency training program, or a medical school. Find out where their chief residents from the last 10-15 years have gone into practice. You may want to arrange a trial run appointment that you pay for.
Your first-rate clinician not only needs to be smart but available. Of course, doctors must have time to renew and restore themselves so they can take good care of you. When they are away, patients’ calls and visits should be covered. Find out who provides that coverage—a colleague in the same office or system is probably preferable to someone in a random emergency room.
You need to have an interview and hands-on exam from time to time, especially if you are not feeling well or find a lump or a spot. You should have a few screening tests, too, to find cracks in your engine block before something breaks down. The purpose is not just to find what’s wrong that you can’t feel but to find what’s wrong that you can do something about. Screening takes little time; early diagnosis and treatment can save your capabilities and your life.
Here are just six screening tests if you are a man; seven if you are a woman. These are my favorites because I am against suffering and these can rescue you from suffering. The array reminds me of the rueful comment by fabled Stanford Law School professor, John Kaplan, who said, “I was asked to make a list of all the faculty members broken down by age and sex. Everyone was on it.”
You need a blood pressure check about every other year or yearly or more often if your blood pressure is edging up. Cholesterol tests are recommended every 5 years unless tests are abnormal or you have a positive family history for heart trouble or other risks. A blood sugar test can find diabetes early so that weight loss or medication can prevent damage to your arteries. This should be done every 2-3 years if you are over 45, sooner or more often if you have risks because of family history or racial reasons (people of color have a higher risk than whites). All of these tests can show early, asymptomatic, treatable signs of potential heart, brain, kidney, and other blood vessel issues before they can cause damage or death.
Women need an annual mammogram if you are over 50 years old or earlier if you have increased risk such as a family history of breast cancer plus an annual Pap test for cervical cancer if you are under 30 and less often as you get older if the tests are normal. Men may want a digital rectal exam or prostate specific antibody (PSA) blood test, although data do not yet show convincingly that screening increases lifespan or decreases deaths from prostate cancer. Conflicting research and advice about tests’ significance means that you and your doctor must have a thorough discussion about them. There are inherent harms and benefits to any screening test, especially ones with uncertain results. You and your doctor can share in the decision about starting or continuing them.
If you are over 50 years of age, you need to have a stool test for blood each year. A sigmoidoscopy or colonoscopy is part of that drill (every 5 years if the stool blood is negative and immediately if the stool is positive) to look for ulcers, irritations, inflammation, polyps or tumors. About ½ of women and ¼ of men over 50 will break a bone because of osteoporosis so it is important to get a bone mineral density test every 1-3 years if you are 65 or over and to eat a diet with abundant calcium and vitamin D (sunshine helps the vitamin D picture only a little). Finally because hindsight, foresight and plain sight are good, a glaucoma check every 3-5 years after you are 40 is wise because high pressure in your eye (glaucoma) usually does not cause symptoms until damage to your nerves and vision has been done. African Americans should be tested earlier because of their higher risk.
This may seem daunting but you do have time and wisdom, and you know the pleasures of foiling an affliction.
Linda Clever’s Favorite Screening Tests for Adults
(Always check with your doctor.)
Test for Who and When What and How Often If You Feel Well and Are Well
Blood pressure All adults Every 1-2 years
Cholesterol All adults Every 5 years
Blood sugar All adults over 50 Every 2-3 years
Breast cancer All women over 40-50 Mammogram if over 50 or earlier if in risk group every year; check with your doctor for self-exam instructions
Cervical cancer All women Under 30, every year; over 30, check with your doctor
Prostate cancer All men over 55 Decide with your doctor
Gastrointestinal bleeding All adults over 50 Stool test for blood every year; direct exam every 5 years or sooner if stool test positive
Osteoporosis All adults over 60-65 Bone mineral density scan for women 60-65; men over 65, every 2-5 years
Glaucoma All adults over 40 Over 40, every 3-5 years or earlier and oftener if very nearsighted or African American
A medical tune-up will also include thoughtful attention, advice (about exercise, smoking, safer sex), instructions, and perhaps medications or more, plus a review of immunizations.
Of the various under-appreciated immunizations, I have in mind influenza immunizations for starters. Influenza is nothing to sneeze at, partly because it doesn’t really involve sneezes. The disease lays people low for one to three weeks, off work, stuffy, feverish, aching, coughing, weak, sometimes nauseated and vomiting, maybe short of breath, maybe with progressive pneumonia, likely distributing the infection to family, friends, and perfect stran
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