OK, So I got my bloodwork back today??

[JFLuvly]

So here's the deal, at 42 I am pretty active but not a health nut by any means. I eat horribly...big glass of pop, bag of chips and a bar almost every night, fast food usually at least once a day, at least three cups of Tim Hortons coffee with 3 sugar and 3 cream. I smoke too much and will have a few beer after baseball twice a week and more after hockey through the winter. My bloodwork came back with everything ok, all on the good side of acceptable limits. My ekg's are normal, including a 24 hour holter monitor, and the Doc said I did better than 97% of the people he sees in my stress test. I am maybe about 20 pounds overweight but still have a relatively flat stomach and am reasonably muscular. I might add that I don't work, and tend to sit around doing nothing quite a bit.

My question is this: I really want to eat better and get more active, but this not so great lifestyle seems to be working for me and I am a little paranoid about changing things. Do I maintain the status quo or change my lifestyle completely?

What say ye Dopers from around the planet?

[Kinthalis]

I don't see why you would have to change your lifestyle "completely". A few changes here and there could mean a longer, healthier life.

PS: Congrats on the good physical. I just got the bad news that my cholesterol is high

[Cowboy8467]

Apropos of nothing I remember when I got my last physical whilst still on my parents health plan. It was about a week or two after graduating from college and I had literally eaten nothing but fast food for an entire week leading up to the physical. We had absolutely no groceries in the house and being college seniors we had little desire to do so.

I went in and got the bloodwork and all that stuff done. Imagine my surprise when the doctor came back with my results and commended me on being very healthy. He said and I quote, "I can see you don't eat very much McDonalds according to these cholesterol levels." It was all I could do to keep from busting out laughing. Thankfully I do eat better now.

[Chronos]

Apparently you're blessed with healthy genes. But healthy genes and good food will get you further than healthy genes alone.

[Qadgop the Mercotan]

If one of my patients told me what you are telling me, I'd tell them:

Eat more vegetables, fewer carbs, and less saturated fat than you currently do.

Exercise more than you currently do.

(Pretty good standard advice for nearly everyone)

[Philster]

Good luck. If Bloodwork told the whole story, you'd be awesome.

Your risk for cancer is high.

Your risk of pain is high.

Your risk of living a more miserable aging existence is high.

[AuntiePam]

Originally Posted by JFLuvly

I might add that I don't work, and tend to sit around doing nothing quite a bit.

This makes me wonder if your stress-free life is (for now) helping to balance the bad habits.

Then again, you're only 42. I had great physicals until I was in my late 50's. That stuff'll catch up with you eventually.

[DrDeth]

Your habits certainly are not keeping your health "good". Your health is good despite your bad habits, and that's likely due to good genes. But the bloodwork isn;t everything- it won;t warn you about lung cancer, for example.

I'll go along with what QtM sez.

Here' s a few other things- make your fast food an occ treat, not daily food. Make your own sandwiches. Eat an apple or two a day.

Try drinking iced tea instead of soda for a while, try some diet drinks.

One day a week eat vegan- salads, fruit, veggies. Make (for example) Monday = "salad day".

Get some of that orange fiber stuff, drink a glass a day along with a vitamin.

Try to switch from cigs to cigars or a pipe. Remember not to inhale.

Skip the chips.

Your coffee and beer intake seems OK.

[cmyk]

If anything, give up the smokes. Otherwise, enjoy the junk while you can.

ETA: Your health can turn on a dime. Especially cancer, that can seem to come out of nowhere.

[kunilou]

It'll creep up on you slowly. You'll go from being 20 pounds overweight to 22, then 25, then 30. Your cholesterol will creep up from "just fine" to "starting to get a little high." Then one day you'll have a cold and won't shake it off as easily as you used to, and your doctor will take blood "just to be sure" and then tell you you really have to get in shape.

Trust me, it's easier to make a few little adjustments at 40 than a bunch of big ones at 50.

[Ring]

My brother had the exact same type of blood test results; Everything was absolutely normal. One year later he had Chronic Kidney Disease.

[janeslogin]

I have a degree in medical technology. I passed the MT(ASCP)test and got the license and worked for a couple of decades in the field before getting sucked into hospital information systems.

I am not at all convinced that the routine tests that are part of a physical exam, or the physical exam for that matter, are of any value unless they come back with a surprise like a high blood sugar that no one was expecting - and then it should be checked and rechecked.

I think these routine screening tests panals were created to generate revenue while covering for unexpected legal surprises. I set in many meetings where pathologists and unions and insurance administrators and lawyers quarreled over what could and could not be included in the package.

[chappachula]

just a silly question about vocabulary:
why is it called "bloodwork"?
It isn't work...

Why not call it a 'blood test', or a 'blood analysis' , or "the lab results", 'a blood checkup'?
I never heard the phrase " blood work" until the 1990'.s or so. Who invented it?

[Qadgop the Mercotan]

Originally Posted by chappachula

I never heard the phrase " blood work" until the 1990'.s or so. Who invented it?

I've called it that since med school in the late '70's. I'm sure the term was prevalent before that too.

My HO: It's called work because it is a lot of work. Obtaining the sample in the proper tube, with correct paperwork, then having the lab assay it for all those things. In this modern day of automation, machines sort it all out nicely. But as a medical scutpuppy I remember running the individual tests, using a variety of reagents, dilutions, stains, smears, microscopes, centrifuges, clot tubes, etc.

It was a hell of a lot of work.

[Chronos]

I think these routine screening tests panals were created to generate revenue while covering for unexpected legal surprises. I set in many meetings where pathologists and unions and insurance administrators and lawyers quarreled over what could and could not be included in the package.

It seems to me that those surprises, when they happen, are plenty good reason to do the tests. I myself have a chronic disease that nobody suspected until it showed up in a routine blood test: Clearly, I'm better off than I would be if they hadn't run that test. Now multiply me by all the other people who got a surprise on their blood tests. The tests are doing good, so therefore they should be administered.

[Qadgop the Mercotan]

Originally Posted by Chronos

The tests are doing good, so therefore they should be administered.

it's never that simple. And figuring out the risk to benefit ratio of doing a test is a complicated process.

from http://boards.straightdope.com/sdmb/...6&postcount=16

Originally Posted by QtM

One must do more good than harm with screening tests.

Take ovarian cancer for example. Virtually without symptoms until it's too late to cure. Then you die.

One can find it with a pelvic ultrasound, before it is so far advanced. Early enough to cure it. So do we ultrasound every woman over 25 every year for the rest of her life? It'll cost billions, and we'll have to train thousands of more ultrasound techs, and radiologists to read the ultrasounds.

Oh, by the way, ovarian cancer is rare enough that for every case you find, you'll have about 15,000 false positives for it on the ultrasound. (I'm approximating these numbers, as I don't have them at my fingertips). So for those 15,000 they'll have to have laparoscopy, an invasive surgical procedure. About 150-300 of those will have significant complications from the procedure (1-2% complication rate) and 1-3 will die from the complications.

So to pick up one cancer early enough to save a life, Billions have been spent and 1 to 3 people have died, and 150-300 have been sickened.

It's the law of unintended consequences.

[Chronos]

Well, yes, but a single blood draw causes only negligible harm to the patient, and there are enough things you can reliably find with simple blood tests to more than make the expense worthwhile. Probably just the high-cholesterol cases (which aren't all that rare) would be enough benefit to justify the tests by themselves.

[Huerta88]

Originally Posted by JFLuvly

I might add that I don't work, and tend to sit around doing nothing quite a bit.

How do you manage all those indulgences without a job?

If I were looking for low-hanging fruit (I'm lazy myself), I'd prioritize it as a combination of a couple of these (in order of ease, at least for me):

(1) Take your coffee black, and learn to be okay with diet soda (Coke Zero tastes just about the same to me as real Coke, then I eventually figured out, I don't really like this all that much to begin with -- adults can usually lessen cravings for sweets by reducing/abstaining from them).
(2) Switch from beer to an equivalent (not greater) no. of units of wine or cocktail.
(3) Cut your smoking in half (I'd rank it higher but if you smoke a lot, you're possibly fairly habituated so it's not easy);
(4) Drag yourself to the gym 2-3 days a week and do 20-30 minutes of intense lifting or treadmill work -- no more is necessary. I go on and off in complying with this, but the lifters convinced me that lean muscle mass is the gift that gives even when you're sedentary, asleep, pigging out on burgers -- the metabolic need for calories means your quadriceps are actually helping you work off that Big Mac. You add fifteen-twenty pounds of muscle and maintain it, you're changing body composition (even if you still have a little flab) and buying some leeway for other bad habits.

[Qadgop the Mercotan]

Originally Posted by Chronos

Well, yes, but a single blood draw causes only negligible harm to the patient, and there are enough things you can reliably find with simple blood tests to more than make the expense worthwhile. Probably just the high-cholesterol cases (which aren't all that rare) would be enough benefit to justify the tests by themselves.

It is still being debated just how often folks should be tested for things like high cholesterol, and diabetes, depending on their risk factors.

Basically we're looking for evidence that early detection of these diseases through screening tests actually improves outcomes.

The complete answers are not there yet.

For example, the American Diabetes Association feels that everyone over 40 should be tested for diabetes every 3 years, even if no risk factors are present. But that recommendation is based on the consensus of a bunch of endocrinologists and diabetic nurses, not on the conclusions from peer-reviewed literature, which thus far doesn't show if there is a benefit to testing low risk people that often.

The cost for this sort of testing, while not great, is not insubstantial when dealing with a large population like the US. So before we commit to doing it, we should see if it makes a significant difference.

[gonzomax]

Originally Posted by Qadgop the Mercotan

It is still being debated just how often folks should be tested for things like high cholesterol, and diabetes, depending on their risk factors.

Basically we're looking for evidence that early detection of these diseases through screening tests actually improves outcomes.

The complete answers are not there yet.

For example, the American Diabetes Association feels that everyone over 40 should be tested for diabetes every 3 years, even if no risk factors are present. But that recommendation is based on the consensus of a bunch of endocrinologists and diabetic nurses, not on the conclusions from peer-reviewed literature, which thus far doesn't show if there is a benefit to testing low risk people that often.

The cost for this sort of testing, while not great, is not insubstantial when dealing with a large population like the US. So before we commit to doing it, we should see if it makes a significant difference.

Are the guidelines the same for other countries? The reason I ask ,is my brother works in Pharm and he was laughing a few years ago . He said pharm pressure and lobbying had convinced the AMA to lower cholesterol guidelines to a level that is difficult to reach without drugs. Cholesterol drugs are tough on the body and have tons of side effects. But pharm was going to make billions off the change.
He said the question was whether lowering the limits was helpful at all or necessary.

[Qadgop the Mercotan]

Originally Posted by gonzomax

Are the guidelines the same for other countries? The reason I ask ,is my brother works in Pharm and he was laughing a few years ago . He said pharm pressure and lobbying had convinced the AMA to lower cholesterol guidelines to a level that is difficult to reach without drugs. Cholesterol drugs are tough on the body and have tons of side effects. But pharm was going to make billions off the change.
He said the question was whether lowering the limits was helpful at all or necessary.

I'd say that claim is BS. There's great evidence that lower LDL levels (70 or under) actually reverse coronary artery disease in folks that have it, and the evidence also shows that the statins (the commonest lipid lowering drugs) are a major factor in reversing the atherosclerosis. Fewer heart attacks, fewer angioplasties, fewer bypass surgeries, fewer deaths. One of the few areas where drugs have really been shown to have a major beneficial effect.

I don't keep track of other country's standards, but frankly they've been pushing statins harder in many european countries for years longer than we have been over here.

[Chronos]

(4) Drag yourself to the gym 2-3 days a week and do 20-30 minutes of intense lifting or treadmill work -- no more is necessary.

Or even without the gym membership, just go for a 20-30 minute walk around your neighborhood. The health benefits are the same, the scenery is often better, and it's cheaper. You can even incorporate it into your daily routine: If the grocery store, or your church, or some other place you go to frequently is in walking distance, just walk there instead of driving. Or even walk to the fast-food place or the coffee shop, if you can't cut back on those: It's the worst of both worlds to drive to get your empty calories.