Old fashioned is still better than none - my insurance won’t pay for a OB/GYN for anything other than actual issues (pregnancy, childbirth, positive pap, etc.). So my internist does it. I didn’t ask what method he was using last time because, frankly, it’s either him or none because I do NOT have the money to go outside of the insurance rules.
Yes, it can suck to be poor.
However, back to the OP - an annual physical isn’t a bad idea. If you haven’t had one for awhile the initial visit might include a family history and possibly some “catch up” stuff, but subsequent ones should be routine and not very time-consuming. Various groups publish guidelines on what should be included. For example here is the one from Medline which is divided by gender and age. There are others out there, but the recommendations tend to be similar.
Right now, my annual testing comprises a blood draw, which is subjected to several tests, weight, blood pressure, blood sugar, allergies (I have a lot of allergies), pap, and mammogram. The biggest headache is finding providers who take my insurance, the actual testing isn’t much time.
The advantage to an annual physical, aside from making sure you get appropriate screening tests and your vaccinations are up to date, is finding problems BEFORE they cause damage. It is far, far better to discover high blood sugar (i.e. pre-diabetes or actual diabetes) by way of a urine or blood test than after your vision or kidneys have been damaged or because you had to be carted off to the hospital due to falling into a coma. It’s better to discover high blood pressure at the doc’s after than after kidney damage or a stroke.
It’s easy to say the dizzy spells were caused by postural hypotension if you have some blood pressure readings on the low side and a sitting/standing difference- otherwise, not so much.
They fall under my aforementioned “any kind of funny turn”.
Around here, a blood draw typically is looked at for basic chemistry, anemia, diabetes, and cholesterol, with women also getting a thyroid hormone check. At least, that’s what it said on my last order for one.
Doing a thorough screening once in the 20’s for all that probably isn’t unreasonable - some forms of heart disease manifest as high cholesterol that early, low/high thryoid can happen early, and so on. But after someone that young is found healthy maybe it’s not so urgent to do all that again until later in life.
No, he’s right. Before then, anything wrong with you will be blamed on your weight, with little or any informed guidance on how to lose it, so why bother?
I used to be number 3 and am now nmber 2. I spent most of last year having bad heartburn, and acid reflux everytime I ate. Just tooks TUMS and went on. Until one day I had the most awful chest pains, and also for good measure developed anxiety. Now I am convinced that every ache and pain means I am a goner. You should tell people that GERD mimics heart attack symptoms!
So Irishgirl is such heartburn something you should see a doctor for?
Sure- see a doc for severe heartburn- it comes under the chest or abdominal pain heading.
It might not be heartburn.
There are effective treatments for heartburn that aren’t available from pharmacies, including stronger medications and even surgery.
The doc may feel further testing is needed (camera tests, tests for H.Pylori, chest xrays etc).
Oesophageal cancer can be related to reflux- which is why it is better to get it treated properly. For people under 60 I’ll try a strong antacid and if that doesn’t settle heartburn, they get sent for camera tests. People over 60 with new onset heartburn go straight for the camera test (OGD).
And that is if I am happy that it is just heartburn.
ENugent, there is “blaming everything on your weight” and saying
“Your weight puts you at greater risk of conditions X, Y and Z which can cause those symptoms you have, and your weight may even be making your symptoms worse. We better make sure you don’t have those conditions, and losing some weight may help you feel better in the meantime”.
But not all doctors see it that way. I’ve heard so many anecdotes about doctors dismissing serious concerns as just weight-related issues.
A friend of mine is obese and had a doctor dismiss her leg numbness, vertigo, and excessive tiredness as just products of her weight. It wasn’t until she went blind on one side on day that they finally investigated further. Turns out she has MS, and the first scan showed that the myelin was quite deteriorated in some parts, meaning she had been dealing with it for many years now.
This is not an isolated example. Now, I have an awesome doctor who takes my concerns seriously and follows up on my symptoms and doesn’t just say “lose weight and see me if you are still having problems,” but there are a lot of doctors out there who just can’t see past the pounds on the scale.
The blog First Do No Harm is a repository of these same stories. It’s just plain sad.
There lies whole crux, How is a layperson supposed to decide. Heart Attacks symptoms can apparently be as mild as a heartburn or nausea. So basically I am supposed to run to hospitalk everytime the after effects of eating too much curry feels a bit off? Me a twenty six year old male, who has been cleared in echo and stress test (general screening). On the other hand you read about people whose tests were clear and they were found dead of heart attack or what not the next morning.
My point is that it is difficult not to switch between extremes when there is a LOT of contarary information out there.
When your piggy-bank is full. I only go to the doctor when I can afford it, which is pretty much never (I even have health insurance! But the deductible is too high for it to be useful for anything that’s not immediately life-threatening).
Does it get better with antacids? Worse on lying flat?
Probably heartburn.
Are you grey and sweaty? Is it worse with exertion?
Probably not heartburn.
If you are in a lot of pain and simple remedies aren’t working- see a doctor.
If you can’t tell whether there is something seriously wrong, you need a doctor.
If you feel very unwell, you need to see a Dr.
If you are a 26 year old man the chances of having a heart attack are slim (unless you’re doing cocaine, are morbidly obese, or have seriously high cholesterol).
If you are a 40 year old man with bad heartburn symptoms, it is still more likely to be heartburn than a heart attack, but I’d probably still want to check it out.
If you are a 60 year old man- I’d want a cardiac panel and a heart tracing before being happy to say it was just heartburn.
There are no definitive guidelines for screening but I would recommend for a woman aged 20-50 that she have a gynecologic exam every 1-3 years (after 3 normal tests you can go to every 3 years if you are not high-risk) and a full physical every 3-5 years.
I do a baseline EKG at 40 and then only if needed, since it isn’t an appropriate screening test. I only do a chest x-ray if there is a reason. Any doctor doing a yearly EKG and chest x-ray is just trying to make money (that’s why we need universal health insurance; I’ve even heard of a doctor doing spirometry and nerve conduction testing on all his patients at every visit).
After age 40, you should have a complete exam, including labs to check for sugar, kidney and liver function, and thyroid every 1-2 years. A normal cholesterol can be rechecked every 5 years.
Do not worry about going to the doctor if you have a new symptom. That is what we are there for.
First of all, either your target weight is only a few pounds off… in which case the Doctor wont care.
Or it’s a long way off and you’re deluding yourself into thinking you’re going to get there in a few months. For too many dudes, their “target weight” is something they will reach only after the worms have eaten half of them.:eek:
Yes, being obese is a health risk and of course any MD worth their salt will mention it. But it’s be medical malpractice to ignore a real health problem and blame all symptoms on weight alone. Pay no attention to lifeboat cases. DO ask questions, don;t be afraid to speak up, ask for a second opinion or a to get another MD.
It’s pure denial to worry about “reaching your target weight” before going in to see a Dr. for a check up. In fact, there very well could be a medical problem that is causing you to gain/keep the weight on.
And “waiting until your piggybank is full”:rolleyes: is also complete bullshit. A serious health problem that is ignored could end up driving you into bankruptcy. It’s always cheaper to maintain than repair.
:eek: Is that the one where you have the rods or wires or whatever shoved into your muscles? My mom had to have that (complete neuropathy in both her feet - I tease her about being a Terminator because she occasionally breaks toes and doesn’t notice until someone points it out to her) and said it was the most painful test she’s ever endured.
I’m a Cat. 3 - I used to never go to doctor. Period. 25 years between doctor visits. If I was ill, I just sucked it up. I’m still pretty much a Cat 3 - I walked on a broken foot for 6 months waiting for it to fix itself. Finally ended up having to have a sesamoid bone removed. I went in because my thyroid was so big it was impeding my swallow. Had that removed. Went in because my stomach kept hurting horribly - had my gallbladder removed. Last time I went to have my annual thyroid level checked, I told her my knee hurt, but I didn’t want surgery! I do, against all terror, go in for an annual mammogram, since my mother, sister and aunt have had breast cancer. I worry about cancer - my mother was one of 11, and 6 have had cancer. My mother had it twice (including uterine cancer while she was pregnant with me). My father was a non-smoker who died of lung cancer.
I hate doctors. I don’t trust them. I hate feeling vulnerable. I hate being undressed in front of someone, I hate the whole thing. But I actually like my doctor more than most people. The rare occasions that I do go, she always sees me, instead of sticking me with a nurse-practioner. I wish I could get over my phobia and take office visits in stride, but I usually have to be in so much pain that I can’t bear it anymore before I go.
However, not everyone has the available funds to pay for the maintenance. Many, if not most doctors live in their own world where everyone has insurance. Most can’t tell you how much that stack of lab test will cost though I’ve heard " they’re not very expensive" for tests that when priced run over $500. To many people that’s not inexpensive.
