Laboratory and Diagnostic Procedures
Pap Smear   Mammogram   Rectal Exam and Stool Blood Testing
Testicular Exam   Prostate Exam   Cholesterol

Immunizations

Health Recommendations
Breast Examination   Hormone Replacement Therapy (HRT)
Weight and Nutrition   Smoking   Dental Health Care  AIDS/HIV    Exercise   Contraceptive Options   Pregnancy   Advance Directives

Mental Health
Depression   Alcohol and Drug Use

Safety and Injury Prevention

Additional Preventative Measures

Well Care Calendar

You should get a Pap smear every year up to age 65. Some authorities suggest that every three years is OK if Pap smears have been normal for three years in a row. Tell your provider if you have ever had genital warts, a sexually transmitted disease, multiple sexual partners or abnormal Pap smears in the past. You may need Pap smears more often than other women.

Although authorities are not in complete agreement, a good general recommendation for mammograms is to begin having one every 1-2 years starting at age 40, and then yearly from ages 50 to 75. Tell your provider if your mother or a sister has had breast cancer. You may need to have mammograms earlier and more often than other women.

A yearly rectal exam for men and women beginning at age 50, along with testing for hidden (occult) blood in the stool is recommended. Another frequently recommended colon cancer screening test is sigmoidoscopy. In this common office procedure, a lighted scope is used to examine the lower part of the colon for polyps or other abnormalities that may later lead to cancer. Sigmoidoscopy is usually performed every five years after age 50. Tell your health care provider if any of your family members have had colon cancer, or if you have had colon polyps or breast, ovarian, or uterine cancer yourself. You may need to have colon cancer screening earlier and more often than other people.

Recommended for men aged 15-35, particularly if you have a history of an undescended testicle. Monthly self-examination of the testicles for lumps is also important in this age group.

Prostate Exam

Eventually up to 80% of men will develop an enlarged prostate, but not all will develop symptoms. The prostate is examined during your yearly rectal exam for lumps or nodules. Your provider may also recommend a PSA (prostate specific antigen) blood test. This may detect cancer of the prostate before it can be felt. Talk with your provider about the pros and cons of having this test.

You should have your cholesterol level checked at least every five years. Screening for total cholesterol and HDL ("good") cholesterol can be done without fasting. If these values are elevated, a fasting test that includes LDL ("bad") cholesterol may be ordered. You will want to set goals for your cholesterol levels. If you have a personal history of heart disease, have had family members who have had heart disease at an early age, or if you smoke, have diabetes, or have high blood pressure, these goals should be stricter. Talk with your provider about what your personal cholesterol goals should be and about what combination of diet, exercise, and medication might be appropriate for you to attain these goals.

Tetanus-Diphtheria (Td) – Booster every 10 years

Pneumonia Shot – If over age 65 or if you have diabetes or chronic lung or heart disease. Most people only need this shot once in their lifetime.

Flu Shot – Yearly starting at age 65 or if you have a chronic disease.

Hepatitis B – A series of three shots for those who are public safety or health care workers, receive blood transfusions or other blood products, engage in male homosexual activity, or use illegal drugs.

Health Recommendations

Women should have their breasts examined yearly by their health care provider for lumps and other signs of cancer. This is usually done at the time of your regular check-up. Monthly breast self-examinations are also important.

Hormone Replacement Therapy (estrogen with or without progesterone) is prescribed to women who have reached menopause to prevent osteoporosis, reduce the risk of heart disease, and to treat menopausal symptoms such as hot flashes, mood swings, vaginal dryness, and sleep disturbance. There may be a slight increase in the risk of breast cancer associated with HRT, but for most women, the benefits of HRT outweigh the risks. You have a higher for developing osteoporosis if you are a woman of slender build, are white or Asian, or if you don’t exercise regularly.

Maintaining a healthy weight and eating the right foods will help you live a longer, healthier life. Ask your health care provider what would be an appropriate weight for you. Many illnesses such as diabetes, heart disease, and high blood pressure can be prevented or controlled through a healthy diet. Follow these guidelines:

If you smoke or chew tobacco, quitting is one of the most important things you can do to improve your health. Ask your health care provider to help you pick a date to quit and for advice on how to keep from starting again. If you fail the first time, don’t give up. Keep trying and learn from your experience. You can succeed and live a longer, healthier life.

Good oral health care is important for your teeth and general health. Visit your dentist regularly for checkups. Brush after meals, using a fluoride toothpaste and floss daily. Limit the amount of sweets you eat, especially between meals. Do not smoke or chew tobacco products.

A virus (HIV) causes AIDS, a fatal disease that breaks down the body’s ability to fight infection and illness. Many different kinds of people are infected with HIV: male and female, married and single, rich and poor. There is currently no cure for AIDS and no vaccine to prevent HIV infection. Many people with HIV got infected by having sex with an infected partner, others through blood transfusions prior to the implementation of improved screening techniques, others from sharing needles to take drugs. Infected mothers can pass HIV on to their infants. You cannot get HIV from shaking hands or working with someone who is infected. You can reduce your risk of getting HIV and other viruses, such as hepatitis, by not having sex, by having sex with only one, mutually faithful, uninfected partner, or by using a latex condom correctly every time you have sex, and by not shooting drugs or sharing needles. Ask your health care provider if you would like to be screened for HIV infection.

Exercise

Regular physical activity will help you feel better and maintain a healthy weight. It will also help you control your blood pressure and cholesterol, and strengthen you heart and muscles. A brisk walk for 20-30 minutes 3 times a week can improve your health, and many experts recommend as much as 45 minutes of aerobic activity 5 times a week. Pick activities that you enjoy, and that you can fit into your daily routine. Be sure to warm up before your activity and to cool down afterwards. Ask your health care provider for specific recommendations or advice if you have a chronic illness or have other concerns.

If you are a sexually active man or woman and not ready to have a child, you should use a reliable method of birth control. Talk with your health care provider about the best method of contraception for you.

Talk with your healthcare provider if you are thinking about becoming pregnant in the near future. You can reduce the risk of some birth defects by taking a vitamin supplement with folic acid before and during your pregnancy, and by checking on your immunity to rubella (German measles). Certain diseases, such as diabetes and high blood pressure, increase your risk of pregnancy complications, as do some prescription and over-the-counter medications. Alcohol and street drugs are also harmful to the baby. These issues are all best discussed and addressed prior to conception.

All adults need to consider having an Advance Directive or a Living Will. This is especially important if you are age 65 or older, or have a serious medical condition. This document puts into writing your wishes with regard to the use of life support devices or other measures to prolong your life. Ask your healthcare provider for more information about Advance Directives.

Mental Health

Everyone feels "down" or "blue" at time, but if these feeling are very strong or last a long time, they may be due to the medical illness known as depression. Depression can be treated, but it is often not recognized by patients or healthcare providers. If you have four or more the following warning signs of depression, please talk with your healthcare provider about depression.

Don’t use illegal (street) drugs of any kind, at any time.

Use prescription drugs only as directed by your doctor, and use non-prescription (over-the-counter, or OTC) drugs only as instructed on the label. If you drink alcohol, do so only in moderation. Do not drink alcohol at all if you are pregnant or plan to conceive in the near future. Do not drink alcohol before or while driving a motor vehicle.

If you have a problem with alcohol or drugs, talk with your health care provider.

Safety and Injury Prevention

Many serious injuries can be prevented by following some basic safety rules:

Mouth Exam - If you have consumed a lot of alcohol or have smoked or chewed tobacco.

Thyroid Exam - If you have had radiation treatments to your upper body.

Skin Exam – If you have had skin cancer in your family or a lot of sun exposure or if you have moles that bleed or change color.

Rubella Test – If you are a woman of childbearing age this test checks your immunity to German Measles.

AIDS (HIV) Test – If you had a blood transfusion between 1978 and 1985, have injected illegal drugs, have had multiple sexual partners or any male homosexual activity.

Syphilis, Gonorrhea or Chlamydia Tests – If you have had multiple sexual partners or any sexually transmitted diseases.

TB Test – If you have injected illegal drugs, have be an alcoholic or health care worker, have been exposed to someone with TB, have recently moved from Asia, Africa, Central or South America or the Pacific Islands, or have kidney failure or HIV infection.

Glucose (sugar) Text – If you have had a family member with diabetes or have had diabetes during pregnancy.

Eye Exam - If you are over age 60 or are over age 40 and are an African American. People with diabetes should also have yearly eye exams.

Aspirin Therapy – Women who have passed menopause and men age 40 or older (especially those with risk factors) may reduce their risk of heart attack and stroke by taking low dose aspirin.

Hormone Therapy – Estrogen therapy in post-menopausal women has many benefits. Ask your provider for information on the pros and cons of this therapy.

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