House Calls / Dr. Michael Schwartz

Dr. Michael Schwartz
Dr. Michael SchwartzContributed Photo

Preventative health care is probably the single most important aspect of preserving health and well-being. Fortunately not much goes wrong when people are in their 30s. Nevertheless, there are screening tests which may be performed to identify medical issues in order to prevent serious illness down the road. Here are a few recommendations.

Tests and Examinations:

Complete physical examination -- a complete physical evaluation should take place every one to two years. This enables your physician to evaluate and review your medical health. He or she will then determine if additional tests or treatments are necessary.

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Blood pressure monitoring -- high blood pressure can lead to heart disease and stroke. Identification and treatment can decrease the risk of future events. Ideal blood pressure is 110/70. A blood pressure measurement higher than 140/90, is undesirable.

Cholesterol screening -- high cholesterol or triglycerides have been shown to increase the risk of heart attack, stroke, kidney disease and circulatory issues. Modification of diet and exercise can alter these outcomes. If diet alone does not improve these numbers, medication may be necessary. Total cholesterol levels should be less than 200 while triglycerides should not exceed 150.

Diabetic testing -- high sugar levels can lead to many chronic problems including blindness, problematic circulation, heart disease and kidney failure. Fasting blood sugar levels should be less than 100.

EKG -- a baseline electrocardiogram (heart test) can identify abnormalities suggestive of future adverse events. Additionally, this EKG may be used for comparison if a patient complains of chest pain or shortness at a future visit. If the studies are different, additional cardiac testing may be necessary.

Breathing tests -- asthma can slowly damage the lungs without someone even knowing they have the disease. A simple breathing test can identify the disease, allowing treatment and cessation of the destructive process.

Eye exams -- yearly eye exams by an optometrist or ophthalmologist can identify abnormalities such as glaucoma, retinal issues and early cataracts.

Skin exams -- a dermatologist can perform full body scans and biopsy suspicious lesions, thereby preventing skin cancer.

Immunizations -- DtaP (Diphtheria, Tetanus and Pertussis) is now recommended every 10 years. The regimen may also include a yearly flu shot, Hepatitis B vaccine (to prevent sexual transmission of the virus) and a Hepatitis A vaccine (especially if traveling to a Third World country). HPV (human papilloma virus) is also a sexually transmitted virus which can increase the risk of cervical cancer in women.

Dental -- twice yearly preventative dental visits can help prevent tooth and gum disease.

Hearing test -- an audiometric exam can help identify early hearing loss. Treatment of the underlying cause can reduce progression.

For Women:

Gynecology visits -- yearly pap and pelvic exams can identify early cancers which could then be readily treated.

Self breast exams -- monthly self-breast exams can help identify early cancers.

Screening Mammogram -- an initial baseline mammogram at age 35 is recommended. If a woman detects an area of concern during self breast exams, an ultrasound (sound wave test) can be performed as well to determine if the area needs additional treatment.

For Men:

Testicular exams -- testicular cancers are most common between the ages of 20 to 40. If a testicular mass or nodule is detected, a visit to the urologist is recommended.

Additional Recommendations

Smoking cessation -- smoking can cause many long term illnesses including emphysema, lung cancer and heart disease. Stopping can significantly reduce the risk.

Exercising -- 30 minutes of vigorous exercise three times a week can improve both cardiovascular and psychological health.

Alcohol -- in moderation, alcohol may reduce the risk of heart disease and stroke. However, too much alcohol can result in liver disease and be detrimental to the body.

Sleep -- 6 to 8 hours per night is recommended. Sleep deprivation can cause fatigue and depression.

Staying healthy demands that patients takes an active role in their health care. Visiting your physician and undergoing the recommended medical testing can go a long way towards promoting long-term wellness.

Dr. Michael Schwartz is board certified in internal medicine with a private practice in Darien. For comments or questions, please visit his web site at