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You know when your child's next doctor's appointment is right down to the hour. But how diligent are you about keeping up with your own health checkups? If you have a Pap smear every year and leave it at that, you're not doing enough, says Dr. Vivian Dickerson, the division director of general obstetrics and gynecology at the University of California at Irvine Medical Center.
"A lot of diseases that begin to develop in your twenties and thirties, like cervical cancer and heart disease, are often silent at first," says Dickerson. "But if they're caught early through screening tests, they may be cured or corrected before more serious complications develop." That's one reason to let your ob/gyn know that you're using her as your primary health-care provider and to make sure that she's comfortable in that role. If she assumes that you also see a family physician or internist, she may not address issues such as skin-cancer and cholesterol screenings during your yearly exam.
If you're between the ages of 18 and 40, here are five important health exams and screenings that can help doctors pinpoint disease early.
1. Breast
Exam
Ideally, you
began doing a monthly breast self-exam at age 20. If you
don't know how, next time you see your doctor, have her
show you. Until then, here's a basic description: Lie on
your back with a pillow under your left shoulder and your
left hand behind your head. With your right hand, use the
flat parts of your three middle fingers (not your
fingertips) to palpate your left breast. Press firmly
around the breast in a circular (clockwise) or up-and-down
motion, or mentally divide your breasts into sections and
examine each one separately. Now use your left hand to
examine your right breast. Next, repeat the exam standing
up, making sure to check the armpit area. Finally, do a
visual exam in the mirror, keeping alert to any changes
in the appearance of your breasts. Remember that breast
tissue is full of glands, which can sometimes swell and
feel hard, probably due to hormonal fluctuations. Also,
some women's breasts are just naturally lumpy. However,
it's important that you inform your doctor of any lump or
any change such as tenderness, pain, or discharge. She
can decide whether a breast ultrasound (to check for
cysts) or a mammogram (to screen for a benign or
cancerous tumor) is necessary.
How often
should you do the exam? Monthly. The best time is
about a week after your period ends, since this is when
hormone levels are at their lowest and your breasts
aren't tender or swollen. If you're not menstruating, due
to pregnancy or breast-feeding, do the exam at the same
time each month. And starting at age 40 (or sooner, if
you have a family history of breast cancer), you should
have a yearly mammogram.
2.
Gynecologic Exam
A thorough
gynecological checkup involves both a breast and pelvic
exam. The pelvic includes a Pap smear, an examination of
the vaginal walls, and possibly a check of the rectum.
With a Pap smearrecommended for all women over 18
and for any girl who's sexually activethe doctor
scrapes cells from the cervix to check for evidence of
abnormalities, which could indicate or be precursors to
cancer.
How often
should you have the exam? Once a year. If you have a
family history of certain cancers or abnormalities such
as ovarian cysts, your health-care provider may wish to
see you more often.
3.
Cholesterol Screening
The American
College of Obstetricians and Gynecologists recommends a
blood test to screen for high cholesterol starting at age
45. However, high cholesterol is associated with coronary
heart disease, so if you have a family history of heart
disease, are more than 20 percent over your ideal body
weight, have high blood pressure, or eat a high-fat diet,
you should have this test done immediately, no matter
what your age. If your cholesterol is above normal, your
doctor will likely recommend dietary changes and an
exercise program and may prescribe a cholesterol-lowering
medication. The most accurate test involves drawing a
sample of blood from your arm, then sending it to a lab
for analysis. Don't rely on finger-prick tests that give
instant results, since they are often unreliable.
How often
should you be screened? Every three to five years, if
everything is normal. If not, this test should be done
yearly.
4. Type II
Diabetes Screening
If you're of
African, Hispanic, Native American, or Asian descent or
have a parent or sibling with the disease, you're at a
higher risk of developing type II diabetesa
condition in which the body becomes resistant to insulin,
a hormone that is essential in helping the body convert
food into energy. The illness often begins gradually
after age 40, most often in people who are overweight. It
can typically be controlled with diet and exercise. If
you fall into a high-risk category, you should have this
test done no matter how old you are; otherwise, you can
wait until age 45. (This test doesn't screen for type I
diabetes, which usually begins in childhood or
adolescence, or gestational diabetes, which affects
pregnant women.)
How often
should you be screened for type II diabetes? Every
three years.
5. Skin-Cancer
Screening
Regular
screenings for skin cancer are recommended beginning at
age 18. If you haven't yet had this exam, it's important
to do so. Your dermatologist or primary-care physician
should examine your skin, from the top of your head to
the soles of your feet, looking for suspicious moles,
freckles, nodules, or lesions. If, during a self-exam,
you notice changes in a freckle, mole, or lesion (it's
bigger than a pencil eraser, it develops irregular
borders, or it bleeds), tell your health-care provider
immediately.
How often
should you be screened? Yearly, either by a
dermatologist or as part of your annual physical.
However, if you have a history of chronic exposure to
sunlight (either due to hobbies such as swimming or
gardening or because of your job), have had one or more
blistering sunburns, or have a family or personal history
of skin cancer, your doctor may want to see you more
often. Self-exams are recommended at least every three
months, more often if you're at high risk.
Dana Sullivan writes about health for several national magazines and is a regular contributor to ClubMom.
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