The Personal Finance Playbook

I don't know if it works...but I LOVE APPLES!!!

This is my wife, Rachel’s first post.  She’s got one in the back of her mind about what every kid should have in terms of shots, etc., too.  I don’t know when we’ll see that one, but I sure appreciate her writing this one.  It’s everything I always want my posts to be (but sometimes aren’t!): informative, interesting and pertinent (and well researched!).  Hopefully you’ll find it helpful.  She’d love it if you left a comment, too!

Hi, my name is Rachel.  If you are a frequent reader of this blog, then I’m sure you have heard of me.  (In case you don’t know, I’m Todd’s wonderful, smart, beautiful wife;)  That’s what he told you, right?  Anyway, I am really proud of Todd for keeping up with the blog and so I wanted to write an entry to give him a break for a night.  As a physician, I thought that I would make a list of things that the average person could their doctor on their toes about.  I know that there is a lot to keep up with in life and thinking about your health maintenance is not always at the top of the list (but it should be!).  Here are ten tips to help you live a healthy life!

Okay so as an adult, do I still need to get shots?  Yes!  What and When?
1. Immunizations
a. Tetanus Vaccine: Every 10 years
b. Measles Vaccine: Booster for 1 dose if born after 1956
c. Rubella Vaccine: All fertile woman without proof of immunity, should receive the vaccination
d. Influenza Vaccine (Flu): Yearly, especially for older people!
More than 90 percent of influenza-related deaths occur among people ≥60 years of age, and these people experience significantly increased morbidity with this.
e. Pneumococcus (Pneumonia) Vaccine: One dose over age 65 years or if you have had your spleen removed.
The vaccination is also recommended for any age if you have one of the following diseases: Diabetes, heart disease, cancer, lung disease,or  immunosuppression.  You guys should receive one vaccine with a repeat immunization within five years.
Pneumonia is a significant cause of morbidity and mortality in the elderly…Get your shot!
f. Hepatitis B Screening and Immunization: Once in your life.
g. Herpes Zoster Vaccine: Once in healthy adults over 60.
Herpes zoster (shingles), is from reactivation of your past infection with chicken pox.  It causes a painful localized rash and can affects about 30% of people over their lifetime, with an increase in risk (8 to 10 fold) in late life.

2. Cancer Screening
a. Colorectal Cancer: If you’re 50 or older you should be getting a colonoscopy every 10 years until age 75.  Fun, Fun!  But it is better than getting cancer!  Flexible sigmoidoscope every five years with stool testing every three years or stool testing every year can be done instead.
The evidence supporting occult blood screening is associated with a 15 to 20 percent decrease in cancer specific mortality, however current recommendation favor colonoscopy.
b. Cervical Cancer: Pap/HPV from age 21-65 years or within three years of sexual activity.  Those of you aged 11-26, should also recieve your HPVimmunization to prevent HPV and thus significantly reduce your risk of getting cervical cancer.
Most recommendations now indicate that screening may be discontinued for women who have had at least three normal Pap smears over the preceding 10 years and/or are older than 65 to 70 years. Screening may also be stopped among those who have had a hysterectomy for a benign indication.
c. Breast Cancer: We all recognize the pink ribbon, but do we all follow the preventative recommendations?  Self breasts exams are still recommended starting at age 20.  Mammogram and physician breast exams should be performed yearly after age 40.  It really is worth it…screening mammography for breast cancer shows an approximate 30% reduction in breast cancer mortality among screened versus unscreened women.
d. Prostate Cancer Screening: Prostate Specific Antigen (PSA) and Direct rectal exams are recommended yearly after age 50 or after age 40 for African Americans.

3. Hypertension (High Blood Pressure)
Regardless of age, everyone should be screened every one to two years.
Hypertension is highly prevalent among older adults (60 to 80 percent) and remains the leading risk factor for ischemic heart disease and stroke!  There are medications and diet regimens that can dramatically improve your outcomes.  It’s so easy to fix!

4. Hyperlipidemia (High Cholesterol)
Starting at age 20, everyone should get their blood levels checked.
There is good evidence that lipid lowering drug therapy decreases the incidence of coronary heart disease in people with abnormal lipids and causes few major harms.  Why not find out if you need treatment.  Eating a low fat, low cholesterol diet and exercising routinely also never hurt anyone!

5.  Osteoporosis/Osteopenia
Women aged 65 and older should be screened routinely for osteoporosis using bone densitometry. Women at increased risk for osteoporotic fractures (caucasian females, smokers, alcoholics, women with early menopause and those with low body weight), should get screened starting at age 60.  Osteopenia is found in 37 percent of post-menopausal women, and osteoporosis is found in 7 percent of these women.  If you are in the older age group and have had recent fractures you may need vitamin D and Calcium replacement or possible other medications.  Talk to your doctor about testing and treatment.

6.  Abdominal aortic aneurysm (AAA)
One-time ultrasonography screening for abdominal aortic aneurysm (AAA) is recommended by several organizations for men ages 65 to 75 who have ever smoked.  These aneurysms can be very deadly and surgery can be performed to correct these and thus save your life.

7. Diabetes
Fasting glucose levels should be measured every three years starting at age 45.  If you are diabetic and do not know it, you could be causing severe damage to your kidneys, eyes, and other organs.

• After quitting for one year, the excess risk of coronary heart disease caused by smoking is reduced by half. After 15 years of abstinence, the risk is similar to that for people who’ve never smoked.
• In 5 to 15 years, the risk of stroke for ex-smokers returns to the level of those who’ve never smoked.
• Male smokers who quit between ages 35 to 39 add an average of 5 years to their lives. Females who quit in this age group add 3 years. Men and women who quit at ages 65 to 69 increase their life expectancy by 1 year.

10. Oral Supplementation
Should you take vitamins to supplement your health?  Well, the daily intake of vitamin D in older adults should be at least 800 IU (IU is the unit that Vitamin D is measured by, this is usually two tablets).  Elemental calcium is also important and often needs to be supplemented.  Every adult should take in about 1.2 grams of elemental calcium.  No data supports the effect of multivitamins on morbidity or mortality. However, supplementation with multivitamins is associated with a reduced risk for several chronic illnesses.  Why not at least chew a Flinstone’s today!

Many medical illnesses can be avoided or minimized by preventive medicine.  The earlier you start taking care of yourself, the better you’ll feel when you get older.  Make yourself focus on at least a couple of these things this year.  If you can get yourself to quit smoking or start exercising, you’ll feel much better about yourself.  I promise;)  Let me know if you have any questions or thoughts.  Thanks for reading! (That was for Todd)

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This entry was posted on Tuesday, October 27th, 2009 at 5:00 am and is filed under Healthy Living. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.