200 Corporate Plaza, Islandia, NY 11749 US
Weight Loss related exam is limited and in no way it should be replaced with annual physical and or gynecological exam. The Basics The physical exam is an essential part of any doctor's visit. For the purpose of weight loss treatment, there are no absolutes in a routine physical. You will experience some aspects of the annual exam: History. This is your chance to mention any complaints or concerns about your health. Your doctor will also likely quiz you about important behaviors, like smoking, excessive alcohol use, sexual health, diet, and exercise and update your personal and family medical history. Vital Signs. These are some vital signs checked by your doctor:
- Blood pressure: less than 120 over 80 is a normal blood pressure. Doctors define high blood pressure (hypertension) as 140 over 90 or higher.
- Heart rate: Values between 60 and 100 are considered normal. Many healthy people have heart rates slower than 60, however.
- Respiration rate: Around 16 is normal. Breathing more than 20 times per minute can suggest heart or lung problems.
- Temperature: 98.6 degrees Fahrenheit is the average, but healthy people can have resting temperatures slightly higher or lower.
General Appearance. Your doctor gathers a large amount of information about you and your health just by watching and talking to you. How is your memory and mental quickness? Does your skin appear healthy? Can you easily stand and walk? Heart Exam. Listening to your heart with a stethoscope, a doctor might detect an irregular heartbeat, a heart murmur, or other clues to heart disease. Lung Exam. Using a stethoscope, a doctor listens for crackles, wheezes, or decreased breath sounds. These and other sounds are clues to the presence of heart or lung disease. Head and Neck Exam. Opening up and saying "ah" shows off your throat and tonsils. The quality of your teeth and gums also provides information about your overall health. Ears, nose, sinuses, eyes, lymph nodes, thyroid, and carotid arteries are also examined. Abdominal Exam. Your doctor can use a range of examination techniques including tapping your abdomen to detect liver size and presence of abdominal fluid, listening for bowel sounds with a stethoscope, and palpating for tenderness. Neurological Exam. Nerves, muscle strength, reflexes, balance, and mental state are assessed. Dermatological Exam. Skin and nail findings could indicate a dermatological problem or disease somewhere else in the body. Extremities Exam. Your doctor will look for physical and sensory changes. Pulses can be checked in your arms and legs. Examining joints can assess for abnormalities. An annual physical exam for men might also include:
- Testicular exam: A doctor can check each testicle for lumps, tenderness, or changes in size. Most men with testicular cancer notice a growth before seeing a doctor.
- Hernia exam: The famous "turn your head and cough" checks for a weakness in the abdominal wall between the intestines and scrotum.
- Penis exam: A doctor might notice evidence of sexually transmitted infections such as warts or ulcers on the penis.
- Prostate exam: Inserting a finger in the rectum lets a doctor feel the prostate for its size and any suspicious areas.
Female Physical Exam A woman's annual exam might include:
- Breast exam. Feeling for abnormal lumps may detect breast cancer or benign breast conditions. The doctor will also check the lymph nodes in the underarm area and look for visual abnormalities of the breasts.
- Pelvic exam: The pelvic exam allows examination of the vulva, vagina, and cervix. Routine checks for sexually transmitted infections are often done. A Pap test can screen for cervical cancer.
Laboratory Tests Types of Blood Tests Some of the most common blood tests are:
- A complete blood count (CBC)
- Blood chemistry tests
- Blood enzyme tests
- Blood tests to assess heart disease risk
Complete Blood Count The CBC is one of the most common blood tests. It's often done as part of a routine checkup. The CBC can help detect blood diseases and disorders, such as anemia, infections, clotting problems, blood cancers, and immune system disorders. This test measures many different parts of your blood, as discussed in the following paragraphs. Red Blood Cells Red blood cells carry oxygen from your lungs to the rest of your body. Abnormal red blood cell levels may be a sign of anemia, dehydration (too little fluid in the body), bleeding, or another disorder. White Blood Cells White blood cells are part of your immune system, which fights infections and diseases. Abnormal white blood cell levels may be a sign of infection, blood cancer, or an immune system disorder. A CBC measures the overall number of white blood cells in your blood. A CBC with differential looks at the amounts of different types of white blood cells in your blood. Platelets Platelets (PLATE-lets) are blood cell fragments that help your blood clot. They stick together to seal cuts or breaks on blood vessel walls and stop bleeding. Abnormal platelet levels may be a sign of a bleeding disorder (not enough clotting) or a thrombotic disorder (too much clotting). Hemoglobin Hemoglobin (HEE-muh-glow-bin) is an iron-rich protein in red blood cells that carries oxygen. Abnormal hemoglobin levels may be a sign of anemia, sickle cell anemia, thalassemia (thal-a-SE-me-ah), or other blood disorders. If you have diabetes, excess glucose in your blood can attach to hemoglobin and raise the level of hemoglobin A1c. Hematocrit Hematocrit (hee-MAT-oh-crit) is a measure of how much space red blood cells take up in your blood. A high hematocrit level might mean you're dehydrated. A low hematocrit level might mean you have anemia. Abnormal hematocrit levels also may be a sign of a blood or bone marrow disorder. Mean Corpuscular Volume Mean corpuscular (kor-PUS-kyu-lar) volume (MCV) is a measure of the average size of your red blood cells. Abnormal MCV levels may be a sign of anemia or thalassemia. Blood Chemistry Tests/Basic Metabolic Panel The basic metabolic panel (BMP) is a group of tests that measures different chemicals in the blood. These tests usually are done on the fluid (plasma) part of blood. The tests can give doctors information about your muscles (including the heart), bones, and organs, such as the kidneys and liver. The BMP includes blood glucose, calcium, and electrolyte tests, as well as blood tests that measure kidney function. Some of these tests require you to fast (not eat any food) before the test, and others don't. Your doctor will tell you how to prepare for the test(s) you're having. Blood Glucose Glucose is a type of sugar that the body uses for energy. Abnormal glucose levels in your blood may be a sign of diabetes. For some blood glucose tests, you have to fast before your blood is drawn. Other blood glucose tests are done after a meal or at any time with no preparation. Calcium Calcium is an important mineral in the body. Abnormal calcium levels in the blood may be a sign of kidney problems, bone disease, thyroid disease, cancer, malnutrition, or another disorder. Electrolytes Electrolytes are minerals that help maintain fluid levels and acid-base balance in the body. They include sodium, potassium, bicarbonate, and chloride. Abnormal electrolyte levels may be a sign of dehydration, kidney disease, liver disease, heart failure, high blood pressure, or other disorders. Kidneys Blood tests for kidney function measure levels of blood urea nitrogen (BUN) and creatinine (kre-AT-ih-neen). Both of these are waste products that the kidneys filter out of the body. Abnormal BUN and creatinine levels may be signs of a kidney disease or disorder. Blood Enzyme Tests Enzymes are chemicals that help control chemical reactions in your body. There are many blood enzyme tests. This section focuses on blood enzyme tests used to check for heart attack. These include troponin and creatine (KRE-ah-teen) kinase (CK) tests. Troponin Troponin is a muscle protein that helps your muscles contract. When muscle or heart cells are injured, troponin leaks out, and its levels in your blood rise. For example, blood levels of troponin rise when you have a heart attack. For this reason, doctors often order troponin tests when patients have chest pain or other heart attack signs and symptoms. Creatine Kinase A blood product called CK-MB is released when the heart muscle is damaged. High levels of CK-MB in the blood can mean that you've had a heart attack. Blood Tests to Assess Heart Disease Risk A lipoprotein panel is a blood test that can help show whether you're at risk for coronary heart disease (CHD). This test looks at substances in your blood that carry cholesterol. A lipoprotein panel gives information about your:
- Total cholesterol.
- LDL ("bad") cholesterol. This is the main source of cholesterol buildup and blockages in the arteries. (For more information about blockages in the arteries, go to the Diseases and Conditions Index Atherosclerosis article.)
- HDL ("good") cholesterol. This type of cholesterol helps decrease blockages in the arteries.
- Triglycerides. Triglycerides are a type of fat in your blood.
A lipoprotein panel measures the levels of LDL and HDL cholesterol and triglycerides in your blood. Abnormal cholesterol and triglyceride levels may be signs of increased risk for CHD. Most people will need to fast for 9 to 12 hours before a lipoprotein panel There are no standard laboratory tests during this exam. However, we may order certain tests routinely:
- Complete blood count
- Chemistry panel
- Urinalysis (UA)
Unless symptoms already suggest a problem, these tests are unlikely to provide useful information. A lipid panel (cholesterol test) is recommended every five years. Abnormal cholesterol levels increase the risk for heart attacks and strokes. Physicals may advise Prevention The annual physical exam is a great opportunity to refocus your attention on prevention and screening:
- At age 50, it's time to begin regular screening for colorectal cancer. People with immediate family members with colorectal cancer may need to be screened before age 50.
- For most women, age 40 marks the time to begin annual mammogram screening for breast cancer.
- Everyone should have their cholesterol (lipids) checked every five years after age 20, according to the American Heart Association.
Healthy behaviors work far better than medicine at preventing illness, and don't require a prescription:
- Do 30 minutes of brisk walking or other exercise, most days of the week. Your risk for cardiovascular disease, diabetes, and cancer will fall dramatically.
- Eat a mostly plant-based diet, low in animal fats.
- Above all, don't smoke.
What should you bring to my "Welcome to Medicare" physical exam? Medical records, family health history and a list of prescription drugs.
- Medical records, including immunization records. Even if your current doctor does the exam, gather as much medical information as you can to make sure nothing is overlooked.
- Family health history. Try to learn as much as you can about your family's health history before your appointment. The information will help you and your doctor better understand what screenings you should get and what to watch for in the future.
- Prescription drugs. Bring a list of any prescription drugs, over-the-counter drugs, vitamins, and supplements that you currently take, how often you take them, and why.