Organize Your Family's Health Care with this Checklist of Routine Physical Exams and

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1 All adults should visit their health care provider from time to time, even if they are healthy. The purpose of these visits is to: Screen for diseases Assess risk of future medical problems Encourage a healthy lifestyle Update vaccinations Maintain a relationship with a health care provider in case of an illness A routine physical exam may just save your life or that of a loved one. Organized and scheduled routine exams and tests are the most effective way to safeguard your family s health. Being proactive and having routine medical exams and tests is simply one of, if not, the best way to head off disease and illness. If you are organized and know when to schedule routine physical exams and tests for your family members, you can pretty much determine the onset of disease at an early stage. This means treatments for early diagnosed disease can begin sooner, which almost always means a more positive outcome. Listed below are exams and tests by age to help you organize and get proactive with your family s health care! Babies: Pediatricians want to see a newborn at 1 week, 1 month, months, 6 months, 9 months, 12 months, 18 months, 2 years, and once a year thereafter until the child reaches age 18, or more if there are other health concerns in between well child visits. A well child exam consists of a check of your child s height, weight, temperature, blood pressure, their eye sight as they get older, administration of vaccines, and to address any questions or concerns you may have. It s a good idea to keep a running list of nonemergency questions handy to address during the next scheduled well child exam. It is also a good idea to schedule their well child visits for the first year as soon as possible after they re born. Well child visits usually are not as readily available as sick visits because pediatricians tend to take more time with these. So, if you wait too long to schedule Organize Your Family's Health Care with this Checklist of Routine Physical Exams and Tests well child visits, you may have to schedule past their due date. And, it s critical to keep your well child visits on time since they help the pediatrician evaluate a child s physical and mental growth along with their milestones. The pediatrician can then immediately address issues in case of abnormalities. Toddlers and Adolescents: The well child visits during toddler and adolescent years focus on growth and continuation of the child s immunizations. It is also during these times that children are evaluated for signs of depression or stress due to school demands and existence of peer pressure. Guidance counseling may be recommended if necessary. The HPV vaccine series of three shots should be given between the ages of 11 to 12 years of age for both boys and girls before any sexual activity with another person begins. It is possible to be infected with HPV the very first time they have sexual contact with another person. The CDC recommends that the second dose be given one to two months after the first, and the third dose be given six months after the first dose.

2 As we get older, disease can become more prevalent so it is important to keep up routine physical exams. Organize yourself and get ready for your routine physical exam by knowing your health history along with your family s medical history. During the routine physical exam you ll fill out a detailed medical health questionnaire that lists your health along with your family s health history. It is important to fill this out as completely as possible for your doctor to review and see your health history along with your family s medical history. They ll be able to spot trends in your family s history and can use this information along with any symptoms you may be experiencing to diagnose and treat you. You ll want to bring along a list of any health questions or concerns you have to address with your doctor. Vital Signs: 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. If your blood pressure is above 15/80 your health care provider will test your blood sugar levels for diabetes. An annual exam generally includes the following: 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. The doctor will also check on your vaccination status and update your personal and family medical history. 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 may also be 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 may be 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.

3 An annual physical exam for men should 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 (DRE or digital rectal examination) lets a doctor feel the prostate for its size and any suspicious areas. An annual physical exam for women should also include: Breast Exam: Along with the woman s monthly self-breast exam, the doctor will palpitate for abnormal lumps that may indicate 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 and Pap Test/Smear: Screening should start within years after first having vaginal intercourse or by age 21. Beginning at age 21, women should have a pelvic exam and Pap smear every 2 years to check for cervical cancer. If you are over age 0 or your Pap smears have been negative three times in a row, your doctor may tell you that you only need a Pap smear every years. Women who have had a total hysterectomy (uterus and cervix removed) may choose not to have Pap smears. Women who are sexually active should be screened for chlamydia infection. This can be done during a pelvic exam. After age 65 most women can stop having Pap smears as long as they have had negative tests within the past 10 years. Be aware that many medical internists do not do pelvic exams and Pap tests. Many leave that up to the woman s gynecologist. Laboratory Tests: There are no standard laboratory tests during an annual physical. However, some doctors will order certain tests routinely: Complete blood count Chemistry panel Urinalysis (UA) Unless symptoms already suggest a problem, however, these tests are unlikely to provide useful information. A lipid panel (cholesterol test) is recommended every five years after the age of 20 according to the American Heart Association. Abnormal cholesterol levels increase the risk for heart attacks and strokes. Immunizations for Adults: You should receive the vaccine against human papilloma virus (HPV) if you are between ages 18 and 26. You should receive a flu vaccine every year. Your doctor may recommend other vaccinations if you have certain medical conditions, such as diabetes. You should have a tetanus-diphtheria booster vaccination every 10 years. If you have not received a tetanus-diphtheria and acellular pertussis (Tdap) vaccine as one of your tetanusdiphtheria vaccines, you should have it once. You should receive two doses of varicella vaccine if you were born after 1980 and never had chickenpox. You may get a shingles or herpes zoster vaccination once after age 60. If you are over 65, get a pneumococcal vaccine if you have never had before, or if you received one more than 5 years before you turned 65. Infectious Disease Screening: Depending on your lifestyle and medical history, you may need to be screened for infections such as syphilis, chlamydia, and HIV, as well as other infections.

4 Prostate Cancer Screening: Men age 40 or older should discuss screening for prostate cancer with their health care provider. A digital rectal examination and PSA (prostate-specific antigen) test should be completed during their annual physical. Colon Cancer Screening: People between ages 50 and 75 should be screened for colorectal cancer. African-Americans should consider starting screening at age 45. This may involve: A stool test done every year. Flexible sigmoidoscopy every 5 years along with a stool occult blood test. Colonoscopy every 10 years. Double-contrast barium enema every 5 years. Computed tomographic colonography (virtual colonoscopy) every 5 years. People with risk factors for colon cancer, such as ulcerative colitis, a personal or family history of colorectal cancer, or a history of large colorectal adenomas may need a colonoscopy more often. Osteoporosis Screening: All men ages 50 to 70 with risk factors for osteoporosis should discuss screening with their doctor. All postmenopausal women with fractures should have a bone density test (DEXA scan). All women under age 65 with risk factors for osteoporosis should be screened. All women over age 65 should have a bone density test (DEXA scan). Abdominal Aortic Aneurysm Screening: Men between ages who have smoked should have an ultrasound done once to screen for abdominal aortic aneurysms. Other men should discuss such screening with their health care provider. Dental Exam: Go to the dentist every year for an exam and cleaning. Eye Exam: Up to the age of 65 if you have vision problems have an eye exam every 2 years. After 65 whether or not you are having vision problems have an eye exam every 2 years. Once you turn 45 make sure your health care provider checks for glaucoma. Mammograms: The American Cancer Society (ACS) guidelines call for yearly mammogram screening beginning at age 40 for women at average risk of breast cancer. Those who have had a close family member diagnosed with breast cancer should consider having annual mammograms starting 10 years earlier than the age at which the relative was diagnosed. Physicals Should Emphasize Prevention! The annual physical exam is a great opportunity to refocus your attention on prevention and screening. Healthy behaviors work far better than medicine at preventing illness, and do not require a prescription: Do 0 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, do not smoke! Knowledge is power and if you have your family s routine health care organized and scheduled, you have the power to head off disease and illness and live a long, happy, and functional life.

5 Health Test timetable Well Child Exam Physical Exam Gynecology Exam Mammogram Self-Breast Exam Pap Smear Dental Exam Eye Exam Blood Pressure Blood Sugar Check Cholesterol 1 week, 1 month, months, 6 months, 9 months, 12 months, 18 months, 2 years and then yearly. Yearly starting at age 40. Those who have had a close family member diagnosed with breast cancer should consider having annual mammograms starting 10 years earlier than the age at which the relative was diagnosed. Monthly, preferable at the same time in the month. Every 2 years unless previous tests were normal and you are in the same monogamous relationship then every years. Yearly, twice a year is better. Up to the age of 65 if you have vision problems every 2 years. After 65 whether or not you have vision problems every 2 years. Yearly with physical. Stool Test Yearly after 50. Colonoscopy Flexible Sigmoidoscopy TDP Booster HPV Vaccine Flu Shot Varicella Vaccine Shingle Vaccine Should be done if yearly blood pressure during physical is 15/80 or greater. At least once every 5 years, if normal. When medicated more frequently. Every 10 years starting at age 50. More frequently with abnormal findings. African-Americans should consider starting at age 45. Every 5 years starting at age 50 along with stool occult blood test. Every 10 years (TDP stands for tetanus, diphtheria and pertussis). Once between the ages of 18 and 26, male and female (HPV stands for human papilloma virus). 2 doses if born after 1980 and never had chickenpox. Once after age 60 if history of having chickenpox. Pneumonia Vaccine Once after age 65 OR again if received shot more than 5 years before age 65. Skin Cancer Check Prostate Exam Do self-exams monthly. Annual check by dermatologist. Starting at least by 40 annual DRE (digital rectal exam) and PSA (prostate specific antigen) test with physical. Bone Density Test All postmenopausal women with history of fractures. (DEXA Scan) All women under age 65 with risk factors for osteoporosis. All women over age 65. All men ages 50 to 70 with risk factors for osteoporosis. Abdominal Aortic Aneurysm Screening Men between ages 65 to 75 who have smoked should have an ultrasound done once to screen for abdominal aortic aneurysms.