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Subject: Re: [ARIZARD-L] Re: Institutionalization- why? (off subject)
Date: Sat, 27 Oct 2001 19:44:00 EDT


Dear list:
My 2 cents: I was taught in nurses training that 50%women were often commited to instituions for the insane that often suffering from thyroid problems. Families thought they went insane with complications of menopause. What a shame. That's why when we have a change in our behavior or mood, the first thing you do is do get a complete physical. Find out if it is a treatable metabolic disorder.
Because most of us are mature adults, I feel a teaching/sermon coming on.
What is a complete physical? Should be done by an M.D.
Can be an internal medicine specialist or family physician. These are board certified specialties. Settle for nothing less.
Include: chest x-ray, blood and urine specimens, and an EKG.
All of these are esential if you are over 50 yo.
Chest x-ray: helps your doctor determine possible abnormalites of heart and lungs. Just the size of each can be an indiacation of illness. Most doctors will have this x-ray sent out to be over-read by a radiologist, he will look for more intricate and less obvious findings. He will even keep it on file to compare the next years x-ray.
EKG: ok, first one is normal. Those little lines can hold subtle changes. When you have "the big one" it would be nice to have an old EKG on file to compair it to the new one. Maybe "the big one" is just a little one and early intervention and treatment can save you life.
Blood:
1. A complete metabolic panel: on just one tube of blood. Tells doc about about your kidneys, liver, cholesterol, diabetes, and thyroid, and even more.
2.CBC: complete blood count. Oops that's a 2nd tube of blood, but we can do that with just one needle stick. As well as giving hints to viral and bacterial infections, can detect leukemia. There are certain types that don't develop until a mature age.
3. PSA: for men, this is key to detection of prostate cancer. Even if it is low when ck'd the 1st time, got to follow up in a year or 2 (depending on age) to see if it is going up. Yes, you doc may still do a 'digital manual rectal exam'. This isn't the most diagnostic rectal exam...more to come on that one later.
PAP smears: more has been written on this than I can possible convey here. Base line: women needs one EVERY year until the doctor says you don't.
Urine spec.: I can't tell you how many people complain of back pain that have urinary tract infections. The presence of bile, bilirubin, blood, and sugar all deserve more testing.
Coli-rectal exam: Colonscope or sigmoidoscope. NO fun from the begining! First you have to be cleaned out! Laxative with a purpuse! That's the worst for me. The actual test is really mind over matter. Trust me, doc's not embarassed by what you tush looks like. It's not the thrill one the day for him either, but he wants to take care of you and gives him a sense of acomplishment that he is doing his best for you. Constipation, diarrehea, gas, abdominal cramping are best dealt with on scientific findings.
Physical Examination: your doctor needs to touch you. Just finding that you skin is dry and flaky can be an indication. He is gonna mash (palpating) some places, and squeeze others. Then he's gonna tap others. Is one foot warm and the other foot cold? More test maybe indicated. Might even send you to another doctor.
He is going to look at you, your body. What color is the skin (here, there, and every where)? Is there a mole or rash? His eyes are trained.
Your input: I hate guessing games. When my mom calls and says, "guess who called me today?" First I ask which state did the call originate from! Do you really want to TEST his abilities with your life. Tell him what you know is wrong or different. Write things down if you think you will be nervous or too embarassed to just spit it out. Tell him you have been to other doctors and take the bottles of medicine with you. Most are too hard to try to spell these days any way.
There is just one more reason to go: If you health plan PAYS for an annual physical, and you are paying your portion of the cost of health care coverage, isn't it stupid not to at least get that much bang for your buck even if you don't feel sick. Not to mention, just in case, you wake up on a strecher in the hospital, wouldn't it be nice to see at least one face you recognize?
Coming down from soap box now.
Wishing you all good health and a marvelous weekend.
Marsha

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