Medical Moment: Staying Healthy

11 Apr Medical Moment: Staying Healthy

Telluride Inside… and Out is proud to feature the Telluride Medical Center’s MEDICAL MOMENT, a weekly column that answers common medical questions in pop culture.

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Nationally certified physician’s assistant Laura Cattell answers this week’s question: What can I do to stay healthy?

Laura Cattell, PA-C

Good health comes not just from receiving quality medical care but from stopping disease before it starts. Over the last century preventive health care has become an increasingly important aspect of medical practice; leading to significant improvements in overall health in the US.

The Affordable Care Act makes preventive care a major focus. Medicare covers a preventive exam and most private insurance companies now provide multiple preventive services free of charge.

The Affordable Care Act aims to move the nation away from a health care system focused on sickness and disease to a system focused on wellness and prevention.

The 10 leading causes of death in persons over 65 years old in the United States are as follows:

1. Heart Disease
2. Cancer
   • Lung Cancer, the most common cancer causing death among males and females
   • Colorectal Cancer, second most common cause of cancer death among males and females
   • Prostate Cancer, most common cancer among men
   • Breast Cancer, most common cancer among women
3. COPD (emphysema/chronic bronchitis)
4. Stroke
5. Alzheimer’s
6. Diabetes Mellitus
7. Influenza and Pneumonia
8. Kidney disease
9. Unintentional Injury
10. Septicemia

What can you do?

Preventive care focuses on two basic principles: identifying conditions that cause the largest burden of suffering for patients and what preventive services actually have demonstrated benefit in improving patient outcomes.

The first step is meeting with your health care provider to review all recommendations, below is a list of preventive strategies to discuss.

• Have your “global cardiovascular (CVD) risk” calculated. This measures your risk for heart disease in the next 10 years.
• If you use tobacco, consider stopping. Your provider can help you find methods and support systems that can help. Tobacco contributes to over 400,000 deaths each year in the United States.
• Maintain a healthy weight, which is a body mass index (BMI) at or below 26. Being overweight (obese a BMI > 30) coupled and being sedentary increases your risk for diabetes, heart disease, high blood pressure, and all cause mortality. A diet high in vegetables and whole grains as well as low in sodium and saturated fats are key to lowering weight and decreasing risk for many diseases.
• Check for high blood pressure. Hypertension accounts for 35% of all strokes and myocardial infarctions, 49% of heart failure cases and 24% of premature deaths in the United States. Hypertension can be well controlled with life style modifications and if that fails medications are indicated. It will be measured as part of your exam.

Prevention for Cancers includes:

• Smoking cessation, tobacco increases the risk of developing almost all cancers. Particularly lung cancer.
• Schedule a colonoscopy! Screening should start at age 50, please review family history with provider as this can change recommendations. Typically screening will stop at age 75 depending on previous studies.
• Consider annual skin exams to review skin cancer risks.
• Men: Please discuss recommendations regarding screening for prostate cancer with your provider and discuss any concerning symptoms including night time urination or change in urine stream
• Women: Annual mammograms beginning at age 40 have proven to decrease mortality. Mammograms should continue through age 75. Discuss previous Pap smear results as there are new recommendations for cervical cancer screening over the age of 65. Tell your provider if you have any uterine bleeding as this can be a sign of endometrial cancer.

Immunizations: Several immunizations are recommended for all adults over age 65.

• Get an Influenza vaccine annually. Please note influenza over the age of 65 carries a higher risk of serious illness, hospitalization and even death
• Pneumococcal vaccine should be given one time to all people over the age of 65, this has shown to decrease the risk of developing certain types of pneumonia.
• Zoster vaccine: The risk of developing herpes zoster (shingles) increases with age as does developing post herpetic neuralgia (a chronic pain condition) following the infection. Recommendation a onetime vaccine

Injury Prevention: Focused on decreasing fall risk, this recommendation includes reviewing all medication as well as increasing bone and muscle strength again through exercise.

Visual and Hearing Problems: Far more common over the age of 65, these problems can affect a person’s ability to function at their highest level. Many can be corrected and simple screening test exist.

Bottom line: Schedule an annual exam to review all preventive recommendations.

For many of you over the age of 65 it is more affordable than in the past. Make sure you are up to date with recommended screening and immunizations. You can limit your risk of certain diseases and live a healthier life.

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