Chapter 9 Wellness Quo

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THE WELLNESS QUOTIENT
KRISHNA G. SESHADRI
The practice of medicine was for a very long time gender blind.
Very little credible information was available about what diseases (other
than gynecologic conditions) are common in women, how to prevent them
and what would be the optimal treatment.
Most research in medicine was done on men and the results were
just extrapolated to women. It is only in the past decade that research
specifc to women’s issues have been done worldwide and the results are
revealing.
Diseases that traditionally were considered to have little impact on
women, like diabetes and heart disease, were found to have the same if
not greater morbidity in women. Finally medicine woke up to the fact
that women are diferent from men; and so the way they need to be cared
for should also be diferent.
This article will examine the preventive health exams that women
need to undergo through their lifetime.
How often should you see a doctor?
No one has come up with clear guidelines on how often a healthy
woman should see a doctor, but an interesting rule of thumb is to get an
examination at least:
• Once in your teens
• Twice in your twenties
• Thrice in your thirties
• Four times in your forties
• Five times in your ffties and
• Once a year thereafter. Needless to add, if you have a medical
problem you need to see your doctor more often.
Do you need a test?
Besides seeing a doctor, a few well – timed periodic tests and
examinations help. Listed below are exams and tests and their frequency
grouped by age. The list has the bare minimum required but for most
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women this is sufcient. Use this ready reckoned to see what test and
examination you need. When in doubt do not hesitate to ask your
doctors.
WOMEN 18 TO 39 YEARS OLD Every year:
• Breast examination
• Pap smear until you have had three normal ones
• Dental examination.
EVERY 2 TO 3 YEARS:
• Blood pressure
• Height and weight measurement
• Brief physical examination, including a pelvic examination, to
screen for cancers of the thyroid, lymph nodes, ovaries, and skin.
• Every 5 years: Cholesterol (lipid Profle)
WOMEN 40 TO 65 YEARS OLD Every year:
• Physical examination, including a pelvic examination, to screen for
cancers of the breast, skin, thyroid, ovaries, uterus, lymph nodes,
and rectum; examination includes a pap smear every 1 to 3 years,
depending on your personal history.
• Dental examination
• Mammogram if you are 50 years old or older.
EVERY 1 TO 2 YEARS:
• Height and weight measurement
• Blood pressure
• Stool sample checked for blood
• If you are 40 to 49 years old, a mammogram according to the
schedule you and your doctor decide based on your risk for breast
cancer.
• Vision and glaucoma check.
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EVERY 3 TO 5 YEARS:
• Lipid profle
• Blood sugar
• Sigmoidoscopy or colonoscopy after age 50 to screen for colon
cancer. While the Amercian Cancer Society recommends this test,
many doctors feel that this test may not be required unless there is
a clear risk for colon cancer.
WOMEN OVER 65 YEARS OLD : Every 6 months: Dental examination.
Every year:
• Weight measurement
• Blood pressure
• Mammogram
• Physical examination, including a pelvic examination, to screen for
cancers of the skin, breast, thyroid, ovaries, uterus, lymph nodes,
and rectum
• Stool sample checked for blood.
EVERY 1 TO 3 YEARS:
• Blood count
• Lipid profle
• Blood sugar
• Hearing check
• Vision and glaucoma check *Pap smear (Consider discontinuing if
previous regular screenings have always produced normal results)
EVERY 5 YEARS:
Consider a Sigmoidoscopy or colonoscopy to screen for colon
cancer.
Once : A measure of bone mineral density to detect osteoporosis.
PREVENTIVE CARE:
No routine medicines are required for most women to prevent
diseases other than during medicine. This includes vitamins,
antitoxidants and the like. Women after menopause must take atleast
one gram of supplemental calcium. The guidelines here are not meant to
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replace your doctor’s clinical judgement but to empower you to be
proactive about yourself .
COMMON DANGER
Two Common Cancers in Women and how to detect them early
• CERVICAL CANCER SCREENING: The most common cancer in
South Indian Women is Cervical Cancer. The cervix is the narrow
opening of the uterus. The main underlying cause of cervical
cancer is infection with a virus, which often does not have any
symptoms. Other risk factors include low socio economic status,
crossing 50 years of age, early age at frst intercourse and multiple
sexual partners.
• In early cases of cervical cancer, most women will not have any
symptoms. When women do develop symptoms, it is often too late
for treatment because the cancer is too advanced. For this reason,
screening is very helpful to help diagnose at an earlier stage,
allowing for early treatment. Women can be screened for cervical
cancer by doing a pelvic examination, which allows visualization of
the cervix.
• The cervix is swabbed with a solution to highlight abnormal tissue
or scrape cells from the cervix onto a glass slide to have it
evaluated under a microscope to look for abnormal cells. The test
is generally done every year starting from the year of frst sexual
intercourse; if two consecutive tests are normal, then it may be
repeated once in two to three years.
• BREAST CANCER SCREENING: Breast cancer is an important
cause of death in women. Symptoms can include lump in the
breast, dimpling or pitting of the skin of the breast, swelling or
lump in the armpit, changes in appearance of the nipple or nipple
discharge. Breast cancer can be detected early by having an
annual clinical examination by a doctor. A breast self examination
is recommended by many societies to be done every other month.
An X-ray of the breast, called the mammogram, is an additional too
that is recommended every year after the age of ffty.
Source : The New Sunday Express March 6,2005
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T he w inner alw ays has a program
T he Loser alw ays has an excuse
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