We sometimes take better care of our cars than our bodies. Of course, a new car comes with an owner's manual, which details what you need checked and serviced at regular intervals. By doing these things, we can keep our engines running smoothly and extend the lives of our cars.
Unfortunately, a human body doesn't come with a maintenance manual. Ironically, the gender that is usually more interested in the mechanics of their motor vehicles tends to be less interested in physical self-maintenance. Many men seem to be under the delusion that their bodies are under a no-maintenance unlimited lifetime warranty. They may look after their outward appearance while taking health itself for granted. This is not unlike washing and waxing your car but forgetting to change the oil.
Women tend to be much better at seeing their physicians for routine checkups, such as Pap smears. Yet most people don't know all the medical tests and procedures they should do periodically to maintain good health.
When should women start doing Pap smears? When and how often should men check their prostates? How do we detect colon cancer early? How often should you have your blood pressure checked?
Part of the problem is our problem-based health-care system. Visits to family doctors are initiated by patients, who present specific problems to be solved. Patients therefore rely on their family physicians to tell them what they should have checked, even if it is unrelated to their visit.
Patients once relied on the complete physical history and examination to review their lifestyles, assess all physical systems and perform the recommended screening tests. However, the B.C. Medical Services Plan will not pay for routine complete physical examinations in the absence of significant medical problems, such as diabetes, heart failure or multisystem conditions.
So how do you find out what you should be doing? You could book a complete physical and pay for it yourself (it would be cheaper than taking your car in for a tune-up) or you can rely on your conscientious family physician to tell you what you're due to check out in addition to dealing with your presenting problems.
Preventive health procedures are not common knowledge. You can look up the Canadian Task Force on Preventive Health Care website at www.ctfphc.org, although it is not user-friendly for the general public.
A screening test is considered useful if it can detect in a symptomless patient a condition, such as diabetes or cancer, and allow treatment at an early enough stage to prevent a more serious outcome. For example, Pap smears can detect early forms of cervical cancer and prompt curative treatment before it causes irreparable damage to the cervix or spreads elsewhere in the body.
Preventive health care refers to interventions, such as counselling, to encourage practices that lessen potential health risks. These include annual flu shots and periodic pneumonia shots to all individuals over 65 and those with chronic diseases, such as emphysema, asthma, diabetes or heart disease.
All women who could become pregnant should take a 0.4 mg folic acid (folate) supplement to prevent neural tube defects (such as spina bifida) in babies.
For men without liver disease, the recommended maximum number of alcoholic drinks per day is three; for women, the limit is two.
All of us (with teeth) should floss and brush with a fluoride-containing toothpaste. I developed this habit early in life after my dentist (who is also my father) jumped out from behind the bathroom door and told me, "You didn't brush long enough!"
Everyone should wear a seatbelt while driving, and children should be in appropriate car seats or boosters. To prevent skin cancer, we should limit our exposure to sunlight with sunblock and protective hats and clothing. To avoid lung, throat and bladder cancer, premature atherosclerosis (hardening of the arteries), chronic bronchitis or emphysema and premature wrinkles, no one should smoke.
In upcoming columns, I will review the screening tests and procedures I recommend to my patients.
You'll then have that user manual at last, and you'll have no excuse for not maintaining your one and only body.
Although you can't trade it in, you may get a new lease on life.
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