By Dr. Ravikumar H N
Health check-up is a preventive medicine wherein we try to find problems before they actually start. The screening programme depends upon the age and the lifestyle of an individual. In some diseases, it will help us to postpone the onset of the disease & push the onset of clinical signs and symptoms sometimes for decades!
In our country, 50% of deaths are due to heart diseases & strokes, and it kills more people than cancer or a combination of both diseases remains the causes of mortality. Diabetes adds to this problem in which our nation has already become the diabetic capital of the world. Thyroid disease is also catching up and has been competing with diabetes to become the No. 1 disease. The only way to keep these diseases at bay is to prevent the disease at the earliest.
Let us see now, what is the importance of routine health check-up is and why one should undergo, at regular intervals.
Now-a-days, Heart and DM are seen among majority of younger people due to sedentary lifestyle, improper diet, lack of exercise, anxiety status, irregular sleep habits, obesity, stress, etc. The most important information such as family history is what we often forget to write in a patient history file many a times. I personally feel that we are making a big mistake by ignoring it.
Family history is very important to plan a health check-up scheme tailormade to all the members of family. For e.g., if both the parents are diabetic at an early age, the chances of siblings becoming a diabetic is almost 50%. He or she must be careful as it might affect them at any age. It is also as a similar case with parents having CHD (coronary heart disease), Familial Ovarian and breast cancer, Familial Polyposis, etc., who also need a tailormade health check-up scheme. These group of people will have genetic defects which leads to an early age of cancer of breast, ovary, and intestine.
Newer guidelines suggests that one must do the lipid profile or coronary risk profile in children, if the parents or family members have CHD early in their life and follow-ups tests are required till they become an adult especially if the child is obese.
Obesity is commonly seen among children with minimal outdoor activity leading them to early onset diabetes, heart disease etc. Obesity profile in children includes Cortisol, TSH, (to R/O secondary causes of obesity) Adiponectin, Human Leptin, FBS, Lipid Profile, Body mass index. Therefore, obesity profile in children has become a common test now-a-day. If there is a family h/0 CHD irrespective of obesity, they need to test as per 2017 AACE (American Association of Endocrinology & American College of Endocrinology)
In adolescent female groups, PCOS profile test is required only if they have – Obesity, Irregular menstrual cycles, abnormal hair growth, acne, ovarian cysts, skin tags etc. Genetics, Excessive androgen secretion (male hormone) and Insulin Resistance are the main causes including stress factors. The other test which is recommended is LP (Lipid profile) in adolescent at every 5 years if one of the parents has CHD/ Stroke in early life (young age).
Like every other disease DM and Thyroid disorder, Hypertension, will have its own stages of the diseases. For example, DM has 4 stages. Stage 1 to 4 and if detected in early stage 1 or 2, we can postpone the onset of DM by taking preventive measures. On the other hand, if the patient is diagnosed at the stage 3 or 4, the disease progression has already occurred, and reversal is not possible. Question of prevention doesn’t arise at all.
Stage 1: Insulin resistance
Stage 2: Prediabetes With border line sugar levels.
Stage 3: Where sugar levels are high
Stage 4: With one or two complications like Retinopathy, Nephropathy, Neuropathy etc.
The same way is with thyroid condition called sub clinical hypothyroidism, wherein many people under this category will have high TSH values & normal FT4 & no symptoms of Hypothyroidism, can be managed by the physicians without medication and by follow up. Medicine is required only if the TSH is elevated and FT4 is reduced. In some individuals’ co-morbidity is also taken into consideration while treating thyroid conditions.
Even Hypertension (BP) has 3 to 4 stages. It is from normal (below 120/80 mm hg), Elevated (120-129 /<80 mm hg),
Stage 1: 130-139/80-89 mm hg)
Stage 2: 140 or higher or 90 mm hg & above).
Overt Hypertension: Higher than 180/120 mm hg.
If the BP is found to be abnormal in early stages, it can be brought under control easily with no damage to organs.
Regular ECG, TMT (at least once in 2 yrs), to rule out any early changes in the heart. Ultrasound examination would help us detect some lesions in any of the abdomen organs. We have picked up many lesions in Abdominal organs like Lymph nodes, Liver, Gall Bladder, Kidney and Ovaries and Endometrium (in females) and prostatic pathology (in males). E.g., Kidney Cancer called Renal Cell Carcinoma, which can be picked up by Ultrasound in an asymptomatic individual. X-ray chest if any lesion can be kept optional because of radiation though it is minimal.
Ear, eye, and teeth examination to detect any abnormality. Mammography helps to detect any breast lesion which are not palpable to R/O Breast cancer. PAP smear (LBC) with HPV DNA – once in 5 years for cervical cancer in women between 30 to 55 years of age. As you are aware, cervical cancer is the leading cause of death in women in India.
Most important of all these is to do thorough clinical physical examination which is the most important examination than all the other tests.
BMI to look at the obesity index.
It is also equally important to note that once the abnormality is detected during health checkup, some of the tests may require to be done at regular interval to make sure that the parameters are under control. Example: HBA1c once in 3 months to ensure that the DM is under control if not complications are bound to happen. Many patients do all sorts of diet and exercise after complication has set in, which is of not much use as damage is already done to the organs which is irreversible.
All these follow up is done by your treating physician to ensue everything is under control. It is recommended to do Health checkup at least once in a year so that any changes seen can be addressed soon. These are the overall guidelines to take care of one’s individual health. Even the Govt employees especially IAS/IFS and other cadre also undergo health check up every year and Govt is taking care of them. There is an income tax benefit on preventive health checkup cost, too!
(The author is an MD., Vice President & Chief of Lab, Metropolis Healthcare, Bengaluru. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of FinancialExpress.com.)