Preventive Screening is Important

with Jeffrey Katt, M.D., Internal Medicine, Advanced Healthcare

Posted: June 1, 2005

What to expect during a checkup
Periodic checkups include different procedures depending on a person’s health history, but there are some basic things you should expect of your physician. For example, when you go in for a physical exam, you’ll find that your doctor places a strong emphasis on prevention.

Also during the checkup, your physician should take a thorough medical history from you and conduct the physical exam based on your concerns.

Your doctor should make specific recommendations for exercise if your exercise habits are inadequate. He or she should caution you about sun exposure and the risk of skin cancer.

Jeffrey Katt, M.D., Internal Medicine, Advanced Healthcare "Everyone should have a fasting blood sugar test every two years, especially those who are overweight and have a family history of diabetes."

Your doctor also will counsel you about a number of other things including not smoking and healthy eating habits. He or she may advise cutting down on cholesterol and saturated fat, and recommend calcium supplements for those who aren’t getting enough through food, especially women.

According to Dr. Jeffrey Katt, an internist for Advanced Healthcare, one of the most important things your physician can do for you to prevent future medical problems is to offer screening tests appropriate for your age and risk factors.

Cholesterol levels
“Cholesterol screening is important for heart disease prevention,” he said.
“We recommend that both men and women have an initial lipid panel. If the results are entirely normal, your cholesterol should be checked thereafter every five years.”

Dr. Katt said the test measures total cholesterol, LDL (low-density lipoprotein, “bad cholesterol”), triglycerides, and the level of beneficial high-density lipoproteins (HDL).

“Having an elevated LDL count, which is undesirable, means you must stay away from cholesterol and saturated fats in your diet. Avoiding those foods should lower your LDL. If that doesn’t help, statin medications like Lipitor and Zocor can lower your LDL.

“An HDL level greater than 40 is desirable and can be raised by aerobic exercise and quitting smoking. We believe everyone should exercise a minimum of 30 minutes three times a week, but five hours of exercise a week is considered more ideal,” he advised.

Blood pressure checks
Blood pressure, according to Dr. Katt, should be checked at least annually. Elevated blood pressure can cause stroke, heart attack or kidney disease at any age.

“Usually we won’t prescribe medication to someone who is otherwise healthy unless the blood pressure is over 140/90,” he said. “However, new guidelines consider you to be prehypertensive if your blood pressure falls in the 120-139/80-89 range. For those who are prehypertensive, we recommend exercise and avoiding salt, because they may be on the road to hypertension.”

Diabetes
Dr. Katt said screening for diabetes also is important. “It’s worth mentioning that diabetes is currently at epidemic proportions. We screen for it with a fasting blood sugar test that determines your blood sugar level after an overnight fast. A normal count would be below 100. Between 101 and 125 is considered pre-diabetic, which is abnormal and shows that you may be destined to contract the disease.

“Someone who has two separate fasting blood sugars over 125 is diagnosed as having diabetes. Everyone should have a fasting blood sugar test every two years, especially those who are overweight and have a family history of diabetes,” Dr. Katt said.

Colon cancer
A panel of the Agency for Health Care Policy and Research recently concluded 55,000 annual deaths from colorectal cancer could be reduced by one-third if all men and women age 50 or older were screened.

According to Dr. Katt, those who are at average risk can choose between an annual stool test, sigmoidoscopy every five years, a combination of stool testing and sigmoidoscopy, a barium enema every five to 10 years, or colonoscopy every 10 years.

“But if you have a parent or sibling who has had colon cancer, screening should be done at age 40 or 10 years before that relative was diagnosed, whichever is the younger age, and in that situation, a colonoscopy would be the most appropriate test.

“Most doctors recommend colonoscopy for screening, but it’s an invasive test, expensive and not always covered by insurance. It is, however, usually considered the standard, the best test,” Dr. Katt said.

Jeffrey Katt, M.D. - Internal Medicine
Good Hope Clinic
3003 W. Good Hope Road
Milwaukee
414-352-3100

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