This is real Health chats real talk about health issues important to you and your family. I'm dr. D. And I'm Becky the doctor's wife. Welcome to the show. Hey everyone. Welcome to real Health chats. This is episode 1 Health screenings. Nothing. We say should be taken as medical advice for specific questions. Please talk to your doctor episode one. That's exciting it is. Alright. So let's get into it what our health screenings. So in general a health screening is a test that's done looking for a disease or health problem when there's not any symptoms present. So is that something that you would get at a yearly checkup which we think everyone should have write a yearly checkup with their doctor? Yes. Usually that's when these tests will be discussed and arranged and talked about with your doctor at a yearly physical or yearly Health wellness exam if you're not one that's prone to going to yearly Wellness exams then Doctor May recommend it when you just show up for an illness. Okay. Yeah because some of us don't really like going to the doctor. Yeah, we know that so we try and get people when they're kind of captive audiences and recommend some of these things when when we have them there in the office, but in general it's something we would recommend during a yearly Wellness physical or exam. Okay. So a screening test is something that's done when there's no symptoms. You have symptoms. That's a complete lie. Different tests, although sometimes it's the same test. Right? Right. That's a good explanation. A screening test is something we do when there's no symptoms, but we're looking for some type of disease or problem a diagnosis or a diagnostic test is when somebody shows up with a symptom and then we order a test to try and diagnose what the problem is that's causing that symptom. Okay, and sometimes that's the same test. So let's go into some of the times be the same test. Okay, so I we could do an example now and then talk about okay the specific screening recommendations later. So a good example of this is a colonoscopy a colonoscopy is a screening test for colon cancer for most people it's recommended at age 50. So when we do a screening colonoscopy, they are doing a test that's looking for problems like colon polyps or colon cancer. If somebody comes in with complaints, it's kind of gross to talk about some of these things but maybe bleeding down there then they're going to get a colonoscopy, but it's going to be in order to look for the source of bleeding. So it's the same test but it's done for different reasons. Okay, so does make sense be prepared because this is a medical podcast. So some of the things we'll talk about some people might find gross. Yeah. But they're just dinner table conversations at our house. So true. It's so true. Some people don't even like to eat with us. That is very true. We gross people out and we don't even know it. All right. Well, let's talk specifically about some of the women's screenings screenings that are specific to women. Okay, I think that's a great place to start because there seems to be a lot more things that women have to do the men have to do right. I know that's the way it is though all the time. It is a matter what so covid screaming's housework. So if your kids I will not argue that point at all. So we've just talked about one. The colonoscopy we'll talk more about that in a minute. Okay, first we can start talking about the pap. Smear the pap. Smear is a test that's looking for cervical cancer or cervical dysplasia. So why is it called a pap smear? It's named after the doctor who invented it and his name was dr. Pepper Niccolo. I think that's how you say it. Interesting. Yeah, there's a good story about how he discovered this process. It's probably too detailed for our discussion here. But basically with an examination We Gather cells from the cervix, which is the very bottom of the uterus and then they make a slide out of that a smear and Someone then looks at that under the microscope and then the pathologist can tell if the cells look normal if there are signs of precancerous changes, which we call dysplasia or if there's cancer cells present. All right, and then what's found determines what's done next? So in a if a pap smear is normal then a woman now can have it repeated. Every three to five years depending on her age and depending on whether or not she's also screened for HPV. So the recommendation used to be every year correct that's changed within the last seven to ten years, which is fabulous. Most women love that information. Yes, so good to know now. It was a good thing. There are some women who still need one more frequently than that, but it fits If the screening test is normal, then it can be done every three to five years. So when should a woman get her first pap smear h21 is now the recommended time to start pap smears. Okay. What if they are sexually active before age 21 is that is that an indication for having a pap? Smear? No, it isnt its age. 21. Okay HPV is a virus. Okay called human papillomavirus and there are some strains of that virus that are responsible for. Most of the cervical cancers in the world. So at age 30, we can start screening for HPV as well. And if a woman has a negative pap smear and a negative HPV screen she can repeat that every five years. Okay, cool. Another screening that women need is breast cancer screening. So when should women start getting me? Mammograms that is a good question. It's a little controversial. There are recommendations or a little different from different Societies in general. We start those screenings between age 40 and 50 and do them every one to two years. So for women who are at higher risk based on family history, we might do the screenings a little bit earlier and a little more often in women who have Low risk and no family history. We might recommend starting a little bit later or it might be recommended to start a little bit later. The important thing is to talk to your doctor discuss your particular risk and your particular level of comfort with starting early versus starting late. Just know that the earlier we start and the more frequently mammograms are done that pieces the rate of unnecessary procedures and potential complications. Okay. So typically I know what my doctor recommends is every year. And you know, they're not that fun. If you're listening and you've had one, you know what I'm talking about. If you haven't had yours yet, then they're not that fun. But they're also quick and very very easy. I've had several friends with breast cancer. And every one of them will say go get your mammogram go get your mammogram and that's very true. And one of the things that if you're listening to our podcast ask one of the things we want to convey with this with this series is You know the importance of having these tests done but also equipping you with information that you can take to your own experience with your doctor. So questions, you can ask that maybe you didn't know you needed to ask like when should I start my screening? Is my family history important? I'm 40 but I don't want to start screening till I'm 50. Is that okay? Those type of things and same with the pap smears? If you have information that we can provide then you'll be better equipped when you're having an interaction or experience with your healthcare provider that ultimately we hope will enhance that experience and make it more productive good answer. And the next one is a chlamydia screening. So this is just a general recommendation that in women who are younger than 24 are younger than 25 that they have a yearly screen for chlamydia, if they're sexually active and if they're older than that if they're at high risk, and then men are it's recommended that men were not really talking about. We're talking about sexual things. So men should be screened for it to if they're at high risk and high risk would be multiple partners things like that. Is that still starting at 21 or is that something that I mean if we don't start pap smear still 21 so we can do a chlamydia. How should I phrase this answer? Yes for sexually active women. They should still be screened for chlamydia, even though they're not having a pap smear done so we can screen for chlamydia with a urine sample now. Oh, so you wouldn't have to have regular pelvic exam in after you have that very much less invasive much. Invasive now, so that's probably the main screening test. That would be specific for women the screening test that might be recommended that are specific to men would be prostate cancer screening. This is a very controversial topic. some societies are recommending against the PSA test PSA stands for prostate specific antigen and it's a test that's been used in the past to screen for prostate cancer the reasons That this test might be recommended against are a little complicated. Honestly, it's hard to explain it's hard to explain in person. And so it may be even more difficult to explain in a setting like this. Maybe what we'll do is a a podcast specific for men's health and prostate cancer screening and try and explain some of those difficulties. Okay, sounds good. Nobody wants to talk about prostates. Anyway, haha. Okay. How about let's go back to the colonoscopy. Okay, we have a fan third coming up this colonoscopy. Everybody's favorite thing to schedule right and what you hear is. Oh the test isn't that bad? It's the prep. That's the bad part of that test. So it's recommended that people have colon cancer screening at age 50. Unless there's a family history and then it's recommended. They start earlier based on you know, the age of when their relative had colon cancer. So there are different ways to check for colon cancer. Other than colonoscopy colonoscopy is probably considered The best although it's gold standard of the gold standard. Yeah, I guess it's the gold standard but it's it's also got some risk associated with it and not everybody, you know wants to tolerate that risk. So other things that can be done to screen for colon cancer our test called a fecal occult blood test and that's checking for blood in the stool to the gross stuff. It's blood that you don't see but it can be tested for chemically and then if that test is positive then you have to go do a diagnostic colonoscopy to see where the blood is coming from. Okay, and then you can also pair a barium enema, which isn't very funny either as not sound like a flexible sigmoidoscopy, which is just a shorter colonoscopy. So basically all roads lead to colonoscopy. In a way now, if you pass those other screening tests, you don't have to have a colonoscopy, but you have to do them more frequently. So a normal colonoscopy means you have to do that or you get to do that every 10 years. If you do one of the other tests you have to do it more frequently because It's more likely that it could be missed. And so you need to do it more frequently to try and catch it. If it's there that makes sense. Yep makes total sense. So let me just go back to one point colonoscopies every 10 years if there's not anything wrong. Yeah, so if everything looks normal, there's no polyps. There's no signs of early problems of cancer or anything like that then it's every 10 years Pulitzer. Very common. Polyps are what? Really turn into cancer. So if there are some polyps the nice thing about the colonoscopy as they can be removed at the time of the test, but then you do usually have to do the colonoscopy a little bit more frequently. Okay. So instead of every 10 years it might be every five years. All right, which still isn't terrible guess who turned 50 this year? I don't know gets to have his colonoscopy. You should announce that to everybody. Nobody wants to know that. Alrighty, so Let's go down to cancer screening in the lung cancer screening. Okay, let's do that. Lung cancer is very common. We don't have any great tests for screening for lung cancer. We know that people who smoke cigarettes or much more likely to develop lung cancer. So in people who smoke and who are older than 65 There are some criteria to do a low radiation dose CT scan as a screening test for colon for lung cancer. Okay, so criteria is smoking over 65 so specifically the criteria are a 30 pack years smoking history. Was 30 pack years question. I was waiting for that question. So where I'm looking for calculate the the smoking burden that a person has over their lifetime in pack years. And so one pack year means they smoked one pack of cigarettes a day for a year. So 30 pack years could be smoking one pack of cigarettes a day for 30 years or it could be smoking two packs of cigarettes a day for 15. Ten years. So that's a lot of cigarettes a lot of cigarettes. So the criteria for having a low dose CT scan screening for lung cancer is a 30 pack years smoking history age 65 or older currently smoking or quit smoking less than 15 years ago. Okay, that makes sense. Yep makes total sense. That's for men or women the Don't smoke. Please don't smoke. All right. Next on the list that I have is AAA. So AAA stands for abdominal aortic aneurysm and aneurysm is a swelling or ballooning in a blood vessel the specific one we're talking about with this test is the aorta. That's in the abdomen. They order is the largest blood vessel that carries blood away from the heart to the rest of the body when it gets down into the pelvis. It branches off and splits and goes into the legs. So an abdominal aortic aneurysm is most common in men who have smoked cigarettes. So men who are 65 or older. Who have ever smoked need a one-time abdominal ultrasound to test the size of their aorta and if it's above a certain whip then that's classified as an aneurysm and then that needs to be followed with more tests. So does that just happen at age 65 for men or do you have to have a history of smoking just to clarify that a little bit So it's more common in people who smoke 65 is not the age that it magically happens, but it's the average age where we're going to be able to find the most so the important thing to remember about a screening test is statistically we're looking for things that are common. that are the most common and relatively easy to find so if it's not, you know, like a mammogram they say start that at 40 do your colonoscopy at 50 so for The abdominal aortic aneurysm look at that, right? There's not like an age of hey, we're going to screen you for this now. Is that what you're saying? Well, it is age 65 is when it starts, but it's a one-time thing. So if you don't have an aneurysm at 65, you're very unlikely to develop one after that. Okay. So 65 year old male smoker smoker so non-smokers nonsmoker. Can develop aneurysms but it's much less likely. Okay, so there's there's not a recommendation for screening if you don't smoke, okay? All right. What about lipids screening? So yes in adulthood, everybody should be screened for lipid disorders. How often if it's normal every five years. Okay. What what are the feds? What are we even screening question? So lipids are cholesterol particles total cholesterol HDL, which stands for high density lipoprotein LDL stands for low density lipoprotein and try Sir Ides those are the typical ones that are on a test called the lipid panel. Mainly we're looking at the total cholesterol, but we're also looking at the LDL and triglycerides and the HDL because it helps us. Know the risk of developing heart disease in the future. Okay, so one avoid The wrong numbers on a lipid screening want to keep the numbers low if the numbers low. Alright then hypertension their screenings for hypertension. Well, there's not really a screening for hypertension other than having your Vital Signs checked when you go, you know for a guy for a checkup. And so when we're screening for that, basically it just means when you get your when you go see your doctor, they're going to check your Vital Signs and part of your overall. Less is making sure that your blood pressure is in a normal range. Then we give in to diabetes what types of screening are there for diabetes. So this kind of also falls in the category of the lipids where you should just have a one-time screening early in adulthood and it also means in your 20s that just yes that consists of blood glucose level and if it's normal Then periodically you should have it rechecked and every five years is probably adequate now. If you have a family history or you're at increased cardiovascular risk for some other reason like your cholesterol is high or your blood pressure is high then you may want to do a diabetes check yearly. Okay, so something else to talk to your doctor about getting on and most of these will be done at your yearly wellness exam. So it's important to get that done. So what about family history in these types of things and diabetes and high blood pressure and high cholesterol? Is that something that would make you want to talk to your doctor about more frequent screenings or earlier screenings, maybe not earlier. If you're following the general recommendations and having these things done early and adulthood in your 20s, but it may prompt your doctor to recommend a more frequently. So family history is is an and factor in cardiovascular disease and all of these things that were talking about cholesterol screening high blood pressure diabetes all of those contribute to cardiovascular disease, which is also known as heart disease heart disease. So cardiovascular disease includes heart disease and the process the same process that occurs in the brain that leads to Strokes. What about hepatitis C. Is that a screening that's done very often. Yes, it's recommended that our baby boomer population be screened one time for Hepatitis C. So no other Generation X or Z or Millennials or so high risk people should be screened high risk means people who use, you know, IV drugs or have had blood transfusions, although nowadays, that's not spread that way because that blood is screened, but people at high risk for Hepatitis C might need to be screened. Mostly, it's that baby boomer population that we're looking for right now. Okay, and then HIV their screenings for HIV there is there's just it's an HIV test and it's recommended that everybody be screened for that at some point. So if you haven't ever been screened it probably is good to be screened. Just your general practitioner the doctor you see every time can do that. Yep. Okay, it's just a blood test now just add it onto your regular blood tests with all the your cholesterol the other blood sugar and all those you're doing right so you can go into your doctor and say just give me all the letters. That's right. All the letters everything. Okay. All right, and then I think then the last screening that that we were going to talk about is a screening for depression. Chin, depression is something that is so common nowadays, and I don't know if everyone knows that there is a type of screening for it. There. Is this screening is a questionnaire and most Physicians or practices will have a system set up where they give the patient a questionnaire as a new patient and then maybe yearly after that. At your yearly well check your yearly well check you can get that done. There's also self-administered questionnaires that people can do online. And it's just it's a questionnaire that helps determine the risk that a person might have depression. And if you do one of those on your own and you see that you score high on that screening questionnaire, then it'd be something you'd want to talk to your doctor about. Okay. So that's going to do it for the inaugural episode of real Health chats. Thanks for listening. We know it might have been a little rough for this first go-round but stick with us, you can find us at real Health Jets.com on Facebook Instagram Twitter. We're out there everywhere and you can subscribe to the real Health chats podcast. I am Becky the doctor's wife. I'm dr. D We'll see you next time. We'll see you next time.
A Health Screening is a test that looks for a problem or disease when no symptoms are present. We recommend everyone have a yearly wellness visit with your personal physician and ask them about any screenings you may need. Pap Smear:  looking for cervical cancer cells or dysplasia (abnormal, possible precancerous cells). Begin at 21. If normal, repeat every 3-5 years. Human Papilloma Virus (HPV): responsible for most cervical cancers. Screening starts at age 30 and continues every 5 years. Breast Cancer Screening - Mammogram: Begin screenings between age 40-50 and continue every 1-2 years. Talk to your doctor about family history of breast cancer or other risk factors. Chlamydia Screening:  Sexually active women younger than 25. Men and women at any age with multiple sex partners. Screening is done with a urine sample. Prostate Cancer Screening:  Some recommend PSA (prostate-specific antigen), but some do not. We will have a full episode on men’s health to discuss this. Men should talk to their doctor about recommendations. Colon Cancer Screening:  Options include colonoscopy, fecal occult blood test and barium enema with flexible sigmoidoscopy. Most common and accurate is the colonoscopy which is recommended at age 50 unless at higher risk. You are at higher risk if you have a relative who had colon cancer and should discuss that with your doctor. During a colonoscopy polyps can be removed. Clear colonoscopies can be done every 10 years. Lung Cancer Screening:  Low radiation dose CT scan for people older than 65 who smoke or quit smoking less than 15 years ago and who have a 30 pack year history (1 pack a day for 30 years or 2 packs for 15 years) Abdominal Aortic Aneurysm Screening: This screen is looking for symptoms of an aneurysm in the largest blood vessel, the aorta. Men 65 or older who have ever smoked need an abdominal ultrasound to check the size of the aorta. If enlargement of the vessel is found, your doctor will follow up with more tests. Lipid screening:  Lipids are Cholesterol, Total Cholesterol, High Density Lipoproteins (HDL), Low Density Lipoproteins (LDL), and Triglycerides. Everyone should be screened for lipid disorders in adulthood and continue screenings every 5 years if normal. Keeping these levels in check will help reduce the risk of heart disease and stroke in the future. Hypertension Screening: at each doctor visit, vital signs checked, including blood pressure. Treat if it is high. Diabetes Screening:  Have a screening early in adulthood to get a baseline blood glucose level. If level normal, check again every 5 years. If there is a family history of high cholesterol, hypertension or diabetes, testing more frequently may be appropriate. When any of these are high it can contribute to heart disease and risk of stroke. Hepatitis C Screening:  All baby boomers (currently 55-75 years old) should be screened. People at higher risk include IV drug user or someone who has had blood transfusions. This is rare today because of improved blood screening practices. HIV Screening:  Everyone should be screened at some point, especially if you are at risk Depression Screening:  It is a questionnaire that you complete at your doctor visit that helps determine risk. You can also find and do a questionnaire on your own and talk to your doctor if you score high. Also, if you have any concerns without a questionnaire, if you have been feeling symptoms of depression or if you have a family history, please talk to your doctor. 