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MEDICAL EXAMS and WELL-DAYS
There is no question that the doctor's expertise is urgently required when a person is not well. But there has been much discussion about the importance of regular visits to the doctor for physical examinations by those who are well. Many people today never visit a doctor unless something is seriously wrong. It is very difficult to value regular exams in terms of years of potential life saved. Life Ahead does include a Well-Days number for a lack of regular exams primarily to remind users that they have a potential benefit for making such regular visits. But this number is not accurate or validated, may be quite conservative, and some people can have a dozen or more years of life saved by a finding from regular medical exams.
The doctor's help can be most useful for helping reduce risk of the key cardiovascular diseases and cancer considered by Life Ahead. Although most heart attacks occur outside the doctors office, an electrocardiogram can identify a specific case of heart disease. Once so identified by an exam, or identified from other occurrence, individuals usually are motivated powerfully toward better future health habits. More than half of those still smoking may be then motivated to quit - a fraction far larger than can be motivated by other means..
An unhealthful cholesterol only can be identified via an exam and an accompanying blood test. Today's drugs for cholesterol lowering are very effective and usually reduce future risk of heart disease by about 33%. This can extend life by up to 2-3 years of Well-Days. 12-15 million US people today are estimated to be benefiting from these drugs.
Our population average level of blood pressure moves into the hypertensive range after ages 60-65. And vast numbers of people become hypertensive at earlier ages. By identifying such and prescribing appropriate blood pressure medication the future risk of stroke and heart attack can be reduced significantly, with potential additions of 2-3 or more years of Well-Days for those so treated.
The early detection of breast cancer via mammograms can add 160 Well-Days for an average woman and up to 400 more Well-Days for one at quite high cancer risk. Benefits of mammograms are identified separately in Life Ahead. Internal exams can help women perhaps similarly, and benefits of these are identified separately herein. And exams also can identify early colon, rectal and other cancers. For men, the PSA test can identify early prostate cancer and suggest effective life-prolonging treatment
Adult onset diabetes occurs far too often today to adults that least suspect such a problem. A regular doctor visit can identify this problem, and initiate treatment that could prevent some serious future health damage. Doctors may identify one or more of a vast number of differing health problems from observations made during a regular exam.
Many people today have a variety of nutritional problems that require specialized diets that will differ from the most healthful diets of the majority. This presents them with new problems for maintaining diets that meet the specialized needs and that still provide best long range protection from the major life-terminating diseases. Again, the doctor can identify these kinds of problems. And Life Ahead can develop from any starting diet restrictions an approach for maximizing its health benefit potential.
How often should regular visits to the doctor be made? There has been much study of and argument about this. But most studies have aimed to identify how medical exams save future health costs. This has little meaning or relevance to the individual interested in prolonging his or her own Well-Days of life. And exams may or may not be covered by medical insurance. The mammogram model that could be verified scientifically suggests that exams at 2 year intervals for those over age 50 may be adequate. But breast cancer develops slower than do some other diseases. An annual exam for most health-interested people over age 50 would appear to be a desirable target. And an exam at least every two years would appear to be a minimal goal for good future health. Once individuals obtain regular prescriptions for permanently needed medications, they usually will be called back for periodic visits.