A few years ago, a private health-care foundation survey asked how often American men and women saw their doctor. Not surprisingly, adult males were infrequent visitors. In fact, one-third said they didn't even have a regular doctor.
Generally speaking, men make lousy patients. They avoid physicians like the plague until, well, they have the plague. Then maybe they'll make an appointment.
|MAN DATES - Generally speaking, men make lousy patients. They often avoid visits to their doctor until things get out of control. CNS Illustration by Cristina Martinez Byvik. |
"Society expects men to be stoic," said Dr. Arman Faravardeh, a general internist with the Scripps Mercy Medical Group in San Diego.
Society also expects men to reach their average life span of 75.6 years, and that typically means regular physical examinations.
"There's a common misconception among people, usually men, that you should wait until you actually feel bad before you see a doctor," said Dr. Carol Salem, a urologist and cancer surgeon. "Sometimes, that's too late."
As a public service, then, we offer this guy's guide to getting a physical. Medical advice is personal, dependent upon factors like age, weight, family history and individual circumstances.
This guide is only that, a collection of essential tips about what to get tested, how often, things to talk with your doctor about and an entirely subjective "annoyance factor index." The scale is one to 10, with 10 being most annoying.
Now be a man and go see your doctor.
VISION AND HEARING
How often: An eye exam every other year is recommended; annually if you wear glasses or contacts. Hearing tests are usually done only if you report a problem.
What to ask about: Vision naturally changes with age, especially after 40. Biggest issues: glaucoma, cataracts and age-related macular degeneration.
AFI: 3. The eyeball pressure test, which involves briefly touching your eyeball with a probe called a tonometer, can be nerve-wracking. But it lasts only a second or so. Just don't blink.
How often: Self-exams should be done occasionally; more frequently as you get older, if you have fair skin or if you spend a lot of time in the sun. (You're looking for moles, freckles or patches of skin that have changed in size, color or texture. The head, face, neck, hands and arms are most at-risk.) See a physician immediately if you spot something.
What to ask about: Basal cell and squamous cell cancer. Melanoma. Prevention.
AFI: 1. You might have to take off some clothes, but that's better than having a doctor take off part of your face later.
How often: Chest X-rays and such depend upon individual circumstances. Talk to your doc, especially if you smoke or once smoked. Get a tuberculosis test annually.
What to ask about: TB risk factors. How to quit smoking.
AFI: 1, the TB test involves a shot.
How often: A checkup and cleaning at least once a year, though twice is better.
What to ask about: Mouth cancer and periodontitis. The latter is gum disease and it's linked to heart attacks and strokes.
AFI: 2-5, depending. Daily flossing at home isn't fun, but it's better than having the hygienist band saw into your gums at the dentist's office.
How often: After age 18, a blood pressure check every two years. Cholesterol levels should be monitored, beginning at 35, with a blood test every five years; more often if you have diabetes, smoke or have a family history of heart disease. At 45, get a blood glucose screening for diabetes and repeat every three years. At 50, do a fecal occult blood test for colorectal cancer and repeat annually.
Tests like an electrocardiogram (EKG), which measures electrical activity in the heart, are usually done only if you have relevant risk factors or symptoms of heart disease.
What to ask about: The different kinds and roles of cholesterol and triglycerides. Ways to reduce high blood pressure and cholesterol levels.
AFI: 1, unless you're afraid of needles and blood, then it's a 2, wimp. Also, those 30-second blood pressure stands in malls and drug stores don't count as an official checkup.
COLON AND PROSTATE
How often: This is why most guys put off physical exams. You should get your first sigmoidoscopy or colonoscopy at age 50. If you don't know what these are, we won't spoil the surprise. Actually, men who've had them insist they're not so bad, but then misery loves company. The worst part is drinking the required gallon or so of purgative the day before the procedure. The liquid comes in a variety of flavors; all are vile. You should have the procedure every three to five years.
After age 50, get a double contrast barium enema every five years.
Prostate cancer is the most common type of cancer among men (and only men) in the United States. Most men, if they live long enough, develop prostate issues. For these reasons alone, you need to do a couple of things every year after age 50 (for African-Americans, it's 45): get a prostate-specific antigen (PSA) test and a digital rectal exam.
What to ask about: The PSA is a blood test, so it's simple to do, though you should inquire about risks of false positives and unnecessary biopsies. As for everything else, your doctor can best explain it. You should be sitting down. For the moment.
How often: Get a flu shot every year. It's a myth that only the very young and old need them or that the side effects are worse than the disease. After age 19, get a tetanus-diphtheria booster shot every 10 years.
What to ask about: Other possible immunizations, such as a one-time herpes zoster vaccine at age 60 and a one-time pneumonia vaccine at age 65.
AFI: 1, unless you suffer from trypanophobia - an irrational fear of injections.
Calculate your body mass index. It's easy to do, just plug in the requisite numbers into the BMI formula, which measures body fat based on height and weight. You can use the National Heart, Lung and Blood Institute's calculator at nhlbisupport.com/bmi. Normal weight range for adult men is 18.5-24.9. The higher the number, the fatter you are. The BMI isn't foolproof. Athletes with lots of muscle can score high. But it's a good starting point.
If necessary or upon medical advice, get tested for HIV or sexually transmitted diseases.
If you've ever smoked, get a one-time test at age 65 for abdominal aortic aneurysm, which is an abnormally large or swollen blood vessel in the abdomen.
Pay attention to your body. For better or worse, it's the only one you've got.