New Year’s Resolutions

Did you make New Year’s resolutions? Diet? Stop smoking? Good for you, but as we begin 2015, please consider adding a few more items to your “To Do” list for this year. We will mention recommendations first for all people in general, then those specifically for men, and finally recommendations for women. All:
1. Update your immunizations. For most adults, these would likely include immunizations for influenza, pneumonia (1 or 2 shots), tetanus and pertussis (whooping cough), and shingles.
2. Check and know your numbers. Know your blood pressure and know what’s normal (18-59, less than 140/90, age 60+, <150/90). These are the latest general recommendations, but there are many considerations depending on age, race, and specific conditions. Know your total cholesterol, as well as the breakdown of the good and bad cholesterol. If you have diabetes, know your sugar before breakfast (fasting) and supper, and know your A1C. A1C is the number that indicates diabetic control over a period of a month or so and doesn’t depend on the hour by hour fluctuations in sugar with meals and exercise.
3. Get a screen for colon cancer, which is largely preventable with meticulous adherence to screening recommendations. Get a check for hidden blood in the stool annually, and a colonoscopy every ten years if previous is normal.
4. If you’re a baby boomer, ask your provider for a blood test for hepatitis C, a liver virus common in this age group.
5. If you use tobacco in any form, make this the year to stop. Your primary care provider (PCP) can help. Limit alcohol intake, if at all. Men should drink no more than 2 drinks per day, and women should limit to one. Of course, if you are pregnant or think you might be, don’t drink alcohol at all. Do not use drugs — oral, inhaled, or intravenous. Seek help if you think you might have a problem with addictions.
6. Get a screen for depression and partner violence.
7. Consider a screening ultrasound for peripheral vascular disease and aneurysm. This will include checking the carotid arteries in the neck that could lead to stroke, the abdominal aorta for an aneurysm (dangerous bulge), and the arteries in the legs for blockages that could lead to non-healing ulcers and even the loss of a limb.
8. Get a screen for diabetes, especially if you have high blood pressure.
9. Practice safe sex and avoid serious to life-threatening sexually transmitted infections. Limit sexual partners.
10. Consider taking a daily 81 mg coated aspirin (“baby aspirin”) to help prevent stroke and heart attack.
Men:
1. Get an annual prostate check at your PCP office that includes a blood test for PSA (prostate specific antigen).
2. Erectile dysfunction is common after age 50, and it can be treated. But not if you don’t ask, so don’t be shy.
Women:
1. Get an annual mammogram and clinical breast exam at your PCP office.
2. Make sure your Pap test is current. Testing now begins at age 21, and should be done every 3 years through age 29. At ages 30-65, the testing interval can be extended to 5 years if “co-testing” is done and negative. Co-testing refers to doing both the Pap test and a test for HPV (human papilloma virus).
3. At age 65 and over, get a DEXA screen for osteoporosis (thinning bones that increase risk for fracture).
These are the latest general guidelines and recommendations. These should only be pursued in a team effort with your PCP. If these seem complicated or overwhelming, remember that you only need to remember to have at least an annual checkup with your PCP. You do have one, right? Wishing you all a happy and healthy 2015!

Dr. Fleming is the Medical Director of The Jane Pauley Community Health Center (closely affiliated with Community Health Network). Ideas for this column can be e-mailed to Dr. Fleming at AskDrFleming@gmail.com. Or you can write your medical questions to Dr, Fleming at Ask Dr. Fleming, 8931 E. 30th Street, Indianapolis, IN 46218. On written correspondence, please include your name and city (names will not be published).