Defining the HEALTH Program:
(Heart Evaluation, Ancillary and Laboratory Testing for Health Program)
Heart Evaluation:
Twelve-Lead Electrocardiogram
EKG Rhythm Strip
Framingham Risk Calculation
Heart Age Calculation
Peripheral Arterial Disease Screening Ankle-Brachial Index
Abdominal Aorta Aneurysm Screening by ultrasound
Ancillary Testing:
Lung Function-Pulmonary Function Testing, Oximetry Measurements
Heart Function-EKG
Vision Testing-Acuity, Intra-ocular Pressure, Color Vision
Cognitive Testing: Memory, Mood, Alcohol Risk Analysis
Hearing Evaluation – Audiogram
Sleep Disorder Screening
Fitness Assessment/Get up and Go assessment
Body mass composition analysis
Laboratory Testing:
Comprehensive Biochemical Screening
Some of the most dangerous diseases in America are related to high blood pressure, high cholesterol, and abnormal glucose metabolism. Using statistical data from the Framingham Study I am able to calculate your risk of developing an acute event related to cerebrovascular disease, coronary artery disease, or peripheral vascular disease over the next 10 years. Understanding risk opens up opportunity to intervene and prevent medical disease from ever causing harm. Understanding glucose metabolism, blood pressure, and cholesterol help us to be sure that we are treating to the most appropriate levels to maintain wellness and prevent disease. In order to minimize the risk of developing cardiovascular related diseases we monitor the ankle-brachial index, explore advanced lipoprotein markers, measure nutritional parameters and look for signs of disease. Cardiovascular risk factors include: family history with a first degree male relative having heart disease before age 55 or a female relative with heart disease before age 65, male gender, diabetes, smoking, metabolic syndrome, abnormal cholesterol numbers and hypertension.
The metabolic syndrome is an early form of diabetes. It is made up of any three of the folowing components: (1) abdominal obesity (greater than 35 inches in females and greater than 40 inches in males), (2)peripheral vascular disease, (3)elevated blood pressure (greater than 130/85), (4) elevated triglyceride level (greater than 150), (5) elevated glucose level (greater than 100), or (6) low HDL cholesterol (less than 40 mg/deciliter in men and less than 50 mg/deciliter in women).
During your physical examination I examine your eyes to look for signs of diabetes, high blood pressure, elevated pressure in the brain, or other medical diseases. I test each of the 12 pairs of cranial nerves. I examine your circulatory system looking for signs of peripheral vascular disease, venous insufficiency, coagulation disorders, heart valve disease, anemia, and congenital or acquired blood vessel diseases. I examine your lymphatic system looking for signs of lymphoma, infections, or other diseases. Examining your heart is especially useful in determining diseases of the cardiac conduction system, heart valves, heart muscle, and covering of the heart (pericardium). The pulmonary/chest examination allows me to discern problems with ventilation or diseases that affect airflow into or out of the lungs as well as diseases of the lung tissue. Diseases that can cause fluid in or around the lungs can be detected on physical examination. Examination of the endocrine system including the thyroid gland, and other hormone-mediated abnormalities can also be detectable by examination of the nervous system, the skin, and the organs which can reveal usual and unusual disorders. Listening to the liver and intestines is a great way to find tumors, blockages, and arteriovenous malformations. The rectal examination allows us to test for the presence of microscopic blood in the stool as well as evaluate the muscles of the lower GI tract. This gives another opportunity for screening for rectal cancer. Examination of the genitourinary system provides information about cancers, potential sexually transmitted diseases, and the hormonal system. Evaluating the prostate gland in males is part of a complete physical examination. Testing the different reflexes and different forms of sensation of the fingers and toes is a good way to screen for peripheral neuropathy, poisonings, brain tumors, and diseases of the spinal column. Balance testing looks at musculoskeletal strength but also at the cerebellar function or balance function of the brain.
A complete physical examination along with the HEALTH Program allows us to look at each of the organ systems including the brain, thyroid, heart and circulatory system, pulmonary, GI, pancreatic, neurologic, skeletal including bone marrow, and other systems of the body. A comprehensive HEALTH Program with a detailed history including use or exposure to tobacco, alcohol, or other hazardous substances as well as family history and present or past physical and emotional stresses are all important in assessing your individual health.