Annual checkup may catch problems
DEAR DR. K: I’m 73 and in great health. Do I really need to have an annual physical? (This column ran originally in October 2014.)
DEAR READER: Let’s start by defining “great health.” I would define it as having no known chronic (ongoing) illnesses. However, most people your age have at least one chronic illness, such as high blood pressure. People with chronic illnesses need to be checked out at least once a year, and usually more often.
There is not a lot of evidence that a complete physical examination is valuable. In fact, an analysis of 14 trials that included more than 180,000 patients did not find that a yearly general health checkup decreased the risk of death or illness.
But when a person has a symptom, parts of the physical examination can be extremely valuable. For example, I remember a man in his 50s who had no chronic conditions and exercised every day. He had a healthy diet. When I asked him if he had been having any bothersome symptoms, he answered “no,” but hesitated just briefly before saying it. So I pushed him: “Even a mild symptom that’s not very bothersome, but that is something new?”
He replied: “Well, sometimes I get this tingling sensation in my feet. It comes and goes.”
That gave me an idea, and influenced what I did on the examination.
I took a tuning fork and whacked it to make it vibrate. I asked him to close his eyes and to tell me when he felt the vibrations touch his skin. When I placed the tuning fork on his ankles, he said nothing.
Then it was time to order tests. I added a blood test for vitamin B12. His symptom of tingling, his inability to feel the vibration of the tuning fork made me suspect that his vitamin B12 levels were low — and they sure were. Fortunately, vitamin B12 pills prevented what could have been permanent damage to his spinal cord.
So, I’d advise you not to skip an annual visit to your doctor. You don’t need to have every nook and cranny of your person probed every year. But you do need certain questions asked, screening tests performed and immunizations given.