DEAR DR. DONOHUE: My husband, age 53 and in good health, has an appointment for a complete physical with our family doctor. Please tell me what it covers and what we can expect. We want to make sure nothing is skipped. – D.P.
ANSWER: There is a controversy about the value of yearly physical exams, but many strongly feel that they’re useful tools for the early detection of disease.
What’s done varies with the doctor, with the patient and with the age of the patient. Height, weight and blood pressure are always recorded. The doctor examines the eyes, ears, nose, mouth and throat. In examining the eyes, he or she checks for cataracts and signs of macular degeneration. For those between 40 and 65, a glaucoma test should be done every three to five years, and for those over 65, it should be done yearly or every two years. In the neck, the doctor feels for nodes and determines the size of the thyroid gland. I won’t mention the obvious examination of the chest, heart and abdomen. Men and women should have a rectal exam, and in men, the doctor feels the prostate gland for its size and any lumps. The pulse is felt at many points. Women should have a pelvic exam and a Pap smear, depending on their age and their past history.
For lab tests, a complete blood count and a chemistry profile are usually ordered. The latter includes tests for kidney and liver function, blood sugar, and cholesterol, including HDL and LDL cholesterol and triglycerides. A thyroid test is often included. Men are usually given a PSA test for prostate cancer, even though the test is an imperfect one. The doctor gives the patient cards on which to place three different stool specimens for blood detection. It too is an imperfect test but is usually done. An electrocardiogram is frequently done.
Beginning at age 50, people should have a colonoscopy to detect polyps and colon cancer.
I don’t think I’ve missed anything. Some doctors do more; others, less.
DEAR DR. DONOHUE: My grandmother won’t let my grandfather fall asleep after eating a meal. She yells, “Are you awake?” and she shakes him to make sure.
She said she heard about a man who fell asleep after a meal and never woke up. I tried to tell her it’s natural to sleep after a meal, but she won’t take her grandson’s word for it. Maybe she’ll take yours. Can you clear this up so my grandfather can catch a few well-deserved winks? – J.M.
ANSWER: Your grandfather isn’t courting death by taking a nap after eating a meal. If napping interferes with his nighttime sleep, then he should cut down the nap time.
If I fell asleep at your grandmother’s house and she yelled at and shook me, I’d be in danger of a stress-induced heart attack. On this subject, your grandmother can listen to her grandson’s advice.
DEAR DR. DONOHUE: I have read that too much vitamin A is unhealthy. What would be an indication that a person has taken too much vitamin A? What is the recommended daily amount? – M.P.
ANSWER: Vitamin A has many valuable functions. It preserves night vision. It keeps the skin, hair and nails healthy. It promotes growth of all body cells. It keeps the immune system working properly. Too much vitamin A, like too much of anything, is definitely unhealthy. It decreases bone density and leads to broken bones.
Taking huge doses of the vitamin over a short period of time causes vitamin A toxicity. People become nauseated, vomit, have a horrible headache and are often dizzy. Excess vitamin A can damage the liver. Such toxicity occurs only when people go hog-wild with the vitamin or when they eat foods that are jam-packed with it. Bear liver is an example.
The recommended daily allotment of vitamin A for an adult woman is 2,300 IU (700 mcg), and for an adult male, 3,000 IU (900 mcg). That limit should not be exceeded by much unless the doctor has given a person direct orders to take extra amounts.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.
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