BY JILL L. HECHTMAN, M.D.
All horse people lead busy lives. Trainers, grooms, riders, sales people, farriers, and veterinarians have physically and mentally draining days. So what can we do to maintain a healthy lifestyle?
No judgment here, because as a busy doctor, I too neglect myself. I have to make an effort to ensure I am practicing what I preach. Time is an obvious barrier to seeking care for many of us, but it’s also hard to know what we need and when in terms of preventive care.
Prevention is key to good health, and now is a great time to incorporate it into your 2020 resolutions to be healthier. My goal is to break it all down so it’s easier for you to prioritize yourself. I can’t cover everything, as everyone is different, but I’ll touch on the basics and let your doctor make their own recommendations for you.
Preventive care is care that focuses on evaluating your current health status when you are symptom free, and taking the necessary steps to maintain your health. This type of care includes counseling, education, immunizations, and screening. The appropriate services will vary from person to person based on age, gender, and other risk factors. This includes your family medical history. I think it is also important to point out that you should know your own personal health history, including what medicines you take. Most doctors don’t know what the pink pill with the letter F is. I recommend creating your own personal health history that you carry in your wallet. This is specifically important in case of an emergency.
In general, it is best to start with a primary care physician, like an internal medicine or family practice physician. I like to think of them as the captain of the ship. They do all of the routine screening and can assess whether you need a referral to a specialist. Some people choose their OB-GYN as their primary care physician. Make sure you let your doctor know that is your plan so they can order the correct screening tests. Some OB-GYNs consider themselves specialists, so you want to ensure you are being tested for everything.
For people of all genders
• Yearly wellness visits. This will include height, weight, and vital sign screening.
• Diabetes screening. A blood glucose test will be very important in patients who are obese or have chronic hypertension.
• Cholesterol screening. The age at which this becomes important depends on your gender and your risk factors for coronary heart disease. Increased risk factors for coronary heart disease include family history, smoking history, hypertension, diabetes, atherosclerosis, and obesity.
• Colorectal cancer screening. Everyone 50 years and older needs this test. If there is a family history, you may need to begin sooner.
• Immunizations. All that are recommended by the CDC. Speaking of, have you had your flu shot yet? Influenza is a dangerous and potentially fatal illness.
• HIV/Syphilis screening. This is recommended for anyone at risk and all pregnant people.
• Alcohol use screening and counseling.
• Depression screening.
• Behavioral counseling to promote a healthy diet.
• Sexually transmitted infection screening and counseling for everyone sexually active.
• Contraceptive education.
• Smoking prevention (this includes vaping).
• Screening for Hepatitis B and C for at risk individuals.
• Screening for anemia.
• Routine prenatal obstetrical visits.
• Genetic counseling and evaluation for BRCA testing to evaluate breast cancer risk.
• Cervical cancer screening including HPV screening, starting at age 21 through age 65.
• Mammograms starting at age 40, and getting them yearly.
• Osteoporosis screening for those age 65 and older.
• Prostate cancer screening for those age 40 and over.
• Abdominal aortic aneurysm screening, a one time screen for those between the ages of 65-75 with a personal history of tobacco use
For children and adolescents of all genders
• Wellness visits with your pediatrician
• Immunizations on the schedule recommended by CDC
• Screening for depressive disorders
• Obesity screening
• Sexually transmitted infection counseling, prevention, and screening
• Vision screening
Tips for talking with your doctor
• First, be honest – really honest. Because leaving something out could prevent us from testing for something you actually need. We are not here to judge you, we are here to help you.
• Prepare for your visit by making a list of concerns and questions. Often, everything falls out of your head the second the white coat walks in!
• Bring that personal health history I recommended you make, including your medical problems, past surgeries, specific meds and dosing, other doctors you see, and any supplements you may be taking.
• Make sure you don’t forget to tell your doctor about any recent changes. For instance weight loss or gain, ER visits, change in appetite, or sleep issues
Overwhelmed? Don’t be. The key here is actually making yourself the appointment and getting in. Cheers (in moderation) to 2020!
This article was originally published in February: The Stallion Issue 2020 of The Plaid Horse Magazine. Read the full issue here: link