You’re in your 40s. You have settled into your life. You know who you are. You’ve probably chosen a career path. If you have children you are watching them grow. And chances are you have settled into a busy routine that works for you.
As we enter mid adulthood, we become more prone to risk of disease. Degenerative disease is no longer something in the far-off future, but something we have to consciously avoid by making changes in our diet and lifestyle.
But with so many things going on, how in the world do you maintain your health after having so many different obligations?
All it takes is setting aside a few hours to see your doctor for a checkup.
But what happens in this process? What are they looking for? We reached out to one of our most trusted resources on the topic.
Keck Medicine of USC’s very own Assistant Professor of Clinical Family Medicine, Dr. Rose Taroyan, MD, MPH goes into detail about exactly what she and her staff look for when you go to visit the doctor’s office in your 40s:
1. Heart Disease Prevention
When you are in your 40s, the first thing your primary care physician is going to want to check is your risk for heart disease. The goal here is to prevent cardiovascular disease and reduce the risk of a myocardial infarction, also known as a heart attack.
If anything looks out of the ordinary, physicians like Dr. Rose Taroyan will be able to provide you with tips and instructions on how to keep it under control.
If you are a man in between the age of 45-79, your primary care physician is going to prescribe aspirin to you to help prevent cardiovascular disease.
2. Diabetes Screening
After your heart is checked, the next thing your primary care physician will do is screen you for diabetes. This goes on regularly from the ages of 40 to 70. There are many risk factors for diabetes, such as being overweight, obese or experiencing hypertension or hyperlipidemia.
Based on your results, your doctor will be able to help provide you with treatment options.
3. Dyslipidemia Screening
Your primary care physician will then do a screening for dyslipidemia. Big word, I know! It means checking for an abnormal amount of cholesterol or fat in the blood.
- Screenings, without risk factors are discussed for men who are at or above the age of 35.
- Screenings, along with risk factors are discussed for women who are at or above 35 years old, but without risk factors for women at or above 45 years old.
4. BMI Evaluation
The next thing your primary care physician checks for is your BMI. Your BMI is your Body Mass Index. In other words, it is a value that you get when you combine your weight and height. This number indicates how healthy you are.
During this process, your primary care physician is going to do an obesity screening. If this value seems out of the ordinary, counseling will be provided.
This is a good time to talk to your primary care physician about your:
- Physical activity
- Daily habits
This discussion will determine whether there should be some counseling on:
- Exercise tips and activities
- Eating habits (consuming 5 or more servings of fruits or vegetables daily)
- Preventing heart disease
- If you are a woman and you are either planning or capable of pregnancy, folic acid supplementation will be discussed as well
5. Depression Screening
While seeing your primary care physician, they will be checking for signs of depression. If you feel down or think you may be suffering from depression, be honest with your doctor.
During this screening, they will go through a quick and simple test that consists of 10 questions:
- Little interest or pleasure in doing things?
- Feeling down, depressed, or hopeless?
- Trouble falling or staying asleep, or sleeping too much?
- Feeling tired or having little energy?
- Poor appetite or overeating?
- Feeling bad about yourself, or that you are a failure, or have let yourself or your family down?
- Trouble concentrating on things, such as reading the newspaper or watching television?
- Moving or speaking so slowly that other people have noticed. Or the opposite – being so fidgety or restless that you have been moving around a lot more than usual?
- Thoughts that you would be better off dead, or of hurting yourself in some way?
- If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
Your answers are recorded in between 0 to 3, depending on whether you have these feelings:
Not at all = 0 points
Several days = 1 point
More than half the days = 2 points
Nearly every day = 3 points
Based off these scores, your doctor will be able to tell you if you suffer from no depression, minimal depression or major depression. This will help your physician be able to identify whether or not you may or may not need an antidepressant or even psychotherapy.
6. Anxiety Screening
In your 40s, you have responsibilities, both to your health and to your children. That could make anxiety a factor in your life. After the depression screening is complete, another quick screening is done to identify your level of anxiety.
The quiz looks like this:
Over the last 2 weeks, how often have you been bothered by the following problems?
|Not at all||Several days||Over half the days||Nearly everyday|
Feeling nervous, anxious, or on edge
Not being able to stop or control worrying
Worrying too much about different things
Being so restless that it’s hard to sit still
Becoming easily annoyed or irritable
Feeling afraid as if something awful might happen
7. Alcohol misuse (CAGE) – screening and behavioral counseling interventions
Your primary care physician is going to want to check for is alcohol misuse through a screening and behavioral counseling interventions.
This starts off by identifying your CAGE score. To figure this out, your primary care physician will ask you 4 simple questions:
- Have you ever felt you should Cut down on your drinking?
- Have people Annoyed you by criticizing your drinking?
- Have you ever felt bad or Guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye-opener)?
A total score of two or greater is considered significant.
8. Tobacco use counseling and pharmacotherapy intervention
During the checkup, your doctor will be asking about your use of tobacco, providing counseling (if necessary) and discussing pharmacotherapy invention (if needed). Pharmacotherapy invention is basically medication to help end tobacco use: for instance, nicotine gum, the patch or prescription pills.
9. Nutritional counseling and physical
In your 40s, diet is key to maintaining a long life. Your primary care physician will ask you about what you are eating, what vitamins you are taking and how much physical activity you are involved in each week. A plan will then be laid out to prevent damage to the heart’s major blood vessels.
10. Domestic violence screening
Some people end up in homes with domestic violence and they don’t know where to turn. If something is happening in your life and you have been looking for someone to share it with, discussions with your primary care physician are safe.
Request an Appointment!
Understanding what your primary care physician is looking for will help you be prepared for your visit. Remember, both you and your physician have the same goal – to keep you healthy. If your current doctor is missing out on some of these crucial screenings, maybe it is time to consider a new primary care doctor.
If you are in the Los Angeles area and are looking for exceptional care from some of the top physicians in the world, be sure to schedule an appointment by calling (800) USC-CARE (800-872-2273) or by visiting http://www.keckmedicine.org/request-an-appointment/
By Leonard Kim