Thursday, May 3, 2012

Just Look In the Mirror

I read an interesting article yesterday on the Fox Business website titled DIY health care: The trouble with direct-to-consumer health screenings. DIY stands for Do It Yourself.
The gist of the article describes the dangers associated with participating in unsolicited screening tests offered by commercial, usually mobile, companies. The article states that if "you get a letter in the mail inviting you to participate in a simple, potentially lifesaving screening to assess your risk for stroke, abdominal aortic aneurysms and other scary stuff, you should probably toss it out with the rest of the junk mail."

The article gives several reasons. One reason is the perils of self-diagnosis. (See my blog from March 14 titled, Are You A Doctient?) The article states, "People might buy direct-to-consumer health screenings for their own self-diagnosis and self-treatment for symptoms of disease. "It's difficult for the lay public to really appreciate the nuances and wholly understand the difference between screening and diagnostic testing. Many patients seek screening tests for symptom diagnosis. These patients can be dangerously falsely reassured by normal results if they have chosen the wrong test, or even led in the wrong direction with abnormal results."
The article adds, "Additionally, many of the medical screening tests are not supported by evidence-based guidelines and therefore expose patients to tremendous and unnecessary harm. "The data has shown that many of these tests [when used for disease screening] will produce far more harm than benefit for most patients." (See my blog on April 5 about unnecessary tests).  
One more consideration. According to Linda Sherry, director of national priorities for Consumer Action, agrees. "These tests have limited or no diagnostic value and may trigger stress [and] fear, and encourage further, more expensive testing to rule out false positives. Insurance won't pay for them unless they are ordered by a doctor for diagnostic reasons, not preventive reasons."

If you're looking to save money, "you can take your own blood pressure at most pharmacy chains and many communities have health screening days designed to educate people about symptoms that might require follow-up," says Sherry.

On a personal note, I participated in such a screening program about a year ago offered by Lifeline Screening. I went for the whole megilla. I did so as part research and part curiosity. A routine blood sugar measurement revealed that I had a 105 level. Such a level is construed as elevated. (by the way, I noticed the tech eating a fruit shortly before th test and contact witht eh fruit could have skewed my result.) 
When sharing the blood results with me, the concerned technician told me that I was pre-diabetic and I should "watch" my number. The absurdity of the statement struck me immediately. What did "watch" my number even mean? He didn't tell me to consult with a physician. He just told me to "watch." Did he mean for me to use his services again to see how the number changed? He didn't say, but I suspect as much. Being pre-diabetic is a warning sign that requires intervention before you progress to full blown diabetes. Telling me to "watch" my number was worthless.

So what's a person to do?  I say instead of relying on marketing solicitations for tests that you probably don't need and should generally only be ordered by a physician when you do need them, let me offer some practical alternatives.

First get on a scale. Then calculate your BMI. Here's a good site to calculate it:
http://www.nhlbisupport.com/bmi/  
If your BMI is over 25, you are in unhealthy territory. Over 30 you are in a real danger zone. Over 40, start saying your goodbyes if you don't do something immediately about it.
Next measure your waist circumference. If you have a bulge around your waste, that typically means you are accumulating the unhealthy type of fat cells called white fat cells. They predict problems and just like with an elevated BMI, you should initiate changes to your lifestyle to improve your health prospects.  I recommend starting with a physician consultation and then moving on to a nutritionist and fitness instructor. If stress and/or sleep are a problem, consult a psychologist as well.
Finally, take a long, hard look at your naked self in the mirror. Do you see a healthy, vibrant, relaxed, age appropriate person in the mirror or a tired, slumped, over- or under-weight, stressed-out individual? Be honest with yourself. If you look good, you probably feel good and you are probably doing well. But if you look worn-out, haggard, depressed, older than your age, I think it's time to get serious about your health and to develop a personal wellness plan.By the way, while you are looking, check for any abnormal growths on any aspect of your body front and back, top and bottom.

Try doing this once a month to take stock of your life and health. It's free, it's easy and it will provide much valuable information that will not lead to unnecessary and expensive testing. So the next time you get a solicitation from a testing company, try making an airplane out of it for fun. Nevertheless, listen to your body and if you have any concerns, consult a physician.

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