For The Over-50 Crowd - Medical Tests You Have Done Regularly

Discussion in 'Everything Else' started by Steve Freides, Jul 7, 2019.

  1. Steve Freides

    Steve Freides Forum Administrator Senior Certified Instructor

    For the Over-50 crowd:

    I'm curious as to medical (or other) tests people have done from time to time. I'll share my own:

    When I was 16 years old, my father, who was 46, had a heart attack. (It was a pretty frightening time in our house - I became the "man of the house" in some senses, e.g., I wrote the checks to pay the bills and other, similar things my mother simply had never done and didn't want to learn how to do. My Dad was in the hospital for a month, and at home for another month before he went back to work.)

    When I turned 46, the age at which my father had a heart attack, I asked my doctor if there was test or procedure I could have done to know if I was following in my father's footsteps or, I hoped, doing better. The procedure my doctor recommended was a Cardiac CT for Coronary Calcium. Apparently, the plaque that can build up in your coronary arteries and cause a heart attack is composed largely of calcium, so by detecting that, doctors can have a fair idea if your coronary arteries are partially block. The results are given as a score - under 100 and you're in good shape, and over 400 and you have significant blockage.

    I got a zero.

    Recently, I turned 64, so perhaps it was the appearance of the same two digits in my age that caused me to have the procedure done again. I got a zero again, so I'm pretty happy about that.

    It's a relatively inexpensive - about $150 - procedure. When I had it done 18 years ago, insurance covered the charge. Now, I'm apparently too healthy otherwise so I paid the $150 out of my pocket to have it done.

    Anyone else have a similar thing, a "just to be on the safe side" test they have done periodically, perhaps related to family history, occupational hazards, or similar?

    -S-
     
  2. offwidth

    offwidth More than 5000 posts

    Colonoscopy
     
    Billy59 likes this.
  3. Steve Freides

    Steve Freides Forum Administrator Senior Certified Instructor

    I had one at 55, and a second one at 63. Seems to be no real need in my case, instructions both times have been "come back in 5 or 10 years." But my understanding is that most people probably should have more often.

    -S-
     
  4. North Coast Miller

    North Coast Miller More than 2500 posts

    I had a CAT scan of my lungs at 39, more to provide a comparison if needed down the line than for any symptoms - my mother died of lung cancer and I smoked for 20+ years. At the time it was considered a useful diagnostic test but ultimately was leading to too many false positives/unnecessary biopsies - is no longer used or recommended in that role IIRC.

    Still haven't had a colonoscopy yet, need to schedule one.
     
  5. Steve Freides

    Steve Freides Forum Administrator Senior Certified Instructor

    I guess we are all trying to keep track of things we know might be issues for us as individuals, based on family history and past health issues.

    I'll repeat one story that I told here at the time it happened - when it was 15 years after my back injury, I went to see my back doctor. I told him I thought it was time for him to see how I was doing since I felt I had some stiffness and loss of range of motion in my left ankle and my right hip. He did examine me, but then told me that what I did on a daily basis was what they prescribe as therapy, and even though I did actually have 15 degrees less ROM in my right hip than my left, they were both very far above normal. So he looked at me and said, "I guess you were thinking we might take some pictures and do a workup on you - well, that ain't gonna happen."

    As I left, I asked him if I should come back in another 15 years, and he said yes. G-d willing and the creek don't rise, I'll see him again in 2027.

    I am very happy I never started smoking - best of luck to you with that, @North Coast Miller.

    -S-
     
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  6. North Coast Miller

    North Coast Miller More than 2500 posts

    @ Steve Freides
    Theoretically I'm in pretty good shape. Normally after 10 years smoke free your odds drop to about the average for non smokers - the wife and I have been smoke free for over 15.

    Still need to have that colonoscopy, and haven't even had my prostate checked in a handful of years.
     
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  7. Denny Phillips

    Denny Phillips Triple-Digit Post Count

    After having initial onset atrial fibrillation at age 41 I have an EKG or two every year. Fortunately for me I know when I experience an ectopic beat (PVC or PAC). Otherwise I just make sure I keep up with routine primary care visits. One colonoscopy so far, they said to come back in ten years. Hopefully, by that time there will be something that agrees with me more than Versed, I really don't like that stuff.
     
  8. Anna C

    Anna C More than 5000 posts Elite Certified Instructor

    If you want a REALLY thorough check-out, volunteer to be a living kidney donor! :D
     
  9. Snowman

    Snowman Quadruple-Digit Post Count

    This is awesome. The predictive value of cholesterol (which is pretty good in most cases) is peanuts compared to a coronary artery calcium scan.

    It's worth pointing out that, once again, Steve demonstrates how consistency and intentionality leads to exceptional outcomes in an otherwise normal individual. According to the Multi-Ethnic Study of Atherosclerosis percentile calculator (here) Steve is well underneath the first percentile for coronary calcification. Literally, at the top of the top 1%, with regard to hearth health.

    There's another MESA calculator (here) that takes into account a few more variable and gives you an 5 and 10 year risk.

    Take my opinion with a grain of salt, coming from a young buck, but I think about the things that tend to kill the most people. Know your risk for heart disease and diabetes so you can stay on top of them. Wear a seatbelt. Don't do drugs, smoke, or drink too much. Get screened for cancer. Get your vaccinations, and see someone if you're getting hit by an exceptionally rough bug. If you struggle with mental health issues, stay on top of them (even if they don't kill you, they will likely influence the thing that does). Not much else you can do, beside looking both ways before crossing and not attempting to pet the bison at Yellowstone Park.
     
  10. Steve Freides

    Steve Freides Forum Administrator Senior Certified Instructor

    It's a complex issue. Traditional interpretations of the numbers are just plain wrong. My total is high, but my number for the good stuff, which we now know to be not only _not_ bad for you but actually _protective_, is very high.

    IDK if you know this already, @Snowman, so please forgive me if I'm preaching to the choir.

    -S-
     
  11. Snowman

    Snowman Quadruple-Digit Post Count

    I hear ya, big time. Traditional interpretations work on populations similar to the study populations, i.e., sedentary people who eat a varied diet that includes lots of processed food. For someone in that population, high LDL is often predictive of future cardiovascular issues. If you eat differently or train regularly, then a lot of that predictive value goes out the window. Not only that, but it's incredibly common for a sedentary person who eats a SAD diet to have pretty decent cholesterol, and suddenly have an "unexpected" heart attack. I guarantee you that person has a considerable amount of calcium in their arteries.

    So yes, there is a lot to be desired with our current methods of trying to predict and prevent cardiac event. Personally, I think we should toss out cholesterol and just give everybody a CAC scan every 5 years or so. The extra cost could be offset by people actually having information that they can act on effectively.
     
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  12. Steve Freides

    Steve Freides Forum Administrator Senior Certified Instructor

    @Snowman, my doctors (two of them, actually) have both told me that my high number for the good cholesterol is not only _not_ bad, it is predictive of a less-than-average likelihood of a cardiac event/problem. It is protective.

    -S-
     
  13. mprevost

    mprevost More than 500 posts

    The predictive value of total cholesterol and LDL cholesterol are both pretty poor. They are especially poor for those with insulin resistance (which is 30-50% of the population), because they tend to have small, dense LDL particles. The better predictor is triglyceride/HDL. If measured in mg/dl, the number should be less than 2. Incidentlally, triglyceride/HDL can be seen as an indicator of insulin resistance too. Makes sense because insulin resistance IS a strong predictor of heart disease.
     
  14. rickyw

    rickyw Quadruple-Digit Post Count

    And insurance would pay less for statins because they would be prescribed less.
    Win, win.
     
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  15. ali

    ali Quadruple-Digit Post Count

    To celebrate reaching 50 years of age in the UK you receive a birthday present from the NHS (national health service).... a bowel cancer screening kit.
    I'd prefer a bottle of champagne but it's the thought that counts.
     
  16. Tarzan

    Tarzan More than 500 posts

    We get a bowel cancer screening test sent in the mail (with a stack of paperwork) in Oz when we turn 50 too. I didn't do mine, it's still kicking around somewhere.

    I would have preferred an invite to get a CAC scan done just for the peace of mind it would give. I've asked several doctors for a CAC scan and they point blank refuse to write a referral over here even if I paid for it myself and didn't try to claim it on insurance. All the doctors I saw suggested that "at my age" taking statins would be a good idea even though they hadn't done any blood work. That seemed like the epitome of quackery to me.

    I ended up settling for a standard cholesterol, triglyceride type test and and everything was fine. I do fairly regular glucose tests with a dual keto/glucose meter and I've never noticed any signs of insulin resistance after rudimentary fasted glucose type tests so I don't think the cholesterol tests mean much at all really.

    I really would have preferred the CAC scan.
     

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