By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

PROPER SCREENING TESTS VITAL FOR WOMEN’S HEALTH CARE

Question: I just got back from my annual visit to my family doctor. She did a pap smear, a physical exam and ordered my mammogram. Are there other tests I need to have done? When my husband gets his annual check up, the doctor orders blood tests.

Answer: The blood tests that your husband had were probably to check his PSA level as a screening test for prostate cancer and to determine if his blood cholesterol level put him at risk for heart disease. As a woman, you need annual blood tests too. Unfortunately, we women sometimes have health care that is too fragmented because we go to a family physician for general concerns, a gynecologist for reproductive disorders, and another doctor -- perhaps an internist -- for yet other problems. If we don’t communicate to the family doctor that we’ve gone to these other doctors, our health care may be less than ideal. That’s why I advocate that you make sure your family physician gets reports from the other physicians you see. That way she can be the captain of your health-care team and make sure you get the tests you need.

I’ll give you a list of the kinds of things that you and your family physician will want to know about your blood chemistry. These tests might be requested by other doctors, but your family physician should have the results on the chart she keeps in your record folder.

Know the levels of your blood fats, or lipids. Specifically, you should know your total cholesterol, the breakdown into the good cholesterol known as HDL and the bad cholesterol known as LDL, as well as your triglycerides. Even if you are young and of normal weight, your lipid levels can be elevated. Your specific results determine how often these levels should be checked.

You should have your thyroid stimulating hormone, or TSH level checked. This is a good screening tool in healthy people to determine if your thyroid gland is working properly. You can have a full thyroid profile, but usually a TSH is adequate for screening purposes.

You should check your fasting blood sugar, or glucose, level, especially if you have relatives with diabetes. Again, being of normal weight and feeling well is not an assurance that you don’t have impaired glucose tolerance. Detecting any blood sugar problems early -- before you have noticeable symptoms -- will insure the best treatment with the fewest complications.

There are also some other tests I’d recommend you consider. Liver tests called ALT and AST can be helpful and can discover liver disease at an early stage. Kidney function can be checked by tests call BUN and Creatinine. As you get over 50, you should discuss having an EKG as well as a screening colonoscopy and screening bone density testing.

Now for the bad news. Your health insurance may not cover all of these tests, and they can be expensive. But that doesn’t mean you don’t need them. So here are a few tips to help you get the tests you need: Watch for health fairs in your community. Cholesterol, triglycerides and blood sugar are frequently checked at these community screening events. Also, sometimes hospitals or gyms have free or low cost mini-stress tests available. Get these done and keep copies of the results. Give a copy to your family physician and keep a copy for your records. Take responsibility for your own health care.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.