Garth Rattray

Last week's column, "Thank God for pain" explained that quite a few patients go to doctors because of pain and end up discovering hypertension, diabetes, high cholesterol levels or other serious medical conditions quite by accident. The piece introduced the essentiality of regular medical checks and screening even when there is no discernable physical problem. Many people have been turning to alternative medical practitioners and products for their health needs. Whereas I have nothing against what principle of healthy lifestyles which most of them promulgate, I am deeply concerned about their lack of evidence-based methodology, flimsy anecdotal 'results' and lack of screening procedures.

Medical science is not perfect, it is in flux but, thankfully, it is constantly improving and evolving. For instance, one reason that we are reporting such high cancer levels and (in spite of this), effect cures in many instances, is because we are now able to identify risk factors and screen for malignant tumours at an early stage. As far as our number one killer, cardiovascular disease is concerned, retrospective studies have enabled us to identify high-risk factors and we can institute preventative lifestyle and medical regimens to reduce them significantly.

People should start their own screening by finding out about medical conditions within their family. This will dictate their level of vigilance and guide the physician in timing the order of screening procedures. People of all ages should have a physical examination performed on them periodically and, the older they get, the more frequent this should be. Adults should have examinations annually and, if there are specific, medical conditions, they should see the doctor more frequently.

Early ckeck-up

Testing for hypertension, diabetes and hyperlipidaemia should be initiated early in our adult life and definitely in our thirties. People with a family history of early-onset cancers of breast, prostate or colon should start screening early also. People who have first-degree relatives with heart attacks at a young age should keep an especially close eye on their glucose, blood pressure and cholesterol levels.

Everyone should know by now that women are to begin doing annual Pap smears soon after they become sexually active, breast self-examinations in their thirties and mammograms at the age of forty (unless a young family member has/had the malady). Men should begin testicular self-examinations in their thirties and get prostate examinations with PSA screening blood tests at forty (or sometimes younger), and everyone should do a colon screening procedure at age fifty (or younger depending on the family history).

Hypertension has long been dubbed the silent killer but there are many other painless and asymptomatic conditions (like some cancers and organ malfunction) that can lurk inside of us and go undiagnosed until it is too late. Unfortunately, patients only tend to seek medical help, take their existing condition(s) seriously and/or stick to their medications only when problems manifest themselves. By that time, we are usually fighting a losing battle in slow motion.

We have a fairly wide variety of chemical tests and high-tech screening procedures here in Jamaica. Now, we can do all manner of imaging and scoping procedures. We even have virtual studies with multidetector computed tomography for colon and coronary vessels for those at high risk.

Some investigations are expensive but most people do not require such in-depth probing. People should not wait until they are sick and/or in pain; they should visit their doctor in order to have screening examinations and investigations performed periodically as recommended. Good health is all about effective risk management.