Hospitals offer them for varying rates, advertising them as â€œcomprehensiveâ€ or â€œpartialâ€. Health, however, is relative, an ever changing equation influenced by several factors. A catastrophe or downhill slide can occur rapidly; a few weeks or even days after a â€œnormalâ€ report is handed over.
Before embarking on a master health check-up, it is better to have an initial physical evaluation by a general physician. In these days of super specialisation, each expert tends to focus solely on his or her own area of expertise. This sometimes blurs the larger picture. A check-up entails a record of the height and weight, blood pressure and pulse rate. After that the whole body needs to be examined in a systematic fashion. Specific concerns need to be mentioned so that they can be evaluated. At any age, the following 10 symptoms have to be immediately assessed, without a wait-and-watch policy:
Weight loss or gain. Significant weight loss is 2 per cent per week, 5 per cent per month, 7.5 per cent per three months, and 10 per cent per six months. If it is unintentional and unaccompanied by any signs of infection, it may be a symptom of uncontrolled diabetes, a hyperactive thyroid gland or cancer. Rapid, unexpected weight gain (3 kg or more) may be due to fluid retention as a result of heart, kidney or liver disease or decreased thyroid function.
Persistent fever (for more than two weeks). This must be documented using a thermometer.
Breathlessness with inability to speak a complete sentence or to lie flat comfortably.
Changes in bowel habits, with constipation, diarrhoea or alternating constipation and diarrhoea, or blood stained stools or feeling full after eating very little.
New headaches (especially in people over 50 years).
Loss of vision, speech or movement, or seeing â€œflashes of lightâ€.
Hot, red or swollen joints.
The frequency of a medical examination depends on individual needs. Usually twice in the 20s, thrice in the 30s, four times in the 40s and annually thereafter is adequate. Men aged 50 or more need a digital exam of the prostate, with a gloved finger in the rectum to evaluate its size. They also need a PSA (prostate specific antigen) determined annually. Women need a pelvic examination and a PAP smear starting at 35-40 years. If the first test is normal, the PAP test should be repeated every three years. If there are changes indicating an increased risk of cancer, it needs to be done yearly.
Breast cancer can be detected early with breast self-examination. A doctor should perform the examination once in three years till the age of 40 years and annually after that. A mammogram should be done at 40 years and then every two years.
Blood tests. An annual haemoglobin value will help to rule out anaemia, which may be due to occult (undetected) blood loss. If the value continues to fall despite adequate treatment, a further evaluation is needed.
Blood sugar, lipid profile, urea, creatinine and thyroid function tests are also needed. Men over the age of 50 years need a PSA. The values rise in prostate cancer.
Chest X-ray. A baseline X-ray will help detect tuberculosis, cancer and emphysema. Repeat X-rays are required if and when symptoms occur. They can then be compared easily with earlier ones.
ECG. A baseline ECG should be done around the age of 50 years and then repeated every two-three years.
Faecal occult blood test. If positive, it is suspicious of colorectal cancer. Further tests can then be done for an early diagnosis.
Flexible Sigmoidoscopy/Colonoscopy. This can be done every four years after the age of 50 years.
Bone densitometry. It evaluates the risk of osteoporosis. It should be done every 1-2 years after menopause.
These recommendations are geared for adults. Children and adolescents should have a complete physical evaluation upon their scheduled visit to the paediatrician for immunisation. With the extended immunisation schedule, the visits occur frequently enough for health issues to be recognised and evaluated. All age groups need an annual dental examination and an eye check up every two years.
Preventive health has a low priority. We rely on the check-ups compulsorily done for insurance or a new job. However, these are often conducted in a mechanical, haphazard and hurried fashion, with both the patient and doctor only interested in completing the required paperwork as soon as possible.
Sources: The Telegraph (Kolkata, India)