Carolyn Nemec, MD, is a family physician who specializes in women’s health at The Cleveland Clinic.
These days, “you’re your own best doctor,” says Carolyn Nemec, MD, a women’s health specialist with The Cleveland Clinic. “You have to take charge of your own health.” The first step is making sure you’re getting all the medical tests and checks an FOF needs.
Posted on July 21, 2010
Here’s Dr. Nemec’s list of medical musts for your next appointment. Print it out and tuck it in your datebook so you can be sure to have another healthy fifty years.
1. A full-body skin check. “Every year, every woman should have her skin checked from top to bottom for signs of skin cancer. Some general physicians will do this, or they’ll send you for a consult to your dermatologist. Make sure you point out any changes you’ve noticed in your own moles and sunspots, and make sure your doctor is checking everywhere from your scalp to the soles of your feet.”
2. A mammogram AND a breast exam. “There’s been a lot of conflicting information lately about when to get a mammogram, but here’s the bottom line: Every woman over fifty needs a yearly mammogram. All the medical societies, from the American Medical Association to the American Cancer Society, agree on that point.
Make sure your doctor or OB/GYN also does a breast exam! I’ve had patients tell me, ‘I had my physical, but my doctor didn’t do a breast exam.’ That’s not okay. You need a breast exam every year.”
3. A pap test AND an HPV test. “You should be getting a pap every three years. If you’ve had an abnormal pap in the past, it may be more frequent. At the same time, you should also get a second swab to check for HPV (human papilloma virus), a virus that can be a precursor to cervical cancer. That’s critical! For some reason—I’m not sure why--some women aren’t getting that second swab. If your doctor’s not doing it automatically, you need to find a new doctor.”
4. A colonoscopy. “Starting at age 50, you need one every 10 years. If there’s a family history, start even sooner.”
5. Tests on your blood sugar, blood pressure, lipids and BMI. “These are critical screens for heart disease and metabolic syndrome, a precursor to heart disease. Not all doctors are talking about metabolic syndrome, but in women’s health we’ve been aware of it for years. Basically, as a woman ages into her 40s and 50s her metabolism can change, putting her at risk for heart disease and diabetes. The five critical factors that signify a problem:
1. Blood sugar is over 100 mg/dl
2. Triglycerides greater than 150 mg/dl
3. HDL under 50
4. Blood pressure of 130/85 or higher
5. A waist measurement over 35 inches or a BMI is over 25
Ask your doctor if he or she screens for metabolic syndrome, and make sure you know your own numbers. You are your own best advocate.”