February 2015

This month’s Hot Topic will review the Health Screenings that you and your family should make a part of your wellness fitness plan.  As your physician at Pine Street Family Practice, our relationship is like a marriage, “In Sickness and in Health”.  Our contribution to the marriage is to prevent and fix the “Sickness” and your role is to actively participate in “Staying Healthy”.  Listed below are the health screenings and testing you and your family should have now or schedule in the future. We want to celebrate and look forward to our 50th Anniversary together!!!

Men’s Health

Here’s how often you should have a complete physical by your doctor.

Age Recommendation
19 to 21 years One visit every 2 to 3 years; every year if you choose
22 years to 64 and older One visit every 2 years; every year if you choose
65 and older One visit every year

Vaccinations for men

Vaccine Recommendation
Hepatitis A 2 doses for men at high risk
Hepatitis B 3 doses for men at high risk
Herpes zoster (shingles) 1 dose at age 60 and older
Influenza (flu) 1 dose every year
Measles, mumps, rubella (MMR) 1 to 2 doses for men who have no history of MMR vaccination or the disease; can be given to men age 40 and older if at high risk.
Meningococcal (meningitis) 1 dose at ages 19 to 24 if not previously vaccinated; can also be given at age 40 and older if at high risk
Pneumococcal (pneumonia 1 dose before age 65 followed by a booster after age 65 for men who have a history of asthma or smoking; 1 dose after age 65 for all others
Tetanus, diptheria and pertussis (Td/Tdap) 1 dose of Tdap for men who have not received a pertussis booster, regardless of the date of the last tetanus vaccination; after that, 1 Td every 10 years.
Varicella (chicken pox) 2-dose series for men with no history of varicella vaccination or the disease

 

Screenings and tests recommended for men

 

Assessments, screenings, and counseling Recommendation
Abdominal aortic aneurysm screening 1 screening between ages 65 and 75 for men who smoke or have smoked in the past
Alcohol misuse screening At physical exams
Blood pressure screening At physical exams
Chlamydia, gonorrhea, syphilis and HIV screenings [How often?] for all sexually active men
Colorectal cancer screening 1 of the following screening options beginning at age 50:

Colonoscopy every 10 years

Flexible sigmoidoscopy every 5 years

Fecal occult blood test annually

For men with a family history (first-degree relative) of colorectal cancer or adenomatous polyps: Begin colonoscopies every 5 years either at age 40 or 10 years before the youngest case in the immediate family. Consider stopping screening at age 75. Screening is not recommended for after age 85.

Depression screening At physical exams
Diabetes screening: Fasting plasma glucose test (Type 2) Every 3 years for men with ongoing blood pressure greater than 135/80, treated or untreated
Diet counseling At physical exams, if at higher risk for chronic disease
Family and intimate partner violence Anticipatory guidance, at physician discretion
Height, weight and body mass index (BMI) At physical exams
Lipoprotein profile, fasting (total cholesterol, LDL, HDL and triglycerides) 1 every 5 years
Medical history At physical exams
Obesity screening, counseling and behavioral interventions At physical exams
Safety, falls and injury prevention Anticipatory guidance at physician discretion
Sexually transmitted infection (STI) prevention counseling At physical exams, for those at high risk
Tobacco use screening and cessation counseling At each visit; includes intervention for tobacco users
Tuberculosis testing For those at high risk

 

Drugs men may need for preventive care

Preventive care drugs may be provided to you at no charge if your plan is not “grandfathered” under the Affordable Health Care Act of 2010. If your plan is “grandfathered,” these prescriptions will be covered according to your prescription plan.

Prescription Recommendation
Low-dose aspirin For men ages 45 to 79 years and others with risk factors for heart disease. Consult your doctor before beginning aspirin therapy.

 

 

Women’s Health

Here’s how often you should have a complete physical by your doctor.

 

19 to 21 years 1 visit every 2 to 3 years; every year if you choose
22 years to 64 and older 1 visit every 2 years; every year if you choose
65 and older 1 visit every year

Vaccinations for women

Immunization Recommendation
Hepatitis A 2 doses for women at high risk
Hepatitis B 3 doses for women at high risk
Herpes zoster (shingles) 1 dose for women age 60 and older
Human papillomavirus (HPV) A 3-dose series for women ages 19 to 26. Requirements: Second dose given at least 4 weeks and preferably 2 months after the first; third dose given at least 12 weeks and preferably 6 months after the second; at least 24 weeks required between the first and third dose
Influenza (flu) 1 dose every year
Measles, mumps, rubella (MMR) 1 to 2 doses for women who have no history of MMR vaccination or the disease

Can be given to women age 40 and older if at high risk

Meningococcal (meningitis) 1 dose for women ages 19 to 24 with no history of meningococcal vaccination

Can be given to women age 40 and older if at high risk

Pneumococcal (pneumonia) 1 dose followed by a booster every 5 years for women age 19 or older who have a history of asthma or smoking; 1 dose for all other women age 65 or older
Tetanus, diptheria and pertussis (Td/Tdap) 1 dose of Tdap for women who have not received a pertussis vaccine previously, regardless of date of the last tetanus vaccination; after that, 1 dose of Td every 10 years

Recommended especially for women who have contact with children under age 1

Varicella (chicken pox) 2-dose series for women with no history of varicella vaccination or the disease

 

Screenings, tests & counseling for women

 

Assessments, screenings, and counseling Recommendation
Alcohol misuse screening At physical exams
Blood pressure screening At physical exams
Breast cancer gene (BRCA1 and 2) screening counseling For women at high risk
Breast cancer screening (mammogram) For ages 40 and older, mammograms once every 2 years
Breast cancer chemoprevention counseling For women at high risk for breast cancer who might benefit from chemoprevention: Discuss benefits and potential harms
Breast self-exam guidance At physician discretion
Cervical dysplasia/cancer screening (Pap tests) Annually starting when a woman becomes sexually active or at age 21, whichever is first, up to age 30; every two to three years after age 30. Suggest stopping at 70 if: 3 or more normal Pap tests in a row, no abnormal Pap test in previous 10 years and not at high risk.
Chlamydia infection, gonorrhea and syphilis screenings At physical exams, for all sexually active women
Colorectal cancer screening One of the following screening options beginning at age 50:

Colonoscopy every 10 years (recommended because it’s the most complete)

Flexible sigmoidoscopy every 5 years

Fecal occult blood test annually

For women with a family history (first-degree relative) of colorectal cancer or adenomatous polyps: Begin colonoscopies every 5 years at age 40 or 10 years before the youngest case in the immediate family. Consider stopping screening at age 75. Screening is not recommended for individuals older than 85.

Contraceptive counseling and contraceptive methods* Access to FDA-approved contraceptive methods, sterilization procedures and patient education and counseling when needed.
Services don’t include prescribing drugs that induce abortion.
Depression screening At physical exams
Diabetes screening: Fasting plasma glucose test
(Type 2)
Every 3 years for women with ongoing treated or untreated blood pressure greater than 135/80
Diet counseling For women at higher risk for chronic disease
Domestic violence screening and counseling* Annually
Height, weight and body mass index (BMI) At physical exams
Human immune-deficiency virus (HIV)counseling and screening* Annually for sexually active women
Human papillomavirus testing* Every 3 years beginning at age 30, regardless of Pap test results
Lipoprotein profile (fasting, for total cholesterol, LDL, HDL and triglycerides) Once every 5 years

Does not include metabolic panel

Medical history At physical exams
Menopause counseling At physician discretion
Obesity screening and counseling Includes counseling and behavioral interventions
Osteoporosis screening For women ages 40 and older, a screening without bone density test once every 2 years during physical exam

Beginning at age 50, a bone mineral density test every 2 years for post-menopausal women with risk factors. If no risk factors, every 2 years beginning at age 65.

Safety, falls & injury prevention guidance At physician discretion
Sexually transmitted infection (STI) prevention counseling At physician discretion, for women at high risk
Sexually transmitted infection (STI) screening and counseling* Annually for sexually active women
Tobacco use screening and counseling At each visit; includes cessation counseling and intervention for tobacco users. Expanded counseling for pregnant women.
Tuberculosis testing At physician discretion, for women at high risk

Prescription drugs for women’s preventive care

These drugs may be provided to you at no charge if your plan is not “grandfathered” under the Affordable Health Care Act of 2010. If your plan is “grandfathered,” these prescriptions will be covered according to your prescription plan.

Prescription Recommendation
Folic acid supplements 0.4 to 0.8 mg of folic acid for women of childbearing age
Low-dose aspirin therapy for the prevention of cardiovascular disease Women age 55 to 79 years, and others with risk factors for heart disease. Consult your doctor before beginning aspirin therapy.

Contraceptives

Prescription Recommendation Benefit level
Barrier Diaphragms
Female condoms
Contraceptive sponge
Generic contraceptive methods for women are covered at 100% (free).

You will pay your prescription copayment for brand-name contraceptives.

Hormonal Oral contraceptives (“the pill”)
Injectable contraceptives
Implantable IUDs
Emergency Ella®
Next Choice®
Next Choice® One Dose
Covered at 100% (free) as a preventive service, not covered by your prescription drug plan.
Permanent Tubal ligation (“tubes tied”) Covered at 100% (free) when performed at outpatient facilities.

If received during an impatient stay, only the services related to the tubal ligation are covered in full.

 

 

Children’s Health

Here’s how often you should have a complete physical by your doctor.

 

Newborns 2 to 3 days after discharge
Under 3 years Well-child visits at 2, 4, 6, 9, 12, 15, 18, 24 and 30 months
3 to 6 years 1 visit every 12 months
7 to 10 years 1 visit every 12 to 24 months
11 to 18 years 1 visit each year
19 to 21 years 1 visit every 2 to 3 years; every year if desired
22 years and older 1 visit every 2 years; every year if desired

Vaccinations recommended for children

Immunizations Recommendation
Diphtheria, tetanus, pertussis (DTaP, Tdap, and Td) 5 doses of DTaP: 1 each at 2, 4 and 6 months, between 15 and 18 months and between 4 and 6 years

1 dose of Tdap between ages 11 and 12

1 Td booster every 10 years after the dose of Tdap

“Make-up” doses:

1 dose of Tdap between ages 7 and 10 if the child missed any of the 5 DTaP doses listed above

1 dose of Tdap for anyone 18 or younger who has not already received it, regardless of when the last Td was given

Haemophilus influenza type b (Hib) 4 doses, 1 each at ages 2, 4, 6 and 15 to 18 months

At the doctor’s discretion, dose 4 may be given as early as 12 months if 6 months have elapsed since dose 3

Hepatitis A 2 doses at least 6 months apart at ages 12 to 23 months

2 doses at least 6 months apart from age 2 to 18 years, if not vaccinated previously and at high risk, at the doctor’s discretion

2 doses at least 6 months apart for all adolescents up to age 18

Hepatitis B 3-dose series for infants: First dose before leaving the hospital, second dose between 1 and 2 months, third dose between 6 and 18 months

May begin 3-dose series at age 2 to 18 years if not vaccinated in infancy

Human papillomavirus (HPV) 3-dose series of either Gardasil® (boys and girls) or Cervarix® (girls only) between ages 9 and 26 years, best given between 11 and 12 years.

Requirements: Second dose given at least 4 weeks and preferably 2 months after the first; third dose given at least 12 weeks and preferably 6 months after the second; 24 weeks required between the first and third dose

Inactivated poliovirus (polio) 4 doses, 1 each at ages 2, 4 and 6 to 18 months, and between ages 4 and 6 years
Influenza (flu) 1 dose annually for healthy children between ages 6 months and 8 years

2 doses separated by 4 weeks if receiving for the first time or if vaccinated during the previous flu season but only received 1 dose

1 dose annually for children 2 years and older

Measles, mumps, rubella (MMR) 2 doses: The first at ages 12 to 15 months, the second between ages 4 and 6; doses should never be less than 1 month apart

After age 7, 2 doses if not previously vaccinated or no history of disease; doses should never be less than 1 month apart

Meningococcal (meningitis) 1 dose between ages 11 and 12 years with a booster at age 16

2 doses 2 months apart between ages 2 and 18 if high risk (HIV, non-functional spleen, etc.)

Catch-up all adolescents 13 and older who have not had Tdap

Pneumococcal (pneumonia) 4 doses at 23 months and younger: 1 each at 2, 4, 6, and 12 to 15 months
Rotavirus 3 doses, 1 each at 2, 4 and 6 months
Varicella (chicken pox) 2 doses: 1 between ages 12 and 15 months and 1 between 4 to 6 years

1 dose between ages 12 months and 12 years if the child has no history of varicella

2 doses between 7 and 18 years if the child has no history of varicella and no previous vaccination

Screenings and tests recommended for children

Assessments, screenings and counseling Recommendation
Alcohol and drug use assessments During each visit between ages 11 to 18 years
Anticipatory guidelines as defined by Bright Futures Throughout a child’s development, at physician discretion
Autism screening Once between ages 18 and 24 months
Blood pressure Every year beginning at 3
Cervical dysplasia/cancer screening For all sexually active females
Congenital hypothyroidism screening Once at birth
Depression screening and behavioral assessments At physician discretion
Developmental screening 3 screenings, 1 each at 9, 18, and 30 months
Dyslipidemia screening Assessments at 2, 4, 6, 8 and 10 years old, then once a year through age 18. Routine lab testing not recommended, but may be done for children identified as high risk.
Gonorrhea preventive medication 1 dose at birth
Hearing loss screening At birth and at ages 3, 4, 5, 6, 8, 10, 12, 15 and 18 years
Height, weight and body mass index/percentile measurements At each visit; all measures up to age 2 years, then starting at 2 years, BMI/percentile only
Hematocrit or hemoglobin screening Once at 12 months, once between ages 11 and 18, and once annually for menstruating adolescents
Lead screening A blood test at 12 and 24 months for children at high risk.

Risk assessments for lead exposure between ages 6 and 12 months, at 24 months, and between ages 2 and 6.

Medical history At each well-child visit and physical exam
Newborn screenings as identified by the federal Health Resources and Services Administration, including but not limited to phenylketonuria (PKU) and sickle cell disease Once at birth
Obesity screening and physical activity and nutrition counseling Beginning at age 6
Oral health risk assessment At 12, 18, 24 and 30 months, 3 years and 6 years
Sexually transmitted infection prevention counseling and screenings for chlamydia, gonorrhea, syphilis and HIV Counseling for sexually active adolescents

Screenings for sexually active females, and for males at high risk

Tobacco-use screening and counseling At each visit. Includes cessation intervention for tobacco users and expanded counseling for pregnant tobacco users.
Tuberculin testing For children at high risk
Vision screening At ages 3, 4, 5, 6, 8, 10, 12, 15 and 18

Prescription drugs children may need for preventive care

These drugs may be provided to your child at no charge if your plan is not “grandfathered” under the Affordable Health Care Act of 2010. If your plan is “grandfathered,” these prescriptions will be covered according to your prescription plan.

Prescription Recommendation
Oral fluoride supplements Children 6 months of age and older without fluoride in their water source to prevent dental caries
Iron supplements Children ages 6 to 12 months at risk for iron-deficiency

 

Please help us celebrate our Golden Wedding Anniversary and stay Healthy!!

 

Dr. Lee Ann