It's happened to all of us.
We are driving our car down the road and suddenly we hear a noise which progressively gets worse over a period of time. Some of us take it to the mechanic right away; others wait until either the wheels fall off or the engine stops.
But let's say you take it in when the sound is not too loud. That is the smart thing to do.
"You have a bad wheel bearing," the mechanic tells you. "We can fix that pretty easily. It's a good thing you caught it now because it could have damage the race (the surface the bearing fits into). But did you also know your exhaust system has a leak, your front brakes pads are very thin and your universals are just about worn out?"
Bad news, turned to worse. He tells you if you would bring the car in regularly instead of waiting for things to go wrong he could prevent a lot of trouble. You have him do the work and fix all the things that need repair and you pay the price.
Subsequently, you get to drive down the road in a newly repaired and well running car.
Comparing the human body to an internal combustion engined, metal vehicle seems ridiculous as does saying a mechanic is like a doctor. But there is a truth to what the mechanic says that also holds true for your body. The regular mechanical inspection for things that are hidden from sight has a lot in common with the yearly physical.
The difference is that no matter what, you can get a car repaired and keep it running if you pour enough money into it. Cars don't die, they get put out of service because the cost exceeds the worth of the vehicle. Human bodies can have something wrong with them that may never be repaired because unlike a steel machine, only certain replacement parts exist and in some cases, things gone too far can never be repaired.
So maintenance inspections, called physical exams, are very important.
People hate physicals. They dread them as they watch them approach on a calendar and they dislike them while they are being conducted. Yet the result of the exam can be telling, in fact life saving.
Or just satisfying, knowing you are in good health.
Many people never had a physical unless they injure themselves or they just don't feel right. That not feeling right, that squeaky wheel, could be a sign of something more serious.
The yearly physical has been a fixture of standard medical practice for decades. Doctors have always maintained "an ounce of prevention is better than a pound of cure."
But the physical has changed over the years. In the early days of physicals physicians looked for signs of infectious diseases. People in 1900 only lived to an average age of 40, so most never contracted chronic diseases. With the advent of vaccinations and antibiotics, the infectious diseases have been largely wiped away (with the exception of a few and depending on where the person lives) and most people get physicals to be sure they are in good shape concerning the big two: cancer and heart disease.
But there is certainly more to it than that. In reality there are five good reasons to get a physical.
* The first, as stated, is to screen for diseases. The big two is not all there is. There are a lot of minor diseases that can turn into big ones if they are not taken care of. And many have few symptoms, if any before they really start to affect a persons health. High blood pressure is a good example. Few people that are diagnosed with it even know they have it before a doctor tells them they do. Untreated it can lead to an endless list of health problems.
* The doctor can assess the risk of future medical problems. One of the things done in a physical is to get a personal history as well as a family history. If your father had heart disease, you may have a higher propensity for it too. Your sister could have diabetes; you are at higher risk. While you many not have something now or even real signs of it, it is good for you and your physician to know to watch for it.
* Physicals are also part of encouraging a healthy lifestyle. Of everything, this may be the thing most people hate the most about a physical exam. If you are overweight, smoke, drink alcohol, love to put salt on everything, eat too much red meat, etc. you may not like what you hear from your doctor. Doctors will tell you to stop smoking. They will preach moderation when it comes to drinking. They will weigh you with those big scales that are a lot more accurate than the one under your bathroom sink and tell you you need to lose a few (or many) pounds. Just like the mechanic needs to tell you about potential problems with your car, doctors must pass on the bad news to give you the option to improve your health or not. It's hard to listen to that.
* Update your vaccination records and keep you current. Are vaccinations just for kids? No. One that comes to mind is the annual flu shot. A yearly physical will bring up this question along with others. If you travel out of the country frequently, this may also be very important to you.
* A physical will keep you in the medical loop. Going to a family doctor at least once a year gives you an advocate for medical treatment you might need due to sudden accident or illness; someone who knows you, your problems and your lifestyle. Admittedly if you go to the emergency room you will probably not be treated by your own family physician, but they always ask the question about who your doctor is, and they often confer with him or her.
Interestingly enough, different parts of the country apparently view annual physicals differently. A review of medical records published in the Archives of Internal Medicine four years ago found that patients that saw doctors in the Northeastern part of the United Sates were the likely candidates to undergo a physical with 29 percent of adults going in for the exam each year. The part of the country with the people that were least like to get physicals was in the West. Only 16 percent were found to regularly have physical exams. In 2009a study revealed that 64 million Americans a year get a physical/gynecological exam. These exams cost almost $8 billion.
There are those in recent years that feel physicals have become a waste of time, even some doctors say that they could be seeing patients that were really sick and spending time on their problems rather than taking the time to look at healthy patients. But most doctors still swear by the yearly exam.
Preparing for the physical
The best thing to do before going for a physical is to be prepared for it. Nervousness is not one of the precepts, but most people have anxiety about the visit. Here are some hints for dealing with the exam.
* First you should have accurate personal information about your present problems (if any), and medications you are taking (types and dose), personal history of surgeries or accidents that caused you physical harm, and family information.
*Keep your mind open to change. Once your doctor has finished the exam he or she will generally give you some advice on how to proceed with your life. Generally these things have to do with weight or habits. What may seem insurmountable, may not be as hard as you think if you can get help doing such things as quitting smoking or losing weight.
*Keep your mind ready to ask questions and don't hesitate to ask them, even if they come up weeks after the visit and consultation. You have a right to know what is going on with your health.
The actual exam
The physical exam that is administered by physicians vary, depending on circumstances. If one comes in with a complaint or two the physical could center on a certain area of the body or of some organ system. But if it is purely a maintenance physical, it could be more general.
Physicians start an examination (particularly if they are not familiar with a person) with an individuals head and work down, looking for abnomalities. This means you will at least get partially undressed, often fully and will have to put on one of those detested hospital gowns. Here are some of the things they look at.
*Your skin. It is examined for cancer and other skin diseases. The doctor may take into account either your occupation (if you are in the sun a lot) or your recreational pursuits (again outdoors a lot) in doing this.
*Your eyes. They may ask you questions while they look. Some of those might include questions about bluriness, floaters in your vision field, double vision, etc.
*Your mouth. The doctor may ask you about your brushing and flossing habits, if you chew tobacco, if you have continual sores or problems with bleeding. They will also ask you about trips to the dentist, who performs another type of physical you should be having regularly too.
*Your lungs and heart. The ubitiquous stethoscope is still used in listening for lungs that are not working right and for heart problems.
*Your abdomen. This is where doctors squeeze and feel, sometimes asking "Does that hurt?"
*Your penis and scrotum. For a man this is often the part they hate the worst, with the exception of the digit prostate check. Doctors look for abnomalities to avoid problems that could come up in terms of diseases and cancer.
*Your pelvic region. Most women hate this part, but most are resigned to it as well. Often for women this has been done even without a complete physical sometime in their lives. Doctors look for abnormalities.
*Your rectum. Okay, now to the digit test in which the doctor checks the prostate. What he looks for is an enlarged prostate and/or descrepancies from a normal prostate. Danger signs of other problems are also checked for.
*Your legs and feet. There is a lot to look for here. Lower extremity problems can be an indicator of other problems in the body. Things like gout, fluid buildup and other things can reveal organ problems.
*Your nervous system. Doctors still use a little hammer (not big ones like in cartoons) to test reflexes. They also look for other things that could reveal nervous systems conditions such as steadiness and shaking.
Doctors may order tests for anything they suspect is a problem. These tests can range from a simple blood draw (well not so simple for some people) to scope tests in which people are put out while doctors explore the inside of their bodies with some kind of scope or camera.
Usually a good, full physical means body fluid testing. This usually comes in the form of a series of blood tests and urine examinations, particularly if certain kinds of diseases are suspected. While it seems gross and disgusting to some people, body excretement analysis is one of the best ways a physician has of telling what is going on in someones body.
Your doctor will confer with you after the results of all the tests are in. This may be done on the phone or they may have you come in the office for the consultation. No one wants to hear bad news, and one of the things that often keeps them away from physicals is finding out about something they didn't know about. Almost everyone wants to think if they don't know about something, it may just go away.
Just remember the squeeky wheel. It won't go away; it will just get worse.