Study questions the value of annual physical exams

Published: Wednesday, October 17, 2012 @ 8:44 PM

Regular physical exams are annual rituals for many Americans.

Now a new research review finds that these kinds of checkups don’t help people live longer, and they don’t cut the risk of dying of cancer or heart disease.

“We did not find any signs of benefit,” on death risk, says researcher Lasse T. Krogsboll, a PhD student at the Nordic Cochrane Center in Copenhagen, Denmark.

Despite the dim light the review casts on annual exams, researchers and independent experts say it’s not necessarily time to give up on regular physicals. For the study, researchers pooled data from 14 studies that included more than 180,000 people. All the studies randomly assigned people to one of two groups: The first group was asked to get regular checkups; the second group only saw a doctor as needed.

Tests done during the checkups varied from study to study, but most included measures of blood pressure, cholesterol, blood sugar, heart rhythms, vision, and hearing.

Studies included in the review followed people for as little as four years and as long as 22 years.

Benefits and Harms of Annual Physicals

When researchers compared the number of deaths between the group that got regular physical exams and the group that only saw a doctor as needed, there was essentially no difference.

On average, about 7% of people died in each group over the course of the studies. That was true even when researchers looked at deaths from cancer and cardiovascular disease, which are thought to benefit from early detection and treatment.

Perhaps unsurprisingly, people who saw a doctor on a regular basis were more likely to be diagnosed with conditions like high blood pressure and high cholesterol.

Some studies found they were more likely to be treated for those conditions, too. Out of four studies in the review that looked at drug use, two found that people who got regular physicals were more likely to be prescribed drugs to treat high blood pressure, for example.

There was a trend among studies for people who got regular physicals to feel healthier than people who did not, but researchers say that finding is unreliable. There were no apparent differences between groups on hospital admissions, worry, referrals to specialists, or disability.

“In the absence of documented health benefits, we would say there’s a risk of overdiagnosis from this,” Krogsboll says.

Should We Leave Wellness Alone?

“One of the questions that arises from this study is, ‘Why didn’t an annual physical work?’” says Michael LeFevre, MD, MSPH, co-vice chair of the U.S. Preventive Services Task Force, a group of government advisors that weighs the evidence behind different kinds of preventive services and makes recommendations about their use.

One reason may be that most of the studies included in the review were done in the 1960s and '70s, an era when doctors ordered many tests during wellness exams.

Some of those tests, like electrocardiograms (ECGs or EKGs), have since been shown to have little value for general screening.

In contrast, only some of the studies asked people about smoking. In one study, people were only offered help to cut back if they were smoking more than 15 cigarettes a day.

Quitting smoking, LeFevre points out, has enormous benefits for health.

“It emphasizes the importance of doing what works. Just showing up for a check-up isn’t going to make you live any longer,” he says.

Another reason there may have been no difference between the two groups, researchers say, is that people who were going to the doctor might have been getting good preventive care on the side during those visits.

“So adding systematic health checks did not add any health benefit,” Krogsboll says.

But other experts found the findings solid and even similar to the results of other reviews showing limited benefits for annual physicals.

“This study adds to growing evidence about the limited role of the periodic health examination in healthy adults,” says Timothy J. Wilt, MD, MPH, a professor at the University of Minnesota’s School of Medicine in Minneapolis.

Wilt just finished another review of annual physicals for the Department of Veterans Affairs. His conclusion? They don’t do much for healthy adults.

Despite that, he says many people just like to get regular physicals and feel reassured by checking it off their list.

In those cases, he says, “We and others recommend that patients and providers should focus on areas of demonstrated health benefits and address concerns if patients notice any abnormal signs or symptoms.”

SOURCES: Krogsboll LT, The Cochrane Library, 2012 Issue 10.Lasse T. Krogsboll, PhD student, The Nordic Cochrane Center, Copenhagen, Denmark.Michael LeFevre, MD, MSPH, professor, Future of Family Medicine, University of Missouri School of Medicine, Columbia, Mo.; co-vice chair, U.S. Preventive Services Task Force, Rockville, Md.Timothy J. Wilt, MD, MPH, core investigator, Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center; professor, University of Minnesota’s School of Medicine, Minneapolis, Minn.

© 2012 WebMD, LLC. All rights reserved.

 

5 reasons to breastfeed your child 

Published: Wednesday, October 11, 2017 @ 12:57 PM
Updated: Wednesday, October 11, 2017 @ 12:57 PM

Breastfeeding has health benefits for mothers and children. A new study suggests breastfeeding can reduce a mother's risk of heart attack and stroke. The study analyzed 289,573 women in China. 6 months of breastfeeding = 4% less likely to have hea

Many new moms have heard that "breast is best" when it comes to feeding their babies, but they may not have all the facts on just what makes it best.

When you're making the personal decision about how to feed your child, it helps to know exactly why experts so strongly recommend breastfeeding.

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Here are five major benefits of breastfeeding:

Providing an immune system boost

Breast milk contains antibodies, immune factors, enzymes and white blood cells – all of which can help protect your baby against diseases and infections, according to the American Academy of Pediatrics. Your baby will be less likely to have ear infections, vomiting, diarrhea, pneumonia and other common yet potentially serious ailments as a result.

Even better, this immune system boost can, in some cases, last after you've weaned your baby.

Breastfeeding provides your baby with many important health benefits.(Sergei Bobylev/For the AJC)

Building a strong emotional bond

Psychology Today touts the bond that develops between nursing moms and their babies. This is not only because of the close, extended contact but also due to the release of hormones in moms as well as their babies.

This close bonding is believed by many to help reduce social and behavioral problems later in life, the Cleveland Clinic says.

Improving brain development

Previous studies have linked breastfeeding to better cognitive outcomes in older adolescents and adults. A Brown University study now suggests that changes in brain development occur even earlier than that  "almost right off the bat." 

Researchers used baby-friendly MRIs to look at the brain's white matter, which helps parts of the brain communicate with one another. Babies in the study who were exclusively being breastfed had 20 to 30 percent more white matter growth than babies who weren't.

Fulfilling your child's unique – and changing – nutritional needs

Breast milk changes composition to adapt to your child's nutritional needs, according to Psychology Today. It contains all the nutrition your baby needs for his or her first six months and continues to provide benefits beyond that.

And even if your baby is premature, the breast milk you produce in the first few weeks is also designed to meet your baby's unique needs. For example, it's higher in protein and minerals; it also contains different types of fat that can be more easily absorbed and digested by your premature baby.

Lowering your child's risk of SIDS

Breastfeeding is thought to lower your child's risk of SIDS – sudden infant death syndrome. 

Medical experts usually recommend that to keep your baby safe, you should keep him or her in the same room if you'd like to, but not in the same bed. They suggest that breastfeeding moms keep their babies in a crib beside their own bed to make breastfeeding easier and keep babies safe from bedding or from being accidently rolled over on.

Need help or advice about breastfeeding?

If you'd like to breastfeed your baby but have concerns or want more information, hospitals usually employ lactation consultants who can help you and your baby with breastfeeding. To find one on your own, search at ilca.org/why-ibclc/falc.

5 ways to stop killing your back with bad posture at work

Published: Tuesday, October 10, 2017 @ 12:10 PM
Updated: Tuesday, October 10, 2017 @ 12:10 PM

Here are five of the best ways to have better posture at work Consider a chair with a backrest that supports the curve of your lower back Sit with your back in a normal, slightly arched position to avoid back pain Combat back pain by spending part of your work day sitting on an exercise ball Lumo Lift, a device that attaches to your shirt with a magnet, vibrates when you should adjust your posture At least once an hour, stand and stretch

"Sit up straight!" may sound like nagging straight out of the 1950s, but it's spot on advice for the 21st century workplace. 

Constant shifting around to get comfortable at your work computer, and hunched over a smart phone at home, wreaks havoc on your back, neck and shoulders.
Regular computer users perform 50,000 to 200,000 keystrokes each day, according to the nonprofit website, OrthoInfo.com, compiled by orthopedic surgeons. "Under certain circumstances and for vulnerable individuals, frequent computer use that involves awkward postures, repetition, and forceful exertions may be related to nerve, muscle, tendon, and ligament damage," OrthoInfo.com noted

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Postures induced by using modern technology can also cause other health problems. When you lean forward at your desk, for example, you're more likely to clench your jaw and tighten facial muscles, which leads to headaches and jaw pain, according to LiveStrong.com.
Hunching over can also reduce your lung capacity by as much as 30 percent, Dr. Rene Cailliet told Livestrong.com. The former director of University of Southern California's Department of Physical Medicine and Rehabilitation noted that lungs underperforming leads to a deficit of oxygenated blood which in turn can contribute to shortness of breath, cloudy thinking and even heart and vascular disease.
But you don't have to sit back and accept these plagues of poor posture as a cost of using technology.

Experts from business coaches to orthopedic surgeons suggest ways to improve your posture and spare your back.

Here are five of the best ways to have better posture at work:

The Edge Desk System is a portable, foldable desk and kneeling chair that expands and collapses in 10 seconds. (Photo courtesy Edge Desk/TNS)

Choose your chair. To encourage great posture in an office environment, your best bet is a chair that is stable and adjusts easily for height and tilt, according to reporting on the OrthoInfo website. "Consider a chair with a backrest that supports the curve of your lower (lumbar) back," the organization said. "Experts recommend you consider positioning your thighs horizontal with your knees at about the same level as your hips. Rest your feet comfortably on the floor or on a footrest if you need one." 

Other chair attributes that encourage great posture included a padded seat with a pan at least one-inch wider than your hips as well as adjustable armrests that position your elbows near your waist.

Sit like you mean it. An OrthoInfo.com article written and reviewed by orthopedic surgeons recommends sitting with your back in a normal, slightly arched position to avoid back pain. Other work posture basics from the orthopedic surgeon community include keeping your head and shoulders erect, and making sure your work surface is set at a height that won't require you to lean forward.

Sit on a ball. Cybersecurity expert and entrepreneur Joseph Steinberg, told Inc magazine that he combats back pain and other drawbacks of bad posture at work by spending part of his work day sitting on an exercise ball, alternating it with his leather office chair. 

"Sitting on the ball makes it more difficult to slouch, engages various muscle groups that remain at rest when slouching on a chair, and builds muscle," he noted. "While the ball is clearly not as comfortable a seat as an executive chair, I got used to it pretty quickly."

Get a vibrating reminder. Steinberg also recommended the Lumo Lift, a tiny device that attaches to your shirt with a magnet. If you slouch, it gently vibrates to remind you to adjust your posture.

Stand and stretch. Even if you're not slouching, you need ample breaks to combat back pain and other effects of working in front of computers for a long time. At least once an hour you should stand and stretch, according to OrthoInfo.com. Place your hands on your lower back and gently arch backward before returning to your work.

5 signs you should ask your doctor about depression

Published: Tuesday, October 10, 2017 @ 9:54 AM
Updated: Tuesday, October 10, 2017 @ 9:54 AM

These 5 signs are solid indicators that you should talk to your doctor about depression 1. Your mind seems foggy and you have trouble concentrating 2. You feel irritated or angry over things you would normally shrug off 3. You have unexplained pain such as back pain or headaches 4. Your eating habits have changed, either an increase or decrease in appetite 5. You sleep too much or too little

A common perception of someone suffering from depression is a person who's sad and/or crying. Although you certainly may feel this way if you're depressed, the illness may also present itself in more subtle ways that you might not expect.

Depression is a very common illness, with about 16 million adults in the U.S. having at least one major episode of depression in the past year. Despite there being many different types of treatment available, about two-thirds of people with major depression never seek treatment

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Sometimes they think they'll "snap out of it" on their own or they may be too embarrassed to address the condition. But delaying treatment could have devastating effects in every area of your life, and at its worst, could result in suicide.

The following five signs are solid indicators that it could be time to talk to your doctor about depression. 

Your mind seems foggy.

If you have trouble concentrating or making decisions on an almost-daily basis, Health's website says, this could be a sign of depression. It can cause fuzzy, unfocused thinking that can affect your memory and ability to make good decisions. This could make you forget work deadlines as well as tasks you need to complete at home. At its most extreme, it could even lead you to engage in unhealthy, risky behavior.

You tend to get angry.

Although most people probably associate depression with sadness, it can also cause you to feel irritated or angry over things that you would normally shrug off. If you find yourself raging at little things at work and home, you may actually be depressed. This can be especially true of men, Reader's Digest says, who may find it more socially acceptable to express anger rather than sadness when they go through something such as divorce.

You have unexplained pain.

The Mayo Clinic says that unexplained pain such as back pain or headaches can sometimes be the first or only sign of depression. In fact, pain and depression can create a vicious cycle. If your depression is causing pain, this can make you further depressed, which increases your pain. In addition, depression-related pain that continues over time can create additional problems such as stress, low self-esteem and difficulty sleeping. Some forms of treatment can help with both pain and depression, while others treat only one condition, so you and your doctor can talk about what's best in your particular case.

Your eating habits have changed.

Depression can affect many aspects of your life, including your eating habits. Health says you may experience a loss of appetite as well as a decreased interest in food and cooking. It can also have the opposite effect, making you more likely to try to soothe yourself by binge eating on unhealthy food. In addition, if you normally eat a healthy diet but find yourself suddenly turning to junk food, you may want to talk to your doctor about depression.

Learn how to get better sleep and find out just how much sleep people in your age group really need from Reid Hospital.

You sleep too much – or too little.

Crawling into bed and escaping into sleep is behavior that may be associated with depression, according to Health. You may find yourself wanting to stay in bed and also escaping into naps when you can during the day. Depression can also cause you to stay awake late at night as you toss, turn and worry. And like many symptoms of depression, sleeping too much or too little can create a vicious cycle. You can feel tired and sluggish from too much sleep, so you may feel even worse, which can make you likely to sleep more or have more trouble getting to sleep at night.

Getting help

The National Alliance of Mental Illness (NAMI) recommends the following tips for getting help:
  • Call 911, go to your local emergency room, or call the National Suicide Prevention Lifeline at 1-800-273-8255 if you're feeling suicidal.
  • If you think your condition is mild to moderate, make an appointment with your primary care physician.
  • If you think your condition is moderate to severe, make an appointment with a specialized doctor such as a psychiatrist.
  • Seek out community support groups, which can serve as valuable tools for help and to know you're not alone in suffering from depression. NAMI can help you find support in your area.

It’s never to late to go get a mammogram

Published: Monday, October 09, 2017 @ 10:37 AM


            Chaya Vidal of Englewood had her first mammogram two years ago, at 72. CONTRIBUTED
Chaya Vidal of Englewood had her first mammogram two years ago, at 72. CONTRIBUTED

Chaya Vidal of Englewood had her first mammogram two years ago, at 72. So she may seem an unlikely public champion of the test.

But she’d learned a valuable lesson and felt compelled to share it in her synagogue’s bulletin.

“There’s never been a history of cancer in my family, and I thought I was probably too old,” she said.

Yet, there she was with an unexplained bruise. She asked her primary care doctor, Jason Schatzel, M.D., to order a mammogram.

The evening after her mammogram on Nov. 24, 2015, Dr. Schatzel called.

“It didn’t take a rocket scientist to see from the technician’s face that it was a bad, bad mammogram on both breasts,” she explained. It was Stage IIIC cancer.

Vidal, now retired from synagogue administration, was teaching a Hebrew lesson when the call came. With her student in the room, she said, “There was no way I could appear worried or nervous. I just acted like I was listening to a casual report from a doctor.”

But Dr. Schatzel was ordering biopsies of both of Vidal’s breasts, immediately.

The next day, the youngest of her three children, Chava, drove in from Cincinnati for Thanksgiving.

“When I said I needed to talk, I must have said it in a very serious tone, because she replied, ‘Why? Are you dying?’ I said I hoped not. I explained that I probably had cancer. We both laughed, because it was such a bizarre thing for her to say, and it broke the tension.”

Vidal added, “I also told her, ‘The last time I had an ultrasound was to find out I was pregnant with you.’ She said, ‘Mom, I was with you then, and I’m with you now.’”

Chava has been with her mother at every doctor’s visit and chemotherapy treatment since the surgical removal of both her breasts.

Two surgeons, Thomas Heck, M.D., and Michelle DeGroat, M.D., conducted the mastectomies simultaneously “to minimize the time I was under anesthesia, because of my age,” Vidal explained. “They were absolutely outstanding.”

In her room after surgery, cheerleading pom-poms covered nearly every surface. Eighty of them. With nurses’ permission, Chava had placed them there, each carrying encouragement from family and friends.

Chava’s special touches graced her mother’s entire journey: a gratitude journal, scrapbooks of cards and letters, a homemade fleece blanket and pillows for chemotherapy, and plenty of crossword puzzles and hard candy.

Vidal had a great concern lifted when she tested negative for an inherited BRCA gene mutation that would have increased her children’s risk for cancer. As a descendant of eastern European Jews, Vidal is at heightened risk of carrying the mutated gene.

“That was the best piece of news during that time,” she said. “It was bad enough being ill, but then finding out that I could possibly pass cancer on to my children was the worst time of my life.”

Vidal’s initial chemotherapy, starting in February 2016, brought debilitating side effects. But her oncologist worked with her to find a milder alternative.

Chemotherapy ended July 25, 2016, and Vidal’s cancer is in remission. For at least five years she’ll take a daily anti-hormone pill. “But the fact that I’m alive and able to do most of the things I love again is great,” Vidal said.

Those include:

• Walking her dog, Kip, adopted a few months before her diagnosis. During treatment, “Even walking a block became an effort.”

• Walking the track and water aerobics at the YMCA.

• Writing and directing spoofs of musicals for her synagogue’s Purim celebrations.

• Teaching adult Hebrew classes.

Vidal’s cancer journey transformed Chava’s life, too.

Like her mom, Chava serves as a synagogue program director. But a year ago, after hours in hospitals and doctors’ offices, she told her mom, “I think I’d like to be a nurse.”

She plans to begin classes soon at Sinclair Community College.

“That’s the best part of the story,” Vidal said. “The nurses would kid her, ‘Chava, you could do this now.’”

For Breast Cancer Awareness Month, we share the inspiring stories of breast cancer survivors here in the Tuesday Life section, contributed by Premier Health.