Doctors are fond of using the car analogy when they talk about preventive health check-ups. “Everyone remembers to take their car for servicing at 5,000km, whether there is anything wrong with it or not,” says Dr Ashutosh Shukla, consultant, internal medicine, at Artemis Health Institute, the newly-opened 500-bed superspeciality hospital at Gurgaon, near New Delhi.
Forty years is the human equivalent of 5,000 km for a car—when every person, male or female, is advised to get a comprehensive physical and clinical examination done to make sure that all systems are functioning normally. But, increasingly, doctors are suggesting these tests should be done earlier, preferably at 35, given the changing lifestyles and new disease patterns.
Of course, a large number of corporate citizens who are still only in their 20s and early 30s do manage to pack in an annual physical examination—thanks to sensitive employers who make sure their employees take compulsory health screening tests every year.
But, there is a significantly large number of men and women who enter their 40s without once having had a dental examination or a lipid profile done. This can prove to be a grave lapse, stresses Dr Shukla, because an analysis of the data from preventive health check-up programmes done so far at Artemis has revealed that “one-third of those who came for routine check-ups were found to have high cholesterol levels”.
Rachna Sharma, a 40-year-old employee with a nationalized bank in Ghaziabad, near New Delhi, is a typical case. Since she was going in for a new health insurance policy, she had to undergo a complete examination—and her high cholesterol levels came to the fore. Now, an alarmed Sharma wakes an hour earlier to accommodate a morning walk into her busy routine and is advising her friends who are entering their 40s to go for check-ups.
Incidentally, although aware of these tests, many like Sharma would never have taken them unless there were some compelling reasons—buying a financial product that requires a medical examination, applying for an immigration visa, or joining a new job where the company has a pre-employment health screening clause.
It is not that people are not aware, but the typical Indian attitude is to resist a trip to the doctor until absolutely required. Accessibility of the tests is no longer an excuse either as almost all hospital groups—from the large ones such as Apollo, Wockhardt and Max to the neighbourhood clinic—offer executive health packages that include a whole battery of tests. Many even customize these packages to individual requirement. If these seem a tad expensive, then there are pathology laboratory chains such as Dr Lal’s, SRL Ranbaxy and Wellspring, with a national network that offers test packages which are more affordable. Or else, for sheer convenience, there is the neighbourhood chemist networked to the closest path lab, which picks up samples at 6.30am from home and SMSes the test results or drops them home, saving one the trouble of fasting till the lab opens.
Also, technological advances in medicine have meant there are a whole lot of predictive tests available, which can be taken by people in the risk group earlier than what is generally prescribed. For instance, even if your routine check shows no block in the arteries, but a genetic predisposition to heart ailments runs in the family, you could go in for blood tests like CRP (C-reactive protein). Individuals with an elevated level of CRP have a higher risk of having a heart attack than individuals with normal levels of CRP.
Often, seemingly trivial results can forebode a serious problem. Take New Delhi-based advertising professional 32-year Dibyendu Ghosh, whose routine blood test showed an alarmingly high level of serum uric acid. Now, this could denote anything from failing kidneys to gout and also be a predictor for potential hypertension, but fortunately for Ghosh, his doctor, after a serious cross examination about his lifestyle, told him it was probably due to strenuous exercising, a poor diet and too much alchohol. Sure enough, the lifestyle adjustment helped Ghosh bring down his uric acid levels.
There are four types of cancers—breast, cervical, prostrate and oral—that can be detected early in regular screenings, though some of these tests are not part of the regular health check protocol. Dr Amit Bhargava, consultant oncologist at Max Healthcare in New Delhi, also points out that those with a family history of colo-rectal cancer should get their stool tested once in a while since they are at increased risk.
Although lung cancer is relatively difficult to detect, doctors do advise smokers to periodically get chest X-rays done. Dr Kushagra Katariya, cardiothoracic surgeon and CEO of Artemis, says that a baseline low-dose CT scan of patients at risk (heavy smokers) can help detect lung cancer early on.
But what most of us are guilty of is skipping the routine dental examination that is recommended once in six months for every individual. However, Dr Atul Mahajan, a New Delhi-based dentist who practices in Mayur Vihar, says “awareness is increasing”. He says: “I have been practising for the last 11 years and in the last 3-4 years, I have observed that people have started coming in for check-ups even when there is nothing wrong.”
Dr Mahajan stresses that it is very important for children to have routine dental examinations as the incidence of tooth decay is very high in childhood and their dental status keeps changing. He suggests checks once in four months.
The high rates of pollution and increased use of computers have also led to doctors prescribing more visits to the eye specialist for routine check-ups. Among other things, the tests can spot weakening of eye muscles, as well as diseases like trachoma and glaucoma.
Changing lifestyles have also meant that recommended protocols for tests are being altered rapidly. Anas Wajid, head (marketing, sales and PR), Artemis, points out how head and neck examinations were not part of the earlier routine checks—but now, increasing reports of headaches and sedentary work habits have led to hospitals tailoring packages to include tests for spondylitis and cervical spine disorders.
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