Can you hear me? And other tests to check your health

Last week’s column discussed how to prevent and detect common medical problems such as hypertension, diabetes, high cholesterol and obesity.

Today’s article will focus on screening tests for other common health problems like hearing loss, periodontal disease, vision changes, skin cancer, and osteoporosis.

A complete preventive health visit should include a review of any symptoms you may be experiencing, your lifestyle, and your medical and family history.

It may include a head-to-toe exam but more likely include a focused look at certain body parts or health conditions, depending on your age and health status.

Hearing Loss

An estimated one-third of people older than age 60 and one-half of those older than 85 have some degree of hearing loss due to normal wear and tear on the ears.  Heredity, exposure to loud noises, some illnesses and medications also increase the risk of age-related hearing loss (presbycusis). Although you can’t reverse hearing loss, you and your ENT physician or hearing specialist (audiologist) can take steps to improve what you hear.

Recommended exams: A baseline hearing test is recommended by age 60, or earlier if you’re exposed to loud noises or suspect hearing loss.

What’s involved: At first, your doctor may conduct a general screening test that involves covering one ear at a time to see how well you hear words spoken at various volumes and how you respond to sounds. During a more thorough testing conducted by an audiologist, you wear earphones and hear sounds directed to one ear at a time. The audiologist presents a range of sounds of various tones and asks you to indicate each time you hear a sound. Each tone is repeated at faint levels to find out when you can barely hear. The audiologist will also present various words to determine your hearing ability.

How to prepare: There’s no preparation. However, you may want to make sure your ears are clear of wax, which can interfere with hearing.

Periodontal Disease

Periodontal disease — an infection of the gums and other tissues that support the teeth — is a frequent problem in adults 45 or older. Almost half the adults at midlife and beyond may be affected by periodontitis, a serious form of periodontal disease that can lead to the loosening and eventual loss of teeth.

Recommended exam: A dental checkup is recommended at least once a year.

What’s involved: During checkups, your teeth and gums will be examined with a probe and small mirror. Your dentist also will usually check the tongue, lips and soft tissues of your mouth to look for abnormalities.

How to prepare: Brushing and flossing on a regular basis is the best way to care for your teeth and prepare for dental checkups. However, you should also be sure your dentist has updated information about your health conditions, medications and drug allergies. For example, people with certain heart conditions or joint replacements may need antibiotic before undergoing cleansing procedures, which can dislodge bacteria and lead to an infection of heart valves or around implanted devices.

Vision Changes, Eye Diseases

As you age, eyesight changes tend to creep up on you and may require you to wear some type of corrective lenses. Age also puts you at greater risk of developing some diseases and conditions that can permanently damage your vision including glaucoma, macular degeneration and cataracts.

Recommended exams: An eye exam is recommended every two to four years between ages 40 ad 65 to identify any vision problems. At age 65 and after, your ophthalmologist or optometrist may want to check every one to two years. More frequent checks may be recommended if you already wear corrective lenses, have vision problems, or are at increased risk of eye disease because of diabetes, high blood pressure or a family history of eye disease.

What’s involved: During a typical exam, your eye doctor will have you read eye charts and dilate your pupils with special eye drops. He or she will also check your eye movements, peripheral vision, color vision and the acuity of your eyesight. In addition, a painless procedure called tonometry will measure the pressure inside your eyeball. Your doctor will also view the inside of your eye using an instrument called an ophthalmoscope.

How to prepare: Bring any current eyeglass prescriptions to your exam. You may also want to arrange for transportation home because when your pupils are dilated, your vision may be blurry and sensitive to light for several hours afterward.

Skin Cancer

Skin cancer is one of the most common forms of cancer. If left unchecked, it can spread from the skin into other tissues and organs. There are different types of skin cancer: basal cell carcinoma, squamous cell carcinoma and melanoma. Basal cell carcinoma is the most common. But melanoma is the leading cause of death from skin cancer.

Recommended exams: A full-body skin cancer screening is recommended every two to three years before age 50 and the annually thereafter. It’s also advised that you regularly check your own body so that you become familiar with existing moles and can spot any new growths or suspicious changes that need to be brought to your doctor’s attention.

What’s involved: Your doctor or dermatologist will examine your skin from head to toe, looking for moles that are irregular in shape, have color variations, have irregular borders, are greater than the size of a pencil eraser or have grown or changed since your previous visit (see photos).

How to prepare: A full-body examination requires no special preparation. Minimizing sun exposure and protecting your skin while in the sun are the best ways to prevent skin cancer or keep new skin cancers from developing.

Osteoporosis

Osteoporosis is the thinning of bone tissue and loss of density over time, which can lead to serious bone fractures. Women over age 50 represent the majority of those with osteoporosis. That’s because bone loss produces much less of the bone-protecting hormone estrogen.

Recommended exams: The US National Osteoporosis Foundation recommends that all women age 65 and older and all men 70 and older have bone mineral density (BMD) testing. A BMD test is also recommended at menopause or earlier if you have a family history of osteoporosis or other risk factors. How often you retest usually depends on your age and risk factors.

What’s involved: Various BMD tests are available. The most commonly used one is dual energy X-ray absorptiometry (DEXA or DXA) test. During this test, you lie on a padded platform for a few minutes while an imager — a mechanical arm-like device - passes over your body and measures the bone density at your hips, spine and wrist.

How to prepare: BMD tests are fast, painless and require no preparation. However, if you’ve recently had an x-ray test with contrast material in the gastrointestinal tract or a nuclear medicine test, tell your doctor. These tests may affect BMD test results.

An Ounce Of Prevention

Although disease prevention has become a major focus of medical practice, it’s important to take an active role in your own health care. To make sure you’re getting the tests and exams that are right for you, talk with your doctor.

Indeed, as far as your health is concerned, an ounce of prevention is truly better than a pound of cure!