ANNUAL PREVENTATIVE EXAMS

Annual preventative exams are important because they can find health problems early, improving your chances of treatment and cure. Your annual preventive exam is an important opportunity to identify underlying conditions that may lead to fatigue, poor functioning and disease, if not corrected. It is not uncommon to identify several such conditions, such as low thyroid, iron deficiency, sleep apnea and Vitamin D deficiency, during one annual exam. In line with the focus of our practice, we offer the opportunity for in-depth, personalized diagnosis that leads to a more in-depth health assessment and a more comprehensive and targeted treatment plan. At Cogent Family Healthcare, we focus on prevention of disease, as well as more strategic and complete intervention. We believe that our unique offering services, screenings, and treatments, give you the necessary steps to live a healthier and more fulfilling life.

This year, you can experience these benefits:

Services:

Travel Vaccines:

Travel preparation including vaccines and other preventive measures, adhering to Centers for Disease guidelines.

Tuberculosis Testing:

Tuberculosis skin and blood testing and treatment of latent tuberculosis.

Pregnancy Testing:

Urine and blood testing for pregnancy.

Testosterone Testing:

Blood tests for testosterone levels and related testing to provide an individualized assessment of the risks of testosterone replacement.

Vaccines:

Shingles Vaccine

Chicken pox from childhood infection is still alive in your spine, if you were born before 1995 when the childhood vaccine was introduced in the U.S. That virus starts multiplying again later in life, and can cause severe lifelong pain, in some people. The one-time adult shingles vaccine, recommended at age 50 or above, reduces by 75% the chance of getting chronic pain from shingles. Adults who didn’t have chicken pox as a child can die from getting infected with chicken pox as an adult. The same shingles vaccine protects against this also.

Adacel DtaP Whooping Cough Vaccine

Whooping cough disease causes a cough that results in vomiting or fainting, lasting three months. Antibiotics are not effective after the first two weeks, when it is often hard to tell that whooping cough is developing. Many thousands of new cases of whooping cough are occurring each month in California. Everyone at least 11 years old is recommended to have the one-time whooping cough tetanus combination vaccine.

ECG (electrocardiogram):

The ECG measures the electricity of the heart, showing abnormal rhythms that can cause stroke, and heart attacks that were not felt, as can happen with diabetes. A baseline ECG enables determining whether later chest pain is due to a heart attack, based on whether changes from baseline are seen on the ECG during the chest pain.

IMT/Artery Disease Analysis:

Both the cholesterol and inflammation that make up artery disease, thicken a layer in the artery wall called the intima media thickness (IMT). Plaque, is a localized mound of artery wall cholesterol inflammation, that is at least 1.3 mm thick, and which further greatly increases the risk of heart attack or stroke, beyond the background IMT. An IMT/plaque ultrasound is an FDA approved test that measures the thickness of the IMT in the walls of the carotid artery (located in the neck) as well as the degree of plaque in the artery. This is one of the only tests to find artery disease at a stage in which it can be stopped before plaque (high risk thickening) occurs, and when the disease is much more likely to be reversible. It is a measure of how much artery wall disease you have at the present time and how bad it is, compared to your cholesterol level which is a risk factor, that can only be used to calculate a statistical chance that you may get a heart attack in the future.

This screening test can be performed between the ages of 25 and 80 but generally should be considered in men over age 25 in South Asians, and, in non-South Asian groups, in men over 45 and women over 55. Risk factors include:

• Family history of heart attack and/or stroke
• Abnormal cholesterol levels (high LDL or “bad” cholesterol, low HDL or “good” cholesterol, or elevated triglycerides)
• High blood pressure (hypertension)
• Smoking (former or current)
• Diabetes or metabolic syndrome
• Overweight or physically inactive or unhealthy lifestyle
• Sleep apnea
• Chronic inflammatory disease or disorder (such as rheumatoid arthritis, lupus, psoriasis, HIV, inflammatory bowel disease)
• Prior abnormal CIMT test to help follow the effectiveness of risk-factor modification

The above risk factors, as well as aging, are contributing factors to an increased carotid intima-media thickness as well as risk for heart attack and stroke

Screening Labs:

In keeping with our focus on discovering and treating underlying causes for symptoms, we screen for low thyroid, iron, and vitamin D, in appropriate patients. These are in addition to a complete blood count and a complete metabolic panel that tests your blood plasma and can indicate any issues that exist in your kidneys, liver and blood chemistry.

Prostate Cancer Screening:

Prostate cancer screening using only a blood test is a way that maximizes detection and minimizes un-necessary treatment. Using our techniques, we have alerted several men in their 40’s of high grade prostate cancer, that would not have remained harmless through their lifetime. Treatment decisions are made with specialists who are very careful to fully educate patients on the benefits and risks of all options, including careful monitoring of known prostate cancer (called “watchful waiting”).

Colon Cancer Screening:

Colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Colonoscopy enables removing polyps before they become cancer. You should begin screening for colorectal cancer soon after turning 50, then continue getting screened at regular intervals. However, you may need to be tested earlier than 50, or more often than other people, if—

You or a close relative have had colorectal polyps or colorectal cancer.
You have an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
You have a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).
Referrals by our office to specialists to do the colonoscopy take into account the expertise of the specialist, since one study found that 40% of colon polyps are missed, when all colonoscopies were evaluated.