Grown-up Checkups

by Barbara C. Neff

With the kids returning to school, you may have recently taken them to the family doctor to update their shots. But, as National Adult Immunization Week (September 20–26) reminds us, regular immunizations—and good old-fashioned medical checkups—aren't just important for children. Despite the hustle and bustle of everyday life, healthy adults need to stay current on their vaccines and medical tests, too.

"Tetanus is the most common vaccine for adults," says Dr. Maleeha Basha, a board-certified internist with the DuPage Medical Group. "You need to make sure your tetanus is updated every ten years. Otherwise, you can get a scrape or cut and then get an infection that passes through your bloodstream."

Doctors say adults might also require the vaccines for measles, mumps and rubella if they didn't receive them as children. The same rule applies to the vaccine for hepatitis B, which may not even have existed when some of today's adults were young.

Of course, there's more to maintaining good health as an adult than just getting your shots. At a minimum, Basha says all adults should see their physicians once a year to check cholesterol levels and screen for diabetes and thyroid problems. The annual visits will also include various tests, depending on a patient's age and risk factors.

Men, for example, generally should first undergo the prostate-specific antigen (PSA) test at age 50. "But we usually do a baseline at 45 or 40 if they have a history of cancer in the family," Basha says.

Colonoscopies also are normally administered after age 50. Depending on the initial results, the procedure is repeated every five to 10 years thereafter.

Cardiovascular screenings may be performed, too, based on a patient's risk factors, such as high blood pressure or cholesterol. "Patients are starting to be screened at 35," Basha says, "especially those who are obese and physically inactive."

"We also recommend that all adults should be screened for depression as early as 25 years of age because it's such a common entity, especially if they have a family history," Basha says. The screening focuses largely on two questions: Have you felt down or depressed in the past two weeks? Have you felt little interest and pleasure in doing things in the past two weeks?

In addition to the standard gender-neutral tests, women must stay current on various other tests for their health. Dr. Judith Bressler, a board-certified obstetrician and gynecologist at the DuPage Medical Group, advises women to have a "female exam" once a year—whether from a gynecologist, family physician or internist—beginning when they become sexually active. "It's mainly about maintenance of health and early detection of cancer," she says. Bressler says that annual Pap smears are now recommended for any woman who has been sexually active for three years.

And Bressler stresses that there is no point at which women can safely stop receiving gynecological exams, including mammograms. Any woman with ovaries requires annual pelvic exams to rule out certain cancers, among other abnormalities, and even women who have had hysterectomies should have breast exams. "I tell all my patients by age 30 that I'd like them to do a self-exam each month," Bressler says. "In low-risk women, mammograms should be done beginning at age 40 and annually after." An annual breast exam by a physician is also critical.

Despite all the attention on the body below the neck, adults shouldn't overlook their vision and hearing. Basha recommends vision and hearing screenings for adults above the age of 65, and earlier vision screenings may be in order for those with diabetes or hypertension.

The goal, of course, is for adults to maintain good health by watching for changes in their bodies, communicating with their doctors and scheduling annual physical exams...even though their back to school days may be a bit of ancient history.