Taking Preventative Health Seriously

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We in Ireland are fortunate to be living in a developed country. Our standards of sanitation are good and we have a ready supply of clean and safe water. The physical environment in which we live is relatively benign and most of us live in reasonable accommodation. Very few people in this country experience hunger. Broadly speaking, most Irish people enjoy a good standard of living.

Most Irish people will eventually die from diseases of affluence. Many of the diseases we are likely to suffer from are lifestyle related. Therefore, we do have a choice.

We can choose to ignore research data on the prevention of certain diseases or we can choose to apply that knowledge and make some basic changes. If some or all of the following suggestions are applied you will modify your risk of developing certain diseases:

  • Don't take up smoking or if you are a smoker get help in trying to quit. It has been proven beyond reasonable doubt that the majority of smokers will eventually die from smoking related diseases. Research has demonstrated that smoking is a key factor in causing a wide variety of cancers. It is also a risk factor for heart disease. Smoking is also the major cause of chronic lung disease especially chronic bronchitis.
  • Diet is important in the development of a wide variety of diseases from cancer to heart disease. The following statements can all be backed up with plenty of research data:
    1. Eat more whole grain foods such as rice, pasta and bread to reduce your risk of getting cancer.
    2. Eat more fruit and vegetables to reduce the risk of cancer, stroke and heart disease.
    3. Eat more fish and reduce your risk of sudden cardiac death by half.
    4. Use less salt on your food and protect your kidneys. You will also reduce your risk of developing high blood pressure.
    5. Drink at least one pint of water in addition to your usual daily intake of fluid. This will be beneficial to your kidneys and will reduce the risk of kidney stones.
    6. Moderate alcohol consumption reduces the risk of heart disease and stroke.
    7. Young women should eat more dairy products to reduce their risk of osteoporosis in later life.
  • Exercising regularly will improve your cardiovascular health. You don't have to punish yourself with aerobics or run a marathon. Walk a mile a day or exercise at least three times a week. Conduct the exercise at sufficient pace to be slightly out of breath or to induce light sweating. A casual stroll would probably not be of any great benefit in relation to reducing the risk of heart disease. Regular exercise can also be extremely important in preventing loss of bone density in women. This is crucial in the prevention of osteoporosis.
  • Measure your height and weight and calculate your body mass index by using the body mass index (BMI) calculator, which you will find on our home page under the heading calculators. The magic figure for body mass is 25. Try to aim for a figure of 25 or less. If you are overweight try to get your weight down. This is easier said than done. In trying to get your weight down there are two basic principles that underlie all successful weight reduction programmes. They are the combination of calorie reduction with increased exercise. If you are bombarded with claims for the miraculous effects of some new master plan for reducing weight, check out if the programme contains these two principles. If the plan does not involve calorie reduction and exercise it won't work. Try the BMI Calculator in this clinic.
  • Try to reduce the levels of stress that you are exposed to. A certain level of stress is good for us but persistent unrelieved stress can cause "burn out". Stress can also have an aggravating impact on virtually any illness you care to mention. There is evidence that stress can impact directly on our immune systems creating a susceptibility to infectious diseases.
  • Practise safe sex if you are sexually active and are not in a monogamous relationship. If you are a man wear a condom. Remember that the incidence of sexually transmitted diseases is on the increase. Sexually transmitted diseases are not trivial infections and can have serious long-term complications. Some of them don't have uncomfortable symptoms so you might not be aware that you have become infected. If you are a woman you could catch chlamydia, a serious sexually transmitted disease which is very prevalent in Ireland. This can be a symptomless disease, which could have serious consequences in terms of your future fertility.
  • Every woman over the age of 50 should attend for breast cancer screening when invited to by the BreastCheck programme. Mammography has been shown to be cost effective in women over the age of 50 but not in younger age groups. Modern treatments for breast cancer are producing better results especially when the condition is diagnosed early. BreastCheck enables earlier diagnosis before a woman might even be aware that there is a lump in her breast.
  • It is a good idea to have your own GP. A GP has had a very broad medical education and can assist you in wide variety of health areas. Your GP can organise referral to a specialist if your condition requires it but the vast majority of health problems that exist within the community are satisfactorily dealt with in general practice. Many GPs offer screening services within their surgeries including:
    • cholesterol measurement
    • cervical screening
    • PSA testing for prostate cancer
    • testing blood and urine to detect high sugar levels
    • ECG testing

Cholesterol testing

The level of cholesterol in the blood can be estimated from a small blood sample. It is recommended that the sample be taken after a period of overnight fasting. Some GPs have a device in the surgery, which enables them to give an immediate result. GPs who don't have such equipment can still take the blood sample and have the analysis performed in the laboratory of the local hospital. The result is usually available in the surgery within a few days.

Cervical screening

Cervical screening is a screening test to detect early changes in the cervix that can herald the later development of cancer of the cervix. The interval of time between these changes and the development of cancer can be as long as 10 to 15 years. The test involves the taking of a sample of cells from the cervix or neck of the womb. This is performed though a device called a speculum, which enables the doctor or nurse to see the cervix clearly. A small wooden spatula is inserted through the speculum and is gently rubbed off the surface of the cervix. This action removes a thin layer of superficial cells from the cervix, which is then smeared on a glass slide. This action gives the alternative name of "smear test" to this screening test. This sample is then sent off to the laboratory where it undergoes analysis.

PSA testing

The letters PSA stand for prostate specific antigen. This is a screening test for carcinoma of the prostate and is based on the analysis of a small blood sample. If the antigen is above a certain level it can indicate the possibility of prostate cancer. The test is not diagnostic of prostate cancer. If the level is high it suggests the need for referral for further investigation.

Glucose measurment

Glucose levels in the urine are readily measured in the surgery by dipping a colour-coded dipstick into a sample of urine. The different coloured bars on the dipstick are impregnated with chemicals, which react by changing colour depending on the level of glucose in the urine. The level of glucose in the blood can be measured by placing a drop of blood on a special reagent strip, which is then inserted, into a special device called a glucometer. A result is obtained in a matter of seconds. Both urine and blood testing are available in most GP surgeries. These simple technologies are well known to diabetics since many of them possess these measuring devices and perform these tests on a regular basis at home.

ECG

Increasing numbers of GPs are now able to perform ECGs in their surgeries. ECGs are used for the detection of heart disease. The letters ECG stand for electrocardiograph. This test involves the attachment of a series of leads to the wrists, ankles and chest wall that are connected in turn to an electrical monitoring device. The device measures the level of electrical activity in the heart and the result is produced on a roll of graph paper. The patterns obtained on the graph paper are then interpreted for signs of heart disease.

Increasing numbers of GPs are now able to perform ECGs in their surgeries. ECGs are used for the detection of heart disease. The letters ECG stand for electrocardiograph. This test involves the attachment of a series of leads to the wrists, ankles and chest wall that are connected in turn to an electrical monitoring device. The device measures the level of electrical activity in the heart and the result is produced on a roll of graph paper. The patterns obtained on the graph paper are then interpreted for signs of heart disease.

Final Words

You have the power to influence your risk of acquiring certain diseases. Unfortunately this advice will not make you immortal. You will die of something. That is the one certainty of human existence but at least you can ensure that you do not damage yourself prematurely through a reckless lifestyle.

As a final thought remember the old proverb, "be moderate in all things, especially in moderation".

Written by Dr Leonard Condren, medical editor, irishhealth.com

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