“Although age is one of the non-modifiable risk factors for chronic disease, you can control other risk factors, thus preventing the onset of illness or slowing the progression of disease for those already living with diabetes, heart disease or cancer,” says George M. Dodds, M.D., a hospitalist and board certified internist with the FirstHealth Moore Regional Hospitalist Service.

“Routine health screening can help you identify early warning signs such as elevated cholesterol or blood pressure, or an unhealthy weight or risky lifestyle choices such as tobacco use—the most easily modifiable risk factors for chronic disease,” he says.

In Leone-Britt’s practice, many individuals proactively request routine screenings such as blood tests for cholesterol and glucose levels, or outpatient screening procedures for breast and colorectal cancer.

“People are becoming more educated and interested in becoming partners in their health care,” she says. “They’re researching on the Internet, reading magazines and talking to their friends about medical issues. People seem more comfortable having a dialogue in the office. Rather than me telling patients what to do, patients are asking me questions about being tested for this or that. The open dialogue is wonderful. It makes the physician-patient interaction much more of a partnership, on more equal footing than it used to be.”

General guidelines for all
When it comes to fighting heart disease, diabetes, stroke and certain types of cancer, the same or similar clinical guidelines apply to both women and men:

• Cholesterol measurement: Elevated blood cholesterol puts you at greater risk for heart disease, the leading cause of death in America, and stroke, the third-leading cause of death. Physicians recommend that you have your cholesterol checked at least once every five years after age 20. To fully protect yourself, experts recommend a test called a lipid panel or lipoprotein profile, which measures total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol and triglycerides.
• Colorectal cancer screening: All adults age 50 and over face an increased risk of developing colorectal cancer, which is believed to develop from non-cancerous growths, called polyps, on the walls of the colon or rectum. Over time, polyps may begin to grow abnormally and become cancerous. If undiagnosed and untreated, colorectal cancer can spread to other parts of the body.
  Doctors use several methods to screen for colorectal cancer: digital rectal examination, fecal occult blood testing, sigmoidoscopy, colonoscopy and barium enema. Ask your doctor which method is appropriate for you.
• Blood pressure screening: Regular blood pressure screening is important as you age because hypertension, or high blood pressure, has no symptoms. Postmenopausal women are especially at risk for high blood pressure. If untreated, hypertension can lead to stroke, heart attack, heart failure or kidney failure.
• Diabetes test: Of the more than 18 million Americans living with this progressive disease, 5.2 million—or one-third—are undiagnosed. Another 41 million adults age 40-74 have elevated blood sugar levels signaling pre-diabetes. Diabetes occurs more frequently in women, African Americans and Latinos.
  The American Diabetes Association recommends a fasting plasma glucose test or an oral glucose tolerance test for all adults beginning at age 45. The American College of Endocrinology and the American Association of Clinical Endocrinologists urge at-risk people—those with high blood pressure or high cholesterol, obese or overweight individuals, or those from susceptible ethnic groups—to start screening at age 30.

• Normal—Less than 120/80 mm Hg
• Prehypertension—120-139/80-89
• Hypertension—140/90 mm Hg or higher

Source: American Heart Association

Medicare is a federal insurance program for people age 65 and over and for many disabled persons. It is not to be confused with Medicaid, which is a joint federal-state assistance program for people with low income and limited assets.

Medicare has two parts: Part A (Hospital Insurance) pays some of the costs of hospitalization, limited skilled nursing home care and hospice care. Part B (Medical Insurance) primarily covers doctor’s fees, most hospital outpatient services and certain related services. Both Parts A and B cover many home health services.

Some of the items and services not covered by Medicare include long-term nursing home care, routine physical and eye exams, hearing aids, dental care and most dental services, routine foot care and orthopaedic shoes (except for diabetics), and services or items paid for by a government program or workers’ compensation.

The Medicare Prescription Drug Improvement and Modernization Act of 2003 added new prescription drug and preventive benefi ts, and provides extra help to people with low incomes.

Bill highlights

In 2004, Medicare began contracting with private companies to offer drug discount cards until a Medicare prescription drug benefit starts in 2006. Enrollment began in May 2004 and will continue through Dec. 31, 2005.

New and improved preventive benefi ts that began in January of this year include:

• A one-time initial wellness physical exam within six months of the day a person fi rst enrolls in Medicare Part B
• Screening blood tests for early detection of cardiovascular (heart) disease
• Diabetes screening tests for people with Medicare who are at risk of getting diabetes

Prescription Drug Benefi ts will be added to Medicare in 2006. All people with Medicare will be able to enroll in plans that cover prescription drugs. Plans may vary, but most will involve the selection of a plan and the payment of a monthly premium and a deductible.

Some plans may also have options to help with out-of-pocket costs, and extra help will be available for people with low incomes and limited assets.

For information on these and other benefits and for additional information about Medicare, visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227.) TTY users should call 1-877-486-2048.