Parental health
Author: MEG H. PARTINGTON

Ensuring that children have all the age-appropriate vaccinations and regular checkups is a major parental responsibility.
Equally important is the need for parents to take care of themselves.
Dr. Robert Jones, who practices internal medicine and pediatrics in Ranson, W.Va., says mothers typically are vigilant about having annual gynecological exams, while men tend to wait to see a doctor until they’re experiencing health problems or until they turn 40, when their wives start hounding them. He attributes men’s avoidance of doctors not to fear, but to their tendency to get wrapped up in their work and to not set aside time for health assessments.
Jones and Dr. Molly Castille, with Winchester (Va.) Family Practice, offer the following preventive health-care guidelines:

Men and women:
* The tetanus vaccine is administered as part of the DTAP (Diphtheria, Tetanus and Pertussis) vaccine at ages 2, 4 and 6 months, then in kindergarten and junior high school. Tetanus vaccines should be updated every 10 years thereafter.
* The Hepatitis B vaccine routinely is given in childhood. It should be administered again in adulthood to those who have had multiple sexual partners, transfusions, have been stuck by needles, are IV drug users or work in health care.
* The meningitis vaccine usually is given during physicals before young adults go off to college. It is especially important for those who will be living in tight quarters, such as college students residing in dorms and those serving in the armed forces.
* Young adults should have checkups every couple of years, during which their height, weight and blood pressure are checked, as are the health of their heart and lungs.
* At age 30, general routine physicals are recommended every one to three years for those who are monogamous or not sexually active, Castille says. The frequency of the checkups depends on family and personal history, Jones adds. Typically, heart and lung function are checked, and the skin is probed for signs of cancer. Kidney tests also may be done.
* Baseline cholesterol levels usually are taken in men around age 35, women at age 45, though they can be done earlier. Those at high risk of having cholesterol problems, such as those with diabetes, a family history of high cholesterol, smokers and the obese should have a baseline check around age 20, Castille says.
* Screenings for colorectal cancer should begin around age 50, earlier if a person’s familial history puts him or her at risk for the disease. Screenings include colonoscopies and flexsigmoidoscopies. During a colonoscopy, a doctor looks at the internal walls of the colon through an instrument called a colonoscope, according to the Centers for Disease Control and Prevention. The doctor may collect samples of tissue or cells for closer examination, and also may remove polyps, the CDC says. A flexsigmoidoscopy is a procedure that involves looking inside the rectum and the lower portion of the colon through a flexible, lighted tube called a sigmoidoscope, the CDC says. The doctor may collect samples of tissue or cells for closer examination and remove some polyps within view, according to the CDC. Such screenings are recommended once every 10 years for those in low-risk groups, every three to five years for those with a higher risk.
* Flu shots are recommended for those 50 and older every year, as well as those with decreased immunity. Women who are past their first trimester of pregnancy also can get the shot, Castille says. “It’s a killed virus,” she says, so people won’t get the flu from the shot.
* Pneumovax, a vaccine against pneumonia, is recommended for those older than 65 or younger individuals with emphysema or renal disease. Those with other significant medical problems should ask their doctors before getting the vaccine, Castille says.
* Those who are traveling to another country should see a doctor or go to their local health department to see what immunizations are recommended.
* Chest X-rays are recommended for men and women who are smokers, Jones says, though the age at which they are done and their frequency is a subject of debate in the medical community.

Women:
* Women should begin self breast exams between the ages of 16 and 18 to become familiar with their breasts, Jones says. He recommends doing the exams at the conclusion of a menstrual cycle; women with cystic breasts may find that their breasts are lumpier prior to their cycle starting, which may cause unnecessary alarm.
* Pap smears, which are part of an annual gynecological exam, should begin within three years of a first sexual experience or by age 21. Gynecological checkups typically include breast exams.
* Women who are thinking about having children should meet with their physician to discuss what vitamins they should be taking and what medicines, food or environmental toxins they should be avoiding, Castille says.
* The first mammogram is recommended between ages 35 and 40, Jones says, though women with family histories of breast cancer should be screened earlier. After the first mammogram, subsequent ones should be done every one to two years until age 50, when they should be done every year, Castille says.
* Blood counts should be checked around age 40 to look for anemia, though women as young as their 20s may be tested if they are experiencing fatigue.
* DEXA scans — X-rays of the hips, lower back and a forearm that can show signs of osteoporosis — usually are done on women older than 65, but can be performed earlier on women who have had hysterectomies, entered menopause early in life, are petite, smoke, have a family history of osteoporosis or have eating disorders that cause irregular menstrual periods.

Men:
* Rectal exams to check for prostate cancer are recommended for black men or men with family histories of the disease around age 45 — sometimes as early as 40 — and white men around age 50, Castille says.
* Men ages 40 and older may want to discuss aspirin therapy with their family physician to help prevent cardiovascular disease, Jones says. Their dosage may be as small as one baby aspirin a day, he says.

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