Checklists for Life

13

Health

Your know that your health is important, of course, but life is hectic and it’s easy to let health maintenance slide unless something goes wrong. These checklists will help you take control of your own good health by giving you the information you need to do it. They’ll guide you in important (but occasionally baffling) matters such as finding a good doctor and selecting an exercise plan.

Choosing a Primary Care Physician

If you can manage the time, it’s a good idea to schedule a get-acquainted visit with a few doctors before you commit yourself to one. As always, start by asking friends and family for recommendations. Then call several physicians in your insurance plan to find out if they’re taking new patients. Schedule a short visit and offer to pay for the time. This investment will pay dividends if it helps you find a doctor you trust and feel comfortable with.

 QUESTIONS TO ASK BEFORE YOU SCHEDULE A VISIT

1.	Where did the doctor go to school? Did he go to a reputable medical school? Did she complete three years of residency training in her advertised area of expertise? The AMA has an on-line service called “Doctor Finder” (www.ama-assn.org), where you can check education and training on any licensed physician in the country.
2.	Is the doctor board-certified for her type of practice? Board certification means the doctor has received advanced training and passed rigorous qualifying exams. But some doctors may emphasize board certification and fail to mention that it’s in a field they no longer do much work in. To check board certification on a physician you’re considering, call the American Board of Medical Specialties at 800-776-CERT (2378) or go to its website at www.certifieddoctor.org.
3.	What hospitals is the doctor affiliated with? Is one of them convenient to your home? Does it have a good reputation?

 QUESTIONS TO ASK AT THE DOCTOR’S OFFICE

1.	Am I comfortable with the doctor’s staff? The way you are treated by the staff makes a big difference to your experience with the doctor, of course. And it’s often a reliable indication of the doctor’s concern for patients as people, rather than as bodies. Pay attention to the atmosphere behind the reception desk: Does the staff seem efficient? Are they helpful in person and on the telephone?
2.	Do you require full payment from me or will you wait for direct payment from my insurance company? There isn’t necessarily a right answer to this (unless you’re on Medicare, in which case the doctor should wait to be paid by them). It’s a matter of your preference and financial situation.

 QUESTIONS FOR THE DOCTOR

1.	What is your approach to health care? Is the doctor oriented toward prevention? Does he ask questions about your lifestyle and health habits and discuss various ways you might improve your health? Does he see himself as your partner, collaborating with you on achieving your health and well-being?
2.	What happens when you’re away? Ask the doctor who covers for her when she’s on vacation and during weekends and days off. Ask why the person has been selected and don’t be afraid to quiz the doctor about the substitute’s credentials.
3.	How often will I need checkups? The answer to this question should be based on your age, general health, and medical and family history.
4.	What tests do you regularly order and what do you check for? Does the doctor explain the tests and the reason for doing them in a way that’s easy to understand?
5.	Can I bring a family member or friend into the examination room? This is a reasonable request and your primary care physician should be open to it if you’d like to do it.

Over-Forty checkups: What You Need When

After age forty most men and women begin to find out what it means to “feel your age.” Those little signs that you’re not a kid anymore—tiring more easily, having a harder time taking off weight—aren’t serious. But they are reminders that we take our health for granted at the risk of losing it. If you’re over forty, talk to your doctor about scheduling the exams on this checklist.

 FOR MEN AND WOMEN

1.	Blood pressure. Test at least every two years. But you needn’t go that long, since blood pressure checks can be part of any routine exam or trip to your doctor.
2.	Cholesterol blood test. Test every five years for total and HDL count; every three to five years after age sixty-five.
3.	Fecal occult blood test. Test annually for blood in feces, which may be an indication of colon cancer or other gastrointestinal problems.
4.	Colorectal cancer screenings. Screen every five to ten years. Each exam should include sigmoidoscopy, colonoscopy, barium enema, digital rectal exam.
5.	Fasting plasma glucose. Screen for diabetes every three years, if you’re overweight or have a family history of diabetes.
6.	Skin exam. In addition to a monthly self-exam, see a doctor annually to detect early skin cancers.
7.	Eye exam. Examine every two years, or annually if you have diabetes or a family history of macular degeneration.
8.	Dental checkup. Schedule regular cleanings, as recommended by your dentist.

 FOR WOMEN

1.	Mammogram. Schedule annually or every other year, depending on your doctor’s opinion.
2.	Pelvic exam and PAP test. Schedule every year. (Sixty percent of cervical cancers are diagnosed in women between the ages of fifty and seventy.)
3.	Bone density test. Have your first one at age fifty, or sooner if you are in a high-risk category (Asian or Caucasian, small boned, low calcium intake, heavy drinking or smoking, family history of osteoporosis).

 FOR MEN

1.	Digital rectal exam. To check for prostate cancer every year.
2.	Prostate specific antigen (PSA) test. This test has been controversial, so discuss it with your doctor.

 How to Join a Gym Without Straining Your Wallet

If you’d like to exercise at a gym, but are scared off by hefty sign-up fees and lengthy contracts, throw on your workout clothes and exercise these tips!

1.	Think car shopping. Just as you wouldn’t think of paying sticker price for the car you buy, you shouldn’t take a health club’s advertised price at face value. Most health clubs are eager to sell memberships—and that gives you some bargaining power.
2.	Shop early in the year. Club owners know that the combination of post-holiday guilt, new year’s optimism, and low prices can send scores of exercisers their way. Many gym managers make sign-up as irresistible as possible in January, offering bargain rates and flexible terms.
3.	Shop around. Spending the time to compare costs at several clubs in your area will pay off in the long run. If you can tell one manager that the club across town will give you a better rate, he may try to match or beat that price.
4.	Be bold. Ask for the sign-up rate the club offered last summer or last month, even if it has expired. If they want your business, they may be happy to give you a discount.
5.	Bargain. Offer them something. For example, if your schedule permits, promise you won’t use the club during their peak hours (usually 6 to 8 A.M. and 4 to 8 P.M. weekdays).
6.	Look for flexible terms. Most clubs make their money by locking you in with a large initiation fee or a long-term contract. This is highly profitable for the clubs because many people stop attending after the first couple of months—but the club still gets its money. Look for the flexibility of month-to-month contracts, the ability to transfer your membership if you move or lose interest, or refunds in case of moving or illness.
7.	Don’t say yes too quickly. Salespeople often pressure club shoppers to sign “now” to take advantage of a discount. Don’t be fooled. Hold out for the terms you want (a one-year contract, rather than a three-year, for example) because you can probably get them.
8.	Bring a friend. Most clubs will reward a new member who refers a friend or give a special rate to friends who join at the same time. Ask about these specials.
9.	Get a group rate. Many companies arrange for group fitness discounts for employees who join a specific gym. If your company doesn’t, ask the gym what you could do to get a group organized.

 How to Choose a Health Club You’ll Use

No matter what kind of deal you get signing up for a health club, you’ll have wasted your money if you stop going after a few months. Take your time to inspect the club and evaluate its features to make sure it meets your needs.

1.	Handy location. Chances are you won’t use a club that’s not easily accessible, no matter how good your intentions are. Narrow your choices to clubs within comfortable distance of home or work.
2.	Activities and scheduling. What hours is the pool open for lap swimming? How far in advance must you reserve tennis, basketball, or racquetball courts? Look over the club’s printed schedule for yoga, aerobics, or other classes you’re interested in. If you want to do aerobics on your way to work, but classes don’t start until 8:00 A.M., this club may not work for you. Find out how often the schedule of activities changes and how likely you are to get into a class you want. Do you need a reservation? Do you have to pay extra for certain classes?
3.	Reciprocity. Does your membership include use of other clubs in the area? If you travel frequently, will your membership allow you to use clubs in other states?
4.	Equipment, facilities, and maintenance. Don’t be taken in by a salesperson’s claim that broken equipment or shabby facilities are about to undergo a transformation. Judge by what you see.
	• Is all the equipment functioning?
	• Does the equipment look shabby or old?
	• Is the pool clean?
	• How clean are the shower and locker room? Do they smell clean?
	• Are the temperature and humidity comfortable in the exercise areas?
5.	Elbow room. Go to the club during prime time and notice crowding in classes and in workout areas. If you’ll be using the club during off hours, visit then and see how crowded it is.
6.	Staff. Ask about the training and experience of staff members. Some certifications to look for: AFAA, the Aerobics and Fitness Association of America; ACSM, the American Council on Exercise; and the Cooper Institute for Aerobics Research. Certification from these institutions doesn’t guarantee competence, but it’s a start. Talk to some of the instructors and judge their knowledge and communication skills yourself.
7.	Atmosphere. If you feel uncomfortable—whether the music is too loud, the other members seem too young, or there’s just an overload of flashy Lycra outfits—you may wind up avoiding the place.

 Ten Ways to Get Exercise Without Being Miserable

You don’t have to lift weights at a gym or run five miles a day to keep yourself fit. Just changing a few sedentary habits will contribute to your fitness and maybe even shift your attitude about exercise. Here are ten ideas to get you moving.

1.	Shun elevators. Make it a point to use the stairs instead of pushing that “Up” arrow every time. It is better for your body—and your morale—not to overdo it. Start with one or two flights at a time and add more flights only when it feels comfortable.
2.	Park your car far away . . . You’ll get significantly more movement into the day, and avoid that frustrating and time-wasting experience of searching for a “good” parking place.
3.	. . . And keep it parked. If you have to drive downtown for a few errands, park and leave the car. If you’re collecting several parcels, walk back to the car to drop them off before you go on to your next errand on foot.
4.	Do two things at once. Add exercise to your everyday activities by stretching and doing leg or arm lifts while you talk on the telephone, brush your teeth, or dry your hair. If you have a cordless phone, walk while you talk.
5.	Dance the dust away. Housecleaning will be a bit more fun (and a decent aerobic workout) if you play danceable CDs while you work. (See “Cleaning Supplies” on page 86.)
6.	Play with your kids. And I don’t mean video games. Get out there and bike or skate with them, walk up and down the soccer field at practices, climb the slide and use the swings at the playground!
7.	Take the long way. Don’t use the closest bathroom. Walk around the block to get where you’re going. Put a little distance between yourself and your destination.
8.	Make a walking date. Do you have a local friend you’d like to spend more time with? Suggest that you both get up an hour earlier and meet for a morning walk. Even twenty minutes of striding and arm swinging will do you good.
9.	Buy a bike. Unless you live in an extremely hilly area, taking a bike ride is an appealing and moderate way to exercise. Consider running errands on your bike—it might make you feel like a kid again!
10.	Go East. Many confirmed couch potatoes have been converted after trying such Eastern practices as yoga or tai chi. These meditative and gentle movements enhance both physical and spiritual well-being.