How often have we heard about sudden illnesses that our loved ones have succumbed to or chronic diseases that crept up on them out of nowhere? The tragedy is that routine medical tests, which take a few minutes to perform, could have picked up these problems so they could be treated or even prevented. Tests are not pleasant but the consequences are far worse.
Common conditions in the UAE
"By far the most common conditions I see are impaired fasting glucose (previously called borderline diabetes), dyslipidemia (abnormal cholesterol levels), overweight and obesity, fatigue (tiredness and loss of energy), headaches and mood disorders like anxiety and depression," says Dr Anees Fatima, a family medicine specialist at The City Hospital in Dubai.
She says Middle Eastern and Asian ethnicities are high on the list for weight, glucose and cholesterol related conditions. "All three conditions I attribute to lifestyle, though genes play a role too. My suggestion to these patients is to lose 10 per cent of their body weight to start with."
The common fatigue, headache and mood disorder cases Dr Fatima sees across all nationalities, ages and both sexes "is possibly related to the increased levels of stress and the break up of social support systems and also due to inadequate food and water intake".
Dr Bernhard Fischer at Medi Clinic in Dubai says he commonly sees misdiagnosed diseases such as diabetes, bowel and cervical cancers and heart problems.
"This is mostly because people do not go for regular check-ups. They only go when they have their first heart attack. People are too busy with work. They do not have time for healthy living, diet, exercise or routine check-ups."
Surprisingly between 60 and 80 per cent of the UAE population is vitamin D deficient and this is important to address in women and children says Dr Fatima. A blood test will indicate whether you are deficient.
"I always stress preventive vaccinations for my adult patients," says Dr Fatima "but when I discuss vaccines the usual response is a sly smile and the question ‘Do I need vaccines at this age?' or ‘I wasn't aware that adults need immunisations'."
Vaccinations are important because people are in a region of the world that is unique. "In the UAE, we are exposed to people of different nationalities and vaccine statuses from developing and developed nations," Dr Fatima adds.
Unwind takes you through check-ups you ought to go for during your adult life …
In your late teens and twenties
There is no need to undergo special medical tests until your thirties, says Cardiologist Dr Brajesh Mittal and obstetrician and gynaecologist at Medcare Hospital. You should see a doctor if you:
- Have physical symptoms of illness or discomfort.
- Have a family history of hypertension, heart disease, cancer, diabetes, etc.
- Have a sedentary lifestyle and lack of exercise.
- Are overweight or obese.
A routine test would include looking at your medical history, an examination, a urine test, a blood test and kidney, lung and liver function test.
Then a systemic examination of skin, ear, nose and throat, lungs, heart, abdomen is conducted.
Your doctor will also check for cardiovascular disease where your blood sugar, cholesterol, blood pressure, family history of disease and smoking history will be looked at, including your previous medical history.
The doctor will look at your general history, which includes height, weight, waist circumference, work and other stressors.
"We also screen for cancer — the most common being prostate, bowel and lung — which is detected by blood tests and chest X-ray," said Dr Fischer.
At the age of 18, women need to go for a Papanicalou smear or cervical smear test. Women need to get the test done every one to three years, depending on various risk factors.
Pap smear testing is done till the age of 60. The pap smear can detect precancerous and cancerous lesions of the cervix.
"There is effective treatment for precancerous lesions of the cervix and we can prevent the progression of these lesions to cancer of cervix. This can be done as early as 20 years till the age of 65," say Dr Mittal and Dr Krishnan.
Depending on the technique used, your gynaecologist can also detect the Human Papilloma Virus infection.
In your thirties
Routine medical tests usually begin in your thirties. Among the tests you ought to go for are:
- Complete blood count: It looks for anaemia, other blood cell abnormalities and is an excellent indicator to a lot of diseases.
- Lipid profile (blood test): This will tell you your total cholesterol level and different types of fats.
- Kidney function test: It rules out kidney diseases that may end up with end-stage renal disease and dialysis.
- SGPT-SGOT-Albumin test: This measures liver function and shows possibility of hepatitis and liver disease.
- Blood sugar tests: To detect pre-diabetic and diabetic states. Diabetes is a risk factor for ischemic heart disease.
- Occult blood in stool: This is useful in patients with a strong family history of cancer of the colon.
- Routine and microscopic urine examination: This test reveals problems such as protein loss, infection, sugar, etc.
- Thyroid Stimulating Hormone (TSH) test: This is a good indicator for less or over functioning of the thyroid gland.
- Annual dental check-up
- Annual eye check-up
- Annual electrocardiogram (ECG): It checks rate and rhythm of heart.
In your forties
- Mammogram: This detects precancerous and early signs of breast cancer. Treatment of early stages of breast cancer has good prognosis and good survival rate. Doctors recommend that any woman over the age of 35, should have the test once to have a baseline image and this can be repeated every two to three years.
- Bone densitometry: This is to detect osteopenia (thinning of the bone) and osteoporosis.
- Stress electrocardiogram: The ECG is a graphical representation of the electrical activity of the heart muscle.
- Stool examination: For cancer after the age of 45.
- Prostate Specific Antigen test: This is a good indicator to screen prostate cancer in men.
In your fifties
- Stool test: This is to check the stool for blood count.
- Colonoscopy and sigmoidoscopy (endoscopy of intestines).
In your sixties
- Bone Mineral Density screening: It is imperative that you are screened for osteoporosis or brittle bones. Those with a low body weight (usually under 70kg) usually have low bone mineral density. Routine testing for osteoporosis involves a Bone Mineral Density (BMD) screening.
Moles should be checked every year by a dermatologist but patients should examine themselves using the "ABCDE" method:
This should be done every month. A good time to do this is during, or just after, menstruation. A simple breast examination done every month can drastically reduce the risk and mortality attributed to breast cancer. Examine all the quadrants of both breasts and look for any visible lump, asymmetry of breast, ulcer or discharge from nipple.
This should be done monthly. A good time to do this is after a warm bath or shower, when the scrotal skin is relaxed.