Health checkup packages: How to choose and prepare for the right one

Do you remember your first tryst with the doctors? Mine was at the health checkups conducted annually in our school. It was a great time for us children to compare our heights and giggle about our weight. The child who struggled to read the black board was found to have a vision defect and was advised glasses. The child who never listens to anyone and labelled a rebel actually had a ear full of wax. Interesting how so much could be found with just basic head to toe examination and non-invasive tests! This was years ago and for many such preventive health checkups ended with school and it would have the most basic health checkup package that we would have encountered.

Who has the time to go do these checkups. Most of the times they turn out to be false alarms right? Wrong! ‘Prevention is better than cure’ and checking if all things are in order periodically even before damage sets in will set you on a path to good health.

In my earlier post about the ice berg phenomenon, I had mentioned how many illnesses remain hidden from plain sight unless tested for early. The importance of periodic preventive health screenings to detect early changes and deviations in our body from the norm was briefly touched upon. Many such diseases like diabetes, hypertension, heart disease and even cancers have a long ‘latency period’ wherein the body does not show any symptoms at all but irreparable damage has already began inside unbeknownst to the individual. In such diseases carrying out an annual health checkup can quickly detect, diagnose and put a person on the early path to recovery. There are many health checkup packages that are available in the market that one can rely upon to identify these hidden illnesses.

Now a health checkup is not just designed to detect diseases earlier it also helps you to cut down unwanted and catastrophic health care costs in the future as well, so a little caution now will go a long way. Many families are pushed daily below the poverty line when a breadwinner of the family has been struck with some devastating illness like a heart attack or stroke. Apart from the massive health care costs, the loss of earning potential makes matters worse. So how can we prevent falling into this trap when we know that someday or the other our health is going to catch up to us. The answer is to be prepared and carry out annual health checkups.

While many have now taken their health seriously, most are faced with the conundrum of which health care package to choose from amongst the many available? Do we do the basic health care package and test only the blood group, hemoglobin and total counts? Or do we go all in and shell out thousands doing a full body CT scan? There is no simple answer to this question.While these health care packages are pricy and might seem like an investment you can choose to get them done for subsidized/free at your nearest government medical colleges and tertiary government hospitals.Also watch out for medical camps organized by government/NGO/corporate CSR activities that offer many of these health checkups for free.

How and what health care package to choose depends upon your age and the risk category you fall into. Your age, gender and family history along with certain habits like smoking, physical inactivity will largely determine what health checkup packages you should choose.

As a rule if you are anywhere between 30 and 40 years you can check for blood sugars, blood pressure, cholesterol and blood hemoglobin values. Women can opt for breast examination and Pap smear testing for detecting cancers.

In case you are a diabetic or a hypertensive patient you can do additional tests to detect their complications such as a kidney profile, fundus examination of the eyes and an ECG test for the heart along with a good foot examination.

If older than 60 years, in addition to the above you can do a treadmill ECG testing and ECHO test to detect your heart function. This is the first step even before getting an angiogram. Liver function test and thyroid testing is recommended in addition to the blood tests above. Men can undergo a pelvic ultrasound to check their prostate gland. A colonoscopy testing once every 10 years is advised for all irrespective of your risk profile and yearly if you are at a high risk of developing colon cancer!

One other thing to focus upon would be immunisation. Use this opportunity to take the annual flu vaccine shot or the five yearly tetanus shot.

A thorough dental examination is also a must when choosing a good healthcare package. Oral health is not just for flashing that ‘million dollar smile’. Poor dentition can lead to so many diseases starting from diabetes, heart disease and even oral cancers!

Again there is no ‘one size fits all’ approach so depending upon your age, habits and family history you can choose any of the tailor-made health packages. Many of the corporate health packages or those offered by the insurance companies have additional ‘perks’ such as consultation by a dietician or a physiotherapist and even a counsellor!

Nowadays, there are specialized tests for detecting more advanced illnesses using artificial intelligence guided CT scans and DNA sequencing analysis. These are not required for the vast majority and need to be performed on a case to case basis only.

Even a simple blood pressure test can have varied results depending upon the time of the day, the posture while testing, the consumption of alcohol, caffeine or any salty drinks prior to testing or even if you had just run into the clinic without waiting for at-least 5 minutes beforehand. So imagine how much our other parameters might vary with a little change in our routine. Keeping this in mind I have written the do’s and don’ts before going for a health checkup. Here goes:

Do’s and Dont’s for a health checkup

1. Eating light the previous day for dinner. Fasting or feasting the previous night can show up in your results especially if testing for blood sugars, thyroid or cholesterol values.

2. Dine before 9: yes, many of the test require you to knock on hospital doors on an empty stomach. Fasting means an 8-10hours since dinner and nothing less or more.

3. Just because you are still fasting at 12pm getting a fasting blood test that time will not be the most prudent thing to do! Beyond the morning hours, the body begins breaking down fat into sugars, so sugar values will likely be higher even if you are technically ‘fasting’.

4. Sleep well the night before. A good sleep can keep the cortisol away and give a very balanced report. Stress on the other hand can make the results go haywire!

5. Avoid consuming alcohol the previous night especially for blood tests like blood sugars. Even caffeinated drinks can influence the result so fasting means skip even your morning coffee! Drink water instead!

6. Take your morning pills: every so often we get patients who come for checking blood sugars without taking any of their medications. The reports will obviously be high and there will be an unnecessary increase in the dose of medications prescribed by the doctor reviewing all reports. For certain medications like beta blockers your doctor might ask to stop taking it before 1-2 days of the check up. For all other cholesterol, blood pressure, diabetes and heart medications it should be continues.

7. Pregnant ladies always drink plenty of water before your pelvic ultrasound exam. Many make the mistake of voiding urine just before going inside the scan room just to be sent back by the doctor. The wait for your bladder to fill again might seem agonisingly long! Carry a bottle with you and periodically keep sipping from it.

8. Menstruation might affect tests like Pap smear or colonoscopy or even a simple urine test so better to do it 5 days before or 5 days after a period.

9. MRI scans require that we remove all metal objects including all jewelry before the scan. Such requirements are not there for a CT scan or an ultrasound test so check what scan has been advised before you leave your home. Please read here to know more about scans.

10. If going for a vision check always carry your glasses along with you. We need to check the vision deficit with and without glasses to find if your glasses need to be changed. Don’t wear contact lenses for a vision test.

11. Talking about vision, many diseases like diabetes and hypertension require a fundus examination. Drops will be put on your eyes and your eyesight will be very blurry for several hours afterwards. So avoid coming alone and definitely do not drive back the way home!

12. Pregnant women should always state their pregnancy status upfront. This will avoid unnecessary exposures to radiations via X ray or CT scans.

13. If you are undergoing a breast mammogram test, in order to get correct results you should avoid using any body lotion,perfume or powder on your body.

14. Talking from experience I know that a visit to a hospital is not going to be hassle free. So carry water, snacks and wear comfortable footwear. If you are expected to do a treadmill ECG test better to be in a sports shoe.

15. Lastly, always carry your previous reports and medication prescriptions when coming for blood tests. While doing an antenatal scan always carry the previous scan reports to compare growth patterns of the baby. Saves a lot of time and effort for both the doctor and you to discern if a finding is new or pre-existing.

Be it a part of your company’s requirement or your own initiative take the annual healthcare checkups seriously. Note down your list of complaints and issues troubling you before meeting your doctor so that he/she can choose the right health checkup package for you.