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DR. BILL HENKE visits with patient Avis West at Essential Health St. Mary's. She spent time in the transitional care unit at Oak Crossing, with the goal of getting back to independent living in her home. (Brian Basham/Record)

Health and Wellness series: Screenings, lifestyle and family history are taken into account by doctors

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There are screenings, lifestyle changes and family history that all come into play when it comes to preventative health care.

"We have a laundry list" of questions and topics to cover when seeing patients, Sanford Health Managing Physician Dr. Jon Larson said.

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"Knowing these things, especially right away, we can start screening early."

That laundry list of health concerns to screen for in adults can include smoking, sun exposure, seat belts, diet, alcohol consumption, vaccines, cancer, diabetes and on and on.

"We check lifestyle, family history, what's already been done. That way we know we're not going to miss anything," Larson said.

Family history

Family history plays an important part of screening. In families with diabetes, cancer and heart disease, screenings start earlier, "at least by mid-30s, if not before," said Essentia Health St. Mary's Dr. Anita Jonason.

"If there's a family history or genetics involved, the screening timeline may be really accelerated."

As a general rule, especially with cancer, doctors will start screening patents 10 years earlier than the earliest onset in family members.

"So with colon cancer, instead of starting at age 50, if a family member got it at age 40, we might recommend to family members to start screening at age 30," she said.

Family history and family lifestyle take a toll on children as well.

"We are seeing more and more diabetes in kids these days and in teenagers," Jonason said.

"If there is a strong family history of diabetes, and we have children that are really overweight, we'll screen them as youth."

Cancer screening

"There are a lot of guidelines, and it's age-dependent, but for all people, we recommend vaccinations; routine pap smears for women over the age of 21; mammograms starting at least age 50, and colon cancer screenings starting at age 50," Jonason said.

There has been some controversy and difference of opinions when it comes to what age mammograms should start, she said, whether they should start at age 40 or age 50.

Larson agreed that there are two schools of thought on what age mammograms should start and how often they should happen after that. He recommends age 40 and every other year after.

There are also screenings for colon cancer and prostate cancer starting at age 50, and cervical cancer when a woman becomes sexually active. Checking for skin cancer is also becoming more and more of a concern, he added.

Lifestyle changes

A doctor can't solve everything though. Life-style is a big part of preventative care.

"Smoking, that's huge. It's No. 1 or 2 on our list of things we address with people," Jonason said, "because it has huge implications for cardiovascular disease and pulmonary lung disease, for strokes. Smoking is a risk factor for diseases."

Exercise and appropriate diet are also major players in staying healthy. The goal is to get people to exercise 3-5 times a week for 30-45 minutes each time, in some sort of aerobic program.

Jonason said immunizations, safe sex, behavior issues, mental health issues (including depression) hearing and vision screening, blood pressure screening and alcohol screening are important topics doctors cover.

Blood screening clinics are offered each year, or more, and they are a "wonderful program. It comes in handy for folks," Larson said.

To determine depression, there are two questions nurses will ask when meeting with a patient -- if the person has felt down, depressed or hopeless for a period of time, and if they take little to no interest or pleasure in normal activities.

"If either of those two questions are positive, then we have a questionnaire which is a longer, maybe 12 items, where there's more specific questions about mood," Jonason said.

There is a rating scale attached that corresponds with the degree of depression.

As people get older, there are still preventative measures for people to take, regardless of their health or age.

"Part of it depends on the individuals," Dr. Bill Henke said.

Some of the main points are immunizations and vaccinations, including influenza and H1N1, pneumonia shots, shingles vaccines and tetanus shots for active seniors who are out and about.

It's not all about health either. Fall prevention is something to think about, for the elderly especially.

"We don't have a very user-friendly climate," Henke said of Minnesota winters.

"As individuals grow old, their desires change. I try to take an individual approach," he said.

"The key point is to sit down and talk with a patient to see what their priorities are and goals are rather than a cookie cutter (approach)."

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