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WHY THE
NEED FOR REGULAR CHECK-Ups
by Dr Paul de Flamingh-Gynaecologist
When we buy a new car or even a previously owned
one we know that in order to get the best return
on our “investment” we need to look after this
vehicle. We even get Motor plans that force us
to have the car regularly serviced otherwise we
forfeit the guarantee! So what is the lesson
that we should learn from this?
PREVENTION IS BETTER THAN CURE!
This is the same principle that Discovery
Medical aid adopted in order to cut their
medical pay-outs. With incentives like
discounts on purchases at certain shops they
encourage their members to join fitness clubs
and to have regular routine physical check-ups
and blood tests, pap smears and urine tests.
Because of this approach they have been able to
offer participating doctors better fees for
service as they save in the long run.
What then should your REGULAR ANNUAL CHECK-UP
entail?
This will very much depend on your age and your
sex. It is important to get the best value for
money especially as many patients now opt for
hospital plans i.s.o. full medical cover which
would mean that the check-up will come out of
own pocket.
In
the case of women the yearly check-up should
include at least a urine dip-stix (to check for
infection, proteins, blood, glucose and bile
salts), blood pressure, breasts examination,
heartbeat and murmurs and circulation, abdominal
examination and pelvic examination. If a lady
has not had a hysterectomy a Pappanicoulou smear
is also indicated. A trans vaginal pelvic
ultrasound (sonar) is extremely helpful in order
to pick up early signs of pelvic tumours of the
ovaries, uterus and gut. Stool samples for
blood is quite often indicated and quite
helpful.
Younger ladies
that still want to have children should also
have a blood test to check for German measles
anti-bodies.
Older ladies
should have blood tests for cholesterol, full
blood count, thyroid function and depending on
the urine test also glucose levels. A
Mammogramme is recommended after the age of 50
unless there are extenuating circumstances like
a strong family history of breast cancer.
Bonedensity (DEXA) is done after the onset or
confirmation of the menopause and repeated on a
regular basis depending on the result of the
previous DEXA.
One
of the most important lessons is that one should
assess every patient on her own merit and not
treat results of tests but treat the patient on
her individuality. Every lady is special in her
own way and should receive special attention
always! Once the basics have been done the
doctor will advise on further tests or otherwise
indicate when the next check-up is due.
On what men need
as part of a yearly general check-up, I am a bit
lost. There is even some debate on the value of
yearly PSA (prostate specific antigen) but that
I will leave to my colleagues in urology to
discuss. I would just like to remind the gents
that erectile dysfuntion (ED) is not only their
problem (but in a future article I will pay
attention to this) but it is quite often also an
indication of other arterial occlusive disease
so do not ignore it, get advice!
Hermanus Doctors
On-line
THE MIRENA TO THE RESCUE
Dr Paul
de Flamigh
In modern times one is almost daily bombarded by
new inventions and developments. One of the most
elegant and useful inventions in medical
practice must be the development of the Mirena,
intra-uterine contraceptive device. This device
has been around for a couple of years and has
been tried and tested by millions of women over
the world. It is an intra-uterine contraceptive
device with a difference that instead of having
copper around the stalk of the device, it has a
reservoir consisting of a slow release
progesterone. The reason for this is that the
progesterone that is slowly released over a
period of 5 – 7 years, works by suppressing the
growth of the lining of the womb (uterus) and
therefore cuts down on the menstrual bleeding
and if the patient is fortunate (as most of them
are) they will eventually stop having periods
all together.
I often get asked if this is detrimental for the
patient but as the action is only localized in
the uterus and not systemically, it means that
there is a limited effect on the particular
cells lining the womb and the hormone does not
enter the bloodstream in significant quantities
to have any systemic effect. The patient
therefore has the advantage of being protected
against unwanted pregnancies, the comfort of
having very little to no periods at all, and
still have normal hormonal cycles because the
ovaries are not affected by this particular
device. Should the patient desire to fall
pregnant again, the device is very easily
removed in the consulting rooms and within
approximately a month she will have a normal
period and can therefore attempt further
pregnancies with no risk. The safety factor of
this device is virtually 100% and considered
statis-tically as safe as having a
sterilization, provided that the apparatus is
properly fitted. It does not need to be fitted
in theatre or under anaesthetic and can be done
in the consulting rooms in most cases, provided
care is taken and it is done gently. One can
also use this device in women that have very
heavy periods but have possibly been sterilized
and where no other pathology is found and
therefore avoid surgery like for instance a
hysterectomy. Although the device is considered
reasonably expensive at approximately R1 500, if
one considers the benefits and comfort it
provides and divide this costs into 60 – 72
months, you quickly realise that this is
actually a bargain.
This is a very liberating device with lots of
benefits for women and should any readers want
to obtain any more information they can go to
the Schering website or phone Sr Dianne Jooste
on 086 010 2667.
Mail us.
Your privacy will be
respected & protected.
unless you permit us to
share
For Social advice
- ask Rosy,
She has learnt from all possible and impossible
faux-pas thinkable and unthinkable.
Medical Services Listed in Hermanus
Maryke van Rhyn
(Occupational Therapist)
084 678 8844
Antionette van Vuuren
Physiotherapist
7 Myrtle Lane Hermanus
+27 (0)28-3121981
Dr Du Toit & Munnik
14 Paterson St Hermanus
+27 (0)28-3121119
Dr Herman Fourie
Dentist
Hoofweg 9 Hermanus
+27 (0)28-3121066
Dr J.G. Tredoux
(Specialist Physician)
48 Fourie St, Hermanus
+27 (0)28-3130356 (24H)
Hermanus Medi Clinic
Hospital
St Hermanus
+27 (0)28-3130168
L Stander & T Visser
Physiotherapist
4 Mountain Drive Hermanus
+27 (0)28-3122735
Optical Eyes
Gateway Centre Hermanus
+27 (0)28-3131101 |
