Annual Preventative Exams
Annual preventative exams are important because they can find health problems early, improving your chances of treatment and cure. Your annual preventive exam is an important opportunity to identify underlying conditions that may lead to fatigue, poor functioning and disease, if not corrected. It is not uncommon to identify several such conditions, such as low thyroid, iron deficiency, sleep apnea and Vitamin D deficiency, during one annual exam. In line with the focus of our practice, we offer the opportunity for in-depth, personalized diagnosis that leads to a more in-depth health assessment and a more comprehensive and targeted treatment plan. At Cogent Family Healthcare, we focus on prevention of disease, as well as more strategic and complete intervention. We believe that our unique offering services, screenings, and treatments, give you the necessary steps to live a healthier and more fulfilling life.
Travel preparation including vaccines and other preventive measures, adhering to Centers for Disease guidelines.
Tuberculosis skin and blood testing and treatment of latent tuberculosis.
Urine and blood testing for pregnancy.
Blood tests for testosterone levels and related testing to provide an individualized assessment of the risks of testosterone replacement.
Chicken pox from childhood infection is still alive in your spine, if you were born before 1995 when the childhood vaccine was introduced in the U.S. That virus starts multiplying again later in life, and can cause severe lifelong pain, in some people. The one-time adult shingles vaccine, recommended at age 50 or above, reduces by 75% the chance of getting chronic pain from shingles. Adults who didn’t have chicken pox as a child can die from getting infected with chicken pox as an adult. The same shingles vaccine protects against this also.
Adacel DtaP Whooping Cough Vaccine
Whooping cough disease causes a cough that results in vomiting or fainting, lasting three months. Antibiotics are not effective after the first two weeks, when it is often hard to tell that whooping cough is developing. Many thousands of new cases of whooping cough are occurring each month in California. Everyone at least 11 years old is recommended to have the one-time whooping cough tetanus combination vaccine.
Asthma is either intermittent, or persistent. Persistent asthma is active every day, but is often not noticed, because it is the best lung function that the patient has known, even though it is decreased from normal. Persistent asthma causes thickening and hardening of the lung airways, resulting in more rapid aging of the lungs, causing the loss of decades of being able to walk without shortness of breath. A spirometry, to test how fast air can be blown out, is recommended every two years, for all asthmatic patients. Spirometry is best done when the patient feels at their best, to discover persistent asthma, that had gone un-noticed. Spirometry during asthma attacks helps determine the level of treatment needed.
The ECG measures the electricity of the heart, showing abnormal rhythms that can cause stroke, and heart attacks that were not felt, as can happen with diabetes. A baseline ECG enables determining whether later chest pain is due to a heart attack, based on whether changes from baseline are seen on the ECG during the chest pain.
IMT/Artery Disease Analysis:
Both the cholesterol and inflammation that make up artery disease, thicken a layer in the artery wall called the intima media thickness (IMT). Plaque, is a localized mound of artery wall cholesterol inflammation, that is at least 1.3 mm thick, and which further greatly increases the risk of heart attack or stroke, beyond the background IMT. An IMT/plaque ultrasound is an FDA approved test that measures the thickness of the IMT in the walls of the carotid artery (located in the neck) as well as the degree of plaque in the artery. This is one of the only tests to find artery disease at a stage in which it can be stopped before plaque (high risk thickening) occurs, and when the disease is much more likely to be reversible. It is a measure of how much artery wall disease you have at the present time and how bad it is, compared to your cholesterol level which is a risk factor, that can only be used to calculate a statistical chance that you may get a heart attack in the future.
This screening test can be performed between the ages of 25 and 80 but generally should be considered in men over age 25 in South Asians, and, in non-South Asian groups, in men over 45 and women over 55. Risk factors include:
- Family history of heart attack and/or stroke
- Abnormal cholesterol levels (high LDL or “bad” cholesterol, low HDL or “good” cholesterol, or elevated triglycerides)
- High blood pressure (hypertension)
- Smoking (former or current)
- Diabetes or metabolic syndrome
- Overweight or physically inactive or unhealthy lifestyle
- Sleep apnea
- Chronic inflammatory disease or disorder (such as rheumatoid arthritis, lupus, psoriasis, HIV, inflammatory bowel disease)
- Prior abnormal CIMT test to help follow the effectiveness of risk-factor modification
The above risk factors as well as aging are contributing factors to an increased carotid intima-media thickness as well as risk for heart attack and stroke
In keeping with our focus on discovering and treating underlying causes for symptoms, we screen for low thyroid, iron, and vitamin D, in appropriate patients. These are in addition to a complete blood count and a complete metabolic panel that tests your blood plasma and can indicate any issues that exist in your kidneys, liver, blood chemistry, and immune system.
Prostate Cancer Screening:
Prostate cancer screening can be done in a way that maximizes detection and minimizes un-necessary treatment. Using our techniques, we have alerted several men in their 40’s of high grade prostate cancer, that would not have remained harmless through their lifetime. Treatment decisions are made with specialists who are very careful to fully educate patients on the benefits and risks of all options, including careful monitoring of known prostate cancer (called “watchful waiting”).
Colon Cancer Screening:
Colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Colonoscopy enables removing polyps before they become cancer. You should begin screening for colorectal cancer soon after turning 50, then continue getting screened at regular intervals. However, you may need to be tested earlier than 50, or more often than other people, if—
- You or a close relative have had colorectal polyps or colorectal cancer.
- You have an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
- You have a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).
Referrals by our office to specialists to do the colonoscopy take into account the expertise of the specialist, since one study found that 40% of colon polyps are missed, when all colonoscopies were evaluated.
Bio Metric Analysis:
Nearly every physiological function in your body requires micronutrients to function properly. Deficiencies in nutrients and antioxidants can be due to genetic defects in absorption, an aging digestive system, or depletion by disease, by healing from surgery, or due some of to the most commonly used medications. These depletions have been shown to result in more breaks in the DNA, which increases the risk of cancer, and in high blood sugar, memory loss, fatigue, increased heart attack and stroke risk, worsening immune function and bone loss. At Cogent Family Healthcare, we conduct:
Micronutrient Analysis: Vitamins and minerals are essential for many body functions. As examples, 3000 genes have vitamin D receptors attached to them, and magnesium is known to participate in over 300 chemical reactions in the body. Nutrient deficiencies result in the breakage of DNA, which contributes to cancer, can contribute to memory loss (B12), fatigue (vitamin D and others), higher blood sugar (chromium), and many other medical conditions and diseases. Replacing nutrients when deficient, often results in an increased sense of well-being. Deficiencies in essential nutrients may reduce the maintenance of healthy function of the brain and other organs, contributing to degenerative diseases. In addition, nutrient deficiencies contribute to worsened cholesterol accumulation and inflammation in the wall of the artery. We conduct a complete micronutrient analysis, that comprises an assessment of 33 vitamins, minerals, amino acids, antioxidants, and metabolites. We also provide an assessment of antioxidant function and immune function. Results from these analyses are incorporated into your chronic disease and preventive care plan.
Cardio Metabolic Analysis: A cardio metabolic analysis covers the three main areas of keeping a healthy metabolic profile: Glycemic Control, Lipid Profile, and Vascular Inflammation. While cholesterol testing has historically been used as the standard indicator for cardiovascular disease, up to 50% of people who dies from a heart attack had “normal” cholesterol numbers. At Cogent Family Healthcare, we provide advanced testing technology that measures both the density and number of lipoprotein particles. More than 30 percent of the population has a condition in which a patient’s cholesterol may be “normal” but their lipoprotein particle number, and hence, their actual risk, could be much higher than expected. Measuring the lipoprotein subgroups is the only way to evaluate such risk factors, which is crucial for an accurate assessment of cardiovascular risk, and the establishment of an effective treatment program.
Pre-Diabetes Analysis: Poor blood sugar regulation and unhealthy triglyceride and lipoprotein levels often present long before the diagnosis of type 2 Diabetes. Pre-diabetes is a condition where the body cannot efficiently metabolize foods, especially carbohydrates, resulting in impaired blood sugar (glycemic) control what may progress to diabetes when not properly treated or addressed through lifestyle changes. The insulin resistance affects fat cells in a way that often causes more cholesterol to move into the artery wall, while reducing insulin resistance often reduces the flux of cholesterol into the artery wall, as measured by the small bad cholesterol particle number. The analysis is especially useful for identifying patients within higher risk groups that are most likely to benefit from early medical and/or lifestyle intervention.
Together with a cardio metabolic analysis, a pre-diabetes analysis offers patients a complete evaluation to help define their risk of atherosclerotic cardiovascular disease and progression toward type 2 diabetes.
Inflammation Analysis: The inflammation analysis covers a variety of inflammatory markers found to correlate with an increased near-term risk of heart attack, the most notable being myeloperoxidase (MPO), an enzyme that has been found to be to play a role in the inflammation in the artery wall. Higher inflammation means that you are at a higher risk of having a heart attack. Studies show that, among patients with chest pain, an increased MPO level increases their risk of heart attack over the next 30 days to six months (Cleveland Clinic).
Because so many health conditions are greatly affected by diet, we have a Registered Dietician in house who has extensive knowledge of current medical research regarding the effects of macronutrient imbalances and micronutrient deficiencies, in following current treatment guidelines for the dietary support of disease treatment. We are able to customize diet advice to your food preferences, daily schedule, and food choice barriers from food preparation challenges, and social and stress factors. All nutrition services are provided within a medical treatment plan developed by Dr. Sims.
How to prepare for your next physical exam
You’ll want to prepare for your physical exam by completing any forms in advance, and making a list of medications you take regularly. Please bring these along with you on the day of your appointment.