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PDF Editor FAQ

What should be included in a routine physical exam?

A physical exam is used to check your overall health and make sure you don’t have any medical problems that you are unaware of. A physical examination is a routine test your primary care provider (PCP) performs to check your overall health. A PCP may be a doctor, a nurse practitioner, or a physician assistant. The exam is also known as a wellness check. You don’t have to be sick to request an exam. There are different tests that can be performed during your physical examination. Depending on your age or medical or family history, your PCP may recommend additional testing. These exams are used to: check for possible diseases so they can be treated early, identify any issues that may become medical concerns in the future, update necessary immunizations, ensure that you are maintaining a healthy diet and exercise routine, build a relationship with your PCP. These exams are also a good way to check cholesterol, blood pressure, and blood sugar levels. These levels may be high without you ever showing any signs or symptoms. Regular screening allows your PCP to treat these conditions before they become severe.

What should I have checked before trying to have a baby with my wife?

Your wife should have a thorough medical exam, especially discussing her reproductive health. She also should be taking a daily vitamin with folic acid. This helps prevents spina bifida, a malformation of the spine. She should do her best to be in good health in general — a good diet, used to exercise, avoiding alcohol and recreational drugs. You should both have your immunizations up to date.Other care to prevent problems during pregnancy will be included in proper prenatal care, beginning with a visit to the doctor before three months of pregnancy. This care is extensive in Western countries, including a lot of blood and urine testing and at least one ultrasound examination.

Do doctors actually know what’s wrong or are they usually just guessing?

Not a doctor.Don’t know anyone can give a definitive answer to that broad of a question.Nothing is more complex than the human body.A doctor would like a proper history from a patient—in some cases the patient can’t really give one and that hampers him; in other cases the patient may give inaccurate info—that hampers the correct diagnosis as well.A good exam is needed—some doctors are better at it than others without a doubt. However, again, there can be interference such as amount of time allotted for the visit.Labs are another way doctors determine a diagnosis. Now we absolutely, positively do have interference in the process because of cost and time factors. Also depending on what you’d like to test, there is going to likely be a delay getting results. The longer doctors practice, the fewer tests MAINSTREAM oriented doctors seem to want to run as they tend to rely on a lot of experience and have seen if they normally can identify if a patient fits the “odds” or not. (MANY issues can cause a host of symptoms; some are far more likely causes than others. It’s the “when you hear hoofbeats, think of horses not zebras” line.) I suspect FUNCTIONAL MEDICINE doctors are not going to limit testing as readily but they will also spend a LOT more time on the lifestyle issues of the patient.Imaging may be useful for some potential diagnoses. What I said re: labs applies and then some. Also some patients will object to certain imaging studies. CTs and X-rays have radiation; MRI might involve a contrast medium (gadolinium) which many try hard to avoid (less objection to the iodine in CTs, I suspect, though there is reason to think about that contrast medium as well). Some MRIs are open, but many are still very enclosed and can freak patients out. The open ones supposedly have poorer resolution. Not a radiologist so no idea how much loss there is. BTW, when imaging of any sort (includes ultrasounds and such as well) is ordered, the doctor DOES have potential diagnoses in mind. His set of differential diagnoses, in his head, will guide him on what will give him the best info.The point is, in order to make a proper diagnosis of a patient, which is typically done with coming up with differential diagnoses that can be eliminated with additional info (and sometimes a NEW one comes up from the info), it takes TIME and good INFO, both of which are typically in short supply.So are they “guessing”? Not in the sense I think most people would take it. Sometimes to help the patient ASAP instead of waiting for testing that may or may not be possible, a doctor will use his judgement and proceed to treat based on his working diagnosis which CAN change and see empirically if in fact the patient gets better. That would indicate he probably got it right.Even when something is obvious (someone comes in with a gunshot wound) that does NOT eliminate the potential for OTHER important issues to be present. THAT patient could have diabetes, AIDS, etc. and you bet THAT will factor into his response to treatment and ability to survive and heal.You didn’t ask, but I will observe this FACT: the vast majority of people WILL be a lot healthier if we make the right choices (in most cases changes) in diet, sleep, and exercise. If we build up our immune systems and allow our bodies to work the way intended (not dousing them in assorted avoidable toxins from tobacco, alcohol, glyphosate and more; giving the body HEALTHY food, clean water, and clean air) the body will work well. Subject it to abuse and the weakest link will break down and there will be medical problems.

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