Serious Talk: Important Health Screening Tests For Women Over 40

First, I officially welcome you to the big 4-0 club! It is a milestone worth celebrating because with  kids possibly all grown up and hopefully with a more stable career, this is the absolute time to take care of yourself. Again. It's funny because when I turned 30, I cried feeling I am getting old. When I turned 40, heck who's old. Now at 43, I am just cruising life, loving every minute of it as I take important steps to a healthier and more fabulous version of me in my 50s and beyond! But let's take a break from anything beauty-related because today's post is more imperative than a holiday limited edition palette or 20 units of Botox you are planning to have come holiday season. Let's revisit our health situation and/or current medical needs.

Get your labs done. If you have never done any type of blood work in the past, now is the time to schedule an appointment with your PCP (primary care physician). Typically, your doctor will order:

1. Basic metabolic profile composed of blood glucose, creatinine, glomerular filtration rate, creatinine, among others. Checking your blood glucose (or blood sugar) is the important aspect of this screen test because your results can flag pre-diabetes or diabetes mellitus type 2 conditions. If your PCP believes that you may have symptoms of DM2, he or she may add A1C which measures 3-month average of your blood glucose. This is the basis of diagnosis for diabetes and pre-diabetes. Normal A1C is 5.7 or lower. Pre-diabetes is 5.8-6.4. Diabetes is 6.5 or higher. If your blood glucose is normal, congratulations but monitor your progress because if it's on the upswing, you need to revisit your lifestyle choices. If you are pre-diabetic, you need to seriously consider your lifestyle, more importantly your eating habits. If you are diagnosed with diabetes, your doctor will start you on medications but it is even more important that you combine it with proper diet and exercise because you can definitely reverse your situation. Remember, diabetes mellitus type 2 is lifestyle-related. 

2. Lipid profile composed of total cholesterol, triglycerides, HDL and LDL. This measures your risk for cardiovascular disease. There are criteria to be considered by your PCP if your results turned out to be outside the normal range. For the most part, your PCP may not start you on medications if your results are borderline high. Again, lifestyle modifications such as healthy diet and exercise, smoking and alcohol cessation will significantly help normalize your lipid situation. Interestingly, when your triglycerides are high, your blood sugar is sometimes high too. Are they parallel? yes and no. High triglycerides won't cause diabetes per se but it can increase your risk for it because it is your body's way of telling you that something is not right because the food you consume isn't turning it into energy and this where its relationship with insulin comes into play. Again, lifestyle and diet modification are key elements to reversing high triglycerides. By simply cutting your sugar intake and eating more vegetables, this relationship between trigylcerides and blood glucose is markedly evident. I speak from experience because I had borderline high triglyceride and borderline high blood glucose last year, no thanks to my sweet tooth (despite being on a plant-based diet)! But ever since eliminating all forms of refined sugar (hiding behind different names to trick a regular consumer--- I will talk more about this next time) obtained from unhealthy desserts and carbonated beverages (diet coke no more), my results this year are back to normal!

3. Additionally, your PCP may order thyroid function tests even if you don't exhibit signs of thyroid disorder just for baseline reference. The recommendation though starts at 50 years old and every 5 years. Of course it will be more frequent if you do have thyroid issues based on your lab results.

Get ready for your mammogram. I'd be honest, I was initially nervous to do this when I turned 40 three years ago despite me knowing that this is just a regular screening test and subsequent procedures to be done in case the results come out abnormal. I mean, it's different when it's me undergoing the test versus me advising patients. Thankfully, it's been normal for the last three years. Now whether you should start at 40 or 50 years old is debatable because of the change in guidelines. My insurance covers yearly mammogram, my doctor advises it so I am going for early detection. Needless to say at this point, you should already know how to do self-breast exam and any suspicious lump or change in the appearance of your breast or nipples and/or unexplained pain immediately warrant a medical advice. If your mammogram results indicate some abnormality, your doctor will order diagnostic mammogram and ultrasound. If both come out normal, you will resume yearly mammogram. If abnormal, your doctor will order biopsy as the next step.

Start pap smear and/or HPV test if you haven't yet. In the United States, cervical cancer screening tests start as soon as women turn 21 and every three years up to age 65. At 30, pap smear is combined with HPV (human papilloma virus) and ideally should be done every five years up to age 65.

Prepare for colon cancer screening test at 50 years old. Your primary care physician may start you with FOBT (fecal occult blood test) but at one point, you really do need to do colonoscopy/endoscopy to get your baseline. If the results are normal, repeat every ten years. If there are polyps found, your gastroenterologist will remove them during the procedure and send them to the labs to determine if they're benign or malignant.

Other tests per your doctor's discretion. HIV once in your lifetime or as necessary and Hepatitis C if you are born between 1945-1965. Eye exam annually especially if you have diabetes. Skin surveillance annually if you have previous history of melanoma or notice suspicious mole, sore that does not heal, asymmetry, change in color.

Can you get these tests done sooner? why not, early detection is key to preventing chronic diseases. Talk to your doctor if you have health issues.

What you can do now to prepare your body and health in the not-so-distant future: I can't emphasize enough the power of committing to a healthy and active lifestyle. As someone who's been on a plant-based diet and staying in tiptop shape for the last ten years, I am telling you that we can defy whatever problems that come with aging. Knock on wood, but at 43, I am not taking any kind of medications for chronic health conditions. My primary care physician tells me that I belong to his top 1% healthy patients and in 20 years, I will be healthier than most people in my age group so I must continue what I am doing now. And this makes me doubly happy because regardless what happens to me health-wise that is beyond my control, I know that I took care of myself the very best way I could. And that alone is the most important thing!

Disclaimer: While it sounds like I know what I am talking about by virtue of my profession (RN for 21 years), my opinion  should not replace your doctor's. If you have serious medical concerns, discuss with your doctor. If you are not satisfied with his or her advice, look for a second (even third) opinion. Do your research but please, don't look it up online and start diagnosing yourself. See a medical professional.