We’re all for getting regular checkups and blood tests. But that’s not to say that in between visits you should close your eyes and cross your fingers that all’s still well. The fact is that while your doctor may see you once or twice a year, you live in your body every single day, and that makes you the best judge of your own health — if you know what cues to look for. Here are 16 ways to play doctor detective.
1. Every evening, think PERF. Essentially, there are four things you should monitor every day to make sure you are living healthy: the amount of vegetables and fruits you ate that day (Produce); whether you walked and were active (Exercise); whether you got at least 15 minutes of laughter and fun time for yourself (Relaxation); and whether you got enough beans, grains, and other high-fiber food in your diet (Fiber). If you can say you did well on all four of these, you lived a very healthy day. If you can say you do well on these on most days, your life begins to look a lot longer and healthier.
2. Monitor your sleepiness. There are three good ways to tell if you are getting enough sleep. First, do you require an alarm clock to wake up most mornings? Second, do you become drowsy in the afternoon to the point that it affects what you are doing? Third, do you doze off shortly after eating dinner? If the answer to any of these is yes, you need more sleep for good health. And if you are getting enough sleep and still have these troubles, you should talk with your doctor about your low energy. A healthy, well-rested person should wake up refreshed without the aid of an alarm clock each morning, not be overly drowsy during the day, and still have some energy left over for after-dinner activity.
3. Check your hairbrush. If your hair is falling out, ask your doctor to check your levels of blood ferritin, an indication of how much iron your body is storing. Some studies suggest that low levels may be related to unexplained hair loss. Thyroid disease is another fairly common cause.
4. Keep a mental color chart of the color of your urine. Sure, it sounds gross, but at least you don’t have to pee into a cup to do it. Your urine should be a clear, straw color; if it’s dark or has a strong smell, you may not be getting enough fluids. If it continues dark colored even after you increase your liquid intake, follow up with your doctor. Bright yellow urine? Chalk it up to the B vitamins in your multivitamin.
5. Check your heartbeat after you exercise. A study published in the Journal of the American Medical Association found that women who had poor heart rate recovery, or HRR, after exercise had twice the 10-year risk of having a heart attack as those who had normal HRR. To test your HRR after regular strenuous activity, count your heartbeats for 15 seconds, then multiply by four to get your heart rate. Then sit down and wait two minutes before checking again. Subtract the second number from the first. If it’s under 55, then your HRR is higher than normal and you should follow up with your doctor.
6. Measure your height every year after you turn 50. This is especially important for women as a way of assessing posture and skeletal health. A change in stature can be as informative as a change on a bone density test in terms of assessing your overall bone health. Don’t skip the bone density test, though: It picks up bone loss before your height changes.
7. If you have diabetes, play footsies every day. By yourself, that is. This form of footsies consists of examining your feet carefully for any blisters, fungus, peeling skin, cuts, or bruises. Because people with diabetes often have some nerve damage in extremities like the feet, these daily self-examinations are critical clues to how well you’re monitoring your blood sugar and if you might have nerve damage.
8. Guys only: check down below. Believe it or not, it’s even more important that men conduct a testicular self-examination than women conduct a breast self-exam. Catching testicular cancer early is the best way to beat it. The Testicular Cancer Resource Center recommends following these steps every month to become familiar with what’s normal so you can recognize if anything feels wrong:
1. Stand in front of a mirror. Check for any swelling on the scrotal skin.
2. Examine each testicle with both hands. Place the index and middle fingers under the testicle with the thumbs placed on top. Roll the testicle gently between the thumbs and fingers — you shouldn’t feel any pain when doing the exam. Don’t be alarmed if one testicle seems slightly larger than the other.
3. If you find a lump on your testicle, see a doctor, preferably a urologist, right away. The abnormality may only be an infection, but if it is testicular cancer, it will spread without treatment. Any free-floating lumps in the scrotum that aren’t attached to a testicle are not testicular cancer. Still, it’s smart to get checked.
9. Take the fall test. If you have osteoporosis, you are at great risk if you fall. So take this simple self-test developed by Joseph Lane, M.D., and his colleagues at the Hospital for Special Surgery in New York City. Time yourself standing on one leg. Do it in shoes or barefoot, but don’t hold on to anything. Try it on both legs (one at a time) three times. A normal 80-year-old should be able to stand without difficulty for at least 12 seconds, says Dr. Lane. If your best leg time is less than 12 seconds, or you wobble back and forth, you have poor balance and should talk to your doctor or physical therapist about exercises to improve it.
10. Check your blood pressure every six months, either at home with a home blood pressure cuff, at the drugstore, or at a health fair or screening. If the top number is over 120 and the bottom number is higher than 80, wait a day, then check it again. If it’s still high, follow up with your doctor.
11. Check your cholesterol once a year either with a home kit, which is available at most drugstores, or at a health fair or screening. If your total cholesterol is over 150 mg/dl, follow up with your doctor.
12. Check the pulse in your feet once every three to six months to monitor the circulation in your legs. There are two pulses you should be able to find: one near the middle of the top of your foot (called the dorsalis pedis), and the other right behind the big bony lump on the inside of your ankle (called the posterior tibialis). Of the two, the posterior tibialis is more important because it’s more consistently in the same place. If the pulses become weak or hard to find, follow up with your doctor, especially if you have any leg pain when walking.
13. Get naked every two to three months. Then, with a significant other (or very close friend) conduct a head-to-toe skin exam looking for any new moles, changed moles, suspicious spots, or rashes. Make sure to check your scalp, between your toes and fingers, and even on the underside of your arms. If you find anything worrisome, follow up with a dermatologist. Do the ABCD test when checking moles:
- Asymmetry: The two halves don’t match
- Border irregularity: The edges are jagged
- Color: It’s not uniform
- Diameter: It’s more than one-quarter inch wide
14. Go over your toenails once a month. Look for early signs of fungal infection or in-grown toenails; both are best treated early.
15. For women only: Conduct a breast self-exam every month just after your period, or, if you’re postmenopausal, on the first of the month. The American Cancer Society provides the following instructions:
1. Lie down and place your right arm behind your head.
2. Use the finger pads of your three middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-size circular motions of the finger pads to feel the breast tissue.
3. Use three different levels of pressure to feel all the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs.
4. Move around the breast in an up-and-down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the breastbone (sternum). Check the entire breast area going down until you feel only ribs and up to the neck or collarbone (clavicle).
5. Repeat the exam on your left breast, using the finger pads of the right hand.
6. While standing in front of a mirror with your hands pressing firmly down on your hips, look at your breasts for any changes of size, shape, contour, or dimpling. (Pressing down on the hips contracts the chest wall muscles and enhances any breast changes.)
7. Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel in this area. Raising your arm straight up tightens the tissue in this area and makes it very difficult to examine.
If you find any changes, see your doctor right away.
16. Know your body mass index, or BMI. This measure has become particularly popular to gauge the health of your weight, because it relates weight to height. A normal BMI is 18.5 to 24.9. A BMI of 25 to 30 puts you in the overweight category, increasing your risk for numerous diseases and health conditions. A BMI above 30 means you are obese, a formal medical condition recognized by the federal government and most insurers. To figure your BMI, go to cdc.gov.