The Human User Manual: Preventive Healthcare One Decade At a Time

By Jennifer L. Grella

The Human User Manual offers preventive healthcare suggestions for adults of all ages in a straightforward yet humorous way. The information presented is a compilation of guidelines found on the websites of a wide variety of legitimate healthcare organizations, packaged in chapters dedicated to each decade of adulthood.

• Language: English
• Publisher: BookBaby
• Release date: Mar 5, 2016
• ISBN: 9781483564876

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CHAPTER ONE: 20-Something

Once upon a time in America, typical boys and girls completed high school at around age 18, moved out of their family homes, and pursued one of several paths:

•   Further education (college, graduate school, and/or professional school)

•   Military service

•   Full-time employment

•   Other, including vocational training, apprenticeship, travel, volunteer work, marriage

•   Some combination of the above

Unless these young people were fortunate enough to secure employment with good health insurance, they might have remained on their family’s health plan as late as their mid-twenties (for full-time students) or even gone without insurance. If their parents did pick up the tab for healthcare, moms and dads probably continued to offer health advice (solicited or not).

In present day America, this scenario really does sound like a fairy tale. Eighteen-year-olds are just as likely to be raising their own families, or working to help support their parents/siblings/grandparents, as to be pursuing any grander dreams. With this accelerated adulthood has come greater responsibility, including for their own (and possibly their dependents’) healthcare. The good news: thanks to The Patient Protection and Affordable Care Act, until they turn 26, young people can remain on their parents’ insurance plans. The bad news: the number of young people living in their parents’ basements because they cannot support themselves is still on the upswing.

Most pediatric professionals stop seeing kids by the time they turn 21. At that point, it is more appropriate for individuals to have adult primary care physicians and specialists as needed. There are exceptions to this standard: some pediatricians continue to see their patients well into adulthood, family practitioners often see patients from birth onward, and some pediatric specialists will continue to see their patients as long as they continue to suffer/be at risk from the pediatric conditions that brought them together in the first place. If you, or your child, have one of these conditions (such as trisomy 21 and cystic fibrosis), you have probably been aware of it for a long time.

Fortunately, typical healthy 20-somethings don’t need a lot of healthcare beyond some basic routine maintenance. However, it is important to impress here that proactive care, health education, and responsible life choices during these younger years will almost certainly result in better health (and greater comfort) in the future. Furthermore, while individuals may opt out of purchasing health insurance, this would be an incredibly short-sighted and foolhardy decision: the penalties imposed are set to become increasingly burdensome over time and the financial consequences of dealing with an unexpected serious illness or accident can make college loans look positively insignificant. No matter how invincible you feel today, get insurance and find a primary care healthcare provider you trust so that you are prepared for whatever adverse health events you may encounter (knock wood!).

Perhaps the most important preventive healthcare step you can take at this point is to research your family history. Talk with older relatives in your family while they are still available, to discover and record any history of disease such as heart disease, diabetes, cancers, and psychiatric conditions. These may be uncomfortable conversations to have with your elders, but the information could prove life-saving for you down the line.

The following are some very basic guidelines to consider while in your 20s:

   Physical Exam – The National Institutes of Health recommends that adults receive two physical exams (also called check-ups or well-visits) during the course of their 20s (www.NIH.gov). Even for healthy adults, these visits are important because they -

a.   Establish some key baselines (such as blood pressure, cholesterol, and blood sugar levels).

b.   Help to head off any problems that might arise in later years.

c.   Begin a dialogue about your personal/familial health history and risk factors so that your primary care provider can recommend a schedule for screenings and other preventive steps to keep you at your healthiest.

Remember: it’s critical to have a primary care provider whom you trust and can be honest with! Shop around until you find a provider with whom you are comfortable, and make sure to find a new one if you move too far away from that person.

   Sleep Health – You should be getting seven to nine hours of sleep each night. If you aren’t, speak to your doctor about the common causes of poor sleep and what you might do to get a good night’s sleep. To learn more about sleep, visit www.sleepfoundation.org; for tips on good sleep health, visit www.sleep.org.

   Immunization – The Centers for Disease Control and Prevention recommends this vaccination schedule for adults in their 20s (www.CDC.gov):

a.   Annual Influenza Vaccination – Speak to your doctor about which type is best for you.

b.   Tetanus/Diptheria/Pertussis (Td/Tdap) –

    i.   Tdap shot if you haven’t gotten vaccinated yet to protect against Tetanus, Diphtheria, and Pertussis (whooping cough)

   ii.   Td booster every 10 years to protect against Tetanus and Diphtheria

  iii.   Speak to your doctor about Tdap vaccine during every pregnancy (recommended during 3rd trimester)

c.   Measles/Mumps/Rubella (MMR) – If you have no record of getting vaccinated as a child, or of having contracted one of these diseases, speak to your doctor about getting one or two doses.

d.   Human Papillomavirus – HPV is a group of very common sexually transmitted viruses that can cause cancer; if you did not receive this vaccine when you were a pre-teen or teenager, you should speak to your doctor about getting it now -

    i.   Women should receive three doses before age 26

   ii.   Men should receive a total of three doses before age 21

  iii.   Men who are 22 to 26 years and are having sex with other men should complete the series if they have not already done so

e.   Varicella (chickenpox) - If you did not receive this vaccine or have chickenpox when you were a child, speak to your doctor about getting vaccinated.

f.   Hepatitis A - If you did not receive this vaccine when you were a child, speak to your doctor about getting it now.

g.   Hepatitis B - If you did not receive this vaccine when you were a child, speak to your doctor about getting it now.

h.   Pneumococcal Disease (a bacterial disease that can cause meningitis and pneumonia) - Speak to your doctor to see if vaccination is recommended for you.

i.   Meningococcal Disease (a bacterial disease that can cause meningitis and blood infections) - Speak to your doctor to see if vaccination is recommended for you.

j.   Haemophilus Influenzae type b - HIB is a type of bacteria that can cause meningitis, pneumonia, and other serious illnesses; speak to your doctor to see if vaccination is recommended for you.

k.   Regardless of your age, if you have any of these health conditions, speak with your doctor regarding specific vaccination schedules:

    i.   Pregnancy

   ii.   Weakened immune system

  iii.   Human immunodeficiency virus infection (HIV)

  iv.   Kidney disease or poor kidney function

   v.   Asplenia (if your spleen doesn’t work well or you do not have a spleen)

  vi.   Heart disease

 vii.   Chronic lung disease

viii.   Chronic alcoholism

  ix.   Diabetes (Type 1 or 2)

   x.   Chronic liver disease

   Cardiovascular Health – According to the American Heart Association The key to preventing cardiovascular disease, also called coronary artery disease (CAD), is managing your risk factors. Everyone is at some level of risk, whether due to family history, lifestyle choices, or just bad luck; the time to start regular screening to determine risks is at 20 years of age. Following is a list of the most common tests/questions, which are typically conducted at regular check-ups. Depending on your specific risk factors your doctor may recommend additional and/or more frequent screening tests, as well as lifestyle changes to prevent the onset of cardiovascular disease(www.heart.org/HEARTORG):

a.   Blood Pressure – Check at least every two years; African Americans have a higher than average risk of developing high blood pressure.

b.   Fasting Cholesterol and Triglycerides Profile – At least every four to six years.

c.   Body Mass Index (BMI) – Baseline at 20 years; recheck periodically.

d.   Blood Glucose – Typically not checked until age 45 unless you are overweight AND have another risk factor (see About Diabetes below).

e.   Smoking – When your doctor asks, answer honestly; if you smoke, QUIT. Smoking is the most important preventable cause of premature death in the United States and smokers are two to four times more likely to develop CAD than non-smokers.

f.   Physical Activity and Diet – When your doctor asks, answer honestly; almost all of us can do better in these areas, and your doctor can help!

g.   Alcohol Consumption – When your doctor asks, answer honestly; too much alcohol can dangerously increase blood pressure: the American Heart Association recommends restricting consumption to two drinks per day for men and one per day for women. If you need help cutting back, speak to your doctor.

   Oral Health – As long as you have a mouth, you will need to make regular visits to the dentist. Many people visit the hygienist every six months; speak to your dentist about the schedule for check-ups, cleanings and x-rays that makes sense for your mouth. Even if you didn’t practice the best oral hygiene regimen as a child, it’s not too late to start. Caring for your teeth and gums will help ward off decay and disease, and lead to early detection of more serious problems. The American Dental Association recommends that you -

a.   Floss your teeth daily.

b.   Brush your teeth twice a day with fluoride toothpaste.

c.   Schedule regular dental check-ups.

d.   Speak to your dentist about the risks of oral piercings if you already have - or are considering getting - any.

e.   Call your dentist’s office if you have concerns in between check-ups. For more information, visit www.mouthhealthy.org.

   Eye Health – The American Academy of Ophthalmology recommends the following:

a.   If your eyes are healthy and your vision is good, have one complete eye exam by your eye doctor during your 20s.

b.   Wear 99% or higher UV (ultraviolet radiation)-absorbent sunglasses and a brimmed hat whenever you're in the sun for long periods of time (any season) to help prevent the development of cataracts (a clouding of the lens of the eye).

c.   If you have diabetes, are pre-diabetic, wear contact lenses, have a family history of eye disease, or have other significant risk factors, speak to your eye doctor about a schedule of eye exams that is right for you.

d.   Call your eye doctor’s office if you have concerns in between exams. For more information, visit www.geteyesmart.org.

   Can You Hear Me NOW?! – In a study cited by the Journal of the American Medical Association (Kesser BW, 2014), Data indicate that 1 in 6 adolescents has high-frequency hearing loss, which is typically noise related and preventable. According to the US Preventive Services Task Force, about 20% to 40% of adults older than age 50, and nearly 80% of adults older than age 80, have some hearing loss (www​.uspreventiveservicestaskforce.​org). Hearing loss can be caused by a variety of factors, most notably from an illness or as a normal part of aging, and there are often steps that can be taken to prevent, aid, delay, halt, or even repair impairment.

a.   The general recommendation is that screening for hearing loss in people who do not perceive any deficit is unnecessary. Should you – or those close to you – perceive any problems with your hearing, speak to your doctor about appropriate testing.

b.   Noise-Induced Hearing Loss (NIHL) – The Hearing Health Foundation explains the everyday risk to our hearing this way: …when we are exposed to harmful noise (above 85 decibels)—sounds that are too loud or loud sounds that last a long time—sensitive structures in our inner ear can be damaged…These sensitive structures, called hair cells, are small sensory cells in the inner ear that convert sound energy into electrical signals that travel to the brain...Once damaged, our hair cells cannot grow back. You might not even know that you have NIHL (a simple hearing test can reveal it), but you should know that NIHL is totally preventable. Most of the recommendations for protecting your hearing are common sense, but here is one specific tip –

    i.   Turn the sound down on stereos and mp3 devices. Listening to an mp3 device at maximum volume (usually around 105 decibels) for more than 15 minutes per day may cause a permanent hearing loss (www.​hearinghealthfoundation.​org)

   Musculoskeletal Health – According to the American Academy of Orthopaedic Surgeons (AAOS), Each year, approximately 1.5 million older Americans suffer fractures because of weak bones, leading to temporary or permanent disability, and even death. Peak bone mass (our maximum bone size and strength) is largely determined by genes and is reached between 20 and 30 years of age. Roughly 95% of our development in this area is completed during childhood; however there are important lifestyle choices we can make as adults to help keep our musculoskeletal system as strong as possible (www.orthoinfo.aaos.org) –

a.   Speak to your doctor to make sure you are getting adequate amounts of calcium and vitamin D (recommendations change during pregnancy).

b.   Get at least 30 minutes of weight-bearing activity (e.g., brisk walking), at least four times per week, as well as muscle strengthening exercise at least twice per week.

c.   Bone Basics –

    i.   Good nutrition is crucial – discuss your diet with your doctor

   ii.   Physical activity (especially weight bearing) is critical

  iii.   Maintain a healthy weight – being overweight or underweight adversely affects bone health

  iv.   Do not smoke (smoking reduces bone mass – as if you needed another reason not to smoke)

   v.   Limit alcohol use (heavy drinking reduces bone mass)

  vi.   Be aware of fall-prevention precautions for your home (banisters, etc.)

   About Diabetes – Diabetes is a condition in which the body either does not produce enough of the hormone insulin, which converts sugar in food to energy, or becomes less sensitive to it. In 2010, diabetes was the 7th leading cause of death in the US; in 2012, over 9% of the US population had diabetes. The good news is that it can be treated and managed very well. To learn more about this serious disease, visit the American Diabetes Association at www.diabetes.org. Following are some facts to be aware of -

a.   Type 1 (also called juvenile diabetes or insulin-dependent diabetes) – Generally diagnosed in childhood or young adulthood; only approximately 5% of diabetics have Type 1; most common treatment is insulin, along with proper nutrition and exercise.

b.   Type 2 – In this case, the body does not use the insulin it makes properly, referred to as insulin resistance; this is the most common form of diabetes and is commonly treated with oral medications and/or insulin, along with proper nutrition and exercise.

c.   Gestational – Approximately 9% of pregnant women experience high blood sugar levels at around the 24th week of pregnancy: their bodies are not able to produce enough insulin or use it properly. A woman can experience gestational diabetes even if she did not have diabetes before her pregnancy, and won’t necessarily have diabetes after delivery; however, for her own health and the long-term health of her child, treatment should be started right away.

d.   Complications – Diabetics are at higher risk for several serious health complications, including –

    i.   Hypoglycemia and hyperglycemia (low and high blood sugar, respectively)

   ii.   Skin complications

  iii.   Eye complications

  iv.   Neuropathy (nerve damage)

   v.   Foot complications

  vi.   Ketoacidosis (a potentially life-threatening form of poisoning)

 vii.   Kidney disease and possibly kidney failure

viii.   Gastroparesis (delayed emptying of the stomach)

  ix.   Mental health conditions (anger, denial, depression)

e.   Prevention – Most diabetes is triggered by genetic predisposition, environmental factors, lifestyle choices, or some combination of the three. According to the American Diabetes Association, the onset of diabetes may be prevented or delayed by lowering your risk in several ways with the help of your healthcare provider –

    i.   Maintain a healthy weight – the incidence of diabetes is highly correlated to obesity (see Obesity below)

   ii.   Eat healthfully

  iii.   Commit to regular physical activity

  iv.   Don’t start smoking – quit if you already smoke

   v.   Manage your blood pressure

  vi.   Manage your cholesterol

 vii.   Manage your blood sugar

   Cancer – Screening for cancers that tend to be sex-specific are covered in the Women’s Health and Men’s Health sections below. For a comprehensive list of screening recommendations, visit the American Cancer Society web site www.cancer.org. Following is a