Over the course of the COVID-19 pandemic, many of us neglected or overlooked subtle — even obvious — medical symptoms or had difficulty getting appointments to follow up when something hasn’t felt right. It’s tempting to go online to check out suspicions — or to blame symptoms on “aging” — but the best course of action is to check in with your physician in person. Early detection of any potential medical problems is one of the keys to good health. If a doctor’s appointment shows there’s nothing to worry about, the peace of mind gained is worth a lot. Here’s a head-to-toe and beyond look at what you need to consider before checking in, and some tips on how to keep yourself well and head off health problems before they happen.
Before You Go
The crucial initial steps to make the most of a doctor’s visit are to know yourself and any concerns that you want addressed by your health care provider. Head problems off by being health aware.
“Prevention means knowing your numbers — blood pressure, cholesterol, glucose,” says Dr. Harjot K. Grover of Virginia Cardiovascular Specialists.
You also need to find a physician who is competent and communicative, and right for you. “Find a physician you are comfortable with,” Grover says. “There’s vulnerability when going to an appointment. You don’t know what’s important and what’s not, but you need to ask all the questions you have and provide all the information you can, including lifestyle changes [diet, exercise, etc.].”
Cardio Care
Heart disease is the No. 1 killer in the United States, according to the American Heart Association. Nearly half of Americans have at least one risk factor for heart disease — high blood pressure or high cholesterol (smoking is the third factor) — and many people are unaware of it.
Statistically, heart disease is the leading cause of death among women, according to Grover, with research showing women face a 20% increased risk of heart failure or dying within five years after their first severe attack compared with men. “It’s a matter of pairing that fluttering in your chest with other symptoms,” she says.
High levels of anxiety or getting more sweaty than usual during activity are additional symptoms to look for.
Contact your health provider if you have any concerns regarding a potential heart problem. “Be aware of a change in your activity level,” Grover cautions. “Older individuals tend to get fatigued more easily or work out less. If your endurance has changed, look for the reason it’s happened.”
Once in a physician’s office, don’t be afraid to ask questions. “Be an advocate for yourself ... and inform your family of what you learn during your medical visits,” she adds.
Down to the Bone: Good Joint Health, Arthritis
The National Arthritis Foundation’s website, arthritis.org, provides tips — diet and exercise — for reducing “physical and emotional pain while making daily life easier and healthier.” Weight-bearing exercise conditions muscles and decreases the incidence of osteoarthritis, the most common form of arthritis that occurs when protective cartilage cushioning the ends of bones wears down over time in the hands, knees, hips and spine.
New (less than a month), intermittent pain associated with strenuous activity such as jogging might send sports enthusiasts for over-the-counter medications or cause us to limit activity for a while. If pain persists, consult a primary care physician or an orthopedic surgeon.
According to OrthoVirginia, anyone having joint discomfort or pain needs to consider the appropriate level of care. Orthopedics includes chronic, urgent and emergency care.
Chronic conditions such as arthritis are longer-term and better treated through appointments involving exercise, weight loss, injections, medications, physical therapy and activity modification. With a physical exam and imaging, an orthopedic surgeon can address whether hip pain, for example, comes from arthritis or from nerve pain in the lower back.
Delaying treatment when chronic conditions are present can cause other parts of the body to compensate, leading to pain elsewhere. Consider the difference between chronic and urgent/emergency situations before going to a medical office.
OrthoVirginia certified physician assistants Anshu Pal and Paige M.C. McNally point out that symptoms including chest pain and shortness of breath or conditions including fractures or head injuries should be treated at an emergency room. Strains and sprains accompanied by pain and swelling may be seen at a walk-in or on-call clinic.
Following the Urinary Tract
Good hydration is essential to good health — especially the health of the urinary tract. Dr. Andrew C. Eschenroeder, a urologist with Virginia Urology, says, “Eight glasses of water a day protect your kidney health — and because of the climate and cuisine, the Southeast U.S. is the kidney-stone capital. There’s generally more salt in the food in this region — and diabetes and obesity increase the likelihood of kidney stones.”
Pay attention to the color of urine — which varies from clear to amber to darker — but “if you’re having pain when you urinate or feeling pressure on the bladder, you might have an infection,” he says. “There are multiple possible causes for blood in the urine, but you need to check it out with your doctor or urologist.”
Virginia Urology sees a lot of patients with overactive bladders. Incontinence is more prevalent in women than men, but Eschenroeder says that good treatment options exist. Don’t be reluctant to seek help: “We see a lot of private or intimate issues with people, and just making a phone call can help get relief and remove the discomfort as well as possible stigma,” Eschenroeder says.
For men ages 18-40, he stresses regular testicular self-exams to become aware of a new lump or bump on a testicle. “Contact a doctor if you have a concern — and know your family history. Anyone with prostate cancer in the family should be screened sooner — in their 40s.”
If you smoke, stop. It can lead to problems like erectile dysfunction and urinary incontinence, Eschenroeder says.
Diet, Regular Medical Checkups
Maintaining good, general health is one of the keys to well-being. That starts with what you eat.
The pandemic has had paradoxical impacts on diets.
“Some people went off the wagon during the pandemic,” says Dr. Renee Y. Carter, associate professor and medical director for women’s health, Division of General Internal Medicine, Virginia Commonwealth University.
“On the other hand, some people who were able to cook at home did and started healthier habits, including portion control and substituting leaner cuts of meat.” (She provided the recipe idea for rubbing a skinless chicken breast with plain, nonfat yogurt, then rolling the chicken in a crumbled crunchy cereal such as “Wheaties” before baking it at 350 degrees for a new version of Southern fried chicken.)
It also helps to stay up to date on immunizations and vaccines. “For good general health,” she says, “I’m a big proponent of vaccines for flu and COVID — and because there’s no vaccine for RSV [respiratory syncytial virus], continuing to wear masks in group settings.”
Skin in the Game
Research shows that one in four Americans has skin disease, according to Dr. Erin Adams of Midlothian Dermatology. “In fact, skin cancer is the most common cancer in the United States, with more than 9,500 people being diagnosed with skin cancer each day. Regular self-skin checks are critical to identifying skin cancer early.”
She says to use a full-length mirror, examining the body and giving attention to armpits, palms, legs, the areas between the toes and the soles of the feet; then, use a handheld mirror to examine the neck, scalp, back, buttocks and genitals. In all cases, look for spots where the symmetry and borders are irregular (or the borders are fuzzy or poorly defined). Other components of a self-check include the color and diameter of spots as well as how a spot might be evolving, i.e., looking different from the rest of the moles and freckles or changing in size, shape or color.
Noticing a spot of concern is a signal to make an appointment for a skin-cancer examination with a board-certified dermatologist. “Lighter-skinned people who easily sunburn or those with a family history of skin cancer should consider regular checkups,” Adams says, as well as those with a weakened immune system or those who have been exposed to radiation or extensive tanning-bed use.
Regularly use sunscreen or sunblock outdoors. Applied correctly, it protects your skin from the sun’s harmful ultraviolet rays and can prevent sunburns, skin cancer and even premature aging, like wrinkles and sun/age spots.
“Sunscreen is one of the [most] important things you can do for your skin,” Adams says.
The Eyes Have It
Ophthalmologists at Virginia Eye Institute cite several symptoms to be aware of that should raise concern and warrant a prompt eye exam. “The most common eye conditions we see are dry eye, cataract, glaucoma, diabetic retinopathy and macular degeneration,” Dr. Steve Tucker says. “Each condition presents with different symptoms.”
Another Virginia Eye Institute ophthalmologist, Dr. Marc Malouf, says that blurred or foggy vision, glare at night, and difficulty reading small print are commonly associated with cataracts and can be fixed with cataract surgery. These vision changes are usually slowly progressive over months to years.
Other diseases have more rapid vision changes. Floating spots or flashing lights in the vision can be a sign of retinal detachment. Distortions in one’s vision or loss of the central vision may be a sign of macular degeneration. “In general, any rapid change in one’s vision should be examined without much delay,” Malouf says.
Symptoms of conjunctivitis or “pink eye” include redness and irritation, according to VEI’s Dr. Donna Brown. There are multiple causes, including allergies and bacterial or viral infections. A red and painful eye can be an emergency if the symptoms are severe, especially in a contact-lens wearer.
Be an advocate for yourself ... and inform your family of what you learn during your medical visits.
—Dr. Harjot K. Grover, Virginia Cardiovascular Specialists
Glaucoma, she says, is a common condition that often is not symptomatic until it reaches an advanced stage. It may be an inheritable condition, so a person who has a family history of glaucoma should see an eye care provider for a baseline exam. It’s treatable, but left untreated, it can lead to vision loss or blindness. Adults 40 and older should have an eye exam every two years.
Diabetes presents another risk factor. Brown notes that people with diabetes are at risk for diabetic retinopathy. That can lead to significant vision loss or blindness, but it is most often treatable. Anyone with diabetes should see an eye care provider annually for a dilated retinal exam.
Women’s Health
VCU’s Carter notes that with the winding down of the pandemic, women have flocked back to clinics — particularly for lab work, cancer screenings and chronic issues related to blood pressure and blood sugar.
“February is heart month, and we need to remember that one [in] five women will suffer from heart disease in this country. Some people don’t have robust immune systems, so it’s important to keep regular doctors’ appointments. We’ve also been accosted by behavioral issues during the pandemic, so people need to check with physicians for anxiety and stress.”
Medical studies have long been skewed by a predominance of studies that relied on white male participants. That may have an impact on treatments. “Some [prosthetic] devices don’t work with women the way they do with men, according to Carter. “A woman’s menstrual cycle influences how devices will work, too. The science in women’s health care is evolving.”
That reliance on male-focused studies is changing. “We have to have women as well as men participating in clinical studies for medicine right down to the cellular level,” Carter says.
