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 Post subject: Physicals and Yearly Exams
PostPosted: Fri Jan 04, 2013 3:49 pm 
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I have an appt with my Primary care doc coming up and I have a list of things I want to discuss with her. Which I am actually going to write down and take with me so I don't forget anything. I'm also hoping this makes her slow down and actually take some time to chat with me. I normally feel like I'm getting blown off when I go to my primary because they are crazy busy. But I'm going to try and force some time out of her this year.

I want to have blood work done to check all of my levels. Iron, B12, Potassium, Calcium, Cholesterol, etc.

My other issues are that I developed SI joint syndrome last year, I still don't know why or how and I've only figured out that cutting gluten helps me feel better cause it reduces joint inflammation. But I'm wondering if there is anything else I can be doing. I've also noticed that other joints are giving me pain and discomfort as well. My ankles and knees aren't as strong as they used to be. I'm sure losing weight will help, but is that the only issue going on? I don't know.

I would like to lose 100 pounds. And I want to make sure I'm getting enough nutrition and protein. The protein thing was not an issue for me when I could eat gluten. Now that I can't I've only been averaging about 30 grams a day which I feel is low.

Does anyone know if there are doctors or specialist that would be able to assess what your dietary needs are and then give you targets? I use online and app trackers but I'm not sure if I trust them. Like I want to be able to say I am vegan and gluten free and these are my goals. And then have them give me meal suggestions or just a list of daily foods I should be eating to obtain proper amounts of nutrition. Does that make sense? I just don't know what type of person I should be seeking out for help or if it even exists.

Ultimately I would like to work on my overall health and well being this year and know that I'm giving my body everything it needs to be healthy and happy.

Thanks! Anyone else getting a yearly physical since there are no co-pays on them now?

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Fri Jan 04, 2013 3:54 pm 
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It sounds like you are looking for a dietician. A general practice doctor can run blood tests to see your current vitamin levels. Then you could talk to a dietician about your diet, your goals, etc and they can help you.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Fri Jan 04, 2013 3:59 pm 
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see if your doc can give you a referral to a registered dietitian. that way maybe your insurance would cover it.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Fri Jan 04, 2013 4:15 pm 
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Are dietitian's normally open to vegan diets?

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Fri Jan 04, 2013 4:24 pm 
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From my experience, they generally work with what they got. Meaning that you being vegan is a parameter that they will need to work with. You could also do research with dieticians within your insurance coverage to get a general feel.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Fri Jan 04, 2013 4:29 pm 
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GraciaKai wrote:
Are dietitian's normally open to vegan diets?


it really depends. You should probably try to ask up front. Most should be ok with it because dietitians in general support eating mostly plants, however, they might try to push milk and fish on you, which is annoying. I guess it's sort of like finding a regular doc or therapist or something. you have to find someone you're comfortable with.

Most doctors will not be able to do any sort of nutrition counseling with you, so a dietitian is the way to go.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Fri Jan 04, 2013 6:15 pm 
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My dietician was very supportive about my vegetarian, trending vegan, diet. It proved too difficult to go vegan after my surgery (the protein shakes), but she was great with finding information for me and making good suggestions. She never suggested I eat animal products and was actively trying to help me get rid of the dairy. It really is luck of the draw, but they are out there.

You can probably make a double appointment with your PCM; that's what I do when I have several things to discuss.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Fri Jan 04, 2013 6:23 pm 
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Ooooh, thats a good idea LW! I had no idea you could ask for a double appt.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Sat Jan 05, 2013 5:24 pm 
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If you choose your dietitian (instead of going for one associated with your doctor), you should be able to find one that says she works with vegetarian diets. Usually their websites list areas they specialize in.


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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Sat Jan 05, 2013 5:40 pm 
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There are many things that could be causing aches in your joints. Just to name two-- osteoarthritis is more associated with aging, normal or abnormal wear and tear, as well as weight gain. But rheumatoid arthritis is diagnosed by a blood test and is an inflammatory disease. Your joint pain would certainly be something to to make sure your doc hears you on.

I always feel rushed at my NP, as well, and I hate it. You are smart to have a list to go down. Good luck with the doc, and finding an RD!

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Sat Jan 05, 2013 5:42 pm 
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Oh, also- if you do have a specific SI jt problem, you may want to schedule an eval with a Physical Therapist. They could help you figure out why you are having this issue, and what you could do about it.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Mon Jan 07, 2013 1:59 am 
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I was just coming here to post about getting my first physical in.....at least 15 years!? I thought it would be good to just add on to this thread. I didn't know a law was passed making it so there were no copays on yearly physicals because I've never tried to get one before. I pay for my own health insurance now and I am trying to be proactive about my health. I don't really care how much anything costs because I have a relatively low maximum amount I have to pay and I'm finally ready to find out what is going on with my health. I've been ignoring it for too long and with the death of my brother this year in addition to a big health scare my Mom is facing, I am starting to think about my own mortality. So I basically want to get tested for everything I can.

Here's what I'm planning to ask for, but I would love some advice/suggestions on things I might have missed. I am a 33 year old female. Have never had any real medical problems, but have semi-frequent stomach/digestion issues and chronic shoulder/chest pain (I have seen doctors for this). I am about 20 pounds over my ideal weight. My mom has a history of kidney cancer and is awaiting the results for a multiple myeloma test right now and my dad has Chrons Disease. So that's my background.

bone density scan (family history of osteoporosis)
cholesterol test
blood glucose test/diabetes test
I know i need a blood panel or something, but I don't know what to ask for...how do I ask for tests to see if I have any vitamin deficiencies or anemia or anything like that?

Thanks so much for any help here, I have been woefully ignorant about my health and I don't know much about medical procedures, I basically have no idea what I'm doing. Go us for trying to get healthy!

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Last edited by ilovemountains on Mon Jan 07, 2013 2:06 am, edited 1 time in total.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Mon Jan 07, 2013 2:06 am 
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I'm so sorry about your brother, ilovemountains, and your other family scares. I'm kind of in a similar boat as far as neglecting check-ups and suddenly thinking about my mortality and I have an appointment in early February. I'm glad you mentioned bone density - I want that checked and I totally would have spaced it. As far as vitamin deficiencies go, I'm planning to just tell my doctor my concerns and what I'd like checked (D, B12, iron, etc). I'm assuming she'll know what to order.


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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Mon Jan 07, 2013 6:03 am 
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as a family, we all did a yearly last year, as it had been the first time in ages-- i had a blood panel the year i graduated from college, and that was 15 years ago..... my husband was even worse. And my kid hadn't had one since she was 5.

We did
fasting blood sugar
standard blood panel (RBC count, triglycerides, cholesterol, hematocrit, white count)
blood TSH
urinalysis
we also all did a poop sample for occult blood and parasites. (you can imagine what a fun family activity the poop collection was)

the anemia/iron thing comes in a standard blood panel (hematocrit) already. the other vitamin things you ask for.

now we're good and don't have to do it again for a while.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Mon Jan 07, 2013 8:50 am 
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I think last year they passed a bill that makes yearly physicals free. You should call your insurance carrier or doctor to check though. And make sure the doc submits the claim as a Physical so the insurance company doesnt bill you for the copay.

Good luck! You sound like you know what you need to ask for and get done.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Mon Jan 07, 2013 12:31 pm 
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i would also add to that list getting your vitamin D level checked :-)

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Mon Jan 07, 2013 2:14 pm 
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They probably won't do a bone density scan for you, even with the family history, unless they find something else, like low vitamin D.


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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Tue Jan 08, 2013 3:46 am 
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Thanks for all the suggestions and the sympathies, Pinko. Realizing you're not going to live forever can be a good thing, I suppose. Torque, what is a blood TSH? I'm glad you mentioned a fasting glucose test and the poop thing, I'll ask about those when I call in case I have to do anything beforehand. I don't have a doctor and have to find one, so I don't have a relationship with someone who I can count on to have my best interests in mind.

I am definitely going to ask about Vitamin D, as I was tested for that a few years ago (when I was being checked for the shoulder/chest pain). But why wouldn't they do a bone density scan if I wanted one? Is it dangerous?

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Tue Jan 08, 2013 6:35 am 
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ilovemountains wrote:
blood TSH

thyroid stimulant hormone level. i think it's pretty standard.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Tue Jan 08, 2013 9:21 am 
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ilovemountains wrote:
But why wouldn't they do a bone density scan if I wanted one? Is it dangerous?

It's an expensive test. In my experience regular primary or general doctors won't order expensive test to be done unless they see something extreme. They might refer you to a specialist, but sometimes even getting that can be hard. Depends on your doctor too. Some are really caring and will talk to you in depth about your concerns and some won't give you the time of day.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Tue Jan 08, 2013 11:40 am 
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There are some guidelines from different organizations on when to do bone density scans. Here is a synthesis of the guidelines:
http://www.guideline.gov/syntheses/synt ... ne+density


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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Tue Jan 08, 2013 8:30 pm 
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GraciaKai wrote:
ilovemountains wrote:
But why wouldn't they do a bone density scan if I wanted one? Is it dangerous?

It's an expensive test. In my experience regular primary or general doctors won't order expensive test to be done unless they see something extreme. They might refer you to a specialist, but sometimes even getting that can be hard. Depends on your doctor too. Some are really caring and will talk to you in depth about your concerns and some won't give you the time of day.


Oh...because of insurance reasons? My insurance doesn't cover any diagnostic testing until I've payed my maximum coinsurance amount, so I was planning to pay for it myself. I guess I will talk to the doctor about it.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Tue Jan 08, 2013 8:40 pm 
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See what they say. It never hurts to ask or push a little.

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 Post subject: Re: Physicals and Yearly Exams
PostPosted: Thu Jan 10, 2013 1:46 pm 
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if you already know you have to pay for it yourself i dont see why it would be a problem to do it. just mention it to your doctor that you know insurance wont cover it and you'll pay out of pocket (ask them how much though!)

and then if there is still a reason they wont do it i guess just ask why.

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