The WholeHealth Chicago Wellness Exam
Patients new to WholeHealth Chicago, along with patients I’ve not seen for a while because they’ve felt good and sensibly wanted to avoid the health care system, often ask for a wellness check-up when they schedule an appointment.
You’ve probably had variations of these exams throughout your life: kicking and screaming in your pediatrician’s office as you tearfully told mom you didn’t want a shot. At a pre-college check-up or a life insurance or pre-employment physical. You know what I’m talking about. Pretty routine stuff, these exams. You fill out a form that skims over your medical history and then get undressed, have some embarrassing measurements taken, blood drawn, pee in a cup, and meet with a doctor or nurse who scans your form, peers into your orifices, listens to and prods your insides, and then advises you to lose weight, eat healthfully, limit alcohol, stop smoking, and exercise more.
If you’re of a certain age or gender, they might throw in a Pap smear, suggest some immunizations, give you a mammogram referral, or schedule a colonoscopy.
Too bad all this really doesn’t accomplish much in terms of wellness or prevention. I actually lifted the list above from the Preventive Wellness Guide distributed to enrollees of Blue Cross/Blue Shield of Mississippi, a state whose population leads the pack when it comes to obesity, tobacco use, and chronic disease.
Let’s be honest here. Say you’ve already had a check-up for whatever reason. You get your test results back and along with any advice received, everything gets filed away into the “I’ll get to that someday” drawer.
Welcome Maureen Milota, APN
At this point, I want to introduce the newest member of our WholeHealth Chicago team, Maureen Milota, APN, one of a handful of Family Nurse Practitioners in the Midwest with both a master’s in nursing and a Fellowship in Integrative Medicine from Andrew Weil’s program at the University of Arizona.
Maureen has an astonishing background: she started as paramedic for the Chicago Fire Department, then obtained her nursing degrees at Ravenswood Hospital and Rush University, worked as an emergency room nurse at Evanston Hospital, and for the past five years as a nurse practitioner at PCC Community Wellness Centers in Chicago. Now that she’s a Fellow in Integrative Medicine, she’s a perfect fit for us.
Since Maureen will be joining Dr. Donigan and me in doing wellness exams (Dr. Kelley now focuses her practice to chronic Lyme patients), it’s worth mentioning how WholeHealth Chicago’s approach to a wellness exam is a bit different than what you may have experienced in the past.
Your WHC wellness exam
Medical history Yes, we have forms, and they’re pretty detailed. By carefully reading your medical history and symptoms, we can spot areas where there might be trouble looming. Although our paperwork can be a challenge, you’ll never hear from us what the poor patient in this New Yorker cartoon experienced (scroll down to cartoons and click on the second dot).
Your biography Completed medical forms are one thing, but you relating your life story is another. Reference my oft-quoted line from Carolyn Myss, PhD: “Your biography is your biology.” Family history is very important here. If a lot of your clan dies of cancer or heart disease or Alzheimer’s, you’ll want to do some serious preventive work.
Lifestyle Your daily habits will either give you the opportunity to enjoy your 90s or die far too young. We’ll review your diet, exercise habits, and stressors and how you go about relieving them. We’ll even remind you to floss each day.
Nutritional supplements Honestly, most people take too much of the wrong stuff. A few carefully chosen supplements can cover nutritional gaps and offer some protection against health risks specific to you.
You’ll have a physical examination, listening to heart, lungs, and all that, probably the least valuable part of your wellness exam. Most people who fall dead in the street or are found to have advanced cancer had been pronounced healthy by their doctors in the weeks or months beforehand.
We’ll also either perform or arrange for standard tests such as routine blood/urine tests, Pap smear, mammogram, colonoscopy, and so forth. It’s important to realize that tests are really just snapshots of your body on the day of the test and have little to do with how your body is functioning as a whole.
We’ll offer functional tests of body systems that seem like potential trouble zones. For example, if you’ve had digestive problems for years but nothing is ever found, the Comprehensive Stool Digestive Analysis checks how well you digest and absorb your food, if you have a good balance of bacteria, and if any parasites are traveling with you. If there’s a lot of cancer in your family, we’ll suggest a test that checks the detoxification capacity of your liver. If heart disease runs in your family, a genetic test can determine your personal genetic risk. There are a lot (a lot!) of functional tests available, so what’s actually useful for you, individually, needs to be selected with care.
Your health insurance often pays some (but rarely all) of the cost of these tests. WholeHealth Chicago earns absolutely nothing from the tests, and any payment we require is sent directly to the lab.
After your wellness exam
Actual serious or life-threatening illness is almost never found during a wellness exam. What we usually see are lifestyle risks and these indeed can interfere with your hope for healthy longevity. Commonly, it’s poor dietary choices, a sedentary lifestyle, or you’re trapped on a treadmill of relentless stress. Just last week, researchers published a report showing that regular exercise reduces the risk of 13 different cancers. That should be quite enough to motivate you to start at a health club or other exercise program…and to show up regularly for it.
Here are some examples of the follow-ups generated by a WHC wellness exam:
- A referral to one of our nutritionists to get your eating habits on track.
- If you’ve got a lot of aches and pains, injuries old or new, or are just starting a new fitness program, a referral to one of our chiropractic physicians.
- If stress is the leitmotiv of your life, a referral to one of our psychologists, a yoga therapy session or meditation workshop.
- If you’re basically fine but want to clean up your act, we’ll walk you through a detoxification.
- If needed, we can guide you to a dentist, optometrist, or audiologist.
Whatever we recommend, our overarching goal is to keep you from being a recidivist in the dysfunctional US health care system. We’re pretty sure that’s your goal too.
David Edelberg, MD