Pushing Your Wellness Exam Into The 21st Century

Patients ask me, “What about those wellness exams my health insurance company says I’m entitled to every year at no cost?”

Bad news. Let’s review one of life’s basic rules: you get what you pay for.

What you receive during your short wellness visit (what many consider a sacrosanct ritual that boosts longevity) is little more than a quick look at the obvious. Your weight, heart rate, blood pressure; a glance into your eyes, ears, nose, and mouth; some prodding at your neck and tummy; a quick listen to your heart and lungs; sometimes a genital check; a look to ensure that your extremities are moving and that’s that.

But it’s the blood tests that provide the real information about me, you think.

Again, just the basics: a blood count, a metabolic and cholesterol profile, sometimes a thyroid check (TSH), and occasionally vitamin D (depending on your plan). Oh, and women are entitled to a Pap smear and mammogram.

But at least you didn’t have to pay for it.

Here’s what you actually get
Patients are puzzled by blood tests. They see a lot of meaningless line items and don’t understand that they’re little more than a snapshot of certain substances in your blood at the very moment of the blood draw. Could these results change over the next day? Sure. Are the results useful in predicting future illnesses? Not often.

Blood count  Very high numbers of white or red cells could mean the test is revealing an early-stage blood cancer. Despite doing hundreds of these, my experience is that something serious appears roughly every five years or so.

Blood chemistries  High blood glucose (sugar) means you may have diabetes or be developing it or you forgot and ate a chocolate scone before your exam; high BUN and/or creatinine may mean something’s off with your kidneys; abnormal electrolytes (sodium, potassium, etc.) may reflect internal fluid imbalances; abnormal liver enzymes might mean something’s amiss with that organ.

Cholesterol  High levels of certain types may mean you’re more susceptible to heart disease than other people.

At this point with your doctor, you’ll receive some well-intentioned advice that most of you know already. “Let’s work on that weight” or “Here’s a statin for your cholesterol” or “Lay off the Jack Daniel’s and let’s check your liver in a month.”

Just about every primary care provider, whether an internist, family practitioner, nurse practitioner, naturopath, or chiropractic physician, is aware that this examination, including the labs, provides low-level information.

It’s better than nothing, but this type of wellness check is very 20th century. Although most old paper medical records were shredded years ago, if you could ever locate a primary care doctor’s office records from, say, 1960, the wellness check (and follow-up advice) would be pretty much the same.

Here’s what you want from a wellness exam in 2018
You want to know what you, as a unique individual, might be facing, healthwise, in the future. Not the future of tomorrow or next week, but in the decades ahead (and we hope there will be plenty of them).

When patients arrive at WholeHealth Chicago for their initial visit, they’ll often bring a shopping bag (or at least a list) of nutritional supplements they’re taking. Sometimes they’ve done their homework and know exactly why they’re taking them, but many people are just hazarding guesses.

It’s somewhat ironic many people are taking supplements their primary physician should be prescribing: anti-inflammatories like fish oil and turmeric, antioxidants, and detoxifiers. They often, and quite accidentally, are covering future health risks. But they also may be taking supplements they simply don’t need. Likely harmless, but a complete waste of money.

Which brings me to the usefulness of genetic testing, which (fortunately for you) has plummeted in price in recent years.

Precision medicine
You’ve probably seen the term “precision medicine.” It means preventive medicine designed for you and only you. Here’s a brief overview of how precision medicine works:

–A painless scraping of your inner cheek is couriered to a lab in Copenhagen, Denmark, for an analysis of the DNA on your chromosomes.
–A geneticist examines pieces of your DNA called SNPS (not surprisingly pronounced “snips”), full name single nucleotide polymorphisms.
–Having a lot of good SNPS is good and reduces your risk for long-term illnesses.
–Having bad SNPS means you’d better undertake some significant lifestyle changes (eat more of this, take that supplement, move to a less polluted city, seriously reduce your stress levels, etc.) if you want to prevent your bad SNPS from snipping you in the rear and shortening your life.

ADNA Health profile examines 44 separate SNPS that are subdivided into:
(1) Lipid metabolism
(2) Methylation
(3) Detoxification
(4) Inflammation
(5) Oxidative stress
(6) Bone health
(7) Insulin sensitivity

For example, let’s say your SNPS show that you’re a poor detoxifier and are chronically inflamed. Many studies have shown that such individuals have a higher incidence of chronic illnesses including cancer, Alzheimer’s, and early heart disease. You now have hard evidence that you need to start on a low-inflammation diet, take detoxifying and anti-inflammatory supplements, and live where you’re not inhaling toxic sludge.

Other genetic tests available include DNA Sport, which determines the best type of exercise for your body, how susceptible you are to injuries, and how quickly you’ll heal.

DNA Diet will help determine the right diet for you. It may also explain why you’re not losing weight despite your best efforts.

Finally, DNA Mind examines your risks for neurodegenerative disorders, like Parkinson’s and Alzheimer’s, so you can take steps to minimize your risk for them.

What to do next
If you’re a WholeHealth Chicago patient, call and schedule a lab-only and we’ll collect the cheek scraping specimen when you arrive and send it to the lab in Copenhagen.

You’ll be notified when your results are back, though be assured we will neither file these in your chart nor release them to anyone except you. Click here for a sample report, which you’ll quickly note requires a helping hand to interpret.

When you’re notified, schedule an appointment with one of our four practitioners who can walk you through your results: Marla Feingold, Olivia Wagner, Dr. Caley Scott, or Dr. Alaina Gemelas.

Each test–Health, Mind, Sport, Diet–costs $350. (If you decide on just one test, choose DNA Health. It provides an astonishing amount of information.) Given the amount of data you’ll receive, these tests are one of the last actual bargains in healthcare.

Your health insurance will not cover them and, really, you wouldn’t want them to. If they pay for it, they’re entitled to a copy and you simply do not want your genetic test results released to the healthcare system because you can’t know what it will do with that information.

You’ll receive your copy and that’s it. If you wish, we can file a second copy at our office, though you can always retrieve additional copies from the lab.

If you’re not a WholeHealth Chicago patient, schedule a lab-only and we’ll send out your sample. When the results are back you can pick them up and have your personal physician interpret them.

Be well,
David Edelberg, MD